Original Article

Subjective refractions determined by Dyop? and LogMAR chart as fixation targets

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Background: Dyop® is a dynamic optotype with a rotating and segmented visual stimulus. It can be used for visual acuity and refractive error measurement. The objective of the study was to compare refractive error measurement using the Dyop® acuity and LogMAR E charts.

Methods: Fifty subjects aged 18 or above with aided visual acuity better than 6/12 were recruited. Refractive error was measured by subjective refraction methods using the Dyop® acuity chart and LogMAR E charts and the duration of measurement compared. Thibo’s notation was used to represent the refractive error obtained for analysis.

Results: There was no significant difference in terms of spherical equivalent (M) (P=0.96) or J0 (P=0.78) and J45 (P=0.51) components measured using the Dyop® acuity and LogMAR E charts. However, subjective refraction measurement was significantly faster using the Dyop® acuity chart (t=4.46, P<0.05), with an average measurement time of 419.90±91.17 versus 452.04±74.71 seconds using the LogMAR E chart.

Conclusions: Accuracy of refractive error measurement using a Dyop® chart was comparable with use of a LogMAR E chart. The dynamic optotype Dyop® could be considered as an alternative fixation target to be used in subjective refraction.

Review Article

Psychophysics in the ophthalmological practice—II. Contrast sensitivity

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Contrast is the differential luminance between one object and another. Contrast sensitivity (CS) quantifies the ability to detect this difference: estimating contrast threshold provides information about the quality of vision and helps diagnose and monitor eye diseases. High contrast visual acuity assessment is traditionally performed in the eye care practice, whereas the estimate of the discrimination of low contrast targets, an important complementary task for the perception of details, is far less employed. An example is driving when the contrast between vehicles, obstacles, pedestrians, and the background is reduced by fog. Many conditions can selectively degrade CS, while visual acuity remains intact. In addition to spatial CS, “temporal” CS is defined as the ability to discriminate luminance differences in the temporal domain, i.e., to discriminate information that reaches the visual cortex as a function of time. Likewise, temporal sensitivity of the visual system can be investigated in terms of critical fusion frequency (CFF), an indicator of the integrity of the magnocellular system that is responsible for the perception of transient stimulations. As a matter of fact, temporal resolution can be abnormal in neuro-ophthalmological clinical conditions. This paper aims at considering CS and its application to the clinical practice.
Review Article

Psychophysics in the ophthalmological practice—I. visual acuity

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Perception is the ability to see, hear, or become aware of external stimuli through the senses. Visual stimuli are electromagnetic waves that interact with the eye and elicit a sensation. Sensations, indeed, imply the detection, resolution, and recognition of objects and images, and their accuracy depends on the integrity of the visual system. In clinical practice, evaluating the integrity of the visual system relies greatly on the assessment of visual acuity, that is to say on the capacity to identify a signal. Visual acuity, indeed, is of utmost importance for diagnosing and monitoring ophthalmological diseases. Visual acuity is a function that detects the presence of a stimulation (a signal) and resolves its detail(s). This is the case of a symbol like “E”: the stimulus is detected, then it is resolved as three horizontal bars and a vertical bar. In fact, within the clinical setting visual acuity is usually measured with alphanumeric symbols and is a three-step process that involves not only detection and resolution, but, due to the semantic content of letters and numbers, their recognition. Along with subjective (psychophysical) procedures, objective methods that do not require the active participation of the observer have been proposed to estimate visual acuity in non-collaborating subjects, malingerers, or toddlers. This paper aims to explain the psychophysical rationale underlying the measurement of visual acuity and revise the most common procedures used for its assessment.
Review Article

RAF near point rule for near point of convergence—a short review

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Abstract: RAF near point rule (RNPR) is a routinely used instrument in ophthalmology and optometry practice as well as for research purposes to measure the near point of convergence (NPC). The measurement of NPC is an important criterion for diagnosis and management of convergence insufficiency. The RNPR forms an important tool for ophthalmic clinicians however, only a very little is understood about it. This article tries to describe and review the designs, measurement techniques, merits and demerits of the RNPR and establish the need for its modification. It recommends that clinicians and researchers consider these findings while measuring NPC with the RNPR.

Original Article
Original Article

Objective electrophysiological contrast sensitivity with monofocal and multifocal intraocular lenses: a prospective clinical study

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Background: To compare objective electrophysiological contrast sensitivity function (CSF) in patients implanted with either multifocal intraocular lenses (MIOLs) or monofocal intraocular lenses (IOLs) by pattern reversal visual evoked potentials (prVEP) measurements.

Methods: Fourty-five cataract patients were randomly allocated to receive bilaterally: apodized diffractive-refractive Alcon Acrysof MIOL (A), full diffractive AMO Tecnis MIOL (B) or monofocal Alcon Acrysof IOL (C). Primary outcomes: 1-year differences in objective binocular CSF measured by prVEP with sinusoid grating stimuli of 6 decreasing contrast levels at 6 spatial frequencies. Secondary outcomes: psychophysical CSF measured with VCTS-6500, photopic uncorrected distance (UDVA), and mesopic and photopic uncorrected near and intermediate visual acuities (UNVA and UIVA respectively).

Results: Electrophysiological CSF curve had an inverted U-shaped morphology in all groups, with a biphasic pattern in Group B. Group A showed a lower CSF than group B at 4 and 8 cpd, and a lower value than group C at 8 cpd. Psychophysical CSF in group A exhibited a lower value at 12 cpd than group B. Mean photopic and mesopic UNVA and UIVA were worse in monofocal group compared to the multifocal groups. Mesopic UNVA and UIVA were better in group B.

Conclusions: Electrophysiological CSF behaves differently depending on the types of multifocal or monofocal IOLs. This may be related to the visual acuity under certain conditions or to IOL characteristics. This objective method might be a potential new tool to investigate on MIOL differences and on subjective device-related quality of vision.

Brain and Perception

AB074. Link between interocular correlation sensitivity and stereoscopic vision

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Background: Stereoscopic Vision uses the disparity between the two images received by the two eyes in order to create a tridimensional representation. With this study, we aimed at providing an estimate of binocular vision at a level prior to disparity processing. In particular, we wanted to assess the spatial properties of the visual system for detecting interocular correlations (IOC).

Methods: We developed dichoptic stimuli, made of textures which IOC is sinusoidally modulated at various correlation spatial frequencies. Then, we compared the sensitivity to these stimuli to the sensitivity to analogous stimuli with disparity modulation.

Results: We observed that IOC sensitivity presents a low-pass/band-pass profile and increases as a function of presentation duration and contrast, in a similar way as disparity sensitivity.

Conclusions: IOC sensitivity is weakly—though significantly—correlated with disparity sensitivity in the general population, which suggests that it could provide a marker for binocular vision, prior to disparity processing.

Brain and Perception

AB071. Psychophysical investigation of dichoptic blur suppression in human vision

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Background: In situations where one eye gives a more blurred input to visual processing than the other, the input from the sharper eye tends to dominate the percept. This phenomenon has clinical relevance for monovision treatment, where the two eyes are corrected separately for different distances. We performed a psychophysical investigation of subjects’ ability to identify which of a set of images was blurred in one eye.

Methods: We tested 17 subjects with normal or corrected-to-normal vision. On each trial, subjects viewed an array of four pictures using a monitor with shutter goggles. In the first experiment, three of the pictures were sharp in both eyes (distractors). The fourth picture was sharp in one eye and blurred by a low-pass filter in the other. Subjects identified that odd-one-out target over many trials with different degrees of blur. In the second experiment the target picture was given the same treatment, but the three non-target pictures were made monocular (sharp in one eye, mean grey in the other).

Results: The results from the first experiment with binocular distractors followed our expectations, with subjects showing better performance at detecting more severe blurs. In the second experiment with monocular distractors, we found large individual differences between our observers. Some performed the same as they did in the first condition, others now found the task impossible, and a few performed worse with severe blurs than they did with slight blurs.

Conclusions: Previous studies have reported individual differences in blur suppression, however this study reveals that these differences may depend on the precise details of the judgements being made.

Brain and Perception

AB067. Cholinergic enhancement of short-term patching in healthy adults

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Background: Patching an eye for a period of 2 hours results in a period of plasticity where inter-ocular balance shifts in favor of the patched eye. Acetylcholine has been shown to improve visual function and augment adult neural plasticity. Here we evaluate whether administering the cholinesterase inhibitor donepezil enhances the magnitude or duration of the patching induced shift in ocular balance.

Methods: We used a double-blind drug treatment design to test the effect of donepezil and patching on the shift in ocular balance. We used a well-known binocular phase combination task to measure ocular balance before and after treatment.

Results: Our results demonstrate that donepezil does not enhance, and may actually reduce the magnitude and duration of the patching-induced shift in ocular balance.

Conclusions: Patching induced adult neural plasticity does not appear to be modulated by the cholinergic system, however, increased dose or longer drug administration periods may yield significant results. Future studies on binocular rivalry are in the pipeline.

Psychophysics in the ophthalmological practice—II. Contrast sensitivity

:-
 

Abstract: Contrast is the differential luminance between one object and another. Contrast sensitivity (CS) quantifies the ability to detect this difference: estimating contrast threshold provides information about the quality of vision and helps diagnose and monitor eye diseases. High contrast visual acuity assessment is traditionally performed in the eye care practice, whereas the estimate of the discrimination of low contrast targets, an important complementary task for the perception of details, is far less employed. An example is driving when the contrast between vehicles, obstacles, pedestrians, and the background is reduced by fog. Many conditions can selectively degrade CS, while visual acuity remains intact. In addition to spatial CS, “temporal” CS is defined as the ability to discriminate luminance differences in the temporal domain, i.e., to discriminate information that reaches the visual cortex as a function of time. Likewise, temporal sensitivity of the visual system can be investigated in terms of critical fusion frequency (CFF), an indicator of the integrity of the magnocellular system that is responsible for the perception of transient stimulations. As a matter of fact, temporal resolution can be abnormal in neuro-ophthalmological clinical conditions. This paper aims at considering CS and its application to the clinical practice.

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    主管:中华人民共和国教育部
    主办: 中山大学
    承办: 中山大学中山眼科中心
    主编: 林浩添
    主管:中华人民共和国教育部
    主办: 中山大学
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