Two Eyes Are Better Than One-Binocular Summation of Dark Vision in Healthy Individuals and Patients with Chronic Respiratory Disease

Scotopic and Photopic Conventional Visual Acuity and Hyperacuity - Binocular Summation

Purpose

The purpose of this study was to determine and compare binocular summation (BiS) of conventional visual acuity (cVA) versus hyperacuity (hVA) for photopic and scotopic luminance conditions as a potential biomarker to assess the outcome of interventions on binocular function.

Methods

Sixteen young adults (age range [years] = 21-31; 8 women; cVA logMAR < 0.0) participated in this study. The Freiburg Visual Acuity Test (FrACT) was used for VA testing and retested on another day. Both cVA and hVA were determined for dark grey optotypes on light grey background. Participants underwent 40 minutes of dark adaptation prior to scotopic VA testing. Binocular and monocular VA testing was performed. The eye with better VA over the 2 days of testing was selected, the BiS was quantified (binocular VA - better monocular VA) and repeated measures ANOVAs were performed.

Results

Binocular VA exceeded monocular VA for all luminance conditions, VA-types, and sessions. We report BiS estimates for photopic and scotopic cVA and hVA, (logMAR BiS ± SEM [decimal BiS]): photopic = -0.01 ± 0.01 [1.03] and -0.06 ± 0.03 [1.15]; and scotopic = -0.05 ± 0.01 [1.12] and -0.11 ± 0.04 [1.28], respectively). Improvement for binocular vision estimates ranged from 0.01 to 0.11 logMAR. A repeated-measures ANOVA (RM ANOVA) did not reveal significant effects of LUMINANCE or VA TYPE on BiS, albeit a trend for strongest BiS for scotopic hVA (15% vs. 28%, photopic versus scotopic, respectively) and weakest for photopic cVA (3% vs. 12%, photopic versus scotopic conditions, respectively).

Conclusions

Our results indicate that BiS of VA is relevant to scotopic and photopic hVA and cVA. It appears therefore a plausible candidate biomarker to assess the outcome of retinal therapies restoring rod or cone function on binocular vision.

Translational Relevance

Binocular summation of visual acuity might serve as a clinical biomarker to monitor therapy outcome on binocular rod and cone-mediated vision.

Lower Internal Additive Noise and Better Perceptual Template Characterize Binocular Contrast Sensitivity Summation

Binocular summation is generally defined as the superiority of binocular over monocular performance. Here, we investigated how external noise modulates the effect of binocular summation on the contrast sensitivity function (CSF) and clarified the corresponding mechanisms with a perceptual template model (PTM). The contrast sensitivity (CS) over 10 spatial frequencies and three external noise levels was assessed under one binocular and two monocular viewing conditions. The binocular summation ratio (BSR) was calculated by dividing the area under the log CSF (AULCSF), or the CS of using both eyes, by that of only using the "good eye" (BSRG) or the "bad eye" (BSRB), respectively. We found that: (1) based on the AULCSF, the BSRB was higher than the BSRG; (2) based on the AULCSF, the BSR was more pronounced under zero-noise than under low-noise conditions, but the BSR was not higher than 1 under high-noise conditions due to a large individual difference; (3) based on the CS, with increasing spatial frequencies, the BSRB steadily increased; (4) both decreased internal additive noise and an improved perceptual template accounted for the gain in binocular summation. These results help us better understand the features of binocular CS and shed light on the clinical studies on populations with monocular CS loss.