Pub Date : 2018-04-16DOI: 10.1017/s0952523817000177
{"title":"The Lasker/IRRF initiative for innovation in vision science amblyopia: Challenges and opportunities","authors":"","doi":"10.1017/s0952523817000177","DOIUrl":"https://doi.org/10.1017/s0952523817000177","url":null,"abstract":"","PeriodicalId":23556,"journal":{"name":"Visual Neuroscience","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2018-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/s0952523817000177","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43698452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-01-01DOI: 10.1017/S0952523818000032
James E Niemeyer, Michael A Paradiso
Neurons in visual areas of the brain are generally characterized by the increase in firing rate that occurs when a stimulus is flashed on in the receptive field (RF). However, neurons also increase their firing rate when a stimulus is turned off. These "termination responses" or "after-discharges" that occur with flashed stimuli have been observed in area V1 and they may be important for vision as stimulus terminations have been shown to influence visual perception. The goal of the present study was to determine the strength of termination responses in the more natural situation in which eye movements move a stimulus out of an RF. We find that termination responses do occur in macaque V1 when termination results from a saccadic eye movement, but they are smaller in amplitude compared to flashed-off stimuli. Furthermore, there are termination responses even in the absence of visual stimulation. These findings demonstrate that termination responses are a component of naturalistic vision. They appear to be based on both visual and nonvisual signals in visual cortex. We speculate that the weakening of termination responses might be a neural correlate of saccadic suppression, the loss of perceptual sensitivity around the time of saccades.
{"title":"Saccade-based termination responses in macaque V1 and visual perception.","authors":"James E Niemeyer, Michael A Paradiso","doi":"10.1017/S0952523818000032","DOIUrl":"https://doi.org/10.1017/S0952523818000032","url":null,"abstract":"<p><p>Neurons in visual areas of the brain are generally characterized by the increase in firing rate that occurs when a stimulus is flashed on in the receptive field (RF). However, neurons also increase their firing rate when a stimulus is turned off. These \"termination responses\" or \"after-discharges\" that occur with flashed stimuli have been observed in area V1 and they may be important for vision as stimulus terminations have been shown to influence visual perception. The goal of the present study was to determine the strength of termination responses in the more natural situation in which eye movements move a stimulus out of an RF. We find that termination responses do occur in macaque V1 when termination results from a saccadic eye movement, but they are smaller in amplitude compared to flashed-off stimuli. Furthermore, there are termination responses even in the absence of visual stimulation. These findings demonstrate that termination responses are a component of naturalistic vision. They appear to be based on both visual and nonvisual signals in visual cortex. We speculate that the weakening of termination responses might be a neural correlate of saccadic suppression, the loss of perceptual sensitivity around the time of saccades.</p>","PeriodicalId":23556,"journal":{"name":"Visual Neuroscience","volume":"35 ","pages":"E025"},"PeriodicalIF":1.9,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/S0952523818000032","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36749498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-01-01DOI: 10.1017/S0952523817000268
John E Dowling
All agree that amblyopia is a disorder that affects visual structures beyond the eye. Many simply say that amblyopia is a brain disorder. But the retina is part of the brain, pushed out into the eye during development. As someone who has long studied the retina, I wonder if the retina is at all affected. At first glance, retinal function appears normal in amblyopia, but is it totally unaltered? I am not convinced, but as yet, nothing of significance has been shown in this regard. The reasons I suggest this are three fold: first, there are centrifugal fibers from higher visual structures that innervate the retina and alterations in higher visual pathways could very well affect the retina. Second, as noted many times in this report, there are many visual deficits that occur in amblyopia—it is not just a defect in visual acuity but in contrast sensitivity, accommodation, fixation, binocularity, and so forth. Third, some visual alterations are seen in the other eye in unilateral amblyopia and suggest to me that a closer examination of retinal function in amblyopia might be useful to undertake. I am not suggesting that retinal changes are the major alterations in amblyopia; clearly, the major effects of amblyopia are manifest in the cortex. But where in the cortex? Beginning in area V1 but certainly in higher visual areas as well and even, probably, in other nonvisual areas. The bottom line is that amblyopia is a very complex disorder consisting of several different forms, each of which is expressed somewhat differently. Today, throughout the world, we are focusing enormous effort on studies of the brain structure and function, and many of the major issues regarding how the brain functions are the front and center in amblyopia research. In other words, findings in amblyopia research are instructive in terms of understanding the brain function and vice versa. A prime example is that of brain plasticity—how hard wired are our brains? Our views on this have changed dramatically over the past half century, beginning with the pioneering studies of Wiesel and Hubel on monocular visual deprivation in cats and monkeys. Dramatic changes in structure and function occur in area V1 of the cortex often after just a relatively short period of deprivation. And as was learned from the clinic, the changes in amblyopia occur most dramatically in the young, during the so-called critical period. It was also recognized in the clinic that if recovery was to be achieved, it happened most readily by interventions in the critical period. All of the above are certainly correct, but what has changed is our understanding of critical periods—when the nervous system is modifiable. Whereas it was once viewed that the critical period was finite, we now recognize that it is not. Brain plasticity can occur all of our lives, although as we grow older it does decline. As described in several of the reviews in this volume, critical periods can be extended and even reopened by various man
{"title":"Concluding remarks on the Lasker/IRRF initiative on amblyopia.","authors":"John E Dowling","doi":"10.1017/S0952523817000268","DOIUrl":"https://doi.org/10.1017/S0952523817000268","url":null,"abstract":"All agree that amblyopia is a disorder that affects visual structures beyond the eye. Many simply say that amblyopia is a brain disorder. But the retina is part of the brain, pushed out into the eye during development. As someone who has long studied the retina, I wonder if the retina is at all affected. At first glance, retinal function appears normal in amblyopia, but is it totally unaltered? I am not convinced, but as yet, nothing of significance has been shown in this regard. The reasons I suggest this are three fold: first, there are centrifugal fibers from higher visual structures that innervate the retina and alterations in higher visual pathways could very well affect the retina. Second, as noted many times in this report, there are many visual deficits that occur in amblyopia—it is not just a defect in visual acuity but in contrast sensitivity, accommodation, fixation, binocularity, and so forth. Third, some visual alterations are seen in the other eye in unilateral amblyopia and suggest to me that a closer examination of retinal function in amblyopia might be useful to undertake. I am not suggesting that retinal changes are the major alterations in amblyopia; clearly, the major effects of amblyopia are manifest in the cortex. But where in the cortex? Beginning in area V1 but certainly in higher visual areas as well and even, probably, in other nonvisual areas. The bottom line is that amblyopia is a very complex disorder consisting of several different forms, each of which is expressed somewhat differently. Today, throughout the world, we are focusing enormous effort on studies of the brain structure and function, and many of the major issues regarding how the brain functions are the front and center in amblyopia research. In other words, findings in amblyopia research are instructive in terms of understanding the brain function and vice versa. A prime example is that of brain plasticity—how hard wired are our brains? Our views on this have changed dramatically over the past half century, beginning with the pioneering studies of Wiesel and Hubel on monocular visual deprivation in cats and monkeys. Dramatic changes in structure and function occur in area V1 of the cortex often after just a relatively short period of deprivation. And as was learned from the clinic, the changes in amblyopia occur most dramatically in the young, during the so-called critical period. It was also recognized in the clinic that if recovery was to be achieved, it happened most readily by interventions in the critical period. All of the above are certainly correct, but what has changed is our understanding of critical periods—when the nervous system is modifiable. Whereas it was once viewed that the critical period was finite, we now recognize that it is not. Brain plasticity can occur all of our lives, although as we grow older it does decline. As described in several of the reviews in this volume, critical periods can be extended and even reopened by various man","PeriodicalId":23556,"journal":{"name":"Visual Neuroscience","volume":"35 ","pages":"E019"},"PeriodicalIF":1.9,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/S0952523817000268","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36224509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-01-01DOI: 10.1017/S0952523818000019
Ilaria Savelli, Iñigo Novales Flamarique
Vertebrate retinal photoreceptors house visual pigments that absorb light to begin the process of vision. The light absorbed by a visual pigment depends on its two molecular components: protein (opsin) and chromophore (a vitamin A derivative). Although an increasing number of studies show intraretinal variability in visual pigment content, it is only for two mammals (human and mouse) and two birds (chicken and pigeon) that such variability has been demonstrated to underlie differences in spectral sensitivity of the animal. Here, we show that the spectral sensitivity of the northern anchovy varies with retinal quadrant and that this variability can be explained by differences in the expression of opsin transcripts. Retinal (vitamin A1) was the only chromophore detected in the retina, ruling out this molecular component as a source of variation in spectral sensitivity. Chromatic adaptation experiments further showed that the dorsal retina had the capacity to mediate color vision. Together with published results for the ventral retina, this study is the first to demonstrate that intraretinal opsin variability in a fish drives corresponding variation in the animal's spectral sensitivity.
{"title":"Variation in opsin transcript expression explains intraretinal differences in spectral sensitivity of the northern anchovy.","authors":"Ilaria Savelli, Iñigo Novales Flamarique","doi":"10.1017/S0952523818000019","DOIUrl":"https://doi.org/10.1017/S0952523818000019","url":null,"abstract":"<p><p>Vertebrate retinal photoreceptors house visual pigments that absorb light to begin the process of vision. The light absorbed by a visual pigment depends on its two molecular components: protein (opsin) and chromophore (a vitamin A derivative). Although an increasing number of studies show intraretinal variability in visual pigment content, it is only for two mammals (human and mouse) and two birds (chicken and pigeon) that such variability has been demonstrated to underlie differences in spectral sensitivity of the animal. Here, we show that the spectral sensitivity of the northern anchovy varies with retinal quadrant and that this variability can be explained by differences in the expression of opsin transcripts. Retinal (vitamin A1) was the only chromophore detected in the retina, ruling out this molecular component as a source of variation in spectral sensitivity. Chromatic adaptation experiments further showed that the dorsal retina had the capacity to mediate color vision. Together with published results for the ventral retina, this study is the first to demonstrate that intraretinal opsin variability in a fish drives corresponding variation in the animal's spectral sensitivity.</p>","PeriodicalId":23556,"journal":{"name":"Visual Neuroscience","volume":"35 ","pages":"E005"},"PeriodicalIF":1.9,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/S0952523818000019","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36225537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-01-01DOI: 10.1017/S0952523817000372
Stephen Ramanoël, Sylvie Chokron, Ruxandra Hera, Louise Kauffmann, Christophe Chiquet, Alexandre Krainik, Carole Peyrin
In age-related macular degeneration (AMD), the processing of fine details in a visual scene, based on a high spatial frequency processing, is impaired, while the processing of global shapes, based on a low spatial frequency processing, is relatively well preserved. The present fMRI study aimed to investigate the residual abilities and functional brain changes of spatial frequency processing in visual scenes in AMD patients. AMD patients and normally sighted elderly participants performed a categorization task using large black and white photographs of scenes (indoors vs. outdoors) filtered in low and high spatial frequencies, and nonfiltered. The study also explored the effect of luminance contrast on the processing of high spatial frequencies. The contrast across scenes was either unmodified or equalized using a root-mean-square contrast normalization in order to increase contrast in high-pass filtered scenes. Performance was lower for high-pass filtered scenes than for low-pass and nonfiltered scenes, for both AMD patients and controls. The deficit for processing high spatial frequencies was more pronounced in AMD patients than in controls and was associated with lower activity for patients than controls not only in the occipital areas dedicated to central and peripheral visual fields but also in a distant cerebral region specialized for scene perception, the parahippocampal place area. Increasing the contrast improved the processing of high spatial frequency content and spurred activation of the occipital cortex for AMD patients. These findings may lead to new perspectives for rehabilitation procedures for AMD patients.
{"title":"Age-related macular degeneration changes the processing of visual scenes in the brain.","authors":"Stephen Ramanoël, Sylvie Chokron, Ruxandra Hera, Louise Kauffmann, Christophe Chiquet, Alexandre Krainik, Carole Peyrin","doi":"10.1017/S0952523817000372","DOIUrl":"https://doi.org/10.1017/S0952523817000372","url":null,"abstract":"<p><p>In age-related macular degeneration (AMD), the processing of fine details in a visual scene, based on a high spatial frequency processing, is impaired, while the processing of global shapes, based on a low spatial frequency processing, is relatively well preserved. The present fMRI study aimed to investigate the residual abilities and functional brain changes of spatial frequency processing in visual scenes in AMD patients. AMD patients and normally sighted elderly participants performed a categorization task using large black and white photographs of scenes (indoors vs. outdoors) filtered in low and high spatial frequencies, and nonfiltered. The study also explored the effect of luminance contrast on the processing of high spatial frequencies. The contrast across scenes was either unmodified or equalized using a root-mean-square contrast normalization in order to increase contrast in high-pass filtered scenes. Performance was lower for high-pass filtered scenes than for low-pass and nonfiltered scenes, for both AMD patients and controls. The deficit for processing high spatial frequencies was more pronounced in AMD patients than in controls and was associated with lower activity for patients than controls not only in the occipital areas dedicated to central and peripheral visual fields but also in a distant cerebral region specialized for scene perception, the parahippocampal place area. Increasing the contrast improved the processing of high spatial frequency content and spurred activation of the occipital cortex for AMD patients. These findings may lead to new perspectives for rehabilitation procedures for AMD patients.</p>","PeriodicalId":23556,"journal":{"name":"Visual Neuroscience","volume":"35 ","pages":"E006"},"PeriodicalIF":1.9,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/S0952523817000372","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36224516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-01-01DOI: 10.1017/S0952523817000335
Kaitlyn D Holman, Kevin R Duffy, Donald E Mitchell
It has been shown that the visual acuity loss experienced by the deprived eye of kittens following an early period of monocular deprivation (MD) can be alleviated rapidly following 10 days of complete darkness when imposed even as late as 14 weeks of age. To examine whether 10 days of darkness conferred benefits at any age, we measured the extent of recovery of the visual acuity of the deprived eye following the darkness imposed on adult cats that had received the same early period of MD as used in prior experiments conducted on kittens. Parallel studies conducted on different animals examined the extent to which darkness changed the magnitude of the MD-induced laminar differences of the cell soma size and immunoreactivity for the neurofilament (NF) protein in the dorsal lateral geniculate nucleus (dLGN). The results indicated that 10 days of darkness imposed at one year of age neither alleviated the acuity loss of the deprived eye induced by an earlier period of MD nor did it decrease the concurrent lamina differences of the soma size or NF loss in the dLGN.
{"title":"Short periods of darkness fail to restore visual or neural plasticity in adult cats.","authors":"Kaitlyn D Holman, Kevin R Duffy, Donald E Mitchell","doi":"10.1017/S0952523817000335","DOIUrl":"https://doi.org/10.1017/S0952523817000335","url":null,"abstract":"<p><p>It has been shown that the visual acuity loss experienced by the deprived eye of kittens following an early period of monocular deprivation (MD) can be alleviated rapidly following 10 days of complete darkness when imposed even as late as 14 weeks of age. To examine whether 10 days of darkness conferred benefits at any age, we measured the extent of recovery of the visual acuity of the deprived eye following the darkness imposed on adult cats that had received the same early period of MD as used in prior experiments conducted on kittens. Parallel studies conducted on different animals examined the extent to which darkness changed the magnitude of the MD-induced laminar differences of the cell soma size and immunoreactivity for the neurofilament (NF) protein in the dorsal lateral geniculate nucleus (dLGN). The results indicated that 10 days of darkness imposed at one year of age neither alleviated the acuity loss of the deprived eye induced by an earlier period of MD nor did it decrease the concurrent lamina differences of the soma size or NF loss in the dLGN.</p>","PeriodicalId":23556,"journal":{"name":"Visual Neuroscience","volume":"35 ","pages":"E002"},"PeriodicalIF":1.9,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/S0952523817000335","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36225437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-01-01DOI: 10.1017/S0952523817000207
David Hunter, Susan Cotter
Amblyopia can be improved or eliminated more easily when treated early in life. Because amblyopia in older children is generally less responsive to treatment (Holmes et al., 2011), there is a premium on the early identification of amblyopia and its risk factors and the subsequent treatment thereof. Clinical preference is to institute treatment in children before 7 years of age when an optimal visual outcome is typically easier to obtain.
弱视在早期治疗时更容易改善或消除。由于大龄儿童的弱视通常对治疗反应较差(Holmes et al., 2011),因此早期识别弱视及其危险因素并进行后续治疗是有价值的。临床倾向于在7岁之前的儿童中进行治疗,因为7岁之前的儿童通常更容易获得最佳的视力结果。
{"title":"Early diagnosis of amblyopia.","authors":"David Hunter, Susan Cotter","doi":"10.1017/S0952523817000207","DOIUrl":"https://doi.org/10.1017/S0952523817000207","url":null,"abstract":"<p><p>Amblyopia can be improved or eliminated more easily when treated early in life. Because amblyopia in older children is generally less responsive to treatment (Holmes et al., 2011), there is a premium on the early identification of amblyopia and its risk factors and the subsequent treatment thereof. Clinical preference is to institute treatment in children before 7 years of age when an optimal visual outcome is typically easier to obtain.</p>","PeriodicalId":23556,"journal":{"name":"Visual Neuroscience","volume":"35 ","pages":"E013"},"PeriodicalIF":1.9,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/S0952523817000207","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36225536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-01-01DOI: 10.1017/S0952523817000360
Melina A Agosto, Ivan A Anastassov, Theodore G Wensel
The transient receptor potential channel TRPM1 is required for synaptic transmission between photoreceptors and the ON subtype of bipolar cells (ON-BPC), mediating depolarization in response to light. TRPM1 is present in the somas and postsynaptic dendritic tips of ON-BPCs. Monoclonal antibodies generated against full-length TRPM1 were found to have differential labeling patterns when used to immunostain the mouse retina, with some yielding reduced labeling of dendritic tips relative to the labeling of cell bodies. Epitope mapping revealed that those antibodies that poorly label the dendritic tips share a binding site (N2d) in the N-terminal arm near the transmembrane domain. A major splice variant of TRPM1 lacking exon 19 does not contain the N2d binding site, but quantitative immunoblotting revealed no enrichment of this variant in synaptsomes. One explanation of the differential labeling is masking of the N2d epitope by formation of a synapse-specific multiprotein complex. Identifying the binding partners that are specific for the fraction of TRPM1 present at the synapses is an ongoing challenge for understanding TRPM1 function.
{"title":"Differential epitope masking reveals synapse-specific complexes of TRPM1.","authors":"Melina A Agosto, Ivan A Anastassov, Theodore G Wensel","doi":"10.1017/S0952523817000360","DOIUrl":"https://doi.org/10.1017/S0952523817000360","url":null,"abstract":"<p><p>The transient receptor potential channel TRPM1 is required for synaptic transmission between photoreceptors and the ON subtype of bipolar cells (ON-BPC), mediating depolarization in response to light. TRPM1 is present in the somas and postsynaptic dendritic tips of ON-BPCs. Monoclonal antibodies generated against full-length TRPM1 were found to have differential labeling patterns when used to immunostain the mouse retina, with some yielding reduced labeling of dendritic tips relative to the labeling of cell bodies. Epitope mapping revealed that those antibodies that poorly label the dendritic tips share a binding site (N2d) in the N-terminal arm near the transmembrane domain. A major splice variant of TRPM1 lacking exon 19 does not contain the N2d binding site, but quantitative immunoblotting revealed no enrichment of this variant in synaptsomes. One explanation of the differential labeling is masking of the N2d epitope by formation of a synapse-specific multiprotein complex. Identifying the binding partners that are specific for the fraction of TRPM1 present at the synapses is an ongoing challenge for understanding TRPM1 function.</p>","PeriodicalId":23556,"journal":{"name":"Visual Neuroscience","volume":"35 ","pages":"E001"},"PeriodicalIF":1.9,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/S0952523817000360","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35766726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-01-01DOI: 10.1017/S0952523817000220
Jonathan M Holmes, Dennis M Levi
Although historically, treatment of amblyopia has been recommended prior to closure of a critical window in visual development, the existence and duration of that critical window is currently unclear. Moreover, there is clear evidence, both from animal and human studies of deprivation amblyopia, that there are different critical windows for different visual functions and that monocular and binocular deprivation have different neural and behavioral consequences. In view of the spectrum of critical windows for different visual functions and for different types of amblyopia, combined with individual variability in these windows, treatment of amblyopia has been increasingly offered to older children and adults. Nevertheless, treatment beyond the age of 7 years tends to be, on average, less effective than in younger children, and the high degree of variability in treatment response suggests that age is only one of many factors determining treatment response. Newly emerging treatment modalities may hold promise for more effective treatment of amblyopia at older ages. Additional studies are needed to characterize amblyopia by using new and existing clinical tests, leading to improved clinical classification and better prediction of treatment response. Attention also needs to be directed toward characterizing and measuring the impact of amblyopia on the patients' functional vision and health-related quality of life.
{"title":"Treatment of amblyopia as a function of age.","authors":"Jonathan M Holmes, Dennis M Levi","doi":"10.1017/S0952523817000220","DOIUrl":"https://doi.org/10.1017/S0952523817000220","url":null,"abstract":"<p><p>Although historically, treatment of amblyopia has been recommended prior to closure of a critical window in visual development, the existence and duration of that critical window is currently unclear. Moreover, there is clear evidence, both from animal and human studies of deprivation amblyopia, that there are different critical windows for different visual functions and that monocular and binocular deprivation have different neural and behavioral consequences. In view of the spectrum of critical windows for different visual functions and for different types of amblyopia, combined with individual variability in these windows, treatment of amblyopia has been increasingly offered to older children and adults. Nevertheless, treatment beyond the age of 7 years tends to be, on average, less effective than in younger children, and the high degree of variability in treatment response suggests that age is only one of many factors determining treatment response. Newly emerging treatment modalities may hold promise for more effective treatment of amblyopia at older ages. Additional studies are needed to characterize amblyopia by using new and existing clinical tests, leading to improved clinical classification and better prediction of treatment response. Attention also needs to be directed toward characterizing and measuring the impact of amblyopia on the patients' functional vision and health-related quality of life.</p>","PeriodicalId":23556,"journal":{"name":"Visual Neuroscience","volume":"35 ","pages":"E015"},"PeriodicalIF":1.9,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/S0952523817000220","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36224515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}