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Tarita-Nistor L, Sverdlichenko I, Mandelcorn MS. What Is a Preferred Retinal Locus? Annu Rev Vis Sci 2023; 9:201-220. [PMID: 36944313 DOI: 10.1146/annurev-vision-111022-123909] [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] [Indexed: 03/23/2023]
Abstract
This review examines the concept of the preferred retinal locus (PRL) in patients with macular diseases. Considering monocular and binocular viewing, we (a) explain how to identify the PRL and discuss the pitfalls associated with its measurement, (b) review the current hypotheses for PRL development, (c) assess whether the PRL is the new reference point of the ocular motor system, and discuss (d) the functional and (e) the clinical implications of the PRL. We conclude that the current definition of the PRL is probably incomplete and should incorporate the need to evaluate the PRL in the framework of binocular viewing. We emphasize the need for more research.
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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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Osaka R, Muraoka Y, Nagasato D, Mitamura Y, Nishigori N, Murakami T, Suzuma K, Tabuchi H, Tsujikawa A. Binocular metamorphopsia in patients with branch retinal vein occlusion: a multi-center study. Int Ophthalmol 2023:10.1007/s10792-023-02731-0. [PMID: 37227617 PMCID: PMC10400688 DOI: 10.1007/s10792-023-02731-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 04/22/2023] [Indexed: 05/26/2023]
Abstract
PURPOSE The pathology of branch retinal vein occlusion (BRVO), a retinal circulatory disease, is related to monocular metamorphopsia-related vision impairment of the affected eyes, but the association of binocular metamorphopsia in such patients is unclear. This study aimed to examine the frequency of binocular metamorphopsia and its association with the clinical characteristics of patients with BRVO. METHODS A total of 87 patients who were treated for BRVO-associated macular edema (ME) were included in this study. At baseline and 1 and 3 months after the initiation of anti-vascular endothelial growth factor (VEGF) treatment, we quantified metamorphopsia in the affected eyes and binocular metamorphopsia using the M-CHARTS® diagnostic tool. RESULTS At baseline, 53 and 7 patients had metamorphopsia in the affected eyes and binocular metamorphopsia, respectively. Although the visual acuity improved significantly after the initiation of anti-VEGF treatment, the mean M-CHARTS score in the affected eyes did not change from the baseline score. At 3 months, 9 patients showed binocular metamorphopsia; it was significantly associated with metamorphopsia in the affected eyes with a 95% confidence interval of 0.021-0.122 (β = 0.306, p = 0.006). CONCLUSION Metamorphopsia in the affected eyes can cause binocular metamorphopsia in patients with BRVO-ME.
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Affiliation(s)
- Rie Osaka
- Department of Ophthalmology, Faculty of Medicine, Kagawa University, Kagawa, Japan
| | - Yuki Muraoka
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan.
| | - Daisuke Nagasato
- Department of Ophthalmology, Saneikai Tsukazaki Hospital, Himeji, Japan
- Department of Technology and Design Thinking for Medicine, Hiroshima University Graduate School, Hiroshima, Japan
- Department of Ophthalmology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Yoshinori Mitamura
- Department of Technology and Design Thinking for Medicine, Hiroshima University Graduate School, Hiroshima, Japan
| | - Naomi Nishigori
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Tomoaki Murakami
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Kiyoshi Suzuma
- Department of Ophthalmology, Faculty of Medicine, Kagawa University, Kagawa, Japan
| | - Hitoshi Tabuchi
- Department of Ophthalmology, Saneikai Tsukazaki Hospital, Himeji, Japan
- Department of Technology and Design Thinking for Medicine, Hiroshima University Graduate School, Hiroshima, Japan
- Department of Ophthalmology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Akitaka Tsujikawa
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
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Pyatova Y, Markowitz SN, Devenyi RG, Tarita‐Nistor L. MAIA microperimeter for short‐duration fixation stability measurements in central vision loss: Repeatability and comparison with the Nidek MP1. Ophthalmic Physiol Opt 2022; 42:633-643. [DOI: 10.1111/opo.12960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 01/13/2022] [Accepted: 01/18/2022] [Indexed: 12/01/2022]
Affiliation(s)
- Yulia Pyatova
- Department of Ophthalmology and Vision Sciences University of Toronto Toronto Ontario Canada
| | - Samuel N Markowitz
- Department of Ophthalmology and Vision Sciences University of Toronto Toronto Ontario Canada
| | - Robert G Devenyi
- Department of Ophthalmology and Vision Sciences University of Toronto Toronto Ontario Canada
- Krembil Research Institute Donald K Johnson Eye Institute Toronto Western Hospital Toronto Ontario Canada
| | - Luminita Tarita‐Nistor
- Krembil Research Institute Donald K Johnson Eye Institute Toronto Western Hospital Toronto Ontario Canada
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Sverdlichenko I, Mandelcorn MS, Issashar Leibovitzh G, Mandelcorn ED, Markowitz SN, Tarita-Nistor L. Binocular visual function and fixational control in patients with macular disease: A review. Ophthalmic Physiol Opt 2021; 42:258-271. [PMID: 34862635 PMCID: PMC9299778 DOI: 10.1111/opo.12925] [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: 08/26/2021] [Revised: 10/29/2021] [Accepted: 10/31/2021] [Indexed: 11/24/2022]
Abstract
For normally sighted observers, the centre of the macula—the fovea—provides the sharpest vision and serves as the reference point for the oculomotor system. Typically, healthy observers have precise oculomotor control and binocular visual performance that is superior to monocular performance. These functions are disturbed in patients with macular disease who lose foveal vision. An adaptation to central vision loss is the development of a preferred retinal locus (PRL) in the functional eccentric retina, which is determined with a fixation task during monocular viewing. Macular disease often affects the two eyes unequally, but its impact on binocular function and fixational control is poorly understood. Given that patients’ natural viewing condition is binocular, the aim of this article was to review current research on binocular visual function and fixational oculomotor control in macular disease. Our findings reveal that there is no overall binocular gain across a range of visual functions, although clear evidence exists for subgroups of patients who exhibit binocular summation or binocular inhibition, depending on the clinical characteristics of their two eyes. The monocular PRL of the better eye has different characteristics from that of the worse eye, but during binocular viewing the PRL of the better eye drives fixational control and may serve as the new reference position for the oculomotor system. We conclude that evaluating binocular function in patients with macular disease reveals important clinical aspects that otherwise cannot be determined solely from examining monocular functions, and can lead to better disease management and interventions.
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Affiliation(s)
| | - Mark S Mandelcorn
- Krembil Research Institute, Donald K Johnson Eye Institute, University Health Network, Toronto, Ontario, Canada.,Department of Ophthalmology and Vision Sciences, Toronto Western Hospital, Toronto, Ontario, Canada
| | - Galia Issashar Leibovitzh
- Krembil Research Institute, Donald K Johnson Eye Institute, University Health Network, Toronto, Ontario, Canada
| | - Efrem D Mandelcorn
- Krembil Research Institute, Donald K Johnson Eye Institute, University Health Network, Toronto, Ontario, Canada.,Department of Ophthalmology and Vision Sciences, Toronto Western Hospital, Toronto, Ontario, Canada
| | - Samuel N Markowitz
- Krembil Research Institute, Donald K Johnson Eye Institute, University Health Network, Toronto, Ontario, Canada.,Department of Ophthalmology and Vision Sciences, Toronto Western Hospital, Toronto, Ontario, Canada
| | - Luminita Tarita-Nistor
- Krembil Research Institute, Donald K Johnson Eye Institute, University Health Network, Toronto, Ontario, Canada
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Candy TR, Cormack LK. Recent understanding of binocular vision in the natural environment with clinical implications. Prog Retin Eye Res 2021; 88:101014. [PMID: 34624515 PMCID: PMC8983798 DOI: 10.1016/j.preteyeres.2021.101014] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 09/26/2021] [Accepted: 09/29/2021] [Indexed: 10/20/2022]
Abstract
Technological advances in recent decades have allowed us to measure both the information available to the visual system in the natural environment and the rich array of behaviors that the visual system supports. This review highlights the tasks undertaken by the binocular visual system in particular and how, for much of human activity, these tasks differ from those considered when an observer fixates a static target on the midline. The everyday motor and perceptual challenges involved in generating a stable, useful binocular percept of the environment are discussed, together with how these challenges are but minimally addressed by much of current clinical interpretation of binocular function. The implications for new technology, such as virtual reality, are also highlighted in terms of clinical and basic research application.
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Affiliation(s)
- T Rowan Candy
- School of Optometry, Programs in Vision Science, Neuroscience and Cognitive Science, Indiana University, 800 East Atwater Avenue, Bloomington, IN, 47405, USA.
| | - Lawrence K Cormack
- Department of Psychology, Institute for Neuroscience, and Center for Perceptual Systems, The University of Texas at Austin, Austin, TX, 78712, USA.
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Tong J, Huang J, Khou V, Martin J, Kalloniatis M, Ly A. Topical Review: Assessment of Binocular Sensory Processes in Low Vision. Optom Vis Sci 2021; 98:310-325. [PMID: 33828038 PMCID: PMC8051935 DOI: 10.1097/opx.0000000000001672] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 12/22/2020] [Indexed: 11/26/2022] Open
Abstract
SIGNIFICANCE This article summarizes the evidence for a higher prevalence of binocular vision dysfunctions in individuals with vision impairment. Assessment for and identification of binocular vision dysfunctions can detect individuals experiencing difficulties in activities including reading, object placement tasks, and mobility.Comprehensive vision assessment in low vision populations is necessary to identify the extent of remaining vision and to enable directed rehabilitation efforts. In patients with vision impairment, little attention is typically paid to assessments of binocular vision, including ocular vergence, stereopsis, and binocular summation characteristics. In addition, binocular measurements of threshold automated visual fields are not routinely performed in clinical practice, leading to an incomplete understanding of individuals' binocular visual field and may affect rehabilitation outcomes.First, this review summarizes the prevalence of dysfunctions in ocular vergence, stereopsis, and binocular summation characteristics across a variety of ocular pathologies causing vision impairment. Second, this review examines the links between clinical measurements of binocular visual functions and outcome measures including quality of life and performance in functional tasks. There is an increased prevalence of dysfunctions in ocular alignment, stereopsis, and binocular summation across low vision cohorts compared with those with normal vision. The identification of binocular vision dysfunctions during routine low vision assessments is especially important in patients experiencing difficulties in activities of daily living, including but not limited to reading, object placement tasks, and mobility. However, further research is required to determine whether addressing the identified deficits in binocular vision in low vision rehabilitative efforts directly impacts patient outcomes.
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Affiliation(s)
- Janelle Tong
- Centre for Eye Health, University of New South Wales, Sydney, New South Wales, Australia
- School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia
| | - Jessie Huang
- Centre for Eye Health, University of New South Wales, Sydney, New South Wales, Australia
- School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia
| | - Vincent Khou
- Centre for Eye Health, University of New South Wales, Sydney, New South Wales, Australia
- School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia
| | - Jodi Martin
- Guide Dogs New South Wales/Australian Capital Territory, Sydney, New South Wales, Australia
| | - Michael Kalloniatis
- Centre for Eye Health, University of New South Wales, Sydney, New South Wales, Australia
- School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia
| | - Angelica Ly
- Centre for Eye Health, University of New South Wales, Sydney, New South Wales, Australia
- School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia
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Silvestri V, Sasso P, Piscopo P, Amore F, Rizzo S, Devenyi RG, Tarita-Nistor L. Reading with central vision loss: binocular summation and inhibition. Ophthalmic Physiol Opt 2020; 40:778-789. [PMID: 32885878 PMCID: PMC7692945 DOI: 10.1111/opo.12726] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 07/08/2020] [Indexed: 11/30/2022]
Abstract
Purpose There are conflicting reports as to whether there is a binocular advantage or disadvantage when reading with central vision loss. This study examined binocular reading summation in patients with macular degeneration. Methods Seventy‐one patients with bilateral central vision loss [mean age: 63 (S.D. = 21) years] participated. Reading performances during binocular and monocular viewing with the better eye (i.e., the eye with the best monocular visual acuity) were evaluated using different versions of the Italian MNREAD reading chart (www.precision‐vision.com). Fixation stability and preferred retinal loci (PRLs) were recorded monocularly for each eye. The overall sample was split into inhibition, equality, and summation groups based on the binocular ratio (i.e., binocular/monocular) of the maximum reading speed. Results 41% of patients experienced binocular inhibition, 42% summation, and 17% equality. Binocular reading speed of the inhibition group was approximately 30 words per minute slower than those of the equality and summation groups, although the inhibition group had the best visual acuity. These patients generally had monocular PRLs in non‐corresponding locations temporal or nasal to the scotoma, had the largest interocular acuity difference and lacked residual stereopsis. The three groups did not differ in fixational control, contrast sensitivity or critical print size. Conclusions Equal proportions of patients with central vision loss show binocular reading summation and inhibition. Patients with binocular reading inhibition have poorer reading performance and different clinical characteristics than those with binocular reading summation and equality.
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Affiliation(s)
- Valeria Silvestri
- National Centre of Services and Research for the Prevention of Blindness and Rehabilitation of Low Vision Patients, International Agency for Prevention of Blindness-IAPB Italia Onlus, Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy
| | - Paola Sasso
- National Centre of Services and Research for the Prevention of Blindness and Rehabilitation of Low Vision Patients, International Agency for Prevention of Blindness-IAPB Italia Onlus, Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy
| | - Paola Piscopo
- National Centre of Services and Research for the Prevention of Blindness and Rehabilitation of Low Vision Patients, International Agency for Prevention of Blindness-IAPB Italia Onlus, Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy
| | - Filippo Amore
- National Centre of Services and Research for the Prevention of Blindness and Rehabilitation of Low Vision Patients, International Agency for Prevention of Blindness-IAPB Italia Onlus, Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy
| | - Stanislao Rizzo
- Department of Ophthalmology, Universita' Cattolica del Sacro Cuore, Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy
| | - Robert G Devenyi
- Donald K Johnson Eye Institute, Krembil Research Institute, University Health Network, Toronto, ON, Canada
| | - Luminita Tarita-Nistor
- Donald K Johnson Eye Institute, Krembil Research Institute, University Health Network, Toronto, ON, Canada
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