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Sawamura H, Asaoka R, Murata H, Ando E, Gillebert CR. Extraction of three-dimensional shapes in glaucoma patients in response to monocular depth cues. Jpn J Ophthalmol 2024; 68:183-191. [PMID: 38598144 PMCID: PMC11087329 DOI: 10.1007/s10384-024-01054-6] [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: 08/30/2023] [Accepted: 01/31/2024] [Indexed: 04/11/2024]
Abstract
PURPOSE To assess the impact of glaucoma on perceiving three-dimensional (3D) shapes based on monocular depth cues. STUDY DESIGN Clinical observational study. METHODS Twenty glaucoma patients, subjected to binocular visual-field sensitivity (binocular-VFS) tests using a Humphrey Visual Field Analyzer, and 20 age-matched healthy volunteers, underwent two tasks: identifying the nearest vertex of a 3D shape using monocular shading (3D-SfS), texture (3D-SfT), or motion (3D-SfM) cues, and distinguishing elementary one-dimensional (1D) features of these cues. The association of the visual-field index (VFI) of binocular-VFS with 3D shape perception in glaucoma patients was also examined. RESULTS Glaucoma patients demonstrated reduced accuracy in distinguishing 1D luminance brightness and a larger "error-in-depth" between the perceived and actual depths for 3D-SfM and 3D-SfS compared to healthy volunteers. Six glaucoma patients with a 100% VFI for binocular-VFS exhibited a similar error-in-depth to the other fourteen glaucoma patients; they had a larger error-in-depth for 3D-SfM compared to healthy volunteers. No correlation between the error-in-depth values and the VFI values of binocular-VFS was observed. CONCLUSIONS The 3D shape perception in glaucoma patients varies based on the depth cue's characteristics. Impaired 1D discrimination and larger thresholds for 3D-SfM in glaucoma patients with a 100% VFI for binocular-VFS indicate more pronounced perceptual deficits of lower-level elementary features for 3D-SfS and higher-level visual processing of 3D shapes for 3D-SfM. The effects of the location and degree of binocular visual-field defects on 3D shape perception remain to be elucidated. Our research provides insights into the 3D shape extraction mechanism in glaucoma.
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Affiliation(s)
- Hiromasa Sawamura
- Department of Ophthalmology, The University of Tokyo Graduate School of Medicine, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
| | - Ryo Asaoka
- Department of Ophthalmology, The University of Tokyo Graduate School of Medicine, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
- Department of Ophthalmology, Seirei Hamamatsu General Hospital, Hamamatsu, Shizuoka, Japan
- Seirei Christopher University, Hamamatsu, Shizuoka, Japan
- Nanovision Research Division, Research Institute of Electronics, Shizuoka University, Shizuoka, Japan
- The Graduate School for the Creation of New Photonics Industries, Shizuoka, Japan
| | - Hiroshi Murata
- Department of Ophthalmology, The University of Tokyo Graduate School of Medicine, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Eriko Ando
- Department of Ophthalmology, The University of Tokyo Graduate School of Medicine, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
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Ye Q, Xu K, Chen Z, Liu Z, Fan Y, Liu P, Yu M, Yang Y. Early impairment of magnocellular visual pathways mediated by isolated-check visual evoked potentials in primary open-angle glaucoma: a cross-sectional study. BMJ Open Ophthalmol 2024; 9:e001463. [PMID: 38237934 PMCID: PMC10806665 DOI: 10.1136/bmjophth-2023-001463] [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: 08/16/2023] [Accepted: 01/02/2024] [Indexed: 01/23/2024] Open
Abstract
OBJECTIVE To explore different performances in the magnocellular (MC) and parvocellular (PC) visual pathways in patients with primary open-angle glaucoma (POAG) and to objectively assess impairment in early stage of POAG. METHODS AND ANALYSIS This is a cross-sectional study. MC and PC visual pathways were assessed using isolated-check visual evoked potential (ic-VEP). Visual acuity, intraocular pressure, fundus examination, optical coherence tomography and visual field were measured. Signal-to-noise ratios (SNRs), mediated by ic-VEP were recorded. The Spearman's correlation analysis was used to estimate the relationships between visual functions and structures. Receiver-operating-characteristic (ROC) curves were used to estimate the accuracy in detection of early POAG. RESULTS 60 participants (30 early POAG eyes and 30 age-matched control subjects) were recruited. MC visual pathway showed a non-linear response function, while PC visual pathway was a linear response function as contrast increased. Early POAG eyes exhibited significantly weaker initial contrast gains and lower maximum responses in the MC visual pathway (p=0.001, p=0.004, respectively). The SNRs at 8% and 32% depths of modulation (DOM) were significantly correlated with temporal-side retinal nerve fibre layer (RNFL) thickness in early POAG in MC-biased stimulation (p=0.017, p=0.020, respectively). The areas under ROC of 16% DOM were 0.780 (sensitivity 80.0%, specificity 63.3%) with the cut-off SNR of 2.07. CONCLUSIONS The MC visual pathway was damaged in the early stage of POAG. The SNRs at 8% and 32% DOM of MC-biased stimulation were significantly correlated with temporal-side RNFL thickness in early POAG, which helped in understanding the mechanisms of visual impairment in the early stage of POAG.
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Affiliation(s)
- Qiaona Ye
- Department of Glaucoma, State Key Laboratory of Ophthalmology, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Kezheng Xu
- Department of Glaucoma, State Key Laboratory of Ophthalmology, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Zidong Chen
- Department of Glaucoma, State Key Laboratory of Ophthalmology, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Zitian Liu
- Department of Glaucoma, State Key Laboratory of Ophthalmology, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Yanmei Fan
- Department of Glaucoma, State Key Laboratory of Ophthalmology, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Pingping Liu
- Department of Glaucoma, State Key Laboratory of Ophthalmology, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Minbin Yu
- Department of Glaucoma, State Key Laboratory of Ophthalmology, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Yangfan Yang
- Department of Glaucoma, State Key Laboratory of Ophthalmology, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China
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Huchzermeyer C, Kremers J. Selective Stimulation of the Different Photoreceptor Classes by Silent Substitution in Psychophysical and Electroretinographic Measurements. Klin Monbl Augenheilkd 2022; 239:1433-1439. [PMID: 36493763 DOI: 10.1055/a-1937-9901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The silent substitution technique allows creating photoreceptor-selective stimuli for psychophysical and electrophysiological tests. In contrast to other techniques, the purpose of silent substitution is not to make the targeted photoreceptor type more sensitive in comparison to the other types, but to make the stimulus invisible ("silent") to the other photoreceptor types. This allows selectivity independent of the retinal state of adaptation and enables comparing photoreceptor types under identical conditions. The foundations of these techniques will be explained in this paper. Furthermore, the importance of postreceptoral processing for the perception of photoreceptor-selective stimuli is discussed here. Although this technique is currently only available in specialized vision science labs, there is an enormous potential for clinical application.
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Affiliation(s)
- Cord Huchzermeyer
- Augenklinik mit Poliklinik, Universitätsklinikum Erlangen, Deutschland
| | - Jan Kremers
- Augenklinik mit Poliklinik, Universitätsklinikum Erlangen, Deutschland
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Fars J, Pasutto F, Kremers J, Huchzermeyer C. Perifoveal Cone- and Rod-Mediated Temporal Contrast Sensitivities in Stargardt Disease/Fundus Flavimaculatus. Invest Ophthalmol Vis Sci 2021; 62:24. [PMID: 34807235 PMCID: PMC8626853 DOI: 10.1167/iovs.62.14.24] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose The purpose of this study was to compare L-cone-driven, S-cone-driven, and rod-driven temporal contrast sensitivities (tCSs) in patients with Stargardt disease 1/fundus flavimaculatus (STGD1/FF). Methods Fourteen patients (eight male, six female; mean age, 43.21 ± 13.18 years) with genetically confirmed STGD1/FF participated in this study. A dedicated light-emitting diode stimulator was used to measure perifoveal tCSs in an annular test field (1°-6° of visual eccentricity) at temporal frequencies between 1 and 20 Hz. Photoreceptor classes were isolated with the triple silent substitution technique. To compare functional damage among photoreceptor classes, sensitivity deviations (decibels) were calculated based on age-related normal values and then averaged across those frequencies where perception is mediated by the same post-receptoral pathway (L-cone red-green opponent pathway: 1, 2, 4 Hz; luminance pathway: 12, 16, 20 Hz; S-cone pathway: 1, 2, 4 Hz; fast rod pathway: 8, 10, 12 Hz). Sensitivity deviations were compared with infrared scanning laser ophthalmoscopy (IR-SLO) and standard automated perimetry (SAP). Results Photoreceptor-driven tCSs were generally lower in patients with STGD1/FF than in normal subjects but were without systematic differences among photoreceptors. Although sensitivity deviations were significantly correlated between each other, only luminance-driven L-cone sensitivity deviations were significantly correlated with the IR-SLO area of hyporeflectance (AoH) and SAP central mean deviation within 6° eccentricity (MD6deg). Conclusions No systematic differences between photoreceptor classes were detected; however, our data suggest that temporal contrasts detected by the luminance pathway were closely correlated with other clinical parameters (AoH and MD6deg) and might be most useful as functional biomarkers in clinical trials.
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Affiliation(s)
- Julien Fars
- Department of Ophthalmology, University Hospital Erlangen, Erlangen, Germany
| | - Francesca Pasutto
- Institute of Human Genetics, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Jan Kremers
- Department of Ophthalmology, University Hospital Erlangen, Erlangen, Germany
| | - Cord Huchzermeyer
- Department of Ophthalmology, University Hospital Erlangen, Erlangen, Germany
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