Loss of sensitivity to motion-defined form in patients with primary open-angle glaucoma and ocular hypertension

Progressive thinning of visual cortex in primary open-angle glaucoma of varying severity

The aim of this study was to investigate possible changes of cortical thickness in the visual cortex in primary open-angle glaucoma (POAG) of varying severity. Twenty normal controls (NC), 20 mild (MP) and 17 severe (SP) POAG patients were recruited and scanned using magnetic resonance imaging. Cortical thickness analyses with regions of interest (V1, V2, ventral V3, V4 and V5/MT+) were used to assess the cortical changes among the three groups. Furthermore, the associations of cortical thickness with retinal nerve fiber layer (RNFL) thickness and mean deviation of visual field were analyzed. Compared with the NC group, decreased cortical thickness was detected in the bilateral V5/MT+ areas in the MP group and the left V1, bilateral V2 and V5/MT+ areas in the SP group. Cortical thinning of the bilateral V2 areas was detected in the SP group compared with the MP group. In addition, cortical thinning of these visual areas was related to the ophthalmologic measurements. In conclusion, POAG patients exhibit cortical thinning in the bilateral V5/MT+ in the early stage of disease. The cortical degeneration in visual areas is discrepant with disease progressing and the dorsal pathway might be selectively damaged in POAG. Therefore, the cortical thinning of these visual areas may play a key role in the progression of POAG and can serve as a novel biomarker for accurately evaluating the severity of POAG.

Morphologic changes in the anterior and posterior subregions of V1 and V2 and the V5/MT+ in patients with primary open-angle glaucoma

The aim of this study was to investigate possible morphologic changes of the visual cortex in primary open-angle glaucoma (POAG) with varying severity. Twenty normal controls (NC), 19 mild (MP) and 17 severe (SP) POAG patients were recruited and scanned using magnetic resonance imaging. Multi-parameter morphologic analyses with regions of interest (V5/MT+, anterior and posterior subregions of V1 and V2) were used to assess the cortical changes among the three groups. Compared with the NC group, decreased cortical thickness was detected in the V5/MT+ area in the MP group and in all of the investigated visual areas except the posterior subregion of V1 in the SP group. Unexpectedly, cortical thinning of the posterior subregion of V2 was detected in the SP group compared with the NC and MP groups. For the other morphologic parameters, only gray matter volume in the posterior subregion of V2 and mean curvature in the V5/MT+ were significantly changed in the SP group. In addition, the clinical measurements were positively correlated with the cortical thickness of the V5/MT+ and the posterior subregion of V2. In conclusion, the V5/MT+ area is involved in early disruption of POAG and the cortical degeneration may be progressive and heterogeneous in different visual cortices. Early neuroprotective therapies on the retina and central visual system may help to preserve vision in patients with POAG.

A significant bilateral field advantage for shapes defined by static and motion cues

Matching performance is better when pairs of visual stimuli are presented in bilateral conditions--in which one stimulus is presented to each side of the visual field--than in unilateral presentations-when both stimuli are presented to one side of the field. This is called the bilateral field advantage (BFA). The processing of visual motion has also been found to be more strongly integrated across the cerebral hemispheres than is processing of static cues. However, in these studies higher-order motion tasks, such as processing motion-defined form, have not been examined. To determine if the BFA generalises to such tasks, we measured the magnitude of the effect using a shape-matching task in which the stimuli were random polygons that were either in motion, motion-defined, or static. The polygon pairs were presented either: (i) bilaterally, one to either side of the vertical meridian; (ii) unilaterally, both to one side of the vertical meridian (left or right visual fields); or (iii) centrally, vertically separated across the horizontal meridian (a control condition). An equal advantage of bilateral conditions over unilateral ones was found for all three types of polygon shape cues, showing that the BFA generalises to conditions where shapes are in motion and where shape is defined by motion. These findings are compatible with the notion that motion processing is strongly integrated across the cerebral hemispheres, and with the idea that this integration manifests itself with simple motion information, rather than with higher-order motion processing such as matching shapes defined by motion.

Defining the nature of motion perception deficits in glaucoma using simple and complex motion stimuli

PURPOSE

The purpose of this study is to determine the nature of motion perception deficits in primary open-angle glaucoma by measuring the sensitivity of simple (luminance-defined) and complex (texture-defined) motion, the latter requiring supplementary neural processing to be resolved. These findings will help address the possible extent of the cortical damage in glaucoma that has been recently demonstrated by anatomic and physiological studies. They also serve the purpose of establishing which motion paradigms would be most appropriate for assessing glaucoma-related functional loss.

METHODS

Direction-identification thresholds for first-order and second-order motion were measured for 26 patients with primary open-angle glaucoma (for both phakic and pseudophakic) and 18 nonglaucomatous observers.

RESULTS

The glaucomatous observers showed significantly increased motion thresholds for both first- and second-order motion conditions when compared with nonglaucomatous observers. However, the relative increase in threshold for first-order motion did not differ significantly from that of second-order motion.

CONCLUSIONS

These findings imply that there is no measurable higher-level cortical function damage caused by the glaucomatous process because no greater loss in second-order motion was observed. Based on the results, we suggest that motion paradigms used to assess functional loss in primary open-angle glaucoma should consist of simple, first-order type stimuli to minimize potential confounds such as those introduced by both the normal and pathologic aging process on complex motion processing (i.e., perimetry using complex motion stimuli).

The Effects of Optical Blur on Motion and Texture Perception

PURPOSE

The purpose of this study is to determine how decreased visual acuity affects performance on tasks of motion and texture perception.

METHODS

Positive diopter lenses were used to match three subjects at five levels of decimal visual acuity (DVA) ranging from an uncorrected DVA of 1.6 to the lowest DVA of 0.2. Performance thresholds were determined at each acuity level for five different psychophysical tasks. The tasks assessed the perception of motion-defined form, global motion, maximum motion displacement (Dmax), texture-defined form, and global texture.

RESULTS

Reducing visual acuity decreased performance on the tasks of motion-defined form identification, texture-defined form identification, and global texture integration. Performance on the Dmax task improved with a reduction in visual acuity. Performance on the global motion task was unaffected by changes in visual acuity.

CONCLUSIONS

Visual acuity should be considered when interpreting the results of developmental or clinical studies of motion and texture perception. The only exception to this is global motion perception, at least when DVA is better than 0.2. The effect of blur on tasks of motion and texture perception may reflect the extent to which high spatial frequency information is required for performance on these tasks.