Optometry and Vision Sciences - Research Publications

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    Altered Outer Retinal Structure, Electrophysiology and Visual Perception in Parkinson's Disease
    Tran, KKN ; Lee, PY ; Finkelstein, DI ; McKendrick, AM ; Nguyen, BN ; Bui, BV ; Nguyen, CTO (IOS PRESS, 2024)
    BACKGROUND: Visual biomarkers of Parkinson's disease (PD) are attractive as the retina is an outpouching of the brain. Although inner retinal neurodegeneration in PD is well-established this has overlap with other neurodegenerative diseases and thus outer retinal (photoreceptor) measures warrant further investigation. OBJECTIVE: To examine in a cross-sectional study whether clinically implementable measures targeting outer retinal function and structure can differentiate PD from healthy ageing and whether these are sensitive to intraday levodopa (L-DOPA) dosing. METHODS: Centre-surround perceptual contrast suppression, macular visual field sensitivity, colour discrimination, light-adapted electroretinography and optical coherence tomography (OCT) were tested in PD participants (n = 16) and controls (n = 21). Electroretinography and OCT were conducted before and after midday L-DOPA in PD participants, or repeated after ∼2 hours in controls. RESULTS: PD participants had decreased center-surround contrast suppression (p < 0.01), reduced macular visual field sensitivity (p < 0.05), color vision impairment (p < 0.01) photoreceptor dysfunction (a-wave, p < 0.01) and photoreceptor neurodegeneration (outer nuclear layer thinning, p < 0.05), relative to controls. Effect size comparison between inner and outer retinal parameters showed that photoreceptor metrics were similarly robust in differentiating the PD group from age-matched controls as inner retinal changes. Electroretinography and OCT were unaffected by L-DOPA treatment or time. CONCLUSIONS: We show that outer retinal outcomes of photoreceptoral dysfunction (decreased cone function and impaired color vision) and degeneration (i.e., outer nuclear layer thinning) were equivalent to inner retinal metrics at differentiating PD from healthy age-matched adults. These findings suggest outer retinal metrics may serve as useful biomarkers for PD.
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    Exercise alone impacts short-term adult visual neuroplasticity in a monocular deprivation paradigm
    Virathone, L ; Nguyen, BN ; Dobson, F ; Carter, OL ; McKendrick, AM (ASSOC RESEARCH VISION OPHTHALMOLOGY INC, 2021-10)
    Adult homeostatic visual plasticity can be induced by short-term patching, heralded by a shift in ocular dominance in favor of the deprived eye after monocular occlusion. The potential to boost visual neuroplasticity with environmental enrichment such as exercise has also been explored; however, the results are inconsistent, with some studies finding no additive effect of exercise. Studies to date have only considered the effect of patching alone or in combination with exercise. Whether exercise alone affects typical outcome measures of experimental estimates of short-term visual neuroplasticity is unknown. We therefore measured binocular rivalry in 20 healthy young adults (20-34 years old) at baseline and after three 2-hour interventions: patching (of the dominant eye) only, patching with exercise, and exercise only. Consistent with previous work, the patching interventions produced a shift in ocular dominance toward the deprived (dominant) eye. Mild- to moderate-intensity exercise in the absence of patching had several effects on binocular rivalry metrics, including a reduction in the dominant eye percept. The proportion of mixed percept and the time to first switch (onset rivalry) did not change from baseline across all interventions. Thus, we demonstrate that exercise alone can impact binocular rivalry outcomes measures. We did not observe a synergistic effect between patching and exercise in our data.
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    Neuroplasticity in older adults revealed by temporary occlusion of one eye
    Nguyen, BN ; Malavita, M ; Carter, OL ; McKendrick, AM (ELSEVIER MASSON, CORP OFF, 2021-10)
    Occluding one eye for several hours alters visual experience. Specifically, occluding one eye shifts the balance of ocular dominance to favour the recently deprived eye, which can be measured using binocular rivalry. This ocular dominance shift demonstrates homeostatic neuroplasticity within the visual system and has been explored in detail in younger adults. Here we measure whether the strength and general features of neuroplasticity revealed by monocular patching are maintained in older adults. Thirty younger (18-35 years) and 30 older adults (60-81 years) participated. Binocular rivalry features were measured before and after 2 h of occlusion. Post-patching, perceptual dominance of the non-patched eye decreased (p < .001) in both age groups. The effect of occlusion on all features of binocular rivalry did not significantly differ between groups. The older visual system maintains the ability to rapidly adjust to changes in perceptual experience induced by eye occlusion. This preservation of neuroplasticity suggests that visual training methods designed to improve visual performance based on eye occlusion should maintain effectiveness into older age.
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    Increased Depth, Reduced Extent, and Sharpened Edges of Visual Field Defects Measured by Compass Fundus Perimeter Compared to Humphrey Field Analyzer
    Liu, P ; Nguyen, BN ; Turpin, A ; McKendrick, AM (ASSOC RESEARCH VISION OPHTHALMOLOGY INC, 2021-10)
    PURPOSE: The purpose of this study was to compare visual field results of the COMPASS fundus perimeter (CMP) and the Humphrey Field Analyzer (HFA) in the same eyes; to compare structure-function concordance between circumpapillary retinal nerve fiber layer (Cp-RNFL) profiles and the two perimetry results; and to evaluate whether differences between the two results reflect postulated advantages of real-time eye movement compensation during perimetry. METHODS: We retrospectively analyzed 24-2 visual field data measured with CMP and HFA together with Cp-RNFL optical coherence tomography (OCT) scan data from 95 eyes of 65 people with glaucoma. We defined visual field locations with total deviation (TD) less than -5 dB as defective. The CMP and HFA fields were compared on measures of: spatial extent (number of defective locations); depth (TD values); and sharpness of scotomata edges (maximum TD difference between defective locations and their neighbors). Structure-function concordance between Cp-RNFL profile and respective visual field was also compared. RESULTS: Compared to the HFA, scotomata measured by CMP were of reduced spatial extent (mean difference = -3.14 locations, p < 0.001), greater depth (median TD of CMP = -17 dB versus HFA = -13 dB, p = 0.029) and steeper edges (median of maximum TD difference of CMP = 10.6 dB versus HFA = 6 dB, p < 0.001). Structure-function concordance between Cp-RNFL profile and either visual field were comparable despite the reduced scotoma spatial extent measured by CMP. CONCLUSIONS: Glaucomatous visual fields measured by CMP displayed characteristics consistent with expected effects of using real-time eye movement compensation technology compared to the widely used HFA. TRANSLATIONAL RELEVANCE: Glaucomatous visual field defects measured by the CMP are more localized, deeper, and steeper than those of the HFA.
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    Ageing elevates peripheral spatial suppression of motion regardless of divided attention
    Park, S ; Nguyen, BN ; McKendrick, AM (WILEY, 2020-03)
    PURPOSE: It is more difficult to perceive the direction of motion of larger, high contrast patterns than smaller, low contrast patterns due to spatial suppression. Spatial suppression of motion is considered important to the segmentation of moving objects in the visual environment. Previous studies have shown that such spatial suppression of motion is reduced in older adults in central vision, to the extent that older adults can have better sensitivity than younger adults for foveally presented stimuli. Our study was designed to explore whether spatial suppression of motion is similarly reduced for older adults in parafoveal regions and whether divided attention impacts on suppression strength because attention is known to impact on spatial interactions. METHODS: Twenty younger (19-34 years) and 18 older (61-77 years) adults completed a single task, where observers identified the direction of a drifting Gabor patch of variable size (σ of the Gaussian envelope = 0.5, 1, 2, 3, 4°) presented at 10 degrees of visual angle while observing a central fixation marker, and a dual task, where observers were required to divide their attention across two stimuli, the peripheral drifting Gabor patch and a central rapid serial visual presentation (RSVP) stream. RESULTS: Older adults showed increased spatial suppression of motion relative to younger adults for both tasks (main effect of group: p < 0.001). Dividing attention elevated thresholds for both age groups to a similar extent (main effect of attention: p = 0.002), but did not specifically alter spatial interactions (group x attention interaction: p = 0.13). CONCLUSIONS: Older adults require significantly longer than younger adults to correctly identify stimulus motion, and demonstrate increased spatial suppression of motion, in peripheral vision. When considered alongside previous evidence for reduced suppression for central fixation, our study provides evidence for substantial differences between foveal and parafoveal mechanisms of spatial suppression.
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    Visual search efficiency and functional visual cortical size in children with and without dyslexia
    Nguyen, BN ; Kolbe, SC ; Verghese, A ; Nearchou, C ; McKendrick, AM ; Egan, GF ; Vidyasagar, TR (Elsevier, 2021-05-14)
    Dyslexia is characterised by poor reading ability. Its aetiology is probably multifactorial, with abnormal visual processing playing an important role. Among adults with normal reading ability, there is a larger representation of central visual field in the primary visual cortex (V1) in those with more efficient visuospatial attention. In this study, we tested the hypothesis that poor reading ability in school-aged children (17 children with dyslexia, 14 control children with normal reading ability) is associated with deficits in visuospatial attention using a visual search task. We corroborated the psychophysical findings with neuroimaging, by measuring the functional size of V1 in response to a central 12° visual stimulus. Consistent with other literature, visual search was impaired and less efficient in the dyslexic children, particularly with more distractor elements in the search array (p=0.04). We also found atypical interhemispheric asymmetry in functional V1 size in the dyslexia group (p=0.02). Reading impaired children showed poorer visual search efficiency (p=0.01), needing more time per unit distractor (higher ms/item). Reading ability was also correlated with V1 size asymmetry (p=0.03), such that poorer readers showed less left hemisphere bias relative to the right hemisphere. Our findings support the view that dyslexic children have abnormal visuospatial attention and interhemispheric V1 asymmetry, relative to chronological age-matched peers, and that these factors may contribute to inter-individual variation in reading performance in children.
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    Increasing the Spatial Resolution of Visual Field Tests Without Increasing Test Duration: An Evaluation of ARREST
    Muthusamy, V ; Turpin, A ; Walland, MJ ; Nguyen, BN ; McKendrick, AM (Association for Research in Vision and Ophthalmology, 2020-12)
    Purpose: The Australian Reduced Range Extended Spatial Test (ARREST) approach was designed to improve visual field spatial resolution while maintaining a similar test duration to clinically used testing algorithms. ARREST does not completely threshold visual field locations with sensitivity < 17 dB, and uses the presentations saved to test new locations in areas of steep gradient within the visual field. Previous assessments of ARREST's performance have used computer simulation. In this study, we cross-sectionally assessed the performance of ARREST in people with visual field loss. Methods: We tested 23 people with glaucoma (mean age: 71 ± 8 years) with established visual field loss. Three visual field procedures were performed using the Open Perimetry Interface: cZEST and ARREST on the Octopus 900 perimeter (Haag-Streit AG, Switzerland), and a reference standard (best available estimate [BAE]) on the Compass perimeter (CenterVue SpA, Italy). ARREST was compared against the cZEST and the BAE. Results: On average, ARREST added seven new locations (range = 0-15) to a visual field test. There was no significant difference in the number of stimulus presentations between procedures (mean = 259 ± 25 [ARREST] vs. 261 ± 25 [cZEST], P = 0.78). In classifying threshold values < 17 dB, ARREST performed similarly when compared against BAE. Conclusions: This study provides empirical evidence to support conclusions from previous computer simulations that ARREST can be used to increase spatial sampling in regions of interest without increasing test time. Translational Relevance: ARREST is a new approach that augments current visual field testing procedures to provide better spatial description of visual field defects without increasing test duration.
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    MR-EYE: High-Resolution MRI of the Human Eye and Orbit at Ultrahigh Field (7T)
    Glarin, RK ; Nguyen, BN ; Cleary, JO ; Kolbe, SC ; Ordidge, RJ ; Bui, B ; McKendrick, AM ; Moffat, BA (Elsevier, 2021-02-01)
    Key points • Dedicated eye imaging can be implemented at 7T to acquire high-resolution, high contrast-to-noise, and high signal-to-noise images in a feasible imaging time suitable for clinical use. • Simple, reproducible participant preparation techniques can be adopted to reduce the motion of the eye leading to a reduction in subsequent artefacts. • Sequences available at ultrahigh field can be used in current 7T clinical applications to visualize ocular structures otherwise impossible with other ophthalmic imaging.
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    Ultra-High Field Magnetic Resonance Imaging of the Retrobulbar Optic Nerve, Subarachnoid Space, and Optic Nerve Sheath in Emmetropic and Myopic Eyes
    Nguyen, BN ; Cleary, JO ; Glarin, R ; Kolbe, SC ; Moffat, BA ; Ordidge, RJ ; Bui, BV ; McKendrick, AM (Association for Research in Vision and Ophthalmology (ARVO), 2021-02-09)
    Purpose: We aimed to image the optic nerve, subarachnoid space and optic nerve sheath in emmetropes and myopes ultra-high field (7-Tesla) magnetic resonance imaging (MRI). We targeted the retrobulbar distance of approximately 3 mm behind the eyeball, an area of clinical interest because of optic nerve sheath distensibility and pressure-related enlargement. Methods: Eleven emmetropes (+0.75 to −0.50D, aged 20–41 years) and 10 myopes (−4.5 to −12D, aged 21–37 years) participated. Cross-sectional area of the optic nerve, subarachnoid space and optic nerve sheath at approximately 3 mm behind the eye were measured from two-dimensional T2-weighted coronal oblique MRI images obtained through the left optic nerve. Axial length of the left eye was measured from T2-weighted axial MRI images. In nine emmetropes and seven myopes, the optic nerve head was imaged with optical coherence tomography to compare retrobulbar and intraocular measures. Results: Retrobulbar optic nerve, subarachnoid space and optic nerve sheath dimensions differed between myopes and emmetropes. Myopes tended to have smaller optic nerve and subarachnoid space. Longer MRI-derived axial length was associated with smaller optic nerve area (P = 0.03). Bruch's membrane opening area did not predict retrobulbar optic nerve area (P = 0.48). Conclusions: This study demonstrates the feasibility of using 7-Tesla MRI to measure optic nerve, subarachnoid space, and optic nerve sheath dimensions behind the eye. In healthy adults, the retrobulbar optic nerve and subarachnoid space size are influenced by the degree of myopia. Translational Relevance: ultra-high field MRI is a practical tool for assessing the morphometry of the optic nerve and surrounding anatomy behind the eye.
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    Illusory Motion Perception Is Associated with Contrast Discrimination but Not Motion Sensitivity, Self-Reported Visual Discomfort, or Migraine Status
    He, C ; Chan, YM ; McKendrick, AM ; Nguyen, B (ASSOC RESEARCH VISION OPHTHALMOLOGY INC, 2020-07-01)
    PURPOSE: Altered visual processing of motion and contrast has been previously reported in people with migraine. One possible manifestation of this altered visual processing is increased self-reported susceptibility to visual illusions of contrast and motion. Here, we use the Fraser-Wilcox illusion to explore individual differences in motion illusion strength in people with and without migraine. The motion-inducing mechanisms of the Fraser-Wilcox illusion are purported to be contrast dependent. To better understand the mechanisms of the illusion, as well as visual processing anomalies in migraine, we explored whether migraine status, susceptibility to visual discomfort, contrast discrimination, or motion sensitivity are related to quantified motion illusion strength. METHODS: Thirty-six (16 with aura, 20 without aura) people with migraine and 20 headache-free controls participated. Outcome measures were motion illusion strength (the physical motion speed that counterbalanced the illusory motion), motion sensitivity, and contrast discrimination thresholds (measured for each contrast pair that formed part of the illusory motion stimulus). Typical daily visual discomfort was self-reported via questionnaire. RESULTS: Motion illusion strength was negatively correlated with contrast discrimination threshold (r = -0.271, P = 0.04) but was not associated with motion sensitivity or migraine status. People with migraine with aura reported experiencing visual discomfort more frequently than the control group (P = 0.001). Self-reported visual discomfort did not relate to quantified perceptual motion illusion strength. CONCLUSIONS: Individuals with better contrast discrimination tend to perceive faster illusory motion regardless of migraine status.