Factors limiting contrast sensitivity in experimentally amblyopic macaque monkeys

Responses to visual motion of neurons in the extrastriate visual cortex of macaque monkeys with experimental amblyopia

Amblyopia is a developmental disorder that results from abnormal visual experience in early life. Amblyopia typically reduces visual performance in one eye. We studied the representation of visual motion information in area MT and nearby extrastriate visual areas in two monkeys made amblyopic by creating an artificial strabismus in early life, and in a single age-matched control monkey. Tested monocularly, cortical responses to moving dot patterns, gratings, and plaids were qualitatively normal in awake, fixating amblyopic monkeys, with primarily subtle differences between the eyes. However, the number of binocularly driven neurons was substantially lower than normal; of the neurons driven predominantly by one eye, the great majority responded only to stimuli presented to the fellow eye. The small population driven by the amblyopic eye showed reduced coherence sensitivity and a preference for faster speeds in much the same way as behavioral deficits. We conclude that, while we do find important differences between neurons driven by the two eyes, amblyopia does not lead to a large scale reorganization of visual receptive fields in the dorsal stream when tested through the amblyopic eye, but rather creates a substantial shift in eye preference toward the fellow eye.

Featural Representation and Internal Noise Underlie the Eccentricity Effect in Contrast Sensitivity

Human visual performance for basic visual dimensions (e.g., contrast sensitivity and acuity) peaks at the fovea and decreases with eccentricity. The eccentricity effect is related to the larger visual cortical surface area corresponding to the fovea, but it is unknown if differential feature tuning contributes to this eccentricity effect. Here, we investigated two system-level computations underlying the eccentricity effect: featural representation (tuning) and internal noise. Observers (both sexes) detected a Gabor embedded in filtered white noise which appeared at the fovea or one of four perifoveal locations. We used psychophysical reverse correlation to estimate the weights assigned by the visual system to a range of orientations and spatial frequencies (SFs) in noisy stimuli, which are conventionally interpreted as perceptual sensitivity to the corresponding features. We found higher sensitivity to task-relevant orientations and SFs at the fovea than that at the perifovea, and no difference in selectivity for either orientation or SF. Concurrently, we measured response consistency using a double-pass method, which allowed us to infer the level of internal noise by implementing a noisy observer model. We found lower internal noise at the fovea than that at the perifovea. Finally, individual variability in contrast sensitivity correlated with sensitivity to and selectivity for task-relevant features as well as with internal noise. Moreover, the behavioral eccentricity effect mainly reflects the foveal advantage in orientation sensitivity compared with other computations. These findings suggest that the eccentricity effect stems from a better representation of task-relevant features and lower internal noise at the fovea than that at the perifovea.

Featural representation and internal noise underlie the eccentricity effect in contrast sensitivity

Human visual performance for basic visual dimensions (e.g., contrast sensitivity and acuity) peaks at the fovea and decreases with eccentricity. The eccentricity effect is related to the larger surface area of the visual cortex corresponding to the fovea, but it is unknown if differential feature tuning contributes to this eccentricity effect. Here, we investigated two system-level computations underlying the eccentricity effect: featural representation (tuning) and internal noise. Observers (both sexes) detected a Gabor embedded in filtered white noise which appeared at the fovea or one of four perifoveal locations. We used psychophysical reverse correlation to estimate the weights assigned by the visual system to a range of orientations and spatial frequencies (SFs) in noisy stimuli, which are conventionally interpreted as perceptual sensitivity to the corresponding features. We found higher sensitivity to task-relevant orientations and SFs at the fovea than the perifovea, and no difference in selectivity for either orientation or SF. Concurrently, we measured response consistency using a double-pass method, which allowed us to infer the level of internal noise by implementing a noisy observer model. We found lower internal noise at the fovea than perifovea. Finally, individual variability in contrast sensitivity correlated with sensitivity to and selectivity for task-relevant features as well as with internal noise. Moreover, the behavioral eccentricity effect mainly reflects the foveal advantage in orientation sensitivity compared to other computations. These findings suggest that the eccentricity effect stems from a better representation of task-relevant features and lower internal noise at the fovea than at the perifovea.

A New Dichoptic Training Strategy Leads to Better Cooperation Between the Two Eyes in Amblyopia

Recent clinical trials failed to endorse dichoptic training for amblyopia treatment. Here, we proposed an alternative training strategy that focused on reducing signal threshold contrast in the amblyopic eye under a constant and high noise contrast in the fellow eye (HNC), and compared it to a typical dichoptic strategy that aimed at increasing the tolerable noise contrast in the fellow eye (i.e., TNC strategy). We recruited 16 patients with amblyopia and divided them into two groups. Eight patients in Group 1 received the HNC training, while the other eight patients in Group 2 performed the TNC training first (Phase 1) and then crossed over to the HNC training (Phase 2). We measured contrast sensitivity functions (CSFs) separately in the amblyopic and fellow eyes when the untested eye viewed mean luminance (monocularly unmasked) or noise stimuli (dichoptically masked) before and after training at a particular frequency. The area under the log contrast sensitivity function (AULCSF) of masked and unmasked conditions, and dichoptic gain (the ratio of AULCSF of masked to unmasked condition) were calculated for each eye. We found that both dichoptic training paradigms substantially improved masked CSF, dichoptic gain, and visual acuity in the amblyopic eye. As opposed to the TNC paradigm, the HNC training produced stronger effects on masked CSFs, stereoacuity, dichoptic gain, and visual acuity in the amblyopic eye. Interestingly, the second-phase HNC training in Group 2 also induced further improvement in the masked contrast sensitivity and AULCSF in the amblyopic eye. We concluded that the HNC training strategy was more effective than the TNC training paradigm. Future design for dichoptic training should not only focus on increasing the tolerable noise contrast in the fellow eye but should also "nurture" the amblyopic eye under normal binocular viewing conditions and sustained interocular suppression.

Mapping the Contrast Sensitivity of the Visual Field With Bayesian Adaptive qVFM

Current clinical evaluation, which focuses on central vision, could be improved through characterization of residual vision with peripheral testing of visual acuity, contrast sensitivity, color vision, crowding, and reading speed. Assessing visual functions in addition to light sensitivity, a comprehensive visual field map (VFM) would be valuable for detecting and managing eye diseases. In a previous study, we developed a Bayesian adaptive qVFM method that combines a global module for preliminary assessment of the VFM's shape and a local module for assessment at individual retinal locations. The method was validated in measuring the light sensitivity VFM. In this study, we extended the qVFM method to measure contrast sensitivity across the visual field. In both simulations and psychophysics, we sampled 64 visual field locations (48 x 48 deg) and compared the qVFM method with a procedure that tested each retinal location independently (qFC; Lesmes et al., 2015). In each trial, subjects were required to identify a single optotype (size: 2.5 x 2.5 deg), one of 10 filtered Sloan letters. To compare the accuracy and precision of the two methods, three simulated eyes were tested in 1,280 trials with each method. In addition, data were collected from 10 eyes (5 OS, 5 OD) of five normal observers. For simulations, the average RMSE of the estimated contrast sensitivity with the qVFM and qFC methods were 0.057 and 0.100 after 320 trials, and 0.037 and 0.041 after 1,280 trials [all in log10 units, represent as log(sensitivity)], respectively. The average SD of the qVFM and qFC estimates were 0.054 and 0.096 after 320 trials, and 0.032 and 0.041 after 1,280 trials, respectively. The within-run variability (68.2% HWCIs) were comparable to the cross-run variability (SD). In the psychophysics experiment, the average HWCI of the estimated contrast sensitivity from the qVFM and qFC methods across the visual field decreased from 0.33 on the first trial to 0.072 and 0.16 after 160, and to 0.060 and 0.10 after 320 trials. The RMSE between the qVFM and qFC estimates started at 0.26, decreased to 0.12 after 160 and to 0.11 after 320 qVFM trials. The qVFM provides an accurate, precise, and efficient mapping of contrast sensitivity across the entire visual field. The method might find potential clinical applications in monitoring vision loss, evaluating therapeutic interventions, and developing effective rehabilitation for visual diseases.

Altered functional interactions between neurons in primary visual cortex of macaque monkeys with experimental amblyopia

Amblyopia, a disorder in which vision through one of the eyes is degraded, arises because of defective processing of information by the visual system. Amblyopia often develops in humans after early misalignment of the eyes (strabismus) and can be simulated in macaque monkeys by artificially inducing strabismus. In such amblyopic animals, single-unit responses in primary visual cortex (V1) are appreciably reduced when evoked by the amblyopic eye compared with the other (fellow) eye. However, this degradation in single V1 neuron responsivity is not commensurate with the marked losses in visual sensitivity and resolution measured behaviorally. Here we explored the idea that changes in patterns of coordinated activity across populations of V1 neurons may contribute to degraded visual representations in amblyopia, potentially making it more difficult to read out evoked activity to support perceptual decisions. We studied the visually evoked activity of V1 neuronal populations in three macaques (Macaca nemestrina) with strabismic amblyopia and in one control animal. Activity driven through the amblyopic eye was diminished, and these responses also showed more interneuronal correlation at all stimulus contrasts than responses driven through the fellow eye or responses in the control animal. A decoding analysis showed that responses driven through the amblyopic eye carried less visual information than other responses. Our results suggest that part of the reduced visual capacity of amblyopes may be due to changes in the patterns of functional interaction among neurons in V1.NEW & NOTEWORTHY Previous work on the neurophysiological basis of amblyopia has largely focused on relating behavioral deficits to changes in visual processing by single neurons in visual cortex. In this study, we recorded simultaneously from populations of primary visual cortical (V1) neurons in macaques with amblyopia. We found changes in the strength and pattern of shared response variability between neurons. These changes in neuronal interactions could impair the visual representations of V1 populations driven by the amblyopic eye.

Binocular Summation and Suppression of Contrast Sensitivity in Strabismus, Fusion and Amblyopia

Purpose: Amblyopia and strabismus affect 2%–5% of the population and cause a broad range of visual deficits. The response to treatment is generally assessed using visual acuity, which is an insensitive measure of visual function and may, therefore, underestimate binocular vision gains in these patients. On the other hand, the contrast sensitivity function (CSF) generally takes longer to assess than visual acuity, but it is better correlated with improvement in a range of visual tasks and, notably, with improvements in binocular vision. The present study aims to assess monocular and binocular CSFs in amblyopia and strabismus patients.

Methods: Both monocular CSFs and the binocular CSF were assessed for subjects with amblyopia (n = 11), strabismus without amblyopia (n = 20), and normally sighted controls (n = 24) using a tablet-based implementation of the quick CSF, which can assess a full CSF in <3 min. Binocular summation was evaluated against a baseline model of simple probability summation.

Results: The CSF of amblyopic eyes was impaired at mid-to-high spatial frequencies compared to fellow eyes, strabismic eyes without amblyopia, and control eyes. Binocular contrast summation exceeded probability summation in controls, but not in subjects with amblyopia (with or without strabismus) or strabismus without amblyopia who were able to fuse at the test distance. Binocular summation was less than probability summation in strabismic subjects who were unable to fuse.

Conclusions: We conclude that monocular and binocular contrast sensitivity deficits define important characteristics of amblyopia and strabismus that are not captured by visual acuity alone and can be measured efficiently using the quick CSF.

Altered Balance of Receptive Field Excitation and Suppression in Visual Cortex of Amblyopic Macaque Monkeys

In amblyopia, a visual disorder caused by abnormal visual experience during development, the amblyopic eye (AE) loses visual sensitivity whereas the fellow eye (FE) is largely unaffected. Binocular vision in amblyopes is often disrupted by interocular suppression. We used 96-electrode arrays to record neurons and neuronal groups in areas V1 and V2 of six female macaque monkeys (Macaca nemestrina) made amblyopic by artificial strabismus or anisometropia in early life, as well as two visually normal female controls. To measure suppressive binocular interactions directly, we recorded neuronal responses to dichoptic stimulation. We stimulated both eyes simultaneously with large sinusoidal gratings, controlling their contrast independently with raised-cosine modulators of different orientations and spatial frequencies. We modeled each eye's receptive field at each cortical site using a difference of Gaussian envelopes and derived estimates of the strength of central excitation and surround suppression. We used these estimates to calculate ocular dominance separately for excitation and suppression. Excitatory drive from the FE dominated amblyopic visual cortex, especially in more severe amblyopes, but suppression from both the FE and AEs was prevalent in all animals. This imbalance created strong interocular suppression in deep amblyopes: increasing contrast in the AE decreased responses at binocular cortical sites. These response patterns reveal mechanisms that likely contribute to the interocular suppression that disrupts vision in amblyopes.SIGNIFICANCE STATEMENT Amblyopia is a developmental visual disorder that alters both monocular vision and binocular interaction. Using microelectrode arrays, we examined binocular interaction in primary visual cortex and V2 of six amblyopic macaque monkeys (Macaca nemestrina) and two visually normal controls. By stimulating the eyes dichoptically, we showed that, in amblyopic cortex, the binocular combination of signals is altered. The excitatory influence of the two eyes is imbalanced to a degree that can be predicted from the severity of amblyopia, whereas suppression from both eyes is prevalent in all animals. This altered balance of excitation and suppression reflects mechanisms that may contribute to the interocular perceptual suppression that disrupts vision in amblyopes.

Developmental visual perception deficits with no indications of prosopagnosia in a child with abnormal eye movements

Visual categories are associated with eccentricity biases in high-order visual cortex: Faces and reading with foveally-biased regions, while common objects and space with mid- and peripherally-biased regions. As face perception and reading are among the most challenging human visual skills, and are often regarded as the peak achievements of a distributed neural network supporting common objects perception, it is unclear why objects, which also rely on foveal vision to be processed, are associated with mid-peripheral rather than with a foveal bias. Here, we studied BN, a 9 y.o. boy who has normal basic-level vision, abnormal (limited) oculomotor pursuit and saccades, and shows developmental object and contour integration deficits but with no indication of prosopagnosia. Although we cannot infer causation from the data presented here, we suggest that normal pursuit and saccades could be critical for the development of contour integration and object perception. While faces and perhaps reading, when fixated upon, take up a small portion of central visual field and require only small eye movements to be properly processed, common objects typically prevail in mid-peripheral visual field and rely on longer-distance voluntary eye movements as saccades to be brought to fixation. While retinal information feeds into early visual cortex in an eccentricity orderly manner, we hypothesize that propagation of non-foveal information to mid and high-order visual cortex critically relies on circuitry involving eye movements. Limited or atypical eye movements, as in the case of BN, may hinder normal information flow to mid-eccentricity biased high-order visual cortex, adversely affecting its development and consequently inducing visual perceptual deficits predominantly for categories associated with these regions.

Noise and the Perceptual Filling-in effect

Nearby collinear flankers increase the false alarm rate (reports of the target being present when it is not) in a Yes-No experiment. This effect has been attributed to "filling-in" of the target location due to increased activity induced by the flankers. According to signal detection theory, false alarms are attributed to noise in the visual nervous system. Here we investigated the effect of external noise on the filling-in effect by adding white noise to a low contrast Gabor target presented between two collinear Gabor flankers at a range of target-flanker separations. External noise modulates the filling-in effect, reducing visual sensitivity (d') and increasing the filling-in effect (False Alarm rate). We estimated the amount of external noise at which the false alarm rate increases by the √2 (which we refer to as NFA). Across flank distances, both the false alarm rate and d' (with no external noise) are correlated with NFA. These results are consistent with the notion that nearby collinear flankers add both signal and noise to the target location. The increased signal results in higher d' values; the increased noise to higher false alarm rates (the filling effect).

"Global" visual training and extent of transfer in amblyopic macaque monkeys

Perceptual learning is gaining acceptance as a potential treatment for amblyopia in adults and children beyond the critical period. Many perceptual learning paradigms result in very specific improvement that does not generalize beyond the training stimulus, closely related stimuli, or visual field location. To be of use in amblyopia, a less specific effect is needed. To address this problem, we designed a more general training paradigm intended to effect improvement in visual sensitivity across tasks and domains. We used a "global" visual stimulus, random dot motion direction discrimination with 6 training conditions, and tested for posttraining improvement on a motion detection task and 3 spatial domain tasks (contrast sensitivity, Vernier acuity, Glass pattern detection). Four amblyopic macaques practiced the motion discrimination with their amblyopic eye for at least 20,000 trials. All showed improvement, defined as a change of at least a factor of 2, on the trained task. In addition, all animals showed improvements in sensitivity on at least some of the transfer test conditions, mainly the motion detection task; transfer to the spatial domain was inconsistent but best at fine spatial scales. However, the improvement on the transfer tasks was largely not retained at long-term follow-up. Our generalized training approach is promising for amblyopia treatment, but sustaining improved performance may require additional intervention.

Discriminating anisometropic amblyopia from myopia based on interocular inhibition

Amblyopia screening during childhood is critical for early detection and successful treatment. In the current study, we develop and evaluate a screening method that exploits the imbalanced interocular inhibition between amblyopic and fellow eyes. In nineteen subjects with anisometropic amblyopia and twenty-two age-matched subjects with myopia, we measured the area under the contrast sensitivity functions (AUCSFs) in eight monocular conditions defined by the tested eye (left, right), patching of the untested eye (translucent, opaque), and refractive status (corrected, uncorrected). For each tested eye, we defined the inhibition index as the ratio between the AUCSF values obtained in the translucent and opaque patching conditions of the untested eye. To evaluate the screening potential of the inhibition index, we compared results from patients with amblyopia and myopia. With and without optical correction, the index was significantly lower in the amblyopic eye than in the fellow eye of the amblyopic subjects and both eyes of the myopic subjects. No significant difference was found among the two eyes of the myopic subjects and the fellow eyes of the amblyopic subjects. With the inhibition index as the predictor, a logistic regression model successfully discriminated amblyopic eyes from myopic eyes with 100% accuracy in the uncorrected condition. In the corrected condition, with the inhibition index and interocular visual acuity difference as predictors, amblyopic eyes were likewise discriminated from myopic eyes with 100% accuracy. This pattern of CSF changes, caused by the different patching modes of the untested eye, provides a potential CSF signature to discriminate anisometropic amblyopia from myopia.

Population representation of visual information in areas V1 and V2 of amblyopic macaques

Amblyopia is a developmental disorder resulting in poor vision in one eye. The mechanism by which input to the affected eye is prevented from reaching the level of awareness remains poorly understood. We recorded simultaneously from large populations of neurons in the supragranular layers of areas V1 and V2 in 6 macaques that were made amblyopic by rearing with artificial strabismus or anisometropia, and 1 normally reared control. In agreement with previous reports, we found that cortical neuronal signals driven through the amblyopic eyes were reduced, and that cortical neurons were on average more strongly driven by the non-amblyopic than by the amblyopic eyes. We analyzed multiunit recordings using standard population decoding methods, and found that visual signals from the amblyopic eye, while weakened, were not degraded enough to explain the behavioral deficits. Thus additional losses must arise in downstream processing. We tested the idea that under monocular viewing conditions, only signals from neurons dominated by - rather than driven by - the open eye might be used. This reduces the proportion of neuronal signals available from the amblyopic eye, and amplifies the interocular difference observed at the level of single neurons. We conclude that amblyopia might arise in part from degradation in the neuronal signals from the amblyopic eye, and in part from a reduction in the number of signals processed by downstream areas.

Visual motion processing by neurons in area MT of macaque monkeys with experimental amblyopia

Early experience affects the development of the visual system. Ocular misalignment or unilateral blur often causes amblyopia, a disorder that has become a standard for understanding developmental plasticity. Neurophysiological studies of amblyopia have focused almost entirely on the first stage of cortical processing in striate cortex. Here we provide the first extensive study of how amblyopia affects extrastriate cortex in nonhuman primates. We studied macaque monkeys (Macaca nemestrina) for which we have detailed psychophysical data, directly comparing physiological findings to perceptual capabilities. Because these subjects showed deficits in motion discrimination, we focused on area MT/V5, which plays a central role in motion processing. Most neurons in normal MT respond equally to visual stimuli presented through either eye; most recorded in amblyopes strongly preferred stimulation of the nonamblyopic (fellow) eye. The pooled responses of neurons driven by the amblyopic eye showed reduced sensitivity to coherent motion and preferred higher speeds, in agreement with behavioral measurements. MT neurons were more limited in their capacity to integrate motion information over time than expected from behavioral performance; neurons driven by the amblyopic eye had even shorter integration times than those driven by the fellow eye. We conclude that some, but not all, of the motion sensitivity deficits associated with amblyopia can be explained by abnormal development of MT.

Spatial contrast sensitivity in dynamic and static additive luminance noise

The purpose of this study was to define the quantitative relationship between the temporal characteristics of additive luminance noise and the properties of the spatial contrast sensitivity function (CSF). CSFs were obtained from two observers using Gabor patch targets of short duration that were added to white luminance noise with a range of root-mean-square contrasts (c(rms)). The noise was either dynamic or static and was either of the same duration as the test target (synchronous) or of longer duration (asynchronous). For targets presented in asynchronous dynamic, synchronous dynamic, and synchronous static noise, the CSFs became increasingly band-pass with increasing c(rms), whereas the CSFs were low-pass at all levels of c(rms) for targets presented in asynchronous static noise. For all noise types, the properties of the CSFs were well-predicted by the linear amplifier model (LAM), in which the signal energy at threshold (E(t)) is related linearly to noise spectral density (N). The fundamentally different characteristics of CSFs obtained in asynchronous static noise can be accounted for by a previous proposal that this noise type biases contrast sensitivity toward transient (inferred magnocellular) mechanisms. The other three modes of noise presentation appear to emphasize detection by sustained (inferred parvocellular) mechanisms.

Bayesian adaptive estimation of the contrast sensitivity function: the quick CSF method

The contrast sensitivity function (CSF) predicts functional vision better than acuity, but long testing times prevent its psychophysical assessment in clinical and practical applications. This study presents the quick CSF (qCSF) method, a Bayesian adaptive procedure that applies a strategy developed to estimate multiple parameters of the psychometric function (A. B. Cobo-Lewis, 1996; L. L. Kontsevich & C. W. Tyler, 1999). Before each trial, a one-step-ahead search finds the grating stimulus (defined by frequency and contrast) that maximizes the expected information gain (J. V. Kujala & T. J. Lukka, 2006; L. A. Lesmes et al., 2006), about four CSF parameters. By directly estimating CSF parameters, data collected at one spatial frequency improves sensitivity estimates across all frequencies. A psychophysical study validated that CSFs obtained with 100 qCSF trials ( approximately 10 min) exhibited good precision across spatial frequencies (SD < 2-3 dB) and excellent agreement with CSFs obtained independently (mean RMSE = 0.86 dB). To estimate the broad sensitivity metric provided by the area under the log CSF (AULCSF), only 25 trials were needed to achieve a coefficient of variation of 15-20%. The current study demonstrates the method's value for basic and clinical investigations. Further studies, applying the qCSF to measure wider ranges of normal and abnormal vision, will determine how its efficiency translates to clinical assessment.

Binocular combination in anisometropic amblyopia

Using a suprathreshold binocular summation paradigm developed by J. Ding and G. Sperling (2006, 2007) for normal observers, we investigated suprathreshold cyclopean perception in anisometropic amblyopia. In this paradigm, two suprathreshold sinewave gratings of the same spatial frequency but different spatial phases are presented to the left and right eyes of the observer. The perceived phase of the binocularly combined cyclopean image is measured as a function of the contrast ratio between the images in the two eyes. We found that both eyes contributed equally in normal subjects. However, stimulus of equal contrast was weighted much less in the amblyopic eye relative to the fellow eye in binocular combination. For the five amblyopes, the effective contrast of the amblyopic eye in binocular combination is equal to about 11%-28% of the same contrast presented to the fellow eye, much less than the ratio of contrast sensitivity between the two eyes (0.73-1.42). The results from the current study have many important implications in amblyopia research and treatment.

Contrast thresholds in additive luminance noise: Effect of noise temporal characteristics

This study investigated the way in which the temporal properties of additive luminance noise influence threshold contrast and affect estimates of equivalent noise and sampling efficiency. Threshold contrast was obtained from four visually normal observers for a 2-cycle-per-degree Gabor patch across a range of target durations in the absence and presence of additive luminance noise that was either static or dynamic. In addition, the temporal relationship between target and noise was either synchronous (simultaneous presentation of both) or asynchronous (noise duration longer than target duration). For both synchronous and asynchronous presentation modes, the extent of temporal integration differed for targets presented in dynamic vs. static noise. Furthermore, for a fixed-duration target, increasing the degree of temporal asynchrony between target and noise monotonically increased threshold contrast in dynamic noise, but had a non-monotonic effect on threshold contrast in static noise. For both dynamic and static noise, estimates of equivalent noise and sampling efficiency were dependent on the degree of temporal asynchrony between target and noise. The observed differences between the effects of dynamic and static noise are consistent with a previous proposal that detection of targets of intermediate spatial frequency in the presence of these two noise types is governed by sustained-like and transient-like visual mechanisms, respectively.

The response of the amblyopic visual system to noise

Visual perception is limited by both the strength of the neural signals, and by the noise in the visual nervous system. Here we use one-dimensional white noise as input, to study the response of amblyopic visual system. We measured the thresholds for detection and discrimination of noise contrast. Using an N-pass reverse correlation technique, we derived classification images and estimated response consistency. Our results provide the first report of the sensitivity of the amblyopic visual system to white noise. We show that amblyopes have markedly reduced sensitivity for detecting noise, particularly at high spatial frequencies, and much less loss for discriminating suprathreshold noise contrast. Compensating for the detection loss almost (but not quite) equates performance of the amblyopic and normal visual system. The classification images suggest that the amblyopic visual system contains adjustable channels for noise, similar to those found in normal vision, but "tuned" to slightly lower spatial frequencies than in normal observers. Our N-pass results show that the predominant factor limiting performance in our task in both normal and amblyopic vision is internal random multiplicative noise. For the detection of white noise the raised thresholds of the amblyopic visual system can be attributed primarily to extra additive noise. However, for the discrimination of suprathreshold white noise contrast, there is surprisingly little additional deficit, after accounting for the visibility of the noise.

Predicting potential acuities in amblyopes

PURPOSE

Amblyopic patients, or their parents, often want to know the potential for success before committing to treatment. Recent reports have indicated that the pattern visual evoked potential (pVEP) can be used as a predictor of the success of amblyopia therapy. Unfortunately, these studies did not determine if acuity estimates from pVEPs could accurately predict the acuity post-treatment. Furthermore, pVEPs are not always practical to obtain because of the time necessary to acquire the data. Sweep VEPs (sVEP) offer the advantage of rapidly estimating visual acuity in amblyopic patients. In this retrospective study, the relationship between sVEP acuities measured pre-amblyopic therapy and Snellen acuities measured post-amblyopic therapy was determined.

METHODS

Seventeen patients with amblyopia were studied. Monocular sVEP and Snellen acuities were determined pre-amblyopic therapy and Snellen acuities were determined post-amblyopic therapy. An Enfant 4010 computer system was used to produce the stimuli, record the VEPs, and extrapolate the acuity. The stimuli were horizontally oriented, sine wave gratings (11 spatial frequencies from 2 to 24 cpd) with a contrast of 80%, counterphased at 7.5 Hz. Standard VEP recording techniques were employed. Therapy consisted of the full refractive correction and occlusion combined with active vision therapy.

RESULTS

The patients demonstrated a significant improvement in pre- to post-amblyopic therapy Snellen acuities (P < 0.00001). The intraclass correlation coefficient (r (i)) between the pre-therapy sVEP acuities and the post-therapy Snellen acuities was 0.73. A paired t-test did not find a significant difference between the two sets of data (P = 0.94). For the amblyopes in this study, the average difference (+/-SD) in the sVEP acuity estimate and the final Snellen visual acuity was +0.002 +/- 0.123 logMAR acuity lines.

CONCLUSION

The results indicate that pre-amblyopic therapy sVEP acuity can be a good predictor of post-amblyopic therapy Snellen acuity.

Treated amblyopes remain deficient in spatial vision: a contrast sensitivity and external noise study

To evaluate residual spatial vision deficits in treated amblyopia, we recruited five clinically treated amblyopes (mean age=10.6 years). Contrast sensitivity functions (CSF) in both the previously amblyopic eyes (pAE; visual acuity=0.944+/-0.019 MAR) and fellow eyes (pFE; visual acuity=0.936+/-0.021 MAR) were measured using a standard psychophysical procedure for all the subjects. The results indicated that the treated amblyopes remained deficient in spatial vision, especially at high spatial frequencies, although their Snellen visual acuity had become normal in the pAEs. To identify the mechanisms underlying spatial vision deficits of treated amblyopes, threshold vs external noise contrast (TvC) functions--the signal contrast necessary for the subject to maintain a threshold performance level in varying amounts of external noise ("TV snow")--were measured in both eyes of four of the subjects in a sine-wave grating detection task at several spatial frequencies. Two mechanisms of amblyopia were identified: increased internal noise at low to medium spatial frequencies, and both increased internal noise and increased impact of external noise at high spatial frequencies. We suggest that, in addition to visual acuity, other tests of spatial vision (e.g., CSF, TvC) should be used to assess treatment outcomes of amblyopia therapies. Training in intermediate and high spatial frequencies may be necessary to fully recover spatial vision in amblyopia in addition to the occlusion therapy.

Sensitivity to visual motion in amblyopic macaque monkeys

Amblyopia is usually considered to be a deficit in spatial vision. But there is evidence that amblyopes may also suffer specific deficits in motion sensitivity as opposed to losses that can be explained by the known deficits in spatial vision. We measured sensitivity to visual motion in random dot displays for strabismic and anisometropic amblyopic monkeys. We used a wide range of spatial and temporal offsets and compared the performance of the fellow and amblyopic eye for each monkey. The amblyopes were severely impaired at detecting motion at fine spatial and long temporal offsets, corresponding to fine spatial scale and slow speeds. This impairment was also evident for the untreated fellow eyes of strabismic but not anisometropic amblyopes. Motion sensitivity functions for amblyopic eyes were shifted toward large spatial scales for amblyopic compared to fellow eyes, to a degree that was correlated with the shift in scale of the spatial contrast sensitivity function. Amblyopic losses in motion sensitivity, however, were not correlated with losses in spatial contrast sensitivity. This, combined with the specific impairment for detecting long temporal offsets, reveals a deficit in spatiotemporal integration in amblyopia which cannot be explained by the lower spatial resolution of amblyopic vision.

Visual processing in amblyopia: animal studies

In the past five years, substantial progress has been made in our knowledge of the neural basis of amblyopia. Recent advances based on animal models are described, along with new psychophysical data showing perceptual deficits in amblyopic animals that are not explained by simple losses in contrast sensitivity. Studies of contour integration and integration of motion and form signals in the presence of noise show that 1) there are fundamental losses in temporal as well as spatial vision, 2) the losses extend to the fellow eye in many cases, 3) amblyopic animals are especially impaired in the presence of background noise, and 4) these losses must depend on a process downstream from area V1 in the extrastriate cortex.

Perceptual learning improves contrast sensitivity and visual acuity in adults with anisometropic amblyopia

To evaluate the effects of perceptual learning on contrast-sensitivity function and visual acuity in adult observers with amblyopia, 23 anisometropic amblyopes with a mean age of 19.3 years were recruited and divided into three groups. Subjects in Group I were trained in grating detection in the amblyopic eye near pre-training cut-off spatial frequency. Group II received a training regimen of repeated contrast-sensitivity function measurements in the amblyopic eye. Group III received no training. We found that training substantially improved visual acuity and contrast-sensitivity functions in the amblyopic eyes of all the observers in Groups I and II, although no significant performance improvement was observed in Group III. For observers in Group I, performance improvements in the amblyopic eyes were broadly tuned in spatial frequency and generalized to the fellow eyes. The latter result was not found in Group II. In a few cases tested, improvements in visual acuity following training showed about 90% retention for at least 1 year. We concluded that the visual system of adult amblyopes might still retain substantial plasticity. Perceptual learning shows potential as a clinical tool for treating child and adult amblyopia.

Contour integration in amblyopic monkeys

Amblyopia is characterized by losses in a variety of aspects of spatial vision, such as acuity and contrast sensitivity. Our goal was to learn whether those basic spatial deficits lead to impaired global perceptual processing in strabismic and anisometropic amblyopia. This question is unresolved by the current human psychophysical literature. We studied contour integration and contrast sensitivity in amblyopic monkeys. We found deficient contour integration in anisometropic as well as strabismic amblyopic monkeys. Some animals showed poor contour integration in the fellow eye as well as in the amblyopic eye. Orientation jitter of the elements in the contour systematically decreased contour-detection ability for control and fellow eyes, but had less effect on amblyopic eyes. The deficits were not clearly related to basic losses in contrast sensitivity and acuity for either type of amblyopia. We conclude that abnormal contour integration in amblyopes reflects disruption of mechanisms that are different from those that determine acuity and contrast sensitivity, and are likely to be central to V1.

Noise provides some new signals about the spatial vision of amblyopes

Amblyopia results in a loss of contrast sensitivity and position acuity. Here we report the results of experiments using noise to try to better understand the nature of the neural losses in amblyopia. In the first experiment, we used noise to derive the template or classification image used to detect a target and to discriminate its position. We found that some amblyopic observers show markedly abnormal templates for the position task and moderately abnormal classification images for the detection task; however, the abnormal template could not fully account for the loss of performance (efficiency). Reduced efficiency in the amblyopic visual system may reflect a poorly matched template, a high fraction of internal to external noise, or both. Comparison of the observers' performance with that of their template suggests that the amblyopes have a high fraction of internal (relative to external) noise. To analyze the internal noise further, we used a "double-pass" technique, in which observers performed the identical experiment twice. The amount of disagreement between the two experiments provides another estimate of the fraction of internal noise. Amblyopes show a much higher fraction of stimulus-dependent internal noise than do normal observers. We conclude that the loss of efficiency in amblyopia is attributable in part to a poorly matched template, but to a greater degree, to a high fraction of internal (relative to external) noise.

BOLD fMRI response of early visual areas to perceived contrast in human amblyopia

In this study, we used a temporal two-alternative forced choice psychophysical procedure to measure the observer's perception of a 22% physical contrast grating for each eye as a function of spatial frequency in four subjects with unilateral amblyopia and in six subjects with normal vision. Contrast thresholds were also measured using a standard staircase method. Additionally, blood-oxygenation-level-dependent (BOLD) functional magnetic resonance imaging (fMRI) was used to measure the neuronal response within early visual cortical areas to monocular presentations of the same 22% physical contrast gratings as a function of spatial frequency. For all six subjects with normal vision and for three subjects with amblyopia, the psychophysically measured perception of 22% contrast as a function of spatial frequency was the same for both eyes. Threshold contrast, however, was elevated for the amblyopic eye for all subjects, as expected. The magnitude of the fMRI response to 22% physical contrast within "activated" voxels was the same for each eye as a function of spatial frequency, regardless of the presence of amblyopia. However, there were always fewer "activated" fMRI voxels during amblyopic stimulation than during normal eye stimulation. These results are consistent with the hypotheses that contrast thresholds are elevated in amblyopia because fewer neurons are responsive during amblyopic stimulation, and that the average firing rate of the responsive neurons, which reflects the perception of contrast, is unaffected in amblyopia.