Optometry and Vision Sciences - Research Publications
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ItemNo Preview AvailableCan HMG Co-A reductase inhibitors ("statins") slow the progression of age-related macular degeneration? The Age-Related Maculopathy Statin Study (ARMSS)(DOVE MEDICAL PRESS LTD, 2008)Age-related macular degeneration (AMD) is responsible for the majority of visual impairment in the Western world. The role of cholesterol-lowering medications, HMG Co-A reductase inhibitors or statins, in reducing the risk of AMD or of delaying its progression has not been fully investigated. A 3-year prospective randomized controlled trial of 40 mg simvastatin per day compared to placebo in subjects at high risk of AMD progression is described. This paper outlines the primary aims of the Age-Related Maculopathy Statin Study (ARMSS), and the methodology involved. Standardized clinical grading of macular photographs and comparison of serial macular digital photographs, using the International grading scheme, form the basis for assessment of primary study outcomes. In addition, macular function is assessed at each visit with detailed psychophysical measurements of rod and cone function. Information collected in this study will assist in the assessment of the potential value of HMG Co-A reductase inhibitors (statins) in reducing the risk of AMD progression.
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ItemNovel measures of cardiovascular health and its association with prevalence and progression of age-related macular degeneration: the CHARM study(BMC, 2008)BACKGROUND: To determine if novel measures of cardiovascular health are associated with prevalence or progression of age-related macular degeneration (AMD). METHODS: Measures of the cardiovascular system: included intima media thickness (IMT), pulse wave velocity (PWV), systemic arterial compliance (SAC), carotid augmentation index (AI). For the prevalence study, hospital-based AMD cases and population-based age- and gender-matched controls with no signs of AMD in either eye were enrolled. For the progression component, participants with early AMD were recruited from two previous studies; cases were defined as progression in one or both eyes and controls were defined as no progression in either eye. RESULTS: 160 cases and 160 controls were included in the prevalence component. The upper two quartiles of SAC, implying good cardiovascular health, were significantly associated with increased risk of AMD (OR = 2.54, 95% CL = 1.29, 4.99). High PWV was associated with increased prevalent AMD. Progression was observed in 82 (32.3%) of the 254 subjects recruited for the progression component. Higher AI (worse cardiovascular function) was protective for AMD progression (OR = 0.30, 95%CL = 0.13, 0.69). Higher aortic PWV was associated with increased risk of AMD progression; the highest risk was seen with the second lowest velocity (OR = 6.22, 95% CL = 2.35, 16.46). CONCLUSION: The results were unexpected in that better cardiovascular health was associated with increased risk of prevalent AMD and progression. Inconsistent findings between the prevalence and progression components could be due to truly different disease etiologies or to spurious findings, as can occur with inherent biases in case control studies of prevalence. Further investigation of these non-invasive methods of characterizing the cardiovascular system should be undertaken as they may help to further elucidate the role of the cardiovascular system in the etiology of prevalent AMD and progression.
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ItemNo Preview AvailableFactors influencing the experience of oscillopsia in infantile nystagmus syndrome(ASSOC RESEARCH VISION OPHTHALMOLOGY INC, 2008-08)PURPOSE: Perceptual instability in infantile nystagmus syndrome (INS) has been reported occasionally. This study was conducted to examine the factors that influence perceptual stability in 18 individuals with INS. METHODS: The subjects were instructed to look continuously at a fixation LED centered in an image (38 degrees x 32 degrees ) at two luminance levels (3.25 and 0.46 cd/m(2), with 21% and 96% contrast, respectively) throughout all trials. A trial consisted of the fixation LED on, followed by a peripheral LED on, and then both LEDs off. Subjects then reported what they perceived. Five trials were conducted per contrast image. Eye movements were recorded with a limbal tracker. After testing, each subject completed a questionnaire to determine whether they ever had or were presently experiencing oscillopsia. RESULTS: Sixteen of 18 subjects reported experiencing oscillopsia on the questionnaire. In the laboratory, the percentages of trials with perceptions of motion of the LED and background were as follows: neither, 45% to 60%; background only, 15% to 30%; both, approximately 15%; and LED only, approximately 10%. Over all trials, 14/18 and 13/17 subjects experienced oscillopsia for the low- and high-contrast images, respectively (i.e., four subjects never experienced oscillopsia). The background was frequently seen moving when both images were displayed, regardless of contrast and/or condition. Trials with and without oscillopsia did not differ between the foveation periods. CONCLUSIONS: Subjects with INS may experience spatially inhomogeneous oscillopsia under certain viewing conditions. The physical attributes of the stimulus, repeated trials, different conduction times, and the role of divided attention may influence a subject's perception differently.
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ItemSaccadic Modulation of Neural Responses: Possible Roles in Saccadic Suppression, Enhancement, and Time Compression(SOC NEUROSCIENCE, 2008-10-22)Humans use saccadic eye movements to make frequent gaze changes, yet the associated full-field image motion is not perceived. The theory of saccadic suppression has been proposed to account for this phenomenon, but it is not clear whether suppression originates from a retinal signal at saccade onset or from the brain before saccade onset. Perceptually, visual sensitivity is reduced before saccades and enhanced afterward. Over the same time period, the perception of time is compressed and even inverted. We explore the origins and neural basis of these effects by recording from neurons in the dorsal medial superior temporal area (MSTd) of alert macaque monkeys. Neuronal responses to flashed presentations of a textured pattern presented at random times relative to saccades exhibit a stereotypical pattern of modulation. Response amplitudes are strongly suppressed for flashes presented up to 90 ms before saccades. Immediately after the suppression, there is a period of 200-450 ms in which flashes generate enhanced response amplitudes. Our results show that (1) MSTd is not directly suppressed, rather suppression is inherited from earlier visual areas; (2) early suppression of the visual system must be of extra-retinal origin; (3) postsaccadic enhancement of neural activity occurs in MSTd; and (4) the enhanced responses have reduced latencies. As a whole, these observations reveal response properties that could account for perceptual observations relating to presaccadic suppression, postsaccadic enhancement and time compression.
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ItemIntegration of the visual and auditory networks in dyslexia: a theoretical perspective(BLACKWELL PUBLISHING, 2005-08)In addition to an intrinsic difficulty in reading and spelling, one of the defining characteristics of dyslexia is an enduring and pervasive difficulty in phonological coding, such that dyslexic readers find it particularly challenging to process and manipulate the constituent sounds of a language. Coexistent with this finding is the evidence that some dyslexic readers also demonstrate subtle sensory coding problems in the visual and auditory domains. Few theories have been proposed to unite these different findings within a coherent model of reading. Here the evidence for visual, auditory and phonological coding problems in dyslexia is briefly reviewed, and a hypothesis is proposed for how adequate early sensory coding may be intrinsic to phonological awareness and subsequent reading ability. In this hypothesis, a cortical network is assumed that incorporates the visual, auditory and phonological skills of reading. The visual sub‐component of the network is mediated by the dorsal visual pathway, which is responsible for the accurate spatial encoding of letters, words and text. The auditory component of the network in pre‐readers is intrinsic to the development of phonological sensitivity, and then grapheme‐phoneme assimilation as reading skills develop. In this hypothesis, some of the symptoms of dyslexia may result from subtle problems in the encoding of both visual and auditory information and their role in maintaining the synchronicity of the reading network.