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Leadbeater RJ, McGraw P, Ledgeway T. Assessing the reliability of web-based measurements of visual function. Behav Res Methods 2024; 56:406-416. [PMID: 36690890 PMCID: PMC10794459 DOI: 10.3758/s13428-022-02057-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/19/2022] [Indexed: 01/25/2023]
Abstract
Many behavioural phenomena have been replicated using web-based experiments, but evaluation of the agreement between objective measures of web- and lab-based performance is required if scientists and clinicians are to reap the benefits of web-based testing. In this study, we investigated the reliability of a task which assesses early visual cortical function by evaluating the well-known 'oblique effect' (we are better at seeing horizontal and vertical edges than tilted ones) and the levels of agreement between remote, web-based measures and lab-based measures. Sixty-nine young participants (mean age, 21.8 years) performed temporal and spatial versions of a web-based, two-alternative forced choice (2AFC) orientation-identification task. In each case, orientation-identification thresholds (the minimum orientation difference at which a standard orientation could be reliably distinguished from a rotated comparison) were measured for cardinal (horizontal and vertical) and oblique orientations. Reliability was assessed in a subsample of 18 participants who performed the same tasks under laboratory conditions. Robust oblique effects were found, such that thresholds were substantially lower for cardinal orientations compared to obliques, for both web- and lab-based measures of the temporal and spatial 2AFC tasks. Crucially, web- and lab-based orientation-identification thresholds showed high levels of agreement, demonstrating the suitability of web-based testing for assessments of early visual cortical function. Future studies should assess the reliability of similar web-based tasks in clinical populations to evaluate their adoption into clinical settings, either to screen for visual anomalies or to assess changes in performance associated with progression of disease severity.
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Affiliation(s)
- Richard J Leadbeater
- Visual Neuroscience Group, School of Psychology, University of Nottingham, Nottingham, NG7 2RD, UK.
| | - Paul McGraw
- Visual Neuroscience Group, School of Psychology, University of Nottingham, Nottingham, NG7 2RD, UK
| | - Timothy Ledgeway
- Visual Neuroscience Group, School of Psychology, University of Nottingham, Nottingham, NG7 2RD, UK
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2
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Cai YH, Huang X. Abnormal functional connectivity strength in age-related macular degeneration patients: a fMRI study. Neuroreport 2023; 34:845-852. [PMID: 37942735 DOI: 10.1097/wnr.0000000000001962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2023]
Abstract
OBJECTIVE Age-related macular degeneration (AMD) is a serious blinding eye disease. Previous neuroimaging studies reported that AMD were accompanied by abnormalities of the brain. However, whether AMD patients were associated with functional connectivity strength (FCS) or not remains unknown. In our study, the purpose of the study was to assess FCS changes in AMD patients. METHODS In our study, 20 AMD patients and 20 healthy controls (HCs), matched closely by sex, age, and educational level were underwent MRI scanning. FCS method and seed-based functional connectivity (FC) method were applied to investigate the functional network changes between two groups. Moreover, support vector machine (SVM) method was applied to assess the FCS maps as a feature to classification of AMD diseases. RESULTS Our study reported that AMD patients showed decreased FCS values in the bilateral calcarine, left supplementary motor area, left superior parietal lobule and left paracentral lobule (ParaL) relative to the HC group. Meanwhile, our study found that the AMD patients showed abnormal FC within visual network, sensorimotor network and default mode network. Moreover, the SVM method showed that FCS maps as machine learning features shows good classification efficiency (area under curve = 0.82) in the study. CONCLUSION Our study demonstrated that AMD patients showed abnormal FCS with the visual network, sensorimotor network and default mode network, which might reflect the impaired vision, cognition and motor function in AMD patients. In addition, FCS indicator can be used as an effective biological marker to assist the clinical diagnosis of AMD.
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Affiliation(s)
- Yue-Hong Cai
- Department of Ophthalmology, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, China
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Hunter AML, Anderson RS, Redmond T, Garway-Heath DF, Mulholland PJ. Investigating the Spatiotemporal Summation of Perimetric Stimuli in Dry Age-Related Macular Degeneration. Transl Vis Sci Technol 2023; 12:37. [PMID: 38019498 PMCID: PMC10691387 DOI: 10.1167/tvst.12.11.37] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 09/26/2023] [Indexed: 11/30/2023] Open
Abstract
Purpose To measure achromatic spatial, temporal, and spatiotemporal summation in dry age-related macular degeneration (AMD) compared to healthy controls under conditions of photopic gaze-contingent perimetry. Methods Twenty participants with dry AMD (mean age, 74.6 years) and 20 healthy controls (mean age, 67.8 years) performed custom, gaze-contingent perimetry tests. An area-modulation test generated localized estimates of Ricco's area (RA) at 2.5° and 5° eccentricities along the 0°, 90°, 180°, and 270° meridians. Contrast thresholds were measured at the same test locations for stimuli of six durations (3.7-190.4 ms) with a Goldmann III stimulus (GIII, 0.43°) and RA-scaled stimuli. The upper limit (critical duration) of complete temporal summation (using the GIII stimulus) and spatiotemporal summation (using the RA stimuli) was estimated using iterative two-phase regression analysis. Results Median (interquartile range [IQR]) RA estimates were significantly larger in AMD participants (2.5°: 0.21 [0.09-0.41] deg2; 5°: 0.32 [0.15-0.65 deg2]) compared to healthy controls (2.5°: 0.08 [0.05-0.13] deg2; 5°: 0.15 [0.08-0.22] deg2) at all test locations (all P < 0.05). No significant difference in median critical duration was found in AMD participants with the GIII stimulus (19.6 [9.9-30.4] ms) and RA-scaled stimuli (22.9 [13.9-40.3] ms) compared to healthy controls (GIII: 17.0 [11.3-24.0] ms; RA-scaled: 22.4 [14.3-33.1] ms) at all test locations (all P > 0.05). Conclusions Spatial summation is altered in dry AMD, without commensurate changes in temporal summation. Translational Relevance The sensitivity of perimetry to AMD may be improved by utilizing stimuli that probe alterations in spatial summation in the disease.
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Affiliation(s)
- Aoife M. L. Hunter
- Centre for Optometry and Vision Science, Biomedical Sciences Research Institute, Ulster University, Coleraine, UK
| | - Roger S. Anderson
- Centre for Optometry and Vision Science, Biomedical Sciences Research Institute, Ulster University, Coleraine, UK
- National Institute for Health Research Moorfields Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
| | - Tony Redmond
- School of Optometry and Vision Sciences, Cardiff University, Cardiff, UK
| | - David F. Garway-Heath
- National Institute for Health Research Moorfields Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
| | - Pádraig J. Mulholland
- Centre for Optometry and Vision Science, Biomedical Sciences Research Institute, Ulster University, Coleraine, UK
- National Institute for Health Research Moorfields Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
- School of Optometry and Vision Sciences, Cardiff University, Cardiff, UK
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4
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Defenderfer MK, Demirayak P, Fleming LL, DeCarlo DK, Stewart P, Visscher KM. Cortical plasticity in central vision loss: Cortical thickness and neurite structure. Hum Brain Mapp 2023; 44:4120-4135. [PMID: 37195035 PMCID: PMC10258531 DOI: 10.1002/hbm.26334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 04/24/2023] [Accepted: 04/28/2023] [Indexed: 05/18/2023] Open
Abstract
Late-stage macular degeneration (MD) often causes retinal lesions depriving an individual of central vision, forcing them to learn to use peripheral vision for daily tasks. To compensate, many patients develop a preferred retinal locus (PRL), an area of peripheral vision used more often than equivalent regions of spared vision. Thus, associated portions of cortex experience increased use, while portions of cortex associated with the lesion are deprived of sensory input. Prior research has not well examined the degree to which structural plasticity depends on the amount of use across the visual field. Cortical thickness, neurite density, and orientation dispersion were measured at portions of cortex associated with the PRL, the retinal lesion, and a control region in participants with MD as well as age-matched, gender-matched, and education-matched controls. MD participants had significantly thinner cortex in both the cortical representation of the PRL (cPRL) and the control region, compared with controls, but no significant differences in thickness, neurite density, or orientation dispersion were found between the cPRL and the control region as functions of disease or onset. This decrease in thickness is driven by a subset of early-onset participants whose patterns of thickness, neurite density, and neurite orientation dispersion are distinct from matched control participants. These results suggest that people who develop MD earlier in adulthood may undergo more structural plasticity than those who develop it late in life.
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Affiliation(s)
- Matthew K. Defenderfer
- Civitan International Research CenterUniversity of Alabama at BirminghamBirminghamAlabamaUSA
- Department of Neurobiology, Heersink School of MedicineUniversity of Alabama at BirminghamBirminghamAlabamaUSA
| | - Pinar Demirayak
- Civitan International Research CenterUniversity of Alabama at BirminghamBirminghamAlabamaUSA
- Department of Neurobiology, Heersink School of MedicineUniversity of Alabama at BirminghamBirminghamAlabamaUSA
| | - Leland L. Fleming
- Civitan International Research CenterUniversity of Alabama at BirminghamBirminghamAlabamaUSA
- Department of Neurobiology, Heersink School of MedicineUniversity of Alabama at BirminghamBirminghamAlabamaUSA
| | - Dawn K. DeCarlo
- Department of Ophthalmology, Heersink School of MedicineUniversity of Alabama at BirminghamBirminghamAlabamaUSA
| | - Paul Stewart
- Civitan International Research CenterUniversity of Alabama at BirminghamBirminghamAlabamaUSA
- Department of Neurobiology, Heersink School of MedicineUniversity of Alabama at BirminghamBirminghamAlabamaUSA
| | - Kristina M. Visscher
- Civitan International Research CenterUniversity of Alabama at BirminghamBirminghamAlabamaUSA
- Department of Neurobiology, Heersink School of MedicineUniversity of Alabama at BirminghamBirminghamAlabamaUSA
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Silson EH, Baker CI, Aleman TS, Maguire AM, Bennett J, Ashtari M. Motion-selective areas V5/MT and MST appear resistant to deterioration in choroideremia. Neuroimage Clin 2023; 38:103384. [PMID: 37023490 PMCID: PMC10119684 DOI: 10.1016/j.nicl.2023.103384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 03/07/2023] [Accepted: 03/20/2023] [Indexed: 04/08/2023]
Abstract
Choroideremia (CHM) is an X-linked recessive form of hereditary retinal degeneration, which preserves only small islands of central retinal tissue. Previously, we demonstrated the relationship between central vision and structure and population receptive fields (pRF) using functional magnetic resonance imaging (fMRI) in untreated CHM subjects. Here, we replicate and extend this work, providing a more in-depth analysis of the visual responses in a cohort of CHM subjects who participated in a retinal gene therapy clinical trial. fMRI was conducted in six CHM subjects and six age-matched healthy controls (HC's) while they viewed drifting contrast pattern stimuli monocularly. A single ∼3-minute fMRI run was collected for each eye. Participants also underwent ophthalmic evaluations of visual acuity and static automatic perimetry (SAP). Consistent with our previous report, a single ∼ 3 min fMRI run accurately characterized ophthalmic evaluations of visual function in most CHM subjects. In-depth analyses of the cortical distribution of pRF responses revealed that the motion-selective regions V5/MT and MST appear resistant to progressive retinal degenerations in CHM subjects. This effect was restricted to V5/MT and MST and was not present in either primary visual cortex (V1), motion-selective V3A or regions within the ventral visual pathway. Motion-selective areas V5/MT and MST appear to be resistant to the continuous detrimental impact of CHM. Such resilience appears selective to these areas and may be mediated by independent retina-V5/MT anatomical connections that bypass V1. We did not observe any significant impact of gene therapy.
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Affiliation(s)
- Edward H Silson
- Section on Learning and Plasticity, Laboratory of Brain and Cognition, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, United States
| | - Chris I Baker
- Section on Learning and Plasticity, Laboratory of Brain and Cognition, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, United States
| | - Tomas S Aleman
- Center for Advanced Retinal and Ocular Therapeutics (CAROT), University of Pennsylvania, Philadelphia, PA, United States; F.M. Kirby Center for Molecular Ophthalmology, Scheie Eye Institute, University of Pennsylvania, Philadelphia, PA, United States
| | - Albert M Maguire
- Center for Advanced Retinal and Ocular Therapeutics (CAROT), University of Pennsylvania, Philadelphia, PA, United States; F.M. Kirby Center for Molecular Ophthalmology, Scheie Eye Institute, University of Pennsylvania, Philadelphia, PA, United States
| | - Jean Bennett
- Center for Advanced Retinal and Ocular Therapeutics (CAROT), University of Pennsylvania, Philadelphia, PA, United States; F.M. Kirby Center for Molecular Ophthalmology, Scheie Eye Institute, University of Pennsylvania, Philadelphia, PA, United States
| | - Manzar Ashtari
- Center for Advanced Retinal and Ocular Therapeutics (CAROT), University of Pennsylvania, Philadelphia, PA, United States; F.M. Kirby Center for Molecular Ophthalmology, Scheie Eye Institute, University of Pennsylvania, Philadelphia, PA, United States; Department of Radiology, University of Pennsylvania, Philadelphia, PA, United States.
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Nekolova J, Kremlacek J, Lukavsky J, Sikl R, Sin M, Langrova J, Szanyi J, Jiraskova N. The intraocular implant and visual rehabilitation improve the quality of life of elderly patients with geographic atrophy secondary to age-related macular degeneration. Graefes Arch Clin Exp Ophthalmol 2023; 261:263-272. [PMID: 35982247 PMCID: PMC9388354 DOI: 10.1007/s00417-022-05803-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 06/27/2022] [Accepted: 08/05/2022] [Indexed: 01/19/2023] Open
Abstract
INTRODUCTION The objective of this prospective study was to evaluate the effects of intraocular macular lens implantation and visual rehabilitation on the quality of life of patients with geographic atrophy (GA) secondary to age-related macular degeneration (AMD). METHODS Patients with bilaterally decreased near vision (not better than 0.3 logMAR with the best correction), pseudophakia, were included in the project. The Scharioth macula lens (SML) was implanted into the patients' better-seeing eye. Intensive visual rehabilitation of the ability to perform nearby activities was performed for 20 consecutive postoperative days. All subjects were examined before and after SML implantation ophthalmologically. The National Eye Institute 25-Item Visual Function Questionnaire (NEI VFQ-25) was administered before and 6 months after surgery. RESULTS Twenty eligible patients with mean age 81 years (63 to 92 years) were included in the project: 7 males and 13 females. Nineteen of them completed the 6-month follow-up. Near uncorrected visual acuity was 1.321 ± 0.208 logMAR before SML implantation and improved to 0.547 ± 0.210 logMAR after 6 months (dz = - 2.846, p < 0.001, BF10 = 3.29E + 07). In the composite score of the NEI VFQ-25, there was an improvement in the general score and the specific domains related to the implantation. Participants reported fewer difficulties in performing near activities (dz = 0.91, p = 0.001, BF10 = 39.718) and upturns in mental health symptoms related to vision (dz = 0.62, p = .014, BF10 = 3.937). CONCLUSION SML implantation, followed by appropriate rehabilitation, improved near vision and increased the quality of life of visually handicapped patients with AMD in our project.
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Affiliation(s)
- Jana Nekolova
- Department of Ophthalmology, University Hospital Hradec Kralove and Faculty of Medicine, Charles University, Hradec Kralove, Czech Republic
| | - Jan Kremlacek
- Department of Biophysics, Faculty of Medicine, Charles University, Simkova 870, 50003 Hradec Kralove, Czech Republic
- Department of Pathological Physiology, Faculty of Medicine, Charles University, Simkova 870, Hradec Kralove, 50003 Czech Republic
| | - Jiri Lukavsky
- Institute of Psychology, Czech Academy of Sciences, Brno, Czech Republic
| | - Radovan Sikl
- Institute of Psychology, Czech Academy of Sciences, Brno, Czech Republic
| | - Martin Sin
- Military University Hospital Prague, Department of Ophthalmology 1st Faculty of Medicine of Charles University and Military University Hospital Prague, Prague, Czech Republic
| | - Jana Langrova
- Department of Pathological Physiology, Faculty of Medicine, Charles University, Simkova 870, Hradec Kralove, 50003 Czech Republic
| | - Jana Szanyi
- Department of Pathological Physiology, Faculty of Medicine, Charles University, Simkova 870, Hradec Kralove, 50003 Czech Republic
| | - Nada Jiraskova
- Department of Ophthalmology, University Hospital Hradec Kralove and Faculty of Medicine, Charles University, Hradec Kralove, Czech Republic
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Tarita-Nistor L, Mandelcorn MS. Binocularity Principles of PRL Development in Patients With Macular Disease. Invest Ophthalmol Vis Sci 2022; 63:19. [PMID: 35976637 PMCID: PMC9400123 DOI: 10.1167/iovs.63.9.19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Purpose We tested the hypothesis that binocularity requirements for correspondence play a role in establishing the preferred retinal locus (PRL) in macular degeneration. Methods Monocular PRL locations in 202 eyes of 101 patients with macular degeneration (79 ± 10 years) were recorded with the MP1 microperimeter. Corresponding PRLs were those with similar polar angle and distance from former fovea in the better eye (BE) and the worse eye (WE). Results On average, the PRL in the BE was in the foveal proximity at 1.1 ± 0.99 degrees for 55 patients (foveal-driven PRL) and eccentrically at 6.9 ± 3.4 degrees for 46 patients with central lesions involving the fovea (peripheral-driven PRL). For the foveal-driven PRL group, the PRL in the BE was not affected by the status of the WE. In 100% of cases, the monocular PRL in the WE was in a corresponding location either on functioning retina or onto the lesion, or would fall onto the lesion during binocular viewing. For the peripheral-driven PRL group, the PRL location depended on the lesion size in both eyes to maximize correspondence and/or the function of peripheral vision during binocular viewing. In this group, PRL correspondence status was different for those with equal, unequal, or extensive lesions in both eyes. Conclusions Binocularity requirements for correspondence play an important role in determining the PRL location. We formulated two principles based on whether the BE has foveal sparing (foveal-driven PRL) or central lesions affecting the fovea (peripheral-driven PRL). The PRL should be evaluated in the framework of binocular viewing.
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Affiliation(s)
- Luminita Tarita-Nistor
- Krembil Research Institute, Donald K Johnson Eye Institute, University Health Network, Toronto, Canada
| | - Mark S Mandelcorn
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Canada.,Department of Ophthalmology, Toronto Western Hospital, University Health Network, Toronto, Canada
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Qian T, Xu X, Liu X, Yen M, Zhou H, Mao M, Cai H, Shen H, Xu X, Gong Y, Yu S. Efficacy of MP-3 microperimeter biofeedback fixation training for low vision rehabilitation in patients with maculopathy. BMC Ophthalmol 2022; 22:197. [PMID: 35484529 PMCID: PMC9047472 DOI: 10.1186/s12886-022-02419-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 04/25/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To evaluate the efficacy of MP-3 microperimeter biofeedback fixation training (MBFT) in vision rehabilitation of low-vision patients affected by macular disease with central vision loss. METHODS Seventeen eyes (7 age-related macular degeneration, 10 myopic maculopathy) of 17 patients were included in this prospective, interventional study. The preferred retinal locus was determined by comprehensive ophthalmoscopic fundus evaluation including fundus photography, autofluorescence, optical coherence tomography, and microperimetry. The rehabilitation consisted of three 10-min sessions per eye to be performed twice per week for 20 consecutive weeks using the MP-3 microperimeter. Best corrected visual acuity (BCVA), reading speed, mean central sensitivity, the percentages of fixation points within specified regions, bivariate contour ellipse area (BCEA) and the 25-item National Eye Institute visual function questionnaire (NEI-VFQ-25) were recorded pre- and post-training. RESULTS The final BCVA, reading speed and mean central sensitivity all showed significant improvements after rehabilitation (P < 0.0001, P = 0.0013, and P = 0.0002, respectively). The percentages of fixation points located within 2° and 4° diameter circles both significantly increased after training (P = 0.0008 and P = 0.0007, respectively). The BCEA encompassing 68.2, 95.4, 99.6% of fixation points were all significantly decreased after training (P = 0.0038, P = 0.0022, and P = 0.0021, respectively). The NEI-VFQ-25 scores were significantly increased at the end of the rehabilitation training (P < 0.0001). CONCLUSION Rehabilitation with MP-3 MBFT is a user-friendly therapeutic option for improving visual function, fixation stability, and quality of life in advanced macular disease. TRIAL REGISTRATION The prospective study was registered with the Chinese Clinical Trial Registry ( http://www.chictr.org.cn/ ). TRIAL REGISTRATION NUMBER ChiCTR2000029586 . Date of registration: 05/02/2020.
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Affiliation(s)
- Tianwei Qian
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, 100 Haining Road, Hongkou District, Shanghai, 200080, China.,National Clinical Research Center for Eye Diseases, Shanghai, 200080, China.,Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai, 200080, China.,Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, 200080, China.,Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Disease, Shanghai, China
| | - Xian Xu
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, 100 Haining Road, Hongkou District, Shanghai, 200080, China.,National Clinical Research Center for Eye Diseases, Shanghai, 200080, China.,Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai, 200080, China.,Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, 200080, China.,Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Disease, Shanghai, China
| | - Xinyi Liu
- Shanghai Zhenshi ophthalmology clinic, Shanghai, 200080, China
| | - Manni Yen
- Shanghai Zhenshi ophthalmology clinic, Shanghai, 200080, China
| | - Hao Zhou
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, 100 Haining Road, Hongkou District, Shanghai, 200080, China.,National Clinical Research Center for Eye Diseases, Shanghai, 200080, China.,Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai, 200080, China.,Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, 200080, China.,Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Disease, Shanghai, China
| | - Manman Mao
- Shanghai Zhenshi ophthalmology clinic, Shanghai, 200080, China
| | - Huiting Cai
- Shanghai Zhenshi ophthalmology clinic, Shanghai, 200080, China
| | - Hangqi Shen
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, 100 Haining Road, Hongkou District, Shanghai, 200080, China.,National Clinical Research Center for Eye Diseases, Shanghai, 200080, China.,Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai, 200080, China.,Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, 200080, China.,Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Disease, Shanghai, China
| | - Xun Xu
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, 100 Haining Road, Hongkou District, Shanghai, 200080, China.,National Clinical Research Center for Eye Diseases, Shanghai, 200080, China.,Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai, 200080, China.,Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, 200080, China.,Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Disease, Shanghai, China
| | - Yuanyuan Gong
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, 100 Haining Road, Hongkou District, Shanghai, 200080, China. .,National Clinical Research Center for Eye Diseases, Shanghai, 200080, China. .,Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai, 200080, China. .,Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, 200080, China. .,Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Disease, Shanghai, China.
| | - Suqin Yu
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, 100 Haining Road, Hongkou District, Shanghai, 200080, China. .,National Clinical Research Center for Eye Diseases, Shanghai, 200080, China. .,Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai, 200080, China. .,Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, 200080, China. .,Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Disease, Shanghai, China.
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Maniglia M, Visscher KM, Seitz AR. Perspective on Vision Science-Informed Interventions for Central Vision Loss. Front Neurosci 2021; 15:734970. [PMID: 34803584 PMCID: PMC8599964 DOI: 10.3389/fnins.2021.734970] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 10/11/2021] [Indexed: 11/13/2022] Open
Abstract
Pathologies affecting central vision, and macular degeneration (MD) in particular, represent a growing health concern worldwide, and the leading cause of blindness in the Western World. To cope with the loss of central vision, MD patients often develop compensatory strategies, such as the adoption of a Preferred Retinal Locus (PRL), which they use as a substitute fovea. However, visual acuity and fixation stability in the visual periphery are poorer, leaving many MD patients struggling with tasks such as reading and recognizing faces. Current non-invasive rehabilitative interventions are usually of two types: oculomotor, aiming at training eye movements or teaching patients to use or develop a PRL, or perceptual, with the goal of improving visual abilities in the PRL. These training protocols are usually tested over a series of outcome assessments mainly measuring low-level visual abilities (visual acuity, contrast sensitivity) and reading. However, extant approaches lead to mixed success, and in general have exhibited large individual differences. Recent breakthroughs in vision science have shown that loss of central vision affects not only low-level visual abilities and oculomotor mechanisms, but also higher-level attentional and cognitive processes. We suggest that effective interventions for rehabilitation after central vision loss should then not only integrate low-level vision and oculomotor training, but also take into account higher level attentional and cognitive mechanisms.
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Affiliation(s)
- Marcello Maniglia
- Department of Psychology, University of California, Riverside, Riverside, CA, United States
- Department of Neurobiology, The University of Alabama at Birmingham, Birmingham, AL, United States
| | - Kristina M. Visscher
- Department of Neurobiology, The University of Alabama at Birmingham, Birmingham, AL, United States
| | - Aaron R. Seitz
- Department of Psychology, University of California, Riverside, Riverside, CA, United States
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Brown HDH, Gouws AD, Vernon RJW, Lawrence SJD, Donnelly G, Gill L, Gale RP, Baseler HA, Morland AB. Assessing functional reorganization in visual cortex with simulated retinal lesions. Brain Struct Funct 2021; 226:2855-2867. [PMID: 34529124 PMCID: PMC8541975 DOI: 10.1007/s00429-021-02366-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 08/23/2021] [Indexed: 11/07/2022]
Abstract
Macular
degeneration (MD) causes central vision loss, removing input to corresponding representations in the primary visual cortex. There is disagreement concerning whether the cortical regions deprived of input can remain responsive, and the source of reported cortical responses is still debated. To simulate MD in controls, normally sighted participants viewed a bright central disk to adapt the retina, creating a transient ‘retinal lesion’ during a functional MRI experiment. Participants viewed blocks of faces, scrambled faces and uniform grey stimuli, either passively or whilst performing a one-back task. To assess the impact of the simulated lesion, participants repeated the paradigm using a more conventional mean luminance simulated scotoma without adaptation. Our results suggest our attempt to create a more realistic simulation of a lesion did not impact on responses in the representation of the simulated lesion. While most participants showed no evidence of stimulus-driven activation within the lesion representation, a few individuals (22%) exhibited responses similar to a participant with juvenile MD who completed the same paradigm (without adaptation). Reliability analysis showed that responses in the representation of the lesion were generally consistent irrespective of whether positive or negative. We provide some evidence that peripheral visual stimulation can also produce responses in central representations in controls while performing a task. This suggests that the ‘signature of reorganization of visual processing’, is not found solely in patients with retinal lesions, consistent with the idea that activity may be driven by unmasked top–down feedback.
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Affiliation(s)
- Holly D H Brown
- Department of Psychology, University of York, York, UK.,York Neuroimaging Centre, University of York, York, UK.,York Biomedical Research Institute, University of York, York, UK
| | - André D Gouws
- Department of Psychology, University of York, York, UK.,York Neuroimaging Centre, University of York, York, UK
| | - Richard J W Vernon
- Department of Psychology, University of York, York, UK.,York Neuroimaging Centre, University of York, York, UK.,York Biomedical Research Institute, University of York, York, UK
| | - Samuel J D Lawrence
- Department of Psychology, University of York, York, UK.,York Neuroimaging Centre, University of York, York, UK
| | - Gemma Donnelly
- Institute of Neuroscience and Psychology, University of Glasgow, Glasgow, UK
| | - Lorraine Gill
- Department of Psychology, University of York, York, UK
| | - Richard P Gale
- Department of Health Sciences, University of York, York, UK.,Academic Unit of Ophthalmology, York Teaching Hospital NHS Foundation Trust, York, UK
| | - Heidi A Baseler
- Department of Psychology, University of York, York, UK.,York Biomedical Research Institute, University of York, York, UK.,Hull York Medical School, University of York, York, UK
| | - Antony B Morland
- Department of Psychology, University of York, York, UK. .,York Neuroimaging Centre, University of York, York, UK. .,York Biomedical Research Institute, University of York, York, UK.
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11
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Li S, Deng X, Zhang J. An Overview of Preferred Retinal Locus and Its Application in Biofeedback Training for Low-Vision Rehabilitation. Semin Ophthalmol 2021; 37:142-152. [PMID: 34436959 DOI: 10.1080/08820538.2021.1931355] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Central vision loss (CVL) caused by macular damage generally disables common daily tasks, which cannot be reversed by present treatments. Fortunately, it has been found that biofeedback training by inducing or reinforcing preferred retinal locus (PRL) as an eccentric fixation reference contributes to the improvement of visual performance in patients with CVL. However, the clinical application is still under controversy due to poor knowledge of its fundamental and inconsistent practical standards. This article aims to summarize the possible rationale for the development, location, re-location and evaluating indicators of PRL, and the general apparatus, protocol, and outcome of biofeedback PRL training.
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Affiliation(s)
- Shengnan Li
- Aier School of Ophthalmology, Central South University, Changsha, Hunan, China
| | - Xuan Deng
- Aier School of Ophthalmology, Central South University, Changsha, Hunan, China
| | - Jinglin Zhang
- Aier School of Ophthalmology, Central South University, Changsha, Hunan, China.,Guangzhou Aier Eye Hospital, Guangzhou, Guangdong China
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12
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Baig A, Buckley D, Codina C. Behavioural Adaptation to Hereditary Macular Dystrophy: A Systematic Review on the Effect of Early Onset Central Field Loss on Peripheral Visual Abilities. Br Ir Orthopt J 2021; 17:104-118. [PMID: 34278226 PMCID: PMC8269784 DOI: 10.22599/bioj.177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 05/25/2021] [Indexed: 11/30/2022] Open
Abstract
Purpose: Hereditary macular dystrophies (HMD) result in early onset central field loss. Evidence for cortical plasticity has been found in HMD, which may enhance peripheral visual abilities to meet the increased demands and reliance on the peripheral field, as has been found in congenitally deaf adults and habitual action video-game players. This is a qualitative synthesis of the literature on the effect of early onset central field loss on peripheral visual abilities. The knowledge gained may help in developing rehabilitative strategies that enable optimisation of remaining peripheral vision. Methods: A systematic search performed on the Web of Science and PubMED databases yielded 728 records published between 1809 to 2020, of which seven case-control studies were eligible for qualitative synthesis. Results: The search highlighted an overall paucity of literature, which lacked validity due to small heterogeneous samples and deficiencies in reporting of methods and population characteristics. A range of peripheral visual abilities at different eccentricities were studied. Superior performance of HMD observers in the peripheral field or similarities between the preferred retinal loci (PRL) and normal fovea were observed in four of seven studies. Findings were often based on studies including a single observer. Further larger rigorous studies are required in this area. Conclusions: Spontaneous perceptual learning through reliance on and repeated use of the peripheral field and PRL may result in some specific superior peripheral visual abilities. However, worse performance in some tasks could reflect unexpected rod disease, lack of intensive training, or persistent limitations due to the need for cones for specific tasks. Perceptual learning through training regimes could enable patients to optimise use of the PRL and remaining peripheral vision. However, further studies are needed to design optimal training regimes.
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13
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Li S, Deng X, Chen Q, Lin H, Zhang J. Characteristics of Preferred Retinal Locus in Eyes with Central Vision Loss Secondary to Different Macular Lesions. Semin Ophthalmol 2021; 36:734-741. [PMID: 33764273 DOI: 10.1080/08820538.2021.1900289] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Preferred retinal locus (PRL) training has been applied to low-vision rehabilitation for patients with central vision loss (CVL). This study aimed to explore the characteristics of a natural PRL in eyes with different macular lesions. The data may be useful in customizing training programs. METHODS A total of 72 eyes with CVL were included and assigned into two groups. In group A, 29 eyes diagnosed with macular holes featured relatively sharp borders and small areas of lesions. In group B, 44 eyes showed lesions characterized by irregular borders and large areas. The PRL location relative to a scotoma in the retina, fixation stability, and the average threshold surrounding the PRL were determined and compared between the two groups. RESULTS In group A, the PRL was located above in 48.28%, below in 27.59%, left in 62.07%, right in 31.03%, and inside in 3.45% of the eyes. In group B, the PRL was located above in 39.53%, below in 4.65%, left in 44.19%, right in 6.98%, and inside in 27.91% of eyes. The amount of retinal displacement occurring within 1° from an initial reference point (P< .05) and the 95% bivariate contour ellipse area (P< .05) in group A were respectively higher and lower than those in group B. However, the average thresholds around the PRLs in the two groups showed no significant difference (P > .05). CONCLUSIONS A PRL to the left of or above a scotoma tends to develop to avoid the right and inferior field defect, regardless of the scale and boundary of lesions. Although light sensitivity around a PRL shows no relation to lesion features, fixation stability is worse in irregular and large lesions.
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Affiliation(s)
- Shengnan Li
- Aier School of Ophthalmology, Central South University, Changsha, Hunan, China
| | - Xuan Deng
- Aier School of Ophthalmology, Central South University, Changsha, Hunan, China
| | - Qianyin Chen
- Guangzhou Aier Eye Hospital, Guangzhou, Guangdong, China
| | - Huimin Lin
- Guangzhou Aier Eye Hospital, Guangzhou, Guangdong, China
| | - Jinglin Zhang
- Aier School of Ophthalmology, Central South University, Changsha, Hunan, China.,Guangzhou Aier Eye Hospital, Guangzhou, Guangdong, China
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14
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Silvestri V, Turco S, Piscopo P, Guidobaldi M, Perna F, Sulfaro M, Amore F. Biofeedback stimulation in the visually impaired: a systematic review of literature. Ophthalmic Physiol Opt 2021; 41:342-364. [PMID: 33733527 DOI: 10.1111/opo.12787] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 11/05/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND It is estimated that approximately 1.3 billion people live with some form of distance or near visual impairment. Numerous studies have been carried out to evaluate the effects of biofeedback (BF) and establish if it could be a useful tool in vision rehabilitation for various eye diseases. OBJECTIVE This systematic review aimed: 1) to examine the current evidence of BF efficacy for the rehabilitation of the visually impaired and 2) to describe methodological variations used in previous BF studies to provide recommendations for vision rehabilitation interventions. METHODS A systematic review was conducted in the Medline, PubMed, Cochrane Library and Web of Science databases to collect documents published between January 2000 and May 2020. Of the 1,960 studies identified, 43 met the criteria for inclusion. The following information was collected from each study: sample size, control group, any eye disease, apparatus used, frequency and number of sessions of BF, main outcomes of training and whether a follow-up was conducted. The first group included studies published as scientific articles in peer-reviewed journals. The second group included abstracts of studies presented at peer-reviewed conferences. Publications were also grouped according to the eye disease treated. RESULTS 25 articles and 18 peer-reviewed conference abstracts (PRCAs) were included in this review. BF stimulation is a commonly used technique for the treatment of visual impairment caused by macular disease. Most BF studies evaluate the effect of training on the preferred retinal locus (PRL), particularly with regard to fixation location and stability. Across these studies, participants who received BF intervention improved fixation stability and reading speed. High variability in the number of sessions and the duration of BF training was found. Most studies did not use a control group. CONCLUSIONS The findings of this review present evidence for biofeedback treatment in vision rehabilitation, with improved oculomotor abilities. Currently, it is not possible to formulate evidence-based recommendations for a standard training procedure due to the poor quality of existing randomised controlled trials. High-quality studies are needed to develop standard protocols for a range of eye diseases.
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Affiliation(s)
- Valeria Silvestri
- National Centre of Services and Research for the Prevention of Blindness and Rehabilitation of Visually Impaired, World Health Organization Collaborating Centre, International Agency for Prevention of Blindness- Italia Onlus, Rome, Italy.,Fondazione Policlinico Universitario "Agostino Gemelli" Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Simona Turco
- National Centre of Services and Research for the Prevention of Blindness and Rehabilitation of Visually Impaired, World Health Organization Collaborating Centre, International Agency for Prevention of Blindness- Italia Onlus, Rome, Italy.,Fondazione Policlinico Universitario "Agostino Gemelli" Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Paola Piscopo
- National Centre of Services and Research for the Prevention of Blindness and Rehabilitation of Visually Impaired, World Health Organization Collaborating Centre, International Agency for Prevention of Blindness- Italia Onlus, Rome, Italy.,Fondazione Policlinico Universitario "Agostino Gemelli" Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Margherita Guidobaldi
- National Centre of Services and Research for the Prevention of Blindness and Rehabilitation of Visually Impaired, World Health Organization Collaborating Centre, International Agency for Prevention of Blindness- Italia Onlus, Rome, Italy.,Fondazione Policlinico Universitario "Agostino Gemelli" Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Fabiana Perna
- National Centre of Services and Research for the Prevention of Blindness and Rehabilitation of Visually Impaired, World Health Organization Collaborating Centre, International Agency for Prevention of Blindness- Italia Onlus, Rome, Italy.,Ophthalmology Clinic, Department of Medicine and Aging Science, University G. d'Annunzio of Chieti-Pescara, Chieti, Italy
| | - Marco Sulfaro
- National Centre of Services and Research for the Prevention of Blindness and Rehabilitation of Visually Impaired, World Health Organization Collaborating Centre, International Agency for Prevention of Blindness- Italia Onlus, Rome, Italy.,Fondazione Policlinico Universitario "Agostino Gemelli" Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Filippo Amore
- National Centre of Services and Research for the Prevention of Blindness and Rehabilitation of Visually Impaired, World Health Organization Collaborating Centre, International Agency for Prevention of Blindness- Italia Onlus, Rome, Italy.,Fondazione Policlinico Universitario "Agostino Gemelli" Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
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15
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Baroncelli L, Lunghi C. Neuroplasticity of the visual cortex: in sickness and in health. Exp Neurol 2020; 335:113515. [PMID: 33132181 DOI: 10.1016/j.expneurol.2020.113515] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 10/14/2020] [Accepted: 10/21/2020] [Indexed: 01/18/2023]
Abstract
Brain plasticity refers to the ability of synaptic connections to adapt their function and structure in response to experience, including environmental changes, sensory deprivation and injuries. Plasticity is a distinctive, but not exclusive, property of the developing nervous system. This review introduces the concept of neuroplasticity and describes classic paradigms to illustrate cellular and molecular mechanisms underlying synapse modifiability. Then, we summarize a growing number of studies showing that the adult cerebral cortex retains a significant degree of plasticity highlighting how the identification of strategies to enhance the plastic potential of the adult brain could pave the way for the development of novel therapeutic approaches aimed at treating amblyopia and other neurodevelopmental disorders. Finally, we analyze how the visual system adjusts to neurodegenerative conditions leading to blindness and we discuss the crucial role of spared plasticity in the visual system for sight recovery.
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Affiliation(s)
- Laura Baroncelli
- Institute of Neuroscience, National Research Council (CNR), I-56124 Pisa, Italy; Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, I-56128 Pisa, Italy.
| | - Claudia Lunghi
- Laboratoire des systèmes perceptifs, Département d'études cognitives, École normale supérieure, PSL University, CNRS, 75005 Paris, France
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16
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Nuzzi R, Dallorto L, Vitale A. Cerebral Modifications and Visual Pathway Reorganization in Maculopathy: A Systematic Review. Front Neurosci 2020; 14:755. [PMID: 32973424 PMCID: PMC7472840 DOI: 10.3389/fnins.2020.00755] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Accepted: 06/26/2020] [Indexed: 01/14/2023] Open
Abstract
Background Macular degeneration (MD) is one of the most frequent causes of visual deficit, resulting in alterations affecting not only the retina but also the entire visual pathway up to the brain areas. This would seem related not just to signal deprivation but also to a compensatory neuronal reorganization, having significant implications in terms of potential rehabilitation of the patient and therapeutic perspectives. Objective This paper aimed to outline, by analyzing the existing literature, the current understanding of brain structural and functional changes detected with neuroimaging techniques in subjects affected by juvenile and age-related maculopathy. Methods Articles using various typologies of central nervous system (CNS) imaging in at least six patients affected by juvenile or age-related maculopathy were considered. A total of 142 were initially screened. Non-pertinent articles and duplicates were rejected. Finally, 19 articles, including 649 patients, were identified. Results In these sources, both structural and functional modifications were found in MD subjects' CNS. Changes in visual cortex gray matter volume were observed in both age-related MD (AMD) and juvenile MD (JMD); in particular, an involvement of not only its posterior part but also the anterior one suggests further causes besides an input-deprivation mechanism only. White matter degeneration was also found, more severe in JMD than in AMD. Moreover, functional analysis revealed differences in cortical activation patterns between MD and controls, suggesting neuronal circuit reorganization. Interestingly, attention and oculomotor training allowed better visual performances and correlated to a stronger cortical activation, even of the area normally receiving inputs from lesioned macula. Conclusion In MD, structural and functional changes in cerebral circuits and visual pathway can happen, involving both cerebral volume and activation patterns. These modifications, possibly due to neuronal plasticity (already observed and described for several brain areas), can allow patients to compensate for macular damage and gives therapeutic perspectives which could be achievable through an association between oculomotor training and biochemical stimulation of neuronal plasticity.
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Affiliation(s)
- Raffaele Nuzzi
- Eye Clinic, Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Laura Dallorto
- Eye Clinic, Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Alessio Vitale
- Eye Clinic, Department of Surgical Sciences, University of Turin, Turin, Italy
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17
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Rapid topographic reorganization in adult human primary visual cortex (V1) during noninvasive and reversible deprivation. Proc Natl Acad Sci U S A 2020; 117:11059-11067. [PMID: 32354998 DOI: 10.1073/pnas.1921860117] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Can the primary visual cortex (V1), once wired up in development, change in adulthood? Although numerous studies have demonstrated topographic reorganization in adult V1 following the loss of bottom-up input, others have challenged such findings, offering alternative explanations. Here we use a noninvasive and reversible deprivation paradigm and converging neural and behavioral approaches to address these alternatives in the experimental test case of short-term topographic reorganization in adult human V1. Specifically, we patched one eye in typical adults, thereby depriving the cortical representation of the other eye's blind spot (BS), and immediately tested for topographic reorganization using functional magnetic resonance imaging and psychophysics. Strikingly, within just minutes of eye-patching, the BS representation in V1 began responding to stimuli presented outside of the BS, and these same stimuli were perceived as elongated toward the BS. Thus, we provide converging neural and behavioral evidence of rapid topographic reorganization in adult human V1, and the strongest evidence yet that visual deprivation produces bona fide cortical change.
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18
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Castaldi E, Lunghi C, Morrone MC. Neuroplasticity in adult human visual cortex. Neurosci Biobehav Rev 2020; 112:542-552. [DOI: 10.1016/j.neubiorev.2020.02.028] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Revised: 12/30/2019] [Accepted: 02/20/2020] [Indexed: 12/27/2022]
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19
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Chu Z, Ma G, Sun X, Xu Z, Zhang J. Grape Seed Extracts Inhibit the Overexpression of Inflammatory Cytokines in Mouse Retinas and ARPE-19 Cells: Potentially Useful Dietary Supplement for Age-Related Eye Dysfunction. J Med Food 2020; 23:499-507. [PMID: 32119812 DOI: 10.1089/jmf.2019.4558] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Aging can cause retinal degeneration, which leads to visual impairment among the elderly population. Age-dependent increases in amyloid beta (Aβ) inducesinflammatory cytokine overexpression in the retinal pigment epithelium (RPE), which promotes the progression of age-related retinal degeneration. However, whether dietary antioxidants are useful for the treatment of RPE degeneration remains to be clarified. This study exposited the protective activities and underlying mechanisms of grape seed extracts (GSEs) against Aβ-induced proinflammatory events in mouse retinas and ARPE-19 cells. The experimental data demonstrated that GSEs attenuated the increases in messenger RNA (mRNA) levels of interleukin 12 (IL-12), interleukin 6 (IL-6), interleukin 1β (IL-1β), and interleukin 18 (IL-18) in the retinal tissues of Aβ-treated mice. The experimental results in mice were confirmed by findings in ARPE-19 cells with or without treatment with GSEs. GSEs affected the protein expression levels of endoplasmic reticulum stress markers in ARPE-19 cells exposed to Aβ. Knockdown of Bip blocked the inhibitory activities of GSEs on mRNA levels of IL-6, IL-1β, IL-18, and IL-8. We conclude that GSEs may suppress proinflammatory cytokines partly by increasing the expression of Bip.
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Affiliation(s)
- Zeying Chu
- Department of Food Science and Technology, College of Agriculture and Biology, Shanghai Jiaotong University, Shanghai, China
| | - Guanqun Ma
- Department of Food Science and Technology, College of Agriculture and Biology, Shanghai Jiaotong University, Shanghai, China
| | - Xiangjun Sun
- Department of Food Science and Technology, College of Agriculture and Biology, Shanghai Jiaotong University, Shanghai, China
| | - Zhihan Xu
- Department of Food Science and Technology, College of Agriculture and Biology, Shanghai Jiaotong University, Shanghai, China
| | - Jianhua Zhang
- Department of Food Science and Technology, College of Agriculture and Biology, Shanghai Jiaotong University, Shanghai, China
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20
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Gemenetzi M, Lotery AJ. Epigenetics in age-related macular degeneration: new discoveries and future perspectives. Cell Mol Life Sci 2020; 77:807-818. [PMID: 31897542 PMCID: PMC7058675 DOI: 10.1007/s00018-019-03421-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 12/04/2019] [Accepted: 12/10/2019] [Indexed: 12/13/2022]
Abstract
The study of epigenetics has explained some of the 'missing heritability' of age-related macular degeneration (AMD). The epigenome also provides a substantial contribution to the organisation of the functional retina. There is emerging evidence of specific epigenetic mechanisms associated with AMD. This 'AMD epigenome' may offer the chance to develop novel AMD treatments.
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Affiliation(s)
- M Gemenetzi
- NIHR Biomedical Research Centre At Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, 162 City Road, London, EC1V 2PD, UK
| | - A J Lotery
- Clinical and Experimental Sciences, Faculty of Medicine, University Hospital Southampton, University of Southampton, South Lab and Path Block, Mailpoint 806, Level D, Southampton, SO16 6YD, UK.
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21
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Contemori G, Battaglini L, Casco C. Contextual influences in the peripheral retina of patients with macular degeneration. Sci Rep 2019; 9:9284. [PMID: 31243292 PMCID: PMC6594941 DOI: 10.1038/s41598-019-45648-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Accepted: 06/06/2019] [Indexed: 12/11/2022] Open
Abstract
Macular degeneration (MD) is the leading cause of low vision in the elderly population worldwide. In case of complete bilateral loss of central vision, MD patients start to show a preferred retinal region for fixation (PRL). Previous literature has reported functional changes that are connected with the emergence of the PRL. In this paper, we question whether the PRL undergoes a use-dependent cortical reorganization that alters the range of spatial lateral interactions between low-level filters. We asked whether there is a modulation of the excitatory/inhibitory lateral interactions or whether contextual influences are well accounted for by the same law that describes the integration response in normal viewers. In a group of 13 MD patients and 7 age-matched controls, we probed contextual influences by measuring the contrast threshold for a vertical target Gabor, flanked by two collinear high-contrast Gabors. Contextual influences of the collinear flankers were indicated by the changes in contrast threshold obtained at different target-to-flanker distances (λs) relative to the baseline orthogonal condition. Results showed that MDs had higher thresholds in the baseline condition and functional impairment in the identification tasks. Moreover, at the shortest λ, we found facilitatory rather than inhibitory contextual influence. No difference was found between the PRL and a symmetrical retinal position (non-PRL). By pulling together data from MD and controls we showed that in the periphery this inversion occurs when the target threshold approach the flankers’ contrast (about 1:3 ratio) and that for patients it does occur in both the PRL and a symmetrical retinal position (non-PRL). We conclude that contrary to previous interpretations, this modulation doesn’t seem to reflect use-dependent cortical reorganization but rather, it might result from a reduction of contrast gain for the target that promotes target-flankers grouping.
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Affiliation(s)
- Giulio Contemori
- Department of General Psychology, University of Padova, Via Venezia 8, 35131, Padova, Italy. .,Neuro.Vis.U.S. Laboratory, University of Padova, Padova, Italy. .,Université de Toulouse-UPS, Centre de Recherche Cerveau et Cognition, Toulouse, France.
| | - Luca Battaglini
- Department of General Psychology, University of Padova, Via Venezia 8, 35131, Padova, Italy.,Neuro.Vis.U.S. Laboratory, University of Padova, Padova, Italy
| | - Clara Casco
- Department of General Psychology, University of Padova, Via Venezia 8, 35131, Padova, Italy.,Neuro.Vis.U.S. Laboratory, University of Padova, Padova, Italy
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22
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Enhanced Visual Attentional Modulation in Patients with Inherited Peripheral Retinal Degeneration in the Absence of Cortical Degeneration. Neural Plast 2019; 2019:8136354. [PMID: 31341470 PMCID: PMC6614956 DOI: 10.1155/2019/8136354] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2019] [Accepted: 06/11/2019] [Indexed: 12/20/2022] Open
Abstract
The role of attentional mechanisms in peripheral vision loss remains an outstanding question. Our study was aimed at determining the effect of genetically determined peripheral retinal dystrophy caused by Retinitis Pigmentosa (RP) on visual cortical function and tested the recruitment of attentional mechanisms using functional magnetic resonance imaging (fMRI). We included thirteen patients and twenty-two age- and gender-matched controls. We analyzed cortical responses under attentional demands and passive viewing conditions while presenting a visual stimulus covering the central and paracentral visual field. Brain activity was studied in visual areas V1, V2, and V3 as well as in cortical regions of interest corresponding to the preserved and the damaged visual field. The influence of visual field extent and age of disease onset were also investigated. Cortical thickness of visual areas was also measured. We found that cortical visual responses under attentional demands were increased in patients with larger degeneration of visual field, as demonstrated by significant interaction effects between group and task conditions. Moreover, activation during the task condition was increased for patients in two cortical regions of interest corresponding to the preserved and damaged visual field, specifically in patients with severe visual field loss. These findings were observed in the presence of preserved visual cortical structure. We conclude that RP patients have enhanced visual attention recruitment despite their retinal degeneration, while cortical structure and overall response levels remain intact. The unmasking of feedback signals from higher level visual regions involved in attentional processes may explain the increased cortical responses. These findings are relevant for the design of strategies for treating retinal diseases, based on attentional cuing.
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23
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Dan HD, Zhou FQ, Huang X, Xing YQ, Shen Y. Altered intra- and inter-regional functional connectivity of the visual cortex in individuals with peripheral vision loss due to retinitis pigmentosa. Vision Res 2019; 159:68-75. [PMID: 30904614 DOI: 10.1016/j.visres.2019.02.013] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Revised: 02/04/2019] [Accepted: 02/27/2019] [Indexed: 01/05/2023]
Abstract
This study investigated changes in intra- and inter-regional functional connectivity (FC) in individuals with retinitis pigmentosa (RP) by using regional homogeneity (ReHo) and FC methods. Sixteen RP individuals and 14 healthy controls (HCs) underwent resting-state functional magnetic resonance imaging scans (fMRI). A combined ReHo and FC method was conducted to evaluate synchronization of brain activity. Compared with HCs, RP individuals had significantly lower ReHo values in the bilateral lingual gyrus/cerebellum posterior lobe (LGG/CPL). In FC analysis, the RP group showed decreased positive FC relative to the HC group, from bilateral LGG/CPL to bilateral LGG/cuneus (CUN) and to left postcentral gyrus (PosCG). In contrast, the RP group showed increased negative FC relative to the HC group, from bilateral LGG/CPL to bilateral thalamus, and decreased negative FC from bilateral LGG/CPL to right middle frontal gyrus (MFG), and to left inferior parietal lobule (IPL). Moreover, ReHo values of the bilateral LGG/CPL showed negative correlations with the duration of RP. FC values of the bilateral LGG/CPL-left IPL showed negative correlations with best-corrected visual acuity (BCVA) of the right eye and left eye in RP individuals. Our results reveal reduced synchronicity of neural activity changes in the primary visual area in RP individuals. Moreover, RP individuals showed intrinsic visual network disconnection and reorganization of the retino-thalamocortical pathway and dorsal visual stream, suggesting impaired visuospatial and stereoscopic vision.
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Affiliation(s)
- Han-Dong Dan
- Eye Center, Renmin Hospital of Wuhan University, Wuhan 430060, Hubei, China
| | - Fu-Qing Zhou
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Jiangxi Province Medical Imaging Research Institute, Nanchang 330006, Jiangxi, China
| | - Xin Huang
- Eye Center, Renmin Hospital of Wuhan University, Wuhan 430060, Hubei, China
| | - Yi-Qiao Xing
- Eye Center, Renmin Hospital of Wuhan University, Wuhan 430060, Hubei, China
| | - Yin Shen
- Eye Center, Renmin Hospital of Wuhan University, Wuhan 430060, Hubei, China.
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24
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Silson EH, Aleman TS, Willett A, Serrano LW, Pearson DJ, Rauschecker AM, Maguire AM, Baker CI, Bennett J, Ashtari M. Comparing Clinical Perimetry and Population Receptive Field Measures in Patients with Choroideremia. Invest Ophthalmol Vis Sci 2019; 59:3249-3258. [PMID: 29971442 PMCID: PMC6110169 DOI: 10.1167/iovs.18-23929] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Purpose Choroideremia (CHM) is an X-linked recessive form of hereditary retinal degeneration, which, at advanced stages, leaves only small central islands of preserved retinal tissue. Unlike many other retinal diseases, the spared tissue in CHM supports excellent central vision and stable fixation. Such spared topography in CHM presents an ideal platform to explore the relationship between preserved central retinal structure and the retinotopic organization of visual cortex by using functional magnetic resonance imaging (fMRI). Methods fMRI was conducted in four participants with CHM and four healthy control participants while they viewed drifting contrast pattern stimuli monocularly. A single ∼3-minute fMRI run was collected for each eye separately. fMRI data were analyzed using the population receptive field (pRF) modeling approach. Participants also underwent ophthalmic evaluations of visual acuity and static automatic perimetry. Results The spatial distribution and strength of pRF estimates correlated positively and significantly with clinical outcome measures in most participants with CHM. Importantly, the positive relationship between clinical and pRF measurements increased with increasing disease progression. A less consistent relationship was observed for control participants. Conclusions Although reflecting only a small sample size, clinical evaluations of visual function in participants with CHM were well characterized by the spatial distribution and strength of pRF estimates by using a single ∼3-minute fMRI experiment. fMRI data analyzed with pRF modeling may be an efficient and objective outcome measure to complement current ophthalmic evaluations. Specifically, pRF modeling may be a feasible approach for evaluating the impact of interventions to restore visual function.
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Affiliation(s)
- Edward H Silson
- Section on Learning and Plasticity, Laboratory of Brain and Cognition, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, United States
| | - Tomas S Aleman
- Center for Advanced Retinal and Ocular Therapeutics (CAROT), University of Pennsylvania, Philadelphia, Pennsylvania, United States.,F.M. Kirby Center for Molecular Ophthalmology, Scheie Eye Institute, University of Pennsylvania, Philadelphia, Pennsylvania, United States
| | - Aimee Willett
- Center for Advanced Retinal and Ocular Therapeutics (CAROT), University of Pennsylvania, Philadelphia, Pennsylvania, United States
| | - Leona W Serrano
- Center for Advanced Retinal and Ocular Therapeutics (CAROT), University of Pennsylvania, Philadelphia, Pennsylvania, United States.,F.M. Kirby Center for Molecular Ophthalmology, Scheie Eye Institute, University of Pennsylvania, Philadelphia, Pennsylvania, United States
| | - Denise J Pearson
- Center for Advanced Retinal and Ocular Therapeutics (CAROT), University of Pennsylvania, Philadelphia, Pennsylvania, United States.,F.M. Kirby Center for Molecular Ophthalmology, Scheie Eye Institute, University of Pennsylvania, Philadelphia, Pennsylvania, United States
| | - Andreas M Rauschecker
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, United States
| | - Albert M Maguire
- Center for Advanced Retinal and Ocular Therapeutics (CAROT), University of Pennsylvania, Philadelphia, Pennsylvania, United States.,F.M. Kirby Center for Molecular Ophthalmology, Scheie Eye Institute, University of Pennsylvania, Philadelphia, Pennsylvania, United States
| | - Chris I Baker
- Section on Learning and Plasticity, Laboratory of Brain and Cognition, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, United States
| | - Jean Bennett
- Center for Advanced Retinal and Ocular Therapeutics (CAROT), University of Pennsylvania, Philadelphia, Pennsylvania, United States.,F.M. Kirby Center for Molecular Ophthalmology, Scheie Eye Institute, University of Pennsylvania, Philadelphia, Pennsylvania, United States
| | - Manzar Ashtari
- Center for Advanced Retinal and Ocular Therapeutics (CAROT), University of Pennsylvania, Philadelphia, Pennsylvania, United States.,F.M. Kirby Center for Molecular Ophthalmology, Scheie Eye Institute, University of Pennsylvania, Philadelphia, Pennsylvania, United States.,Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, United States
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Abstract
AbstractIn age-related macular degeneration (AMD), the processing of fine details in a visual scene, based on a high spatial frequency processing, is impaired, while the processing of global shapes, based on a low spatial frequency processing, is relatively well preserved. The present fMRI study aimed to investigate the residual abilities and functional brain changes of spatial frequency processing in visual scenes in AMD patients. AMD patients and normally sighted elderly participants performed a categorization task using large black and white photographs of scenes (indoors vs. outdoors) filtered in low and high spatial frequencies, and nonfiltered. The study also explored the effect of luminance contrast on the processing of high spatial frequencies. The contrast across scenes was either unmodified or equalized using a root-mean-square contrast normalization in order to increase contrast in high-pass filtered scenes. Performance was lower for high-pass filtered scenes than for low-pass and nonfiltered scenes, for both AMD patients and controls. The deficit for processing high spatial frequencies was more pronounced in AMD patients than in controls and was associated with lower activity for patients than controls not only in the occipital areas dedicated to central and peripheral visual fields but also in a distant cerebral region specialized for scene perception, the parahippocampal place area. Increasing the contrast improved the processing of high spatial frequency content and spurred activation of the occipital cortex for AMD patients. These findings may lead to new perspectives for rehabilitation procedures for AMD patients.
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26
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Vottonen P. Anti-vascular endothelial growth factors treatment of wet age-related macular degeneration: from neurophysiology to cost-effectiveness. Acta Ophthalmol 2018; 96 Suppl A109:1-46. [PMID: 29468838 DOI: 10.1111/aos.13706] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Pasi Vottonen
- Department of Ophthalmology; Kuopio University Hospital; University of Eastern Finland; Kuopio Finland
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27
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Gannon MA, Long SM, Parks NA. Homeostatic plasticity in human extrastriate cortex following a simulated peripheral scotoma. Exp Brain Res 2017; 235:3391-3401. [PMID: 28821922 DOI: 10.1007/s00221-017-5042-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2016] [Accepted: 07/20/2017] [Indexed: 12/19/2022]
Abstract
Neuroimaging and patient work over the past decade have indicated that, following retinal deafferentation, the human visual cortex undergoes a large-scale and enduring reorganization of its topography such that the classical retinotopic organization of deafferented visual cortex remaps to represent non-classical regions of visual space. Such long-term visual reorganization is proposed to occur through changes in the functional balance of deafferented visual circuits that engage more lasting changes through activity-dependent neuroplasticity. Here, we investigated the short-term changes in functional balance (short-term plasticity; homeostatic plasticity) that occur within deafferented human visual cortices. We recorded electroencephalogram (EEG) while observers were conditioned for 6 s with a simulated retinal scotoma (artificial scotoma) positioned 8.0° in the periphery. Visual evoked potentials (VEPs) evoked by the onset of sinusoidal visual probes that varied in their tilt were used to examine changes in cortical excitability within and around cortical representations of the simulated scotoma. Psychophysical orientation functions obtained from discrimination of visual probe tilt were used to examine alterations in the stimulus selectivity within the scotoma representations. Consistent with a mechanism of homeostatic disinhibition, an early extrastriate component of the VEP (the early phase P1) exhibited increased amplitude following the condition with a simulated scotoma relative to a stimulus-matched control condition. This increased visual cortical response was associated with a reduction in the slope of the psychophysical orientation function, suggesting a broader tuning of neural populations within scotoma representations. Together, these findings support a mechanism of disinhibition in promoting visual plasticity and topographical reorganization.
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Affiliation(s)
- Matthew A Gannon
- Department of Psychological Science, University of Arkansas, Fayetteville, AR, USA.
| | - Stephanie M Long
- Department of Psychological Science, University of Arkansas, Fayetteville, AR, USA
| | - Nathan A Parks
- Department of Psychological Science, University of Arkansas, Fayetteville, AR, USA
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28
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Abstract
PURPOSE In patients with central visual field scotomata, a large part of visual cortex is not adequately stimulated. Patients often use a new eccentric fixation area on intact peripheral retina ("preferred retinal locus"-PRL) that functions as a pseudo-fovea. We used functional magnetic resonance imaging (fMRI) to examine whether stimulating this pseudo-fovea leads to increased activation or altered activation patterns in visual cortex in comparison to stimulating a comparable peripheral area in the opposite hemifield (OppPRL). METHODS Nineteen patients with binocular central scotomata caused by hereditary retinal dystrophies and an age-matched control group were tested. The center of the visual field, PRL, and OppPRL were stimulated with flickering checkerboard stimuli and object pictures during fMRI measurement. RESULTS Results show that stimulation with pictures of everyday objects led to overall larger BOLD (blood oxygen level dependent) responses in visual cortex compared to that evoked by stimulation with flickering checkerboards. Patients showed this enhancement as early as in V1. When the PRL was directly stimulated with object pictures, the central representation area in early visual cortex was coactivated in the patients but not in the controls. In higher visual areas beyond retinotopic cortex, BOLD responses to stimulation of the PRL with object pictures were significantly enhanced in comparison to stimulation of the OppPRL area. Highly stable eccentric fixation with the PRL was associated with a higher BOLD signal in visual cortex in patients, and this effect was most pronounced in the conditions with object picture stimulation. CONCLUSIONS The observed results suggest that naturalistic images are more likely to trigger top-down processes that regulate activation in early visual cortex in patients with central vision loss.
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29
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O'Connell C, Mahboobin A, Drexler S, Redfern MS, Perera S, Nau AC, Cham R. Effects of acute peripheral/central visual field loss on standing balance. Exp Brain Res 2017; 235:3261-3270. [PMID: 28765993 DOI: 10.1007/s00221-017-5045-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2016] [Accepted: 07/22/2017] [Indexed: 10/19/2022]
Abstract
Vision impairments such as age-related macular degeneration (AMD) and glaucoma are among the top risk factors for geriatric falls and falls-related injuries. AMD and glaucoma lead to loss of the central and peripheral visual fields, respectively. This study utilized a custom contact lens model to occlude the peripheral or central visual fields in healthy adults, offering a novel within-subject approach to improve our understanding of the etiology of balance impairments that may lead to an increased fall risk in patients with visual field loss. Two dynamic posturography tests, including an adapted version of the Sensory Organization Test and a virtual reality environment with the visual scene moving sinusoidally, were used to evaluate standing balance. Balance stability was quantified by displacement and time-normalized path length of the center of pressure. Nine young and eleven older healthy adults wore visual field occluding contact lenses during posturography assessments to compare the effects of acute central and peripheral visual field occlusion. The results found that visual field occlusion had greater impact on older adults than young adults, specifically when proprioceptive cues are unreliable. Furthermore, the results suggest that both central and peripheral visions are important in postural control; however, peripheral vision may be more sensitive to movement in the environment.
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Affiliation(s)
- Caitlin O'Connell
- Department of Bioengineering, University of Pittsburgh, 439 Benedum Hall, 3700 O'Hara Street, Pittsburgh, PA, 15261, USA.
| | - Arash Mahboobin
- Department of Bioengineering, University of Pittsburgh, 439 Benedum Hall, 3700 O'Hara Street, Pittsburgh, PA, 15261, USA
| | - Scott Drexler
- UPMC Eye Center, Department of Ophthalmology, University of Pittsburgh, 203 Lothrop Street, Pittsburgh, PA, 15213, USA
| | - Mark S Redfern
- Department of Bioengineering, University of Pittsburgh, 439 Benedum Hall, 3700 O'Hara Street, Pittsburgh, PA, 15261, USA
| | - Subashan Perera
- Division of Geriatric Medicine, University of Pittsburgh, 3471 Fifth Avenue, Pittsburgh, PA, 15213, USA.,Department of Biostatistics, University of Pittsburgh, 130 De Soto Street, Pittsburgh, PA, 15261, USA
| | - Amy C Nau
- Korb Research, 400 Commonwealth Avenue, Unit 2, Boston, MA, 02215, USA
| | - Rakié Cham
- Department of Bioengineering, University of Pittsburgh, 439 Benedum Hall, 3700 O'Hara Street, Pittsburgh, PA, 15261, USA
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30
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Vottonen P, Kaarniranta K, Pääkkönen A, Tarkka IM. Visual processing in patients with age-related macular degeneration performing a face detection test. Clin Ophthalmol 2017; 11:1245-1252. [PMID: 28740360 PMCID: PMC5505620 DOI: 10.2147/opth.s132583] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
PURPOSE People with age-related macular degeneration (AMD) have difficulties in familiar face recognition and facial expression discrimination. Our aim was to evaluate the visual processing of faces in AMD patients and whether this would be improved by anti-vascular endothelial growth factor therapy. This was a prospective interventional cohort study. PATIENTS Twelve patients with monocular wet AMD and 6 control subjects were recruited. Face detection processes were studied using cortical event-related potentials (ERPs). Patients received 3 bevacizumab intravitreal injections to the single affected eye. At baseline and 4-6 weeks after the last injection, clinical presentation and ERPs of the face task were evaluated. Face pictures were shown as targets (16.7%) among standard pictures of pixelated faces in an oddball-type paradigm. RESULTS Face pictures elicited well-defined electrical components in occipital and parieto-occipital cortical areas at baseline and after treatment. The face-specific N170 component was evident in all subjects with longer peak latency in patients than in controls (170±13 vs 155±14, P=0.032). Unexpectedly, an early component reflecting unintentional prediction of perceiving a face, that is, deviance-related negativity, was present in patients and controls. Visual acuity of the affected eye seemed improved in patients from logarithm of the minimum angle of resolution 0.71 (±0.33) to 0.52 (±0.39) by 119 (±23) days without accompanying significant change in face-specific ERPs. CONCLUSIONS Monocular wet AMD distinctly influenced face-specific brain electrophysiological components. However, the anti-vascular endothelial growth factor treatment did not improve the binocular face detection ability. The EudraCT number of this study is 2012-000765-20.
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Affiliation(s)
- Pasi Vottonen
- Department of Ophthalmology, Kuopio University Hospital, Kuopio, Finland
| | - Kai Kaarniranta
- Department of Ophthalmology, Kuopio University Hospital, Kuopio, Finland
- Department of Ophthalmology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Ari Pääkkönen
- Department of Clinical Neurophysiology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Ina M Tarkka
- Department of Health Sciences, University of Jyväskylä, Jyväskylä, Finland
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31
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Brown HDH, Woodall RL, Kitching RE, Baseler HA, Morland AB. Using magnetic resonance imaging to assess visual deficits: a review. Ophthalmic Physiol Opt 2017; 36:240-65. [PMID: 27112223 PMCID: PMC4855621 DOI: 10.1111/opo.12293] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Accepted: 02/15/2016] [Indexed: 01/25/2023]
Abstract
Purpose Over the last two decades, magnetic resonance imaging (MRI) has been widely used in neuroscience research to assess both structure and function in the brain in health and disease. With regard to vision research, prior to the advent of MRI, researchers relied on animal physiology and human post‐mortem work to assess the impact of eye disease on visual cortex and connecting structures. Using MRI, researchers can non‐invasively examine the effects of eye disease on the whole visual pathway, including the lateral geniculate nucleus, striate and extrastriate cortex. This review aims to summarise research using MRI to investigate structural, chemical and functional effects of eye diseases, including: macular degeneration, retinitis pigmentosa, glaucoma, albinism, and amblyopia. Recent Findings Structural MRI has demonstrated significant abnormalities within both grey and white matter densities across both visual and non‐visual areas. Functional MRI studies have also provided extensive evidence of functional changes throughout the whole of the visual pathway following visual loss, particularly in amblyopia. MR spectroscopy techniques have also revealed several abnormalities in metabolite concentrations in both glaucoma and age‐related macular degeneration. GABA‐edited MR spectroscopy on the other hand has identified possible evidence of plasticity within visual cortex. Summary Collectively, using MRI to investigate the effects on the visual pathway following disease and dysfunction has revealed a rich pattern of results allowing for better characterisation of disease. In the future MRI will likely play an important role in assessing the impact of eye disease on the visual pathway and how it progresses over time.
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Affiliation(s)
| | | | | | - Heidi A Baseler
- Department of Psychology, University of York, York, UK.,Hull York Medical School, University of York, York, UK
| | - Antony B Morland
- Department of Psychology, University of York, York, UK.,Hull York Medical School, University of York, York, UK
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32
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Littrell J. Questioning the Medical Model of Mental Health. JOURNAL OF CONSTRUCTIVIST PSYCHOLOGY 2017. [DOI: 10.1080/10720537.2016.1268080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Jill Littrell
- School of Social Work, Georgia State University, Atlanta, Georgia, USA
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33
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Maniglia M, Cottereau BR, Soler V, Trotter Y. Rehabilitation Approaches in Macular Degeneration Patients. Front Syst Neurosci 2016; 10:107. [PMID: 28082876 PMCID: PMC5187382 DOI: 10.3389/fnsys.2016.00107] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Accepted: 12/12/2016] [Indexed: 11/13/2022] Open
Abstract
Age related macular degeneration (AMD) is a visual disease that affects elderly population. It entails a progressive loss of central vision whose consequences are dramatic for the patient's quality of life. Current rehabilitation programs are restricted to technical aids based on visual devices. They only temporarily improve specific visual functions such as reading skills. Considering the rapid increase of the aging population worldwide, it is crucial to intensify clinical research on AMD in order to develop simple and efficient methods that improve the patient's visual performances in many different contexts. One very promising approach to face this challenge is based on perceptual learning (PL). Through intensive practice, PL can induce neural plasticity in sensory cortices and result in long-lasting enhancements for various perceptual tasks in both normal and visually impaired populations. A growing number of studies showed how appropriate PL protocols improve visual functions in visual disorders, namely amblyopia, presbyopia or myopia. In order to successfully apply these approaches to more severe conditions such as AMD, numerous challenges have to be overcome. Indeed, the overall elderly age of patients and the reduced cortical surface that is devoted to peripheral vision potentially limit neural plasticity in this population. In addition, ocular fixation becomes much less stable because patients have to rely on peripheral fixation spots outside the scotoma whose size keeps on evolving. The aim of this review article is to discuss the recent literature on this topic and to offer a unified approach for developing new rehabilitation programs of AMD using PL. We argue that with an appropriate experimental and training protocol that is adapted to each patient needs, PL can offer fascinating opportunities for the development of simple, non-expensive rehabilitation approaches a large spectrum of visual functions in AMD patients.
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Affiliation(s)
- Marcello Maniglia
- Centre de Recherche Cerveau et Cognition, Université de Toulouse-UPSToulouse, France; Centre National de la Recherche ScientifiqueToulouse, France; Department of Psychology, University of CaliforniaRiverside, CA, USA
| | - Benoit R Cottereau
- Centre de Recherche Cerveau et Cognition, Université de Toulouse-UPSToulouse, France; Centre National de la Recherche ScientifiqueToulouse, France
| | - Vincent Soler
- Department of Ophthalmology, Hopital CHU Purpan Toulouse, France
| | - Yves Trotter
- Centre de Recherche Cerveau et Cognition, Université de Toulouse-UPSToulouse, France; Centre National de la Recherche ScientifiqueToulouse, France
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34
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Ferreira S, Pereira AC, Quendera B, Reis A, Silva ED, Castelo-Branco M. Primary visual cortical remapping in patients with inherited peripheral retinal degeneration. NEUROIMAGE-CLINICAL 2016; 13:428-438. [PMID: 28116235 PMCID: PMC5233796 DOI: 10.1016/j.nicl.2016.12.013] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2016] [Revised: 11/10/2016] [Accepted: 12/14/2016] [Indexed: 12/17/2022]
Abstract
Human studies addressing the long-term effects of peripheral retinal degeneration on visual cortical function and structure are scarce. Here we investigated this question in patients with Retinitis Pigmentosa (RP), a genetic condition leading to peripheral visual degeneration. We acquired functional and anatomical magnetic resonance data from thirteen patients with different levels of visual loss and twenty-two healthy participants to study primary (V1) visual cortical retinotopic remapping and cortical thickness. We identified systematic visual field remapping in the absence of structural changes in the primary visual cortex of RP patients. Remapping consisted in a retinotopic eccentricity shift of central retinal inputs to more peripheral locations in V1. Importantly, this was associated with changes in visual experience, as assessed by the extent of the visual loss, with more constricted visual fields resulting in larger remapping. This pattern of remapping is consistent with expansion or shifting of neuronal receptive fields into the cortical regions with reduced retinal input. These data provide evidence for functional changes in V1 that are dependent on the magnitude of peripheral visual loss in RP, which may be explained by rapid cortical adaptation mechanisms or long-term cortical reorganization. This study highlights the importance of analyzing the retinal determinants of brain functional and structural alterations for future visual restoration approaches.
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Key Words
- FPZ, Function Projection Zone
- Functional magnetic resonance imaging (fMRI)
- Human
- LE, Left Eye
- LH, Left Hemisphere
- LPZ, Lesion Projection Zone
- MRI, Magnetic Resonance Imaging
- Plasticity
- Primary visual cortex
- RE, Right Eye
- RH, Right Hemisphere
- RNFL, Retinal Nerve Fiber Layer
- RP, Retinitis Pigmentosa
- Reorganization
- Retinitis pigmentosa
- Retinotopy
- fMRI, functional Magnetic Resonance Imaging
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Affiliation(s)
- Sónia Ferreira
- Visual Neuroscience Laboratory, Institute for Biomedical Imaging and Life Sciences (CNC.IBILI), Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal
| | - Andreia Carvalho Pereira
- Visual Neuroscience Laboratory, Institute for Biomedical Imaging and Life Sciences (CNC.IBILI), Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal
| | - Bruno Quendera
- Institute of Nuclear Sciences Applied to Health (ICNAS), Brain Imaging Network of Portugal, University of Coimbra, 3000-548 Coimbra, Portugal
| | - Aldina Reis
- Visual Neuroscience Laboratory, Institute for Biomedical Imaging and Life Sciences (CNC.IBILI), Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal; Ophthalmology Unit, Centro Hospitalar e Universitário de Coimbra (CHUC), 3000-075 Coimbra, Portugal
| | - Eduardo Duarte Silva
- Visual Neuroscience Laboratory, Institute for Biomedical Imaging and Life Sciences (CNC.IBILI), Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal
| | - Miguel Castelo-Branco
- Visual Neuroscience Laboratory, Institute for Biomedical Imaging and Life Sciences (CNC.IBILI), Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal; Institute of Nuclear Sciences Applied to Health (ICNAS), Brain Imaging Network of Portugal, University of Coimbra, 3000-548 Coimbra, Portugal
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35
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Lemos J, Pereira D, Castelo-Branco M. Visual Cortex Plasticity Following Peripheral Damage To The Visual System: fMRI Evidence. Curr Neurol Neurosci Rep 2016; 16:89. [DOI: 10.1007/s11910-016-0691-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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36
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Burge WK, Griffis JC, Nenert R, Elkhetali A, DeCarlo DK, ver Hoef LW, Ross LA, Visscher KM. Cortical thickness in human V1 associated with central vision loss. Sci Rep 2016; 6:23268. [PMID: 27009536 PMCID: PMC4806312 DOI: 10.1038/srep23268] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Accepted: 03/03/2016] [Indexed: 01/25/2023] Open
Abstract
Better understanding of the extent and scope of visual cortex plasticity following central vision loss is essential both for clarifying the mechanisms of brain plasticity and for future development of interventions to retain or restore visual function. This study investigated structural differences in primary visual cortex between normally-sighted controls and participants with central vision loss due to macular degeneration (MD). Ten participants with MD and ten age-, gender-, and education-matched controls with normal vision were included. The thickness of primary visual cortex was assessed using T1-weighted anatomical scans, and central and peripheral cortical regions were carefully compared between well-characterized participants with MD and controls. Results suggest that, compared to controls, participants with MD had significantly thinner cortex in typically centrally-responsive primary visual cortex – the region of cortex that normally receives visual input from the damaged area of the retina. Conversely, peripherally-responsive primary visual cortex demonstrated significantly increased cortical thickness relative to controls. These results suggest that central vision loss may give rise to cortical thinning, while in the same group of people, compensatory recruitment of spared peripheral vision may give rise to cortical thickening. This work furthers our understanding of neural plasticity in the context of adult vision loss.
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Affiliation(s)
- Wesley K Burge
- University of Alabama at Birmingham Department of Psychology, Campbell Hall 415, 1530 3rd Avenue South, Birmingham, AL 35294, USA
| | - Joseph C Griffis
- University of Alabama at Birmingham Department of Psychology, Campbell Hall 415, 1530 3rd Avenue South, Birmingham, AL 35294, USA
| | - Rodolphe Nenert
- University of Alabama at Birmingham School of Medicine Department of Neurology, SC 350, 1720 2nd Ave South Birmingham, AL 35294, USA
| | - Abdurahman Elkhetali
- University of Alabama at Birmingham School of Medicine Department of Neurobiology, SHEL 911, 1720 2nd Avenue South, Birmingham, AL 35294, USA
| | - Dawn K DeCarlo
- University of Alabama at Birmingham School of Medicine Department of Ophthalmology, 700 S. 18th Street, Suite 601, Birmingham, AL 35294, USA
| | - Lawrence W ver Hoef
- University of Alabama at Birmingham School of Medicine Department of Neurology, SC 350, 1720 2nd Ave South Birmingham, AL 35294, USA
| | - Lesley A Ross
- The Pennsylvania State University, Department of Human Development and Family Studies, 119 Health and Human Development Bldg, University Park, PA 16802, USA
| | - Kristina M Visscher
- University of Alabama at Birmingham School of Medicine Department of Neurobiology, SHEL 911, 1720 2nd Avenue South, Birmingham, AL 35294, USA
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37
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Morland AB. Organization of the Central Visual Pathways Following Field Defects Arising from Congenital, Inherited, and Acquired Eye Disease. Annu Rev Vis Sci 2015; 1:329-350. [PMID: 28532373 DOI: 10.1146/annurev-vision-082114-035600] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Visual field defects that arise from eye disease are increasing as human life spans lengthen. The consequences of visual field defects on the central visual pathways are important to assess, particularly in light of potential treatments of eye disease that restore function to the retina. For individuals with field defects arising from congenital eye disease, primary visual cortex (V1) appears to remap, whereas this form of reorganization is not present in individuals with field defects that arise later in life as a result of inherited or acquired eye disease. However, research has revealed that the areas of V1 that normally map the visual field defect are active under specific circumstances. This review attempts to resolve whether or not this activity reflects reorganization of the central visual pathways. Alongside the measures of function are measures of anatomical properties of the human visual pathway, which demonstrate transneuronal degeneration in individuals with eye disease. These results are concerning because degeneration of the central visual pathways may ultimately limit the success of sight-restoring treatments of eye disease.
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Affiliation(s)
- Antony B Morland
- Department of Psychology, University of York, York YO10 5DD, United Kingdom;
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38
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Banin E, Gootwine E, Obolensky A, Ezra-Elia R, Ejzenberg A, Zelinger L, Honig H, Rosov A, Yamin E, Sharon D, Averbukh E, Hauswirth WW, Ofri R. Gene Augmentation Therapy Restores Retinal Function and Visual Behavior in a Sheep Model of CNGA3 Achromatopsia. Mol Ther 2015; 23:1423-33. [PMID: 26087757 DOI: 10.1038/mt.2015.114] [Citation(s) in RCA: 81] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2015] [Accepted: 06/05/2015] [Indexed: 12/15/2022] Open
Abstract
Achromatopsia is a hereditary form of day blindness caused by cone photoreceptor dysfunction. Affected patients suffer from congenital color blindness, photosensitivity, and low visual acuity. Mutations in the CNGA3 gene are a major cause of achromatopsia, and a sheep model of this disease was recently characterized by our group. Here, we report that unilateral subretinal delivery of an adeno-associated virus serotype 5 (AAV5) vector carrying either the mouse or the human intact CNGA3 gene under the control of the red/green opsin promoter results in long-term recovery of visual function in CNGA3-mutant sheep. Treated animals demonstrated shorter maze passage times and a reduced number of collisions with obstacles compared with their pretreatment status, with values close to those of unaffected sheep. This effect was abolished when the treated eye was patched. Electroretinography (ERG) showed marked improvement in cone function. Retinal expression of the transfected human and mouse CNGA3 genes at the mRNA level was shown by polymerase chain reaction (PCR), and cone-specific expression of CNGA3 protein was demonstrated by immunohistochemisrty. The rescue effect has so far been maintained for over 3 years in the first-treated animals, with no obvious ocular or systemic side effects. The results support future application of subretinal AAV5-mediated gene-augmentation therapy in CNGA3 achromatopsia patients.
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Affiliation(s)
- Eyal Banin
- Department of Ophthalmology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Elisha Gootwine
- Agricultural Research Organization, The Volcani Center, Bet Dagan, Israel
| | - Alexey Obolensky
- Department of Ophthalmology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Raaya Ezra-Elia
- Koret School of Veterinary Medicine, Hebrew University of Jerusalem, Rehovot, Israel
| | - Ayala Ejzenberg
- Department of Ophthalmology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Lina Zelinger
- Department of Ophthalmology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Hen Honig
- Agricultural Research Organization, The Volcani Center, Bet Dagan, Israel
| | - Alexander Rosov
- Agricultural Research Organization, The Volcani Center, Bet Dagan, Israel
| | - Esther Yamin
- Department of Ophthalmology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Dror Sharon
- Department of Ophthalmology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Edward Averbukh
- Department of Ophthalmology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - William W Hauswirth
- Department of Ophthalmology, University of Florida, Gainesville, Florida, USA
| | - Ron Ofri
- Koret School of Veterinary Medicine, Hebrew University of Jerusalem, Rehovot, Israel
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Wandell BA, Winawer J. Computational neuroimaging and population receptive fields. Trends Cogn Sci 2015; 19:349-57. [PMID: 25850730 DOI: 10.1016/j.tics.2015.03.009] [Citation(s) in RCA: 116] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2015] [Revised: 03/09/2015] [Accepted: 03/16/2015] [Indexed: 10/23/2022]
Abstract
Functional magnetic resonance imaging (fMRI) noninvasively measures human brain activity at millimeter resolution. Scientists use different approaches to take advantage of the remarkable opportunities presented by fMRI. Here, we describe progress using the computational neuroimaging approach in human visual cortex, which aims to build models that predict the neural responses from the stimulus and task. We focus on a particularly active area of research, the use of population receptive field (pRF) models to characterize human visual cortex responses to a range of stimuli, in a variety of tasks and different subject populations.
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Affiliation(s)
- Brian A Wandell
- Psychology Department and Neurosciences Institute, Stanford University, Stanford, CA, USA.
| | - Jonathan Winawer
- Psychology Department and Center for Neural Science, New York University, New York, NY, USA.
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Cideciyan AV, Aguirre GK, Jacobson SG, Butt OH, Schwartz SB, Swider M, Roman AJ, Sadigh S, Hauswirth WW. Pseudo-fovea formation after gene therapy for RPE65-LCA. Invest Ophthalmol Vis Sci 2014; 56:526-37. [PMID: 25537204 DOI: 10.1167/iovs.14-15895] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
PURPOSE The purpose of this study was to evaluate fixation location and oculomotor characteristics of 15 patients with Leber congenital amaurosis (LCA) caused by RPE65 mutations (RPE65-LCA) who underwent retinal gene therapy. METHODS Eye movements were quantified under infrared imaging of the retina while the subject fixated on a stationary target. In a subset of patients, letter recognition under retinal imaging was performed. Cortical responses to visual stimulation were measured using functional magnetic resonance imaging (fMRI) in two patients before and after therapy. RESULTS All patients were able to fixate on a 1° diameter visible target in the dark. The preferred retinal locus of fixation was either at the anatomical fovea or at an extrafoveal locus. There were a wide range of oculomotor abnormalities. Natural history showed little change in oculomotor abnormalities if target illuminance was increased to maintain target visibility as the disease progressed. Eleven of 15 study eyes treated with gene therapy showed no differences from baseline fixation locations or instability over an average of follow-up of 3.5 years. Four of 15 eyes developed new pseudo-foveas in the treated retinal regions 9 to 12 months after therapy that persisted for up to 6 years; patients used their pseudo-foveas for letter identification. fMRI studies demonstrated that preservation of light sensitivity was restricted to the cortical projection zone of the pseudo-foveas. CONCLUSIONS The slow emergence of pseudo-foveas many months after the initial increases in light sensitivity points to a substantial plasticity of the adult visual system and a complex interaction between it and the progression of underlying retinal disease. The visual significance of pseudo-foveas suggests careful consideration of treatment zones for future gene therapy trials. (ClinicalTrials.gov number, NCT00481546.).
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Affiliation(s)
- Artur V Cideciyan
- Scheie Eye Institute, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, United States
| | - Geoffrey K Aguirre
- Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, United States
| | - Samuel G Jacobson
- Scheie Eye Institute, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, United States
| | - Omar H Butt
- Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, United States
| | - Sharon B Schwartz
- Scheie Eye Institute, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, United States
| | - Malgorzata Swider
- Scheie Eye Institute, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, United States
| | - Alejandro J Roman
- Scheie Eye Institute, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, United States
| | - Sam Sadigh
- Scheie Eye Institute, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, United States
| | - William W Hauswirth
- Department of Ophthalmology, University of Florida, Gainesville, Florida, United States
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