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Vergmann AS, Olsen FE, Nielsen AB, Vestergaard AH, Thomsen ASS, Konge L, Grauslund J. Lack of stereopsis does not reduce surgical performance but prolongs the learning curve of vitreoretinal surgery. Acta Ophthalmol 2024; 102:697-702. [PMID: 38269526 DOI: 10.1111/aos.16635] [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: 08/08/2023] [Revised: 12/06/2023] [Accepted: 01/04/2024] [Indexed: 01/26/2024]
Abstract
PURPOSE To investigate whether individuals with long-term reduced stereopsis were able to obtain the same level of surgical skills in simulated vitreoretinal surgery on the Eyesi Surgical Simulator as individuals with normal stereopsis. METHODS Twenty-four medical students were recruited and divided into two groups according to their degree of stereopsis: Group 1 (n = 12) included subjects with normal stereopsis (60 arcsec or lower) and Group 2 (n = 12) included subjects with reduced stereopsis (120 arcsec or higher). Stereopsis was tested using the TNO test (Lameris Ootech BV, Nieuwegein, the Netherlands). The participants were trained in virtual reality-simulated vitreoretinal surgery and continuously measured using a test with solid validity evidence and a pre-defined pass-fail score. All data were analysed using the Wilcoxon rank sum test. RESULTS We observed no differences in overall performance scores for any of the four modules. The participants with reduced stereopsis used 5.8 more attempts in bimanual training (p = 0.04), 8.8 more attempts in removal of posterior hyaloid (p = 0.04), 9.1 more attempts in navigation training (p = 0.20) and 0.3 fewer attempts in removal of internal limiting membrane (p = 0.69). CONCLUSION The final performance scores on the Eyesi Surgical Simulator were independent of the degree of stereopsis. However, the number of attempts to achieve the pre-defined pass-fail score increased significantly with reduced stereopsis in two of four modules. These results indicate that a high degree of stereopsis is not necessary to become proficient in microsurgery but may prolong the learning curve.
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Affiliation(s)
- Anna Stage Vergmann
- Department of Ophthalmology, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
- Regional Centre for Technical Simulation, Region of Southern Denmark, Odense, Denmark
| | - Frederik Emil Olsen
- Department of Ophthalmology, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Anders Bo Nielsen
- Regional Centre for Technical Simulation, Region of Southern Denmark, Odense, Denmark
- Department of Anesthesiology and Intensive Care, Odense University Hospital, Svendborg, Denmark
| | - Anders Højslet Vestergaard
- Department of Ophthalmology, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Ann Sofia Skou Thomsen
- Department of Ophthalmology, Rigshospitalet, Glostrup, Denmark
- Copenhagen Academy for Medical Education and Simulation, Centre for HR and Education, Capital Region of Denmark, Copenhagen, Denmark
- University of Copenhagen, Faculty of Health and Medical Sciences, Copenhagen, Denmark
| | - Lars Konge
- Regional Centre for Technical Simulation, Region of Southern Denmark, Odense, Denmark
- Copenhagen Academy for Medical Education and Simulation, Centre for HR and Education, Capital Region of Denmark, Copenhagen, Denmark
| | - Jakob Grauslund
- Department of Ophthalmology, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
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Asensio-Jurado L, Argilés M, Quevedo-Junyent L, Mestre C, Levi DM. Can viewing a 3D movie improve visual function in children with a history of amblyopia and neurotypical children?: A pilot study. PLoS One 2024; 19:e0305401. [PMID: 38917142 PMCID: PMC11198783 DOI: 10.1371/journal.pone.0305401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 05/24/2024] [Indexed: 06/27/2024] Open
Abstract
PURPOSE The aim of this pilot study was to determine whether viewing an immersive 3D movie with large disparities in a cinema resulted in improved visual acuity (VA), stereoscopic depth perception (ST), and improved eye alignment in residual amblyopic children and children without amblyopia. METHODS A total of 24 children aged between 5 and 12 years with a history of anisometropic and/or strabismic amblyopia, that had been previously treated and who currently have residual amblyopia (N = 14), and in children with typical development without amblyopia (N = 10) viewed the movie in 3D Sing 2 in a cinema for 110 minutes. Visual acuity, stereoacuity and ocular deviation were assessed before viewing the movie, and three months later. Stereoacuity and ocular deviation were also measured immediately after viewing the movie. RESULTS We observed an improvement in visual acuity in the non-dominant (amblyopic) eye 3 months after viewing the movie in the amblyopic group (P<0.001). Stereopsis improved immediately after viewing the movie (P = 0.02), and after 3 months by ≈ 40% (P = 0.01). Moreover, improvements in stereopsis were also observed in children without amblyopia (P = 0.04). No significant changes in ocular deviation were observed in either group. CONCLUSIONS These pilot results suggest that brief exposure to large disparities by viewing a 3D movie in a cinema can help to improve stereopsis and visual acuity in children aged 5‒12 years with previously treated amblyopia, and provide a rationale for a randomized clinical trial.
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Affiliation(s)
- Laura Asensio-Jurado
- Centre for Sensors, Instruments and Systems Development (CD6), Universitat Politècnica de Catalunya, Terrassa, Spain
- Departament d’Òptica i Optometria, Universitat Politècnica de Catalunya, BarcelonaTech (UPC), Terrassa, Spain
- Hospital Universitari Mutua Terrassa, Terrassa, Spain
| | - Marc Argilés
- Centre for Sensors, Instruments and Systems Development (CD6), Universitat Politècnica de Catalunya, Terrassa, Spain
- Departament d’Òptica i Optometria, Universitat Politècnica de Catalunya, BarcelonaTech (UPC), Terrassa, Spain
| | - Lluïsa Quevedo-Junyent
- Departament d’Òptica i Optometria, Universitat Politècnica de Catalunya, BarcelonaTech (UPC), Terrassa, Spain
| | - Clara Mestre
- Centre for Sensors, Instruments and Systems Development (CD6), Universitat Politècnica de Catalunya, Terrassa, Spain
| | - Dennis M. Levi
- Herbert Wertheim School of Optometry & Vision Science, University of California, Berkeley, Berkeley, CA, United States of America
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Upadhyaya DP, Shaikh AG, Cakir GB, Prantzalos K, Golnari P, Ghasia FF, Sahoo SS. A 360° View for Large Language Models: Early Detection of Amblyopia in Children using Multi-View Eye Movement Recordings. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.05.03.24306688. [PMID: 38765973 PMCID: PMC11100845 DOI: 10.1101/2024.05.03.24306688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2024]
Abstract
Amblyopia is a neurodevelopmental visual disorder that affects approximately 3-5% of children globally and it can lead to vision loss if it is not diagnosed and treated early. Traditional diagnostic methods, which rely on subjective assessments and expert interpretation of eye movement recordings presents challenges in resource-limited eye care centers. This study introduces a new approach that integrates the Gemini large language model (LLM) with eye-tracking data to develop a classification tool for diagnosis of patients with amblyopia. The study demonstrates: (1) LLMs can be successfully applied to the analysis of fixation eye movement data to diagnose patients with amblyopia; and (2) Input of medical subject matter expertise, introduced in this study in the form of medical expert augmented generation (MEAG), is an effective adaption of the generic retrieval augmented generation (RAG) approach for medical applications using LLMs. This study introduces a new multi-view prompting framework for ophthalmology applications that incorporates fine granularity feedback from pediatric ophthalmologist together with in-context learning to report an accuracy of 80% in diagnosing patients with amblyopia. In addition to the binary classification task, the classification tool is generalizable to specific subpopulations of amblyopic patients based on severity of amblyopia, type of amblyopia, and with or without nystagmus. The model reports an accuracy of: (1) 83% in classifying patients with moderate or severe amblyopia, (2) 81% in classifying patients with mild or treated amblyopia; and (3) 85% accuracy in classifying patients with nystagmus. To the best of our knowledge, this is the first study that defines a multi-view prompting framework with MEAG to analyze eye tracking data for the diagnosis of amblyopic patients.
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Affiliation(s)
- Dipak P Upadhyaya
- Department of Population & Quantitative Health Sciences, School of Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - Aasef G Shaikh
- National VA Parkinson's Consortium Center, Louis Stokes Cleveland VA Medical Center Cleveland, OH, USA
| | - Gokce Busra Cakir
- Visual Neuroscience Laboratory, Cole Eye Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Katrina Prantzalos
- Department of Population & Quantitative Health Sciences, School of Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - Pedram Golnari
- Department of Population & Quantitative Health Sciences, School of Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - Fatema F Ghasia
- Visual Neuroscience Laboratory, Cole Eye Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Satya S Sahoo
- Department of Population & Quantitative Health Sciences, School of Medicine, Case Western Reserve University, Cleveland, OH, USA
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Ong J, Waisberg E, Masalkhi M, Suh A, Kamran SA, Paladugu P, Sarker P, Zaman N, Tavakkoli A, Lee AG. "Spaceflight-to-Eye Clinic": Terrestrial advances in ophthalmic healthcare delivery from space-based innovations. LIFE SCIENCES IN SPACE RESEARCH 2024; 41:100-109. [PMID: 38670636 DOI: 10.1016/j.lssr.2024.02.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 02/08/2024] [Indexed: 04/28/2024]
Abstract
The phrase "Bench-to-Bedside" is a well-known phrase in medicine, highlighting scientific discoveries that directly translate to impacting patient care. Key examples of translational research include identification of key molecular targets in diseases and development of diagnostic laboratory tests for earlier disease detection. Bridging these scientific advances to the bedside/clinic has played a meaningful impact in numerous patient lives. The spaceflight environment poses a unique opportunity to also make this impact; the nature of harsh extraterrestrial conditions and medically austere and remote environments push for cutting-edge technology innovation. Many of these novel technologies built for the spaceflight environment also have numerous benefits for human health on Earth. In this manuscript, we focus on "Spaceflight-to-Eye Clinic" and discuss technologies built for the spaceflight environment that eventually helped to optimize ophthalmic health on Earth (e.g., LADAR for satellite docking now utilized in eye-tracking technology for LASIK). We also discuss current technology research for spaceflight associated neuro-ocular syndrome (SANS) that may also be applied to terrestrial ophthalmic health. Ultimately, various advances made to enable to the future of space exploration have also advanced the ophthalmic health of individuals on Earth.
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Affiliation(s)
- Joshua Ong
- Department of Ophthalmology and Visual Sciences, Kellogg Eye Center, University of Michigan, Ann Arbor, MI, United States.
| | - Ethan Waisberg
- Department of Ophthalmology, University of Cambridge, Cambridge, United Kingdom
| | - Mouayad Masalkhi
- University College Dublin School of Medicine, Belfield, Dublin, Ireland
| | - Alex Suh
- Tulane University School of Medicine, New Orleans, LA, United States
| | - Sharif Amit Kamran
- Human-Machine Perception Laboratory, Department of Computer Science and Engineering, University of Nevada, Reno, NV, United States
| | - Phani Paladugu
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States; Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, United States
| | - Prithul Sarker
- Human-Machine Perception Laboratory, Department of Computer Science and Engineering, University of Nevada, Reno, NV, United States
| | - Nasif Zaman
- Human-Machine Perception Laboratory, Department of Computer Science and Engineering, University of Nevada, Reno, NV, United States
| | - Alireza Tavakkoli
- Human-Machine Perception Laboratory, Department of Computer Science and Engineering, University of Nevada, Reno, NV, United States
| | - Andrew G Lee
- Center for Space Medicine, Baylor College of Medicine, Houston, TX, United States; Department of Ophthalmology, Blanton Eye Institute, Houston Methodist Hospital, Houston, TX, United States; The Houston Methodist Research Institute, Houston Methodist Hospital, Houston, TX, United States; Departments of Ophthalmology, Neurology, and Neurosurgery, Weill Cornell Medicine, New York, NY, United States; Department of Ophthalmology, University of Texas Medical Branch, Galveston, TX, United States; University of Texas MD Anderson Cancer Center, Houston, TX, United States; Texas A&M College of Medicine, TX, United States; Department of Ophthalmology, The University of Iowa Hospitals and Clinics, Iowa City, IA, United States
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Liu C, He X, Yi L. Determinants of multimodal fake review generation in China's E-commerce platforms. Sci Rep 2024; 14:8524. [PMID: 38609469 PMCID: PMC11015007 DOI: 10.1038/s41598-024-59236-8] [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: 10/12/2023] [Accepted: 04/08/2024] [Indexed: 04/14/2024] Open
Abstract
This paper develops a theoretical model of determinants influencing multimodal fake review generation using the theories of signaling, actor-network, motivation, and human-environment interaction hypothesis. Applying survey data from users of China's three leading E-commerce platforms (Taobao, Jingdong, and Pinduoduo), we adopt structural equation modeling, machine learning technique, and Bayesian complex networks analysis to perform factor identification, path analysis, feature factor importance ranking, regime division, and network centrality analysis of full sample, male sample, and female sample to reach the following conclusions: (1) platforms' multimodal recognition and governance capabilities exert significant negative moderating effects on merchants' information behavior, while it shows no apparent moderating effect on users' information behavior; users' emotional venting, perceived value, reward mechanisms, and subjective norms positively influence multimodal fake review generation through perceptual behavior control; (2) feature factors of multimodal fake review generation can be divided into four regimes, i.e., regime 1 includes reward mechanisms and perceived social costs, indicating they are key feature factors of multimodal fake review generation; merchant perception impact is positioned in regime 2, signifying its pivotal role in multimodal fake review generation; regime 3 includes multimodal recognition and governance capabilities, supporting/disparaging merchants, and emotional venting; whereas user perception impact is positioned in regime 4, indicating its weaker influence on multimodal fake review generation; (3) both in full sample, male sample, and female sample, reward mechanisms play a crucial role in multimodal fake review generation; perceived value, hiring review control agency, multimodal recognition and governance capabilities exhibit a high degree of correlation; however, results of network centrality analysis also exhibit heterogeneity between male and female samples, i.e., male sample has different trends in closeness centrality values and betweenness centrality values than female sample. This indicates that determinants influencing multimodal fake review generation are complex and interconnected.
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Affiliation(s)
- Chunnian Liu
- School of Public Policy and Administration, Nanchang University, Nanchang, 330031, China
- Digital Literacy and Skills Enhancement Research Center, Jiangxi Province Philosophy and Social Science Key Research Base, Nanchang University, Nanchang, 330031, China
| | - Xutao He
- School of Public Policy and Administration, Nanchang University, Nanchang, 330031, China
- Digital Literacy and Skills Enhancement Research Center, Jiangxi Province Philosophy and Social Science Key Research Base, Nanchang University, Nanchang, 330031, China
| | - Lan Yi
- School of Public Policy and Administration, Nanchang University, Nanchang, 330031, China.
- Digital Literacy and Skills Enhancement Research Center, Jiangxi Province Philosophy and Social Science Key Research Base, Nanchang University, Nanchang, 330031, China.
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Yu X, Zhao F, Li X, Lu W, Zhao L, Li D, Chen D, Wang Y, Wang B. Resting-State Functional Connectivity of the Primary Visual Cortex in Children with Anisometropia Amblyopia. Ophthalmic Res 2024; 67:275-281. [PMID: 38588644 DOI: 10.1159/000538380] [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: 08/22/2023] [Accepted: 03/11/2024] [Indexed: 04/10/2024]
Abstract
INTRODUCTION This study aimed to explore the functional connectivity of the primary visual cortex (V1) in children with anisometropic amblyopia by using the resting-state functional connectivity analysis method and determine whether anisometropic amblyopia is associated with changes in brain function. METHODS Functional magnetic resonance imaging (fMRI) data were obtained from 16 children with anisometropia amblyopia (CAA group) and 12 healthy children (HC group) during the resting state. The Brodmann area 17 (BA17) was used as the region of interest, and the functional connection (FC) of V1 was analyzed in both groups. A two-sample t test was used to analyze the FC value between the two groups. Pearson's correlation was used to analyze the correlation between the mean FC value in the brain function change area of the CAA group and the best corrected visual acuity (BCVA) of amblyopia. p < 0.05 was considered statistically significant. RESULTS There were no significant differences in age and sex between the CAA and HC groups (p > 0.05). Compared to the HC group, the CAA group showed lower FC values in BA17 and the left medial frontal gyrus, as well as BA17 and the left triangle inferior frontal gyrus. Conversely, the CAA group showed higher FC values in BA17 and the left central posterior gyrus. Notably, BCVA in amblyopia did not correlate with the area of change in mean FC in the brain function of the CAA group. CONCLUSION Resting-state fMRI-based functional connectivity analysis indicates a significant alteration in V1 of children with anisometropic amblyopia. These findings contribute additional insights into the neuropathological mechanisms underlying visual impairment in anisometropic amblyopia.
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Affiliation(s)
- Xueliang Yu
- Department of Ophthalmology, Dezhou Municipal Hospital, Dezhou, China
| | - Feng Zhao
- Department of Ophthalmology, Dezhou Municipal Hospital, Dezhou, China
| | - Xiujuan Li
- Medical Imaging Center, The Affiliated Taian City Central Hospital of Qingdao University, Taian, China
| | - Weizhao Lu
- School of Radiology, Shandong First Medical University and Shandong Academy of Medical Sciences, Taian, China
| | - Lisheng Zhao
- Department of Radiology, Dezhou Municipal Hospital, Dezhou, China
| | - Dandan Li
- Department of Radiology, Dezhou Municipal Hospital, Dezhou, China
| | - Di Chen
- Department of Ophthalmology, The Second Affiliated Hospital of Shandong First Medical University, Taian, China
| | - Yi Wang
- Department of Ophthalmology, The Second Affiliated Hospital of Shandong First Medical University, Taian, China
| | - Baojian Wang
- Medical Imaging Center, The Affiliated Taian City Central Hospital of Qingdao University, Taian, China
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Yeh WH, Ju YJ, Hsieh TH, Liu YT. Effects of grating stimulation on vision in individuals with amblyopia: a systematic review and meta-analysis. Graefes Arch Clin Exp Ophthalmol 2024; 262:395-410. [PMID: 37306731 DOI: 10.1007/s00417-023-06142-w] [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: 04/05/2023] [Revised: 05/26/2023] [Accepted: 06/05/2023] [Indexed: 06/13/2023] Open
Abstract
PURPOSE To investigate the effects of Cambridge Stimulator with grating element stimulation on visual acuity (VA), grating acuity (GA), and contrast sensitivity (CS) in patients with amblyopia. METHODS Three electronic databases (PubMed, Embase, and Cochrane Library) were searched for studies published from January 1970 to November 2022. The searched studies were reviewed and extracted independently by two authors. The included studies were evaluated by the Cochrane risk of bias. A meta-analysis calculating Hedges' g effect-size metric with 95% confidence intervals using random-effects DerSimonian-Laird model was employed. Heterogeneity was estimated using I2 statistics. Outcomes of interest included VA, GA, and CS. RESULTS A total of 1221 studies were identified. Twenty-four studies including 900 subjects met the inclusion criteria. The outcome measure of all visual indexes (VA: Hedges' g of - 0.43, 95% CI = - 0.81 to - 0.05, I2 = 86%, p = 0.02; GA: Hedges' g of 3.79, 95% CI = 1.05 to 6.54, I2 = 98%, p = 0.01; CS: Hedges' g of 0.64, 95% CI = 0.19 to 1.09, I2 = 41%, p = 0.00) significantly favored in the grating group. CONCLUSIONS Grating stimulation may be a positive help for visual functions in patients with amblyopia. The effects of grating stimulation on VA and CS appear to be opposite. This study is registered with www.crd.york.ac.uk/prospero/ (CRD42022366259).
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Affiliation(s)
- Wen-Hsiu Yeh
- Department of Physical Therapy, Shu-Zen Junior College of Medicine and Management, Kaohsiung City, 821, Taiwan.
| | - Ya-Ju Ju
- Department of Physical Therapy, Shu-Zen Junior College of Medicine and Management, Kaohsiung City, 821, Taiwan
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan City, 701, Taiwan
| | - Tzu-Han Hsieh
- Department of Ophthalmology, Far-Eastern Memorial Hospital, New Taipei City, 220, Taiwan
| | - Yu-Ting Liu
- Department of Medical Science Industries, Chang Jung Christian University, Tainan, 711, Taiwan
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Zwierko T, Redondo B, Jedziniak W, Molina R, Jiménez R, Vera J. Gaze behaviour during multiple object tracking is dependent on binocular vision integrity. Ophthalmic Physiol Opt 2024; 44:23-31. [PMID: 37641939 DOI: 10.1111/opo.13225] [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: 04/14/2023] [Revised: 08/15/2023] [Accepted: 08/16/2023] [Indexed: 08/31/2023]
Abstract
INTRODUCTION Despite the critical importance of binocular vision integrity in daily activities, there exists limited understanding of how alterations in binocular vision integrity impact gaze behaviour during dynamic, complex psychomotor skills. This study aimed to measure how alterations in binocular vision integrity, created by Bangerter filters (BF), affect gaze behaviour during multiple object tracking (MOT). METHODS During the experiment, 22 volunteers completed the MOT task under three different visual conditions. The first condition involved natural binocular viewing, while the second and third conditions used 0.4 and 0.2 neutral density BF, respectively, resulting in monocular blur in the sensorially dominant eye. During the MOT task, participants were instructed to track three of eight balls for 10 s, and the speed was adjusted using a staircase procedure. Throughout the task, the following gaze parameters were recorded: fixation duration, saccade duration, amplitude and frequency as well as blink rate. RESULTS During MOT execution, participants employed three gaze strategies regardless of viewing conditions: saccadic movements were predominant, followed by maintaining fixation on a central location throughout the trial and to a lesser extent, smooth pursuit eye movements. There was a significant effect of manipulating viewing conditions on the MOT scores (p = 0.046, η2 = 0.09). As the viewing conditions became more difficult, we observed a decrease in fixation duration (p = 0.004, η2 = 0.16) and blink rate (p < 0.001, η2 = 0.20) and an increase in saccadic amplitude (p < 0.001, η2 = 0.29). CONCLUSIONS The results support the notion that perceptual-cognitive skills depend on the integrity of binocular vision, underscoring the sensitivity of gaze behaviours to any impairment of binocular function.
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Affiliation(s)
- Teresa Zwierko
- Institute of Physical Culture Sciences, Laboratory of Kinesiology, Functional and Structural Human Research Centre, University of Szczecin, Szczecin, Poland
- CLARO (Clinical and Laboratory Applications of Research in Optometry) Research Group, Department of Optics, University of Granada, Granada, Spain
| | - Beatríz Redondo
- CLARO (Clinical and Laboratory Applications of Research in Optometry) Research Group, Department of Optics, University of Granada, Granada, Spain
- New England College of Optometry, Boston, Massachusetts, USA
| | - Wojciech Jedziniak
- Institute of Physical Culture Sciences, Laboratory of Kinesiology, Functional and Structural Human Research Centre, University of Szczecin, Szczecin, Poland
| | - Ruben Molina
- CLARO (Clinical and Laboratory Applications of Research in Optometry) Research Group, Department of Optics, University of Granada, Granada, Spain
| | - Raimundo Jiménez
- CLARO (Clinical and Laboratory Applications of Research in Optometry) Research Group, Department of Optics, University of Granada, Granada, Spain
| | - Jesús Vera
- CLARO (Clinical and Laboratory Applications of Research in Optometry) Research Group, Department of Optics, University of Granada, Granada, Spain
- New England College of Optometry, Boston, Massachusetts, USA
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Ahmad Z, Kelly KR, Freud E. Reduced perception-action dissociation in children with amblyopia. Neuropsychologia 2023; 191:108738. [PMID: 38007150 DOI: 10.1016/j.neuropsychologia.2023.108738] [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: 07/31/2023] [Revised: 11/08/2023] [Accepted: 11/19/2023] [Indexed: 11/27/2023]
Abstract
The functional distinction between vision-for-perception and vision-for-action is a key aspect of understanding the primate visual system. While this dissociation has been well-established in adulthood, its development and dependence on typical visual experience remain unclear. To address these questions, we examined two groups of children: typically developed children and those with amblyopia, who presumably have a sub-optimal visual experience. The Ponzo illusion, known to impact perception but not visuomotor behaviors across age groups, was employed to assess the extent of dissociation. Participants engaged in two tasks involving the Ponzo illusion: a grasping task (vision-for-action) and a manual estimation task (vision-for-perception), with objects placed on the "close" and "far" surfaces of the illusion. Typically developed children displayed grasping movements that were unaffected by the illusion, as their grasping apertures were scaled based on object size, independent of its location. In contrast, children with amblyopia exhibited a clear susceptibility to the illusion, showing larger apertures for objects placed on the 'far' surface of the illusion, and smaller apertures for objects placed on the 'close' surface. Interestingly, both groups of children demonstrated similar susceptibility to the illusion during the perceptual task, with objects placed on the far surface being perceived as longer compared to objects placed on the close surface. These findings shed light on the impact of atypical visual development on the emergence of the dissociation between perception and action, highlighting the crucial role of typical visual experience in establishing this distinction.
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Affiliation(s)
- Zoha Ahmad
- Department of Biology, York University, Canada; The Centre for Vision Research, York University, Canada.
| | - Krista R Kelly
- School of Optometry and Vision Science, University of Waterloo, Canada; Retina Foundation of the Southwest, Dallas, USA
| | - Erez Freud
- The Centre for Vision Research, York University, Canada; Department of Psychology, York University, Canada
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Grant S, Conway ML. Deficits in Reach Planning and On-Line Grasp Control in Adults With Amblyopia. Invest Ophthalmol Vis Sci 2023; 64:45. [PMID: 38032338 PMCID: PMC10691391 DOI: 10.1167/iovs.64.14.45] [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: 06/21/2023] [Accepted: 10/26/2023] [Indexed: 12/01/2023] Open
Abstract
Purpose Adults with amblyopia exhibit impairments when reaching to grasp three-dimensional objects. We examined whether their deficits derive from problems with feedforward planning of these prehension movements or in using visual feedback to control them on-line. Methods Twenty-one adults with mild to severe anisometropic and/or strabismic amblyopia and reduced binocularity participated, along with 21 normally sighted age- and gender-matched controls. Subjects used their preferred hand to reach for, precision grasp, and then lift cylindrical table-top objects (two sizes, two distances) using binocular, dominant eye, or amblyopic/non-sighting eye vision just to plan their movements during a 1-second task preview with vision then occluded so feedback was absent or to plan and execute them (i.e., with visual feedback fully available). Kinematic and error measures of the timing and accuracy of the reach and grasp were quantified by view and feedback and compared by ANOVA. Results The amblyopic adults performed generally worse than controls across all three views in both feedback conditions. With vision for planning only, their movement initiation and duration times were significantly increased, as were their initial reach times and error rates, especially when using the amblyopic eye alone, whatever its visual acuity loss. These relative planning deficits were only partially rectified with visual feedback available on-line. Relative grasp planning deficits were less evident in the amblyopia group, who instead produced significantly increased grip times and errors under binocular and amblyopic eye visual feedback conditions, although the subgroup with unmeasurable stereovision also formed wider (inaccurate) grasps across all conditions. Conclusions Adults with amblyopia seem to have problems constructing reliable internal spatial representations for the feedforward planning of prehension, particularly with their affected eye and mainly affecting their reach, with additional deficits in on-line grasp control related to poor binocularity.
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Affiliation(s)
- Simon Grant
- Centre for Applied Vision Research, School of Health & Psychological Sciences, City, University of London, London, United Kingdom
| | - Miriam L. Conway
- Centre for Applied Vision Research, School of Health & Psychological Sciences, City, University of London, London, United Kingdom
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Verghese P. The utility of peripheral stereopsis. Front Neurosci 2023; 17:1217993. [PMID: 37795187 PMCID: PMC10545962 DOI: 10.3389/fnins.2023.1217993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Accepted: 08/14/2023] [Indexed: 10/06/2023] Open
Abstract
This perspective article makes the case for evaluating and training peripheral stereopsis, particularly when the central visual field is compromised in one or both eyes. Examples of clinical conditions that preferentially affect the central visual field include macular degeneration, which affects the central macular region in one or both eyes, and amblyopia where the central field is often affected in one eye, but the peripheral field is largely intact. While binocular acuity may be preserved when the monocular central field of one eye is affected, fine stereopsis is compromised because it requires intact vision in corresponding locations in the two eyes. Even in these clinical conditions, recent studies that map stereoacuity at locations across the visual field demonstrate that the periphery supports coarse stereopsis, and that training efforts to use residual stereopsis may have greater benefit if they take this finding into account.
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Affiliation(s)
- Preeti Verghese
- Smith-Kettlewell Eye Research Institute, San Francisco, CA, United States
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12
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Castilla Martinez G, Tarazona Jaimes CP, Gutierrez Amoros C, Fernandez Nadal A, Romero Valero D, Escolano Serrano J, Monera Lucas CE, Martinez Toldos JJ. Comparability of the Retinomax K-plus 3 handheld autorefractometer in quick mode versus on-table autorefractometer in standard mode. ARCHIVOS DE LA SOCIEDAD ESPANOLA DE OFTALMOLOGIA 2023; 98:533-539. [PMID: 37595789 DOI: 10.1016/j.oftale.2023.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 07/04/2023] [Indexed: 08/20/2023]
Abstract
INTRODUCTION This study analyzes the comparability of measurements taken by a Retinomax K-plus 3 handheld autorefractometer in Quick mode and a Topcon KR-800 on-table autorefractometer in standard mode on the pediatric population, and establishes their correlation. METHODS It is a retrospective comparative study. Spherical diopter power (SPH), cylindrical diopter power (CYL), angle of cylindrical axis (AX), and spherical equivalent (SE) were measured with the Retinomax in Quick mode and with the Topcon in standard mode. Each patient was evaluated in cycloplegic and non-cycloplegic conditions by both autorefractometers. Student's t-test was performed between the two instruments for SPH, CYL, and SE. The Pearson correlation coefficient was calculated and the dispersion was represented using Bland-Altman graphs, also evaluating the subgroup of patients under 4 years of age. A descriptive analysis of the percentages of measures that differed was performed. RESULTS It included 98 eyes of 49 subjects (age range: 3-16 years). The data for HPS without cycloplegia are virtually identical, whereas with cycloplegia there is a hyperopic bias of +0.5 diopters measured with Retinomax. CYL results are very similar with and without cycloplegia. There is a high Pearson correlation for both instruments (>0.91) and a low degree of dispersion in the Bland-Altman plots under cycloplegia. CONCLUSION The Retinomax data were consistent with those obtained by Topcon. The Retinomax is a useful instrument for detecting refractive errors in children between 3 and 16 years of age.
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Affiliation(s)
| | | | | | | | - D Romero Valero
- Hospital General Universitario de Elche, Elche, Alicante, Spain
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13
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Piller S, Senna I, Wiebusch D, Ben-Zion I, Ernst MO. Grasping behavior does not recover after sight restoration from congenital blindness. Curr Biol 2023; 33:2104-2110.e4. [PMID: 37130520 DOI: 10.1016/j.cub.2023.04.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 03/17/2023] [Accepted: 04/11/2023] [Indexed: 05/04/2023]
Abstract
We investigated whether early visual input is essential for establishing the ability to use predictions in the control of actions and for perception. To successfully interact with objects, it is necessary to pre-program bodily actions such as grasping movements (feedforward control). Feedforward control requires a model for making predictions, which is typically shaped by previous sensory experience and interaction with the environment.1 Vision is the most crucial sense for establishing such predictions.2,3 We typically rely on visual estimations of the to-be-grasped object's size and weight in order to scale grip force and hand aperture accordingly.4,5,6 Size-weight expectations play a role also for perception, as evident in the size-weight illusion (SWI), in which the smaller of two equal-weight objects is misjudged to be heavier.7,8 Here, we investigated predictions for action and perception by testing the development of feedforward controlled grasping and of the SWI in young individuals surgically treated for congenital cataracts several years after birth. Surprisingly, what typically developing individuals do easily within the first years of life, namely to adeptly grasp new objects based on visually predicted properties, cataract-treated individuals did not learn after years of visual experience. Contrary, the SWI exhibited significant development. Even though the two tasks differ in substantial ways, these results may suggest a potential dissociation in using visual experience to make predictions about an object's features for perception or action. What seems a very simple task-picking up small objects-is in truth a highly complex computation that necessitates early structured visual input to develop.
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Affiliation(s)
- Sophia Piller
- Applied Cognitive Psychology, Faculty for Computer Science, Engineering, and Psychology, Ulm University, Albert-Einstein-Allee 43, 89081 Ulm, Germany; Transfer Center for Neuroscience and Education (ZNL), Ulm University, Parkstraße 11, 89073 Ulm, Germany.
| | - Irene Senna
- Applied Cognitive Psychology, Faculty for Computer Science, Engineering, and Psychology, Ulm University, Albert-Einstein-Allee 43, 89081 Ulm, Germany; Department of Psychology, Liverpool Hope University, Hope Park, Liverpool L16 9JD, UK
| | - Dennis Wiebusch
- Applied Cognitive Psychology, Faculty for Computer Science, Engineering, and Psychology, Ulm University, Albert-Einstein-Allee 43, 89081 Ulm, Germany
| | - Itay Ben-Zion
- Pediatric Ophthalmology Service, Padeh Medical Center, Tiberias 1528001, Israel
| | - Marc O Ernst
- Applied Cognitive Psychology, Faculty for Computer Science, Engineering, and Psychology, Ulm University, Albert-Einstein-Allee 43, 89081 Ulm, Germany
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14
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Niechwiej-Szwedo E, Colpa L, Wong A. The role of binocular vision in the control and development of visually guided upper limb movements. Philos Trans R Soc Lond B Biol Sci 2023; 378:20210461. [PMID: 36511416 PMCID: PMC9745875 DOI: 10.1098/rstb.2021.0461] [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: 04/04/2022] [Accepted: 06/16/2022] [Indexed: 12/15/2022] Open
Abstract
Vision provides a key sensory input for the performance of fine motor skills, which are fundamentally important to daily life activities, as well as skilled occupational and recreational performance. Binocular visual function is a crucial aspect of vision that requires the ability to combine inputs from both eyes into a unified percept. Summation and fusion are two aspects of binocular processing associated with performance advantages, including more efficient visuomotor control of upper limb movements. This paper uses the multiple processes model of limb control to explore how binocular viewing could facilitate the planning and execution of prehension movements in adults and typically developing children. Insight into the contribution of binocularity to visuomotor control also comes from examining motor performance in individuals with amblyopia, a condition characterized by reduced visual acuity and poor binocular function. Overall, research in this field has advanced our understanding of the role of binocular vision in the development and performance of visuomotor skills, the first step towards developing assessment tools and targeted rehabilitation for children with neurodevelopment disorders at risk of poor visuomotor outcomes. This article is part of a discussion meeting issue 'New approaches to 3D vision'.
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Affiliation(s)
- Ewa Niechwiej-Szwedo
- Kinesiology and Health Sciences, University of Waterloo, 200 University Avenue, Waterloo, ON, Canada N2L 3G1
| | - Linda Colpa
- Department of Ophthalmology and Vision Sciences, The Hospital for Sick Children, 555 University Avenue, Toronto, ON, Canada M5G 1X8
| | - Agnes Wong
- Department of Ophthalmology and Vision Sciences, The Hospital for Sick Children, 555 University Avenue, Toronto, ON, Canada M5G 1X8
- University of Toronto, 27 King's College Circle, Toronto, ON, Canada M5S 1A4
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15
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Abstract
Extended reality (XR) devices, including virtual reality (VR), augmented reality (AR), and mixed reality (MR) devices, are immersive technologies that can swap or merge the natural environment with virtual content (e.g., videogames, movies, or other content). Although these devices are widely used for playing videogames and other applications, they have one distinct feature that makes them potentially very useful for the measurement and treatment of binocular vision anomalies-they can deliver different content to the two eyes simultaneously. Indeed, horizontally shifting the images in the two eyes (thereby creating binocular disparity) can provide the user with a compelling percept of depth through stereopsis. Because these devices are stereoscopic, they can also be used as high-tech synoptophores, in which the images to the two eyes differ in contrast, luminance, size, position, and content for measuring and treating binocular anomalies. The inclusion of eye tracking in VR adds an additional dimension to its utility in measuring and treating binocular vision anomalies, as well as other conditions. This paper describes the essential requirements for testing and treating binocular anomalies and reviews current studies in which XR devices have been used to measure and treat binocular vision anomalies.
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Affiliation(s)
- Dennis M. Levi
- Herbert Wertheim School of Optometry and Vision Science, University of California, Berkeley, Berkeley, CA, USA,
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16
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Bui Quoc E, Kulp MT, Burns JG, Thompson B. Amblyopia: A review of unmet needs, current treatment options, and emerging therapies. Surv Ophthalmol 2023; 68:507-525. [PMID: 36681277 DOI: 10.1016/j.survophthal.2023.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 01/03/2023] [Accepted: 01/13/2023] [Indexed: 01/20/2023]
Abstract
Amblyopia is a global public health issue with extensive, multifaceted impacts on vision and quality of life (QoL) for both patients and families. Geographical variation exists in the management of amblyopia, with traditional mainstay treatments, optical correction, and fellow eye occlusion most successful when implemented at an early age. In recent years, however, studies demonstrating meaningful improvements in older children and adults have challenged the concept of a complete loss of visual processing plasticity beyond the critical period of visual development, with growing evidence supporting the potential efficacy of emerging, more engaging, binocular therapies in both adults and children. Binocular approaches aim to restore deficits in amblyopia that extend beyond monocular visual acuity impairment, including binocular fusion and visuomotor skills. In view of this, incorporating outcome measures that evaluate the visual performance and functional ability of individuals with amblyopia will provide a clearer understanding of the effect of amblyopia on QoL and a more comprehensive evaluation of amblyopia therapies.
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Affiliation(s)
- Emmanuel Bui Quoc
- Ophthalmology Department, Robert Debré University Hospital, Assistance Publique Hôpitaux de Paris, Paris, France.
| | | | | | - Benjamin Thompson
- School of Optometry and Vision Science, University of Waterloo, Canada; Centre for Eye and Vision Research, Hong Kong
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17
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Verghese P, Ghahghaei S, Lively Z. Mapping residual stereopsis in macular degeneration. J Vis 2022; 22:7. [PMID: 36580297 PMCID: PMC9804019 DOI: 10.1167/jov.22.13.7] [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] [Indexed: 12/30/2022] Open
Abstract
Individuals with macular degeneration typically lose vision in the central region of one or both eyes. A binocular scotoma occurs when vision loss occurs in overlapping locations in both eyes, but stereopsis is impacted even in the non-overlapping region wherever the visual field in either eye is affected. We used a novel stereoperimetry protocol to measure local stereopsis across the visual field (up to 25° eccentricity) to determine how locations with functional stereopsis relate to the scotomata in the two eyes. Participants included those with monocular or binocular scotomata and age-matched controls with healthy vision. Targets (with or without depth information) were presented on a random dot background. Depth targets had true binocular disparity of 20' (crossed), whereas non-depth targets were defined by monocular cues such as contrast and dot density. Participants reported target location and whether it was in depth or flat. Local depth sensitivity (d') estimates were then combined to generate a stereopsis map. This stereopsis map was compared to the union of the monocular microperimetry estimates that mapped out the functional extent of the scotoma in each eye. The "union" prediction aligned with residual stereopsis, showing impaired stereopsis within this region and residual stereopsis outside this region. Importantly, the stereoblind region was typically more extensive than the binocular scotoma defined by the intersection (overlap) of the scotomata. This explains why individuals may have intact binocular visual fields but be severely compromised in tasks of daily living that benefit from stereopsis, such as eye-hand coordination and navigation.
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Affiliation(s)
- Preeti Verghese
- Smith-Kettlewell Eye Research Institute, San Francisco, CA, USA,https://www.ski.org/users/preeti-verghese
| | | | - Zachary Lively
- Smith-Kettlewell Eye Research Institute, San Francisco, CA, USA,
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18
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Abstract
Stereopsis provides us with a vivid impression of the depth and distance of objects in our 3- dimensional world. Stereopsis is important for a number of everyday visual tasks, including (but not limited to) reaching and grasping, fine visuo-motor control, and navigating in our world. This review briefly discusses the neural substrate for normal binocular vision and stereopsis and its development in primates; outlines some of the issues and limitations of stereopsis tests and examines some of the factors that limit the typical development of stereopsis and the causes and consequences of stereo-deficiency and stereo-blindness. Finally, we review several approaches to improving or recovering stereopsis in both neurotypical individuals and those with stereo-deficiency and stereo-blindness and outline some emerging strategies for improving stereopsis.
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19
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Brin TA, Xu Z, Zhou Y, Feng L, Li J, Thompson B. Amblyopia is associated with impaired balance in 3–6-year-old children in China. Front Neurosci 2022; 16:993826. [PMID: 36213736 PMCID: PMC9544236 DOI: 10.3389/fnins.2022.993826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 09/05/2022] [Indexed: 12/03/2022] Open
Abstract
Purpose School-age children in China have more advanced motor development than their North American counterparts. This is likely due to cultural differences in children’s regular motor activities. It is unknown whether the motor function impairments associated with binocular visual disorders (BVDs) such as amblyopia in children raised in North America exist for children raised in China. Design Prospective case-control study. Methods A major tertiary eye hospital in China tested children aged 3 to <7 (n = 63) belonging to three groups: anisometropic or strabismic amblyopia (n = 22), anisometropia or strabismus without amblyopia (n = 20), or controls (n = 21). The main outcome measure was motor function scores (Movement Assessment Battery for Children 2nd edition). Results Balance scores varied significantly across groups (F2,61 = 4.2, p = 0.02) with the amblyopia group (mean ± SD: 12.5 ± 3.0) exhibiting significantly poorer scores than controls (14.8 ± 2.3). The no-amblyopia BVD group (12.8 ± 3.1) did not differ significantly from the other groups. Manual dexterity, catching and throwing and total scores did not vary significantly across the three groups. A separate pre-planned comparison of only the amblyopia and control groups revealed significantly poorer total motor scores in the amblyopia group (10.1 ± 3.2) vs. controls (12 ± 2.4). A linear regression model was unable to significantly predict associations between total motor score and binocular function score (standardized β = −0.09, 95%, p = 0.7), amblyopia etiology (standardized β = 0.14, 95%, p = 0.4), or inter-ocular acuity difference (standardized β = −0.18, 95%, p = 0.4), in the amblyopia group. Conclusion Amblyopia is associated with motor function impairment in children raised in China. Motor deficits that may impact everyday activities have been observed in patients with amblyopia across multiple cultures.
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Affiliation(s)
- Taylor A. Brin
- School of Optometry and Vision Science, University of Waterloo, Waterloo, ON, Canada
| | - Zixuan Xu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Yusong Zhou
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Lei Feng
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Jinrong Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
- Jinrong Li,
| | - Benjamin Thompson
- School of Optometry and Vision Science, University of Waterloo, Waterloo, ON, Canada
- Center for Eye and Vision Research Limited, Hong Kong, Hong Kong SAR, China
- Liggins Institute, University of Auckland, Auckland, New Zealand
- *Correspondence: Benjamin Thompson,
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20
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陈 霞, 廖 孟, 蒋 苹, 刘 陇, 龚 启. [Abnormal spontaneous brain functional activity in adult patients with amblyopia: a resting-state functional magnetic resonance imaging study]. SHENG WU YI XUE GONG CHENG XUE ZA ZHI = JOURNAL OF BIOMEDICAL ENGINEERING = SHENGWU YIXUE GONGCHENGXUE ZAZHI 2022; 39:759-766. [PMID: 36008340 PMCID: PMC10957354 DOI: 10.7507/1001-5515.202203072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 06/19/2022] [Indexed: 06/15/2023]
Abstract
Amblyopia is a visual development deficit caused by abnormal visual experience in early life, mainly manifesting as defected visual acuity and binocular visual impairment, which is considered to reflect abnormal development of the brain rather than organic lesions of the eye. Previous studies have reported abnormal spontaneous brain activity in patients with amblyopia. However, the location of abnormal spontaneous activity in patients with amblyopia and the association between abnormal brain function activity and clinical deficits remain unclear. The purpose of this study is to analyze spontaneous brain functional activity abnormalities in patients with amblyopia and their associations with clinical defects using resting-state functional magnetic resonance imaging (fMRI) data. In this study, 31 patients with amblyopia and 31 healthy controls were enrolled for resting-state fMRI scanning. The results showed that spontaneous activity in the right angular gyrus, left posterior cerebellum, and left cingulate gyrus were significantly lower in patients with amblyopia than in controls, and spontaneous activity in the right middle temporal gyrus was significantly higher in patients with amblyopia. In addition, the spontaneous activity of the left cerebellum in patients with amblyopia was negatively associated with the best-corrected visual acuity of the amblyopic eye, and the spontaneous activity of the right middle temporal gyrus was positively associated with the stereoacuity. This study found that adult patients with amblyopia showed abnormal spontaneous activity in the angular gyrus, cerebellum, middle temporal gyrus, and cingulate gyrus. Furthermore, the functional abnormalities in the cerebellum and middle temporal gyrus may be associated with visual acuity defects and stereopsis deficiency in patients with amblyopia. These findings help explain the neural mechanism of amblyopia, thus promoting the improvement of the treatment strategy for amblyopia.
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Affiliation(s)
- 霞 陈
- 四川大学华西医院 眼科(成都 610041)Department of Ophthalmology, West China Hospital of Sichuan University, Chengdu 610041, P. R. China
- 四川大学 华西临床医学院 眼视光学系(成都 610041)Department of Optometry and Visual Science, West China School of Medicine, Sichuan University, Chengdu 610041, P. R. China
| | - 孟 廖
- 四川大学华西医院 眼科(成都 610041)Department of Ophthalmology, West China Hospital of Sichuan University, Chengdu 610041, P. R. China
- 四川大学 华西临床医学院 眼视光学系(成都 610041)Department of Optometry and Visual Science, West China School of Medicine, Sichuan University, Chengdu 610041, P. R. China
| | - 苹 蒋
- 四川大学华西医院 眼科(成都 610041)Department of Ophthalmology, West China Hospital of Sichuan University, Chengdu 610041, P. R. China
- 四川大学 华西临床医学院 眼视光学系(成都 610041)Department of Optometry and Visual Science, West China School of Medicine, Sichuan University, Chengdu 610041, P. R. China
| | - 陇黔 刘
- 四川大学华西医院 眼科(成都 610041)Department of Ophthalmology, West China Hospital of Sichuan University, Chengdu 610041, P. R. China
- 四川大学 华西临床医学院 眼视光学系(成都 610041)Department of Optometry and Visual Science, West China School of Medicine, Sichuan University, Chengdu 610041, P. R. China
| | - 启勇 龚
- 四川大学华西医院 眼科(成都 610041)Department of Ophthalmology, West China Hospital of Sichuan University, Chengdu 610041, P. R. China
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21
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Chow A, Nallour Raveendran R, Erkelens I, Babu R, Thompson B. Increased saccadic latency in Amblyopia: Oculomotor and attentional factors. Vision Res 2022; 197:108059. [DOI: 10.1016/j.visres.2022.108059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 04/04/2022] [Accepted: 04/19/2022] [Indexed: 11/15/2022]
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22
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Long-Term Efficacy of the Combination of Active Vision Therapy and Occlusion in Children with Strabismic and Anisometropic Amblyopia. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9071012. [PMID: 35883996 PMCID: PMC9315543 DOI: 10.3390/children9071012] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 06/13/2022] [Accepted: 07/06/2022] [Indexed: 11/17/2022]
Abstract
This retrospective study was conducted to evaluate the efficacy of the combined treatment of occlusion and active vision therapy in a total of 27 amblyopic children, including 14 strabismic and 13 anisometropic cases. For such purpose, changes in distance and near visual acuity as well as in the binocular function was evaluated during a two-year follow-up. In both amblyopia groups, significant improvements were found in distance and near visual acuity in the non-dominant eye (p < 0.001). In the strabismic amblyopia group, the percentage of patients with binocular function score (BF) > 3.3 decreased significantly from a baseline value of 64.3% to a two-year follow-up value of 7.1% (p < 0.001). In the anisometropic amblyopia group, this percentage also decreased significantly from a baseline value of 15.4% to a two-year follow-up value of 0.0% (p < 0.001). No recurrences were observed in the anisometropic amblyopia group, whereas recurrence occurred in two cases of the strabismic amblyopia group after finishing the vision rehabilitation process. In conclusion, the combined approach of the treatment evaluated is efficacious for providing an improvement in visual acuity and binocular function in both anisometropic and strabismic amblyopia, which was maintained over time.
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23
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Hou SW, Zhang Y, Christian L, Niechwiej‐Szwedo E, Giaschi D. Evaluating visuomotor coordination in children with amblyopia. Dev Psychobiol 2022; 64:e22270. [DOI: 10.1002/dev.22270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 02/05/2022] [Accepted: 02/20/2022] [Indexed: 11/08/2022]
Affiliation(s)
- Sabrina W. Hou
- Department of Ophthalmology and Visual Sciences University of British Columbia Vancouver British Columbia Canada
| | - Yan Zhang
- Department of Ophthalmology and Visual Sciences University of British Columbia Vancouver British Columbia Canada
| | - Lisa Christian
- Department of Optometry and Vision Science University of Waterloo Waterloo Ontario Canada
| | | | - Deborah Giaschi
- Department of Ophthalmology and Visual Sciences University of British Columbia Vancouver British Columbia Canada
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24
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Affiliation(s)
- Ali Nouraeinejad
- Department of Clinical Ophthalmology, UCL, Institute of Ophthalmology, 11-43 Bath Street, London, EC1V 9EL, UK
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25
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Chow A, Quan Y, Chui C, Itier RJ, Thompson B. Orienting of covert attention by neutral and emotional gaze cues appears to be unaffected by mild to moderate amblyopia. J Vis 2021; 21:5. [PMID: 34623398 PMCID: PMC8504194 DOI: 10.1167/jov.21.11.5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Amblyopia is a developmental disorder of vision associated with higher-order visual attention deficits. We explored whether amblyopia affects the orienting of covert spatial attention by measuring the magnitude of the gaze cueing effect from emotional faces. Gaze and emotion cues are key components of social attention. Participants with normal vision (n = 30), anisometropic (n = 7) or strabismic/mixed (n = 5) amblyopia performed a cued peripheral target detection task under monocular and binocular viewing conditions. The cue consisted of a centrally presented face with left or right gaze (50% validity to target location) and a fearful, happy, or neutral expression. The magnitude of spatial cueing was computed as the reaction time difference between congruent and incongruent trials for each expression. Fearful facial expressions oriented spatial attention significantly more than happy or neutral expressions. The magnitude of the gaze cueing effect in our cohort of mild-to-moderate amblyopia was comparable to that in normal vision and was not correlated with the severity of amblyopia. There were no statistical group or amblyopia subtype differences for reaction time in any viewing condition. These results place constraints on the range of attentional mechanisms affected by amblyopia and possibly suggest normal covert processing of emotional face stimuli in mild and moderate amblyopia.
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Affiliation(s)
- Amy Chow
- Department of Optometry and Vision Science, University of Waterloo, Waterloo, Canada
| | - Yiwei Quan
- Department of Psychology, University of Waterloo, Waterloo, Canada
| | - Celine Chui
- Department of Psychology, University of Waterloo, Waterloo, Canada
| | - Roxane J Itier
- Department of Psychology, University of Waterloo, Waterloo, Canada
| | - Benjamin Thompson
- Department of Optometry and Vision Science, University of Waterloo, Waterloo, Canada
- Centre for Eye and Vision Research, 17W Science Park, Hong Kong
- Liggins Institute, University of Auckland, Auckland, New Zealand
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26
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Ionta S. Visual Neuropsychology in Development: Anatomo-Functional Brain Mechanisms of Action/Perception Binding in Health and Disease. Front Hum Neurosci 2021; 15:689912. [PMID: 34135745 PMCID: PMC8203289 DOI: 10.3389/fnhum.2021.689912] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 05/06/2021] [Indexed: 12/16/2022] Open
Abstract
Vision is the main entrance for environmental input to the human brain. Even if vision is our most used sensory modality, its importance is not limited to environmental exploration. Rather it has strong links to motor competences, further extending to cognitive and social aspects of human life. These multifaceted relationships are particularly important in developmental age and become dramatically evident in presence of complex deficits originating from visual aberrancies. The present review summarizes the available neuropsychological evidence on the development of visual competences, with a particular focus on the associated visuo-motor integration skills in health and disease. With the aim of supporting future research and interventional settings, the goal of the present review is to constitute a solid base to help the translation of neuropsychological hypotheses into straightforward empirical investigations and rehabilitation/training protocols. This approach will further increase the impact, ameliorate the acceptance, and ease the use and implementation of lab-derived intervention protocols in real-life situations.
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Affiliation(s)
- Silvio Ionta
- Sensory-Motor Lab (SeMoLa), Department of Ophthalmology-University of Lausanne, Jules Gonin Eye Hospital-Fondation Asile des Aveugles, Lausanne, Switzerland
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Ibrahimi D, Mendiola-Santibañez JD, Gkaros AP. Analysis of the potential impact of strabismus with and without amblyopia on visual-perceptual and visual-motor skills evaluated using TVPS-3 and VMI-6 tests. JOURNAL OF OPTOMETRY 2021; 14:166-175. [PMID: 32535162 PMCID: PMC8093528 DOI: 10.1016/j.optom.2020.04.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 03/06/2020] [Accepted: 04/08/2020] [Indexed: 05/22/2023]
Abstract
PURPOSE To investigate the potential impact of strabismus and amblyopia on visual-perceptual skills (VPS) and visual-motor skills (VMS) of patients according to the type of strabismus, visual acuity (VA), state of binocularity, and sex. METHODS This observational, transverse, prospective study analyzed a sample of 146 children with strabismus (88 male and 58 female) aged 5-15 years from Querétaro, México. To determine the strabismus type, we considered the deviation direction, frequency, binocularity state, and associated and dissociated elements. VPS and VMS were evaluated using the Test of Visual-Perceptual Skills 3rd ed. (TVPS-3) and Visual-Motor Integration Test of Beery 6th ed. (VMI-6). RESULTS Sex was the main variable associated with the performance of the analyzed patients on TVPS-3 and VMI-6 (p<0.05); boys obtained better scores than girls in all evaluated aspects. Stereopsis was not a determinant of the patients' performance level but was associated with the far and near angles of deviation in both types of strabismus, esotropia and exotropia. Amblyopia was associated with the spatial relationship (p=0.001) and visual closure abilities (p=0.044). Form constancy skill scores diminished in both types of strabismus (esotropia: p=0.011; exotropia: p=0.004), and VMS were the most affected in patients with strabismus. CONCLUSIONS The performance of patients with strabismus with and without amblyopia on TVPS-3 and VMI-6 suggests that they adopt a mechanism to compensate for the impact of strabismus on their VPS and VMS.
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Affiliation(s)
- Danjela Ibrahimi
- Facultad de Ingeniería, Universidad Autónoma de Querétaro, Cerro de las Campanas s/n, B.P 76010 Querétaro, Mexico; Facultad de Medicina, Universidad Autónoma de Querétaro, Clavel 200, Prados de la Capilla, B.P 76176 Querétaro, Mexico.
| | | | - Alfrent-Pantelis Gkaros
- Department of Economics, School of Economics, Business and International Studies, University of Piraeus, M. Karaoli & A. Dimitriou 80, 18534 Piraeus, Greece
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Miller NP, Aldred B, Schmitt MA, Rokers B. Impact of Amblyopia on the Central Nervous System. J Binocul Vis Ocul Motil 2020; 70:182-192. [PMID: 33206009 DOI: 10.1080/2576117x.2020.1841710] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Amblyopia is a common perceptual disorder resulting from abnormal visual input during development. The clinical presentation and visual deficits associated with amblyopia are well characterized. Less is known however, about amblyopia's impact on the central nervous system (CNS). While early insights into the neuropathophysiology of amblyopia have been based on findings from animal models and postmortem human studies, recent advances in noninvasive magnetic resonance imaging (MRI) techniques have enabled the study of amblyopia's effects in vivo. We review recent retinal and neuroimaging research documenting amblyopia's structural and functional impact on the CNS. Clinical imaging provides some evidence for retinal and optic nerve abnormalities in amblyopic eyes, although the overall picture remains inconclusive. Neuroimaging studies report clearer changes in both structure and function of the visual pathways. In the optic nerves, optic tracts, and optic radiations of individuals with amblyopia, white-matter integrity is decreased. In the lateral geniculate nuclei, gray matter volume is decreased and neural activity is reduced. Reduced responses are also seen in the amblyopic primary visual cortex and extrastriate areas. Overall, amblyopia impacts structure and function at multiple sites along the visual processing hierarchy. Moreover, there is some evidence that amblyopia's impact on the CNS depends on its etiology, with different patterns of results for strabismic and anisometropic amblyopia. To clarify the impact of amblyopia on the CNS, simultaneous collection of retinal, neural, and perceptual measures should be employed. Such an approach will help (1) distinguish cause and effect of amblyopic impairments, (2) separate the impact of amblyopia from other superimposed conditions, and (3) identify the importance of amblyopic etiology to specific neural and perceptual deficits.
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Affiliation(s)
- Nathaniel P Miller
- Department of Psychology, University of Wisconsin-Madison , Madison, Wisconsin.,Psychology, New York University Abu Dhabi , Abu Dhabi, UAE
| | - Breanna Aldred
- Department of Ophthalmology and Visual Sciences, University of Wisconsin-Madison , Madison, Wisconsin
| | - Melanie A Schmitt
- Department of Ophthalmology and Visual Sciences, University of Wisconsin-Madison , Madison, Wisconsin
| | - Bas Rokers
- Psychology, New York University Abu Dhabi , Abu Dhabi, UAE
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29
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Vision Screening in Belgian Children: Too Much or Not Enough? Ophthalmic Epidemiol 2020; 27:364-375. [DOI: 10.1080/09286586.2020.1767151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Milla M, Piñero DP. Characterization, passive and active treatment in strabismic amblyopia: a narrative review. Int J Ophthalmol 2020; 13:1132-1147. [PMID: 32685403 PMCID: PMC7321947 DOI: 10.18240/ijo.2020.07.18] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Accepted: 03/15/2020] [Indexed: 12/22/2022] Open
Abstract
Strabismic amblyopia is characterized by a distorted spatial perception. In this condition, the neurofunctional disorder occurring during first years of life provoke several monocular and binocular anomalies such as crowding, deficits in the accommodative response, contrast sensitivity, and ocular motility abilities. The inhibition of the binocular function of the brain by the misaligned amblyopic eye induces a binocular imbalance leading to interocular suppression and the reduction or lack of stereoacuity. Passive treatments such as occlusion, optical and/or pharmacological penalization, and Bangerter foils has been demonstrated to be potentially useful treatments for strabismic amblyopia. Recent researches have proved new pharmacological options to improve and maintain visual acuity after occlusion treatment in strabismic amblyopia. Likewise, the active vision therapy, in the last years, is becoming a very relevant therapeutic option in combination with passive treatments, especially during and after monocular therapy, in the attempt of recovering the imbalanced binocular vision.
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Affiliation(s)
- Myriam Milla
- Department of Optometry, OFTALVIST Alicante, Alicante 03016, Spain
- Group of Optics and Visual Perception, Department of Optics, Pharmacology and Anatomy, University of Alicante, San Vicente del Raspeig, Alicante 03690, Spain
| | - David P. Piñero
- Group of Optics and Visual Perception, Department of Optics, Pharmacology and Anatomy, University of Alicante, San Vicente del Raspeig, Alicante 03690, Spain
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Vision Development Differences between Slow and Fast Motor Development in Typical Developing Toddlers: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17103597. [PMID: 32443815 PMCID: PMC7277625 DOI: 10.3390/ijerph17103597] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 05/14/2020] [Accepted: 05/18/2020] [Indexed: 11/17/2022]
Abstract
Many studies have established a relationship between visual function and motor development in toddlers. This is the first report to study two-year-olds via an assessment of their visual and motor skills. The purpose of this study is to describe the possible changes that can occur between visual and motor systems in typical developing toddlers. A total of 116 toddlers were included in this observational, descriptive, and cross-sectional study. Their mean age was 29.57 ± 3.45 months. Motor development variables studied were dominant hand/foot; stationary, locomotion, object manipulation, grasping, visual motor integration percentiles; gross motor, fine motor, and total motor percentiles; and gross motor, fine motor, and total motor quotients. Visual development variables were assessed including visual acuity, refractive error, ocular alignment, motor fusion and suppression, ocular motility, and stereopsis. Our findings demonstrated that typical developing toddlers with slow gross motor development had higher exophoria and further near point of convergence values compared to toddlers with fast gross motor development (p < 0.05). No statistically significant differences were found in visual acuity and stereopsis between slow and fast gross motor development toddlers.
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Abstract
Amblyopia is a cortical visual disorder caused by unequal visual input to the brain from the two eyes during development. Amblyopes show reduced visual acuity and contrast sensitivity and abnormal binocularity, as well as more “global” perceptual losses, such as figure-ground segregation and global form integration. Currently, there is no consensus on the neural basis for these higher-order perceptual losses. One contributing factor could be that amblyopes have deficiencies in attention, such that the attentional processes that control the selection of information favor the better eye. Previous studies in amblyopic adults are conflicting as to whether attentional deficits exist. However, studies where intact attentional ability has been shown to exist were conducted in adults; it is possible that it was acquired through experience. To test this hypothesis, we studied attentional processing in amblyopic children. We examined covert endogenous attention using a classical spatial cueing paradigm in amblyopic and visually typical 5- to 10-year old children. We found that all children, like adults, independently of visual condition, benefited from attentional cueing: They performed significantly better on trials with an informative (valid) cue than with the uninformative (neutral) cue. Response latencies were also significantly shorter for the valid cue condition. No statistically significant difference was found between the performance of the amblyopic and the visually typical children or between dominant and nondominant eyes of all children. The results showed that covert spatial attention is intact in amblyopic and visually typical children and is therefore not likely to account for higher-order perceptual losses in amblyopic children.
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Niechwiej-Szwedo E, Meier K, Christian L, Nouredanesh M, Tung J, Bryden P, Giaschi D. Concurrent maturation of visuomotor skills and motion perception in typically-developing children and adolescents. Dev Psychobiol 2019; 62:353-367. [PMID: 31621075 DOI: 10.1002/dev.21931] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Revised: 09/18/2019] [Accepted: 09/22/2019] [Indexed: 12/24/2022]
Abstract
Perceptual and visuomotor skills undergo considerable development from early childhood into adolescence; however, the concurrent maturation of these skills has not yet been examined. This study assessed visuomotor function and motion perception in a cross-section of 226 typically-developing children between 4 and 16 years of age. Participants were tested on three tasks hypothesized to engage the dorsal visual stream: threading a bead on a needle, marking dots using a pen, and discriminating form defined by motion contrast. Mature performance was reached between 8 and 12 years, with youngest maturation for kinematic measures for a reach-to-grasp task, and oldest maturation for a precision tapping task. Performance on the motion perception task shared no association with motor skills after controlling for age.
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Affiliation(s)
| | | | - Lisa Christian
- Optometry and Vision Science, University of Waterloo, Waterloo, ON, Canada
| | - Mina Nouredanesh
- Mechanical and Mechatronics Engineering, University of Waterloo, Waterloo, ON, Canada
| | - James Tung
- Mechanical and Mechatronics Engineering, University of Waterloo, Waterloo, ON, Canada
| | - Pamela Bryden
- Kinesiology and Physical Education, Wilfrid Laurier University, Waterloo, ON, Canada
| | - Deborah Giaschi
- Ophthalmology & Visual Sciences, University of British Columbia, Vancouver, BC, Canada
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