Fixation instability, astigmatism, and lack of stereopsis as factors impeding recovery of binocular balance in amblyopia following binocular therapy.

Dichoptic therapy is a promising method for improving vision in pediatric and adult patients with amblyopia. However, a systematic understanding about changes in specific visual functions and substantial variation of effect among patients is lacking. Utilizing a novel stereoscopic augmented-reality based training program, 24 pediatric and 18 adult patients were trained for 20 h along a three-month time course with a one-month post-training follow-up for pediatric patients. Changes in stereopsis, distance and near visual acuity, and contrast sensitivity for amblyopic and fellow eyes were measured, and interocular differences were analyzed. To reveal what contributes to successful dichoptic therapy, ANCOVA models were used to analyze progress, considering clinical baseline parameters as covariates that are potential requirements for amblyopic recovery. Significant and lasting improvements have been achieved in stereoacuity, interocular near visual acuity, and interocular contrast sensitivity. Importantly, astigmatism, fixation instability, and lack of stereopsis were major limiting factors for visual acuity, stereoacuity, and contrast sensitivity recovery, respectively. The results demonstrate the feasibility of treatment-efficacy prediction in certain aspects of dichoptic amblyopia therapy. Furthermore, our findings may aid in developing personalized therapeutic protocols, capable of considering individual clinical status, to help clinicians in tailoring therapy to patient profiles for better outcome.

Maturation of cyclopean visual evoked potential phase in preterm and full-term infants.

PURPOSE: P1 is the major positive component of pattern-reversal visual evoked potentials (PR-VEPs). The rapid decrease of its latency correlates with the progressive myelination in the developing infant brain, which affects signal transmission in the visual system. An age-dependent phase shift, analogous to P1 peak latency, can be observed in dynamic random dot correlogram (DRDC)-evoked VEPs (DRDC-VEPs), a method used to assess binocular function. Our goal was to study the relationship between cyclopean DRDC-VEP phases and PR-VEP P1 latencies in full-term and preterm infants so as to further explore the experience dependence of early binocular developmental processes. METHODS: DRDC-VEPs and PR-VEPs were recorded in 128 full-term and 47 preterm healthy infants and toddlers. DRDC stimuli were presented on the red and green channels of a CRT monitor while infants wore red-green goggles for dichoptic viewing. Reliability of VEP responses was assessed by the statistic. Logistic function was fit to the phase and latency data as a function of age, and goodness of fit was assessed by analysis of residuals. RESULTS: The phase shift of DRDC-VEPs and the rapid decrease of P1 latencies occur at identical postconceptual ages. A correlation also was found between P1 latencies and DRDC-VEP phases. CONCLUSIONS: Although development of binocularity is an extremely experience-dependent process, our data suggest that DRDC-VEP phase and P1 latency mature independently from visual experience. We propose that both the phase shift and decreasing P1 latency are indicators of myelination and increasingly faster signal transmission in the developing visual system.

Lack of association between VAP-1/SSAO activity and corneal neovascularization in a rabbit model.

The aim of this study is to determine the efficacy of a potent and specific vascular adhesive protein-1/semicarbazide-sensitive amine oxidase (VAP-1/SSAO) inhibitor, LJP 1207, as a potential antiangiogenic and anti-inflammatory agent in the therapy of corneal neovascularization. Corneal neovascularization was induced with intrastromal suturing in rabbits (n = 20). Topical treatment with VAP-1/SSAO inhibitor LJP 1207 (n = 5, 4 times a day), bevacizumab (n = 5, daily), their combination (n = 5) and vehicle only (n = 5, 4 times a day) were applied postoperatively for 2 weeks. The development and extent of corneal neovascularization were evaluated by digital image analysis. At the end of the observation period, the level of corneal and serum VAP-1/SSAO activity was measured fluorometrically and radiochemically. The corneal VAP-1/SSAO activity was significantly elevated in the suture-challenged vehicle-treated group (3,075 ± 1,009 pmol/mg/h) as compared to unoperated controls (464.2 ± 135 pmol/mg/h, p < 0.001). Treatment with LJP 1207 resulted in slower early phase neovascularization compared to vehicle-treated animals (not significant). At days 7-14, there was no significant difference in the extent of corneal neovascularization between inhibitor- and vehicle-treated corneas, even though inhibitor treatment caused a normalization of corneal VAP-1/SSAO activity (885 ± 452 pmol/mg/h). Our results demonstrate that the significant elevation of VAP-1/SSAO activity due to corneal injury can be prevented with VAP-1/SSAO inhibitor LJP 1207 treatment. However, normalization of VAP-1/SSAO activity in this model does not prevent the development of corneal neovascularization.

Effects of luminance on dynamic random-dot correlogram evoked visual potentials.

Although dynamic random-dot correlogram evoked visual potentials (DRDC-VEPs) are a three-decade-old method to detect the cortical binocularity in humans and animals, our knowledge of the influence of fundamental stimulus parameters and the underlying cerebral processing mechanisms has remained limited. The purpose of this study was to evaluate the effect of luminance on DRDC-VEPs in adults. The variability and detectability of DRDC-VEPs were investigated under different stimulus luminance conditions with neutral density filters. Our results have demonstrated that DRDC-VEPs can be evoked in a wide luminance range, and the response amplitude was practically independent of luminance between 4.75 cd m(-2) and 0.015 cd m(-2), while DRDC-VEP latencies showed a strong linear correlation with log luminance. There is, however, a limit (0.06 cd m(-2)) below which DRDC-VEPs are not reliably recordable. Luminance reduction-induced delays in DRDC-VEP latencies cannot be explained simply by retinal mechanisms, since their regression slope does not follow the course of electroretinogram and cortical evoked potential latencies. Luminance independence of DRDC-VEP amplitude suggests that binocular correlation-processing cortical neurons receive input predominantly from the magnocellular visual pathway.

Early-onset binocularity in preterm infants reveals experience-dependent visual development in humans.

Although there is a great deal of knowledge regarding the phylo- and ontogenetic plasticity of the neocortex, the precise nature of environmental impact on the newborn human brain is still one of the most controversial issues of neuroscience. The leading model-system of experience-dependent brain development is binocular vision, also called stereopsis. Here, we show that extra postnatal visual experience in preterm human neonates leads to a change in the developmental timing of binocular vision. The onset age of binocular function, as measured by the visual evoked response to dynamic random dot correlograms (DRDC-VEP), appears to be at around the same time after birth in preterm (4.07 mo) and full-term (3.78 mo) infants. To assess the integrity of the visual pathway in the studied infants, we also measured the latency of the visual-evoked response to pattern reversal stimuli (PR-VEP). PR-VEP latency is not affected by premature birth, demonstrating that the maturation of the visual pathway follows a preprogrammed developmental course. Despite the immaturity of the visual pathway, clearly demonstrated by the PR-VEP latencies, our DRCD-VEP data show that the visual cortex is remarkably ready to accept environmental stimulation right after birth. This early plasticity makes full use of the available extra stimulation time in preterm human infants and results in an early onset of cortical binocularity. According to our data, the developmental processes preceding the onset of binocular function are not preprogrammed, and the mechanisms turning on stereopsis are extremely experience-dependent in humans.

Contrast independence of dynamic random dot correlogram evoked VEP amplitude.

Dynamic random dot correlograms (DRDCs) are binocular stimuli that evoke a percept and a visual evoked potential (VEP) only in case of a mature and functional binocular system. DRDC-VEP is a method extensively used to study cortical binocularity in human infants and nonverbal children. Although the DRDC-VEP was invented 3 decades ago, neither the fundamental parameters, including contrast, of the stimulation nor the cerebral processing mechanisms have been clarified. The objective of the present study was to investigate the variability and detectability of adults' VEPs to DRDC under different stimulus contrast conditions. DRDCs were presented on the red and green channels of a computer monitor and were viewed with red-green goggles. The steady state DRDC-VEPs were recorded in healthy adult volunteers, and response reliability was assessed by the T(circ)(2) statistic. DRDC-VEP amplitude was independent of contrast, while VEP phases showed a weak correlation with contrast. Contrast invariance of DRDC-VEP amplitude suggests a very high contrast gain and dominant magnocellular input to the binocular correlation processing system.