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Central visual field (CVF) loss is important in maintaining vision-related quality of life in eyes with open-angle glaucoma (OAG). The present study investigated whether nasalized location of central retinal vessel trunk (CRVT) at baseline is associated with rapid rate of CVF loss in early-stage OAG eyes. This study included 76 OAG eyes with high nasalization CRVT [HNL] group and 75 OAG eyes with low nasalization CRVT [LNL] group matched for glaucoma severity at baseline that showed progressive visual field (VF) loss. The rates of mean threshold changes at various regions were compared in the two groups using a linear mixed model. Clinical variables associated with rapid rate of CVF progression were also identified using a linear mixed model. The rate of CVF loss in the central 10° was significantly higher in the HNL group than that in the LNL group (−0.452 dB/year vs. −0.291 dB/year, P P P

To evaluate macular features and fixation pattern in patients with retinitis pigmentosa (RP) compared with healthy controls, using spectral-domain optical coherence tomography and MP-1 microperimetry.Eighty-one eyes of 81 patients with RP and 90 eyes of 90 healthy subjects were assessed. The central foveal thickness, subfoveal choroidal thickness, ellipsoid zone length, and the mean retinal sensitivities and fixation characteristics were evaluated by spectral-domain optical coherence tomography and MP-1 microperimetry.Compared with healthy subjects, patients with central macular thinning had lower best corrected visual acuity, central foveal thickness, ellipsoid zone length, retinal sensitivity, and visual field than patients with cystoid macular edema or no macular change (all P0.001). Correlations between fixation characteristics and best corrected visual acuity, central foveal thickness, ellipsoid zone length, retinal sensitivity, and visual field were statistically significant (all P0.001). Patients with no macular change had more centralized and stabilized fixation than patients with central foveal thinning and cystoid macular edema.The spectrum of macular features from the nearly normal retina to complete chorioretinal atrophy can be seen in RP patients without associations with age or duration of symptoms. Unlike other macular degenerations, most patients with RP obtained at least a central 2° of visual field, with foveal and stable fixation.

Purpose A method of evaluating central visual field (VF) progression in eyes with retinitis pigmentosa (RP) has still to be established. We previously reported the potential merit of applying a binomial test to pointwise linear regression (binomial PLR) in glaucoma progression. In the current study, we investigated the usefulness of binomial PLR in eyes with RP. Methods A series of 10 VFs (VF 1–10, Humphrey field analyzer, 10-2 test) from 196 eyes of 103 patients with RP were collected retrospectively. The PLR was performed by regressing the total deviation of all test points with the complete series of 10 VFs. The accuracy (positive predictive value, negative predictive value, and false-positive rate) and the time required to detect VF progression with shorter VF series (from VF 1–5 to VF 1–9) were compared across the binomial PLR, a permutation analysis of PLR (PoPLR), and a mean deviation (MD) trend analysis. Results In evaluating VF progression, the binomial PLR was comparable with the PoPLR and MD trend analyses in its positive predictive value (0.55 to 0.95), negative predictive value (0.67 to 0.92), and false-positive rate (0.01 to 0.05). The binomial PLR required significantly less time to detect VF progression (5.0 ± 2.0 years) than the PoPLR and MD trend analyses (P < 0.01, P < 0.001, respectively). Conclusions The application of a binomial PLR achieved reliable and earlier detection of central VF progression in eyes with RP. Translational Relevance A binomial PLR was useful in assessing VF progression in RP.

Sound is a vital cue in helping hearing people orient their gaze and attention towards events outside their central line of sight, especially in the far periphery, where vision is poor. Without sound cues, deaf individuals must rely on vision as an ‘early warning system’ for peripheral events, and in fact numerous behavioural studies demonstrate that deaf adults have superior visual sensitivity, particularly to far peripheral stimuli. We asked whether an increased demand on peripheral vision throughout development might be reflected in early visual brain structures. Using functional magnetic resonance imaging (fMRI), we mapped visual field representations in 16 early, profoundly deaf adults and 16 hearing age-matched controls. To target the far periphery, we used wide-field retinotopic mapping stimuli to map visual field eccentricity out to 72°, well beyond conventional mapping studies. Deaf individuals exhibited a larger representation of the far peripheral visual field in both the primary visual cortex and the lateral geniculate nucleus of the thalamus. Importantly, this was not due to a total expansion of the visual map, as there was no difference between groups in overall size of either structure, but a smaller representation of the central visual field in the deaf group, suggesting a redistribution of neural resources. Here, we demonstrate for the first time that the demands placed on vision due to lifelong hearing loss can sculpt visual maps at the first level of inputs from the retina, increasing neural resources for processing stimuli in the far peripheral visual field.

A brain computer interface whose operation is transmitted by SSVEP is often investigated to control a wheelchair. The operation is generated by the user’s attention to blinking visual stimulus. In order to avoid various accidents, the user needs to pay own attention to the surrounding situation and visual stimulus, simultaneously. Miura showed the relationship between the position of visual stimulus and the amount of SSVEP. In addition, the amount of SSVEP is rapidly decreased when the visual stimulus is located on the outside of the central visual field. However, a square visual stimulus used in the previous research is not suitable since the distance from eye-sight to visual stimulus is not constant. In this paper, we adopt the circle-form pattern reversal stimulus to clear the relationship between the visual field and SSVEP.

To evaluate the relationship between peripapillary tilt and visual field (VF) defects in glaucomatous eyes with axial myopia. Retrospective cross-sectional study. One hundred four eyes of 104 patients with primary open-angle glaucoma (POAG) with myopia were included (52 eyes with high myopia [HM], 26.5 mm ≤ axial length [AL]

Aging and central vision loss are associated with cortical atrophies, but little is known about the relationship between cortical thinning and the underlying cellular structure. We compared the macro- and micro-structure of the cortical gray and superficial white matter of 38 patients with juvenile (JMD) or age-related (AMD) macular degeneration and 38 healthy humans (19-84 years) by multimodal MRI including diffusion-tensor imaging (DTI). A factor analysis showed that cortical thickness, tissue-dependent measures, and DTI-based measures were sensitive to distinct components of brain structure. Age-related cortical thinning and increased diffusion were observed across most of the cortex, but increased T1-weighted intensities (frontal), reduced T2-weighted intensities (occipital), and reduced anisotropy (medial) were limited to confined cortical regions. Vision loss was associated with cortical thinning and enhanced diffusion in the gray matter (less in the white matter) of the occipital central visual field representation. Moreover, AMD (but not JMD) patients showed enhanced diffusion in lateral occipito-temporal cortex and cortical thinning in the posterior cingulum. These findings demonstrate that changes in brain structure are best quantified by multimodal imaging. They further suggest that age-related brain atrophies (cortical thinning) reflect diverse micro-structural etiologies. Moreover, juvenile and age-related macular degeneration are associated with distinct patterns of micro-structural alterations.

Standard automated perimetry (SAP), the most common form of perimetry used in clinical practice, is associated with high test variability, impacting clinical decision making and efficiency. Contrast sensitivity isocontours (CSIs) may reduce test variability in SAP by identifying regions of the visual field with statistically similar patterns of change that can be analysed collectively and allow a point (disease)-to-CSI (normal) comparison in disease assessment as opposed to a point (disease)-to-point (normal) comparison. CSIs in the central visual field however have limited applicability as they have only been described using visual field test patterns with low, 6° spatial sampling. In this study, CSIs were determined within the central 20° visual field using the 10-2 test grid paradigm of the Humphrey Field Analyzer which has a high 2° sampling frequency. The number of CSIs detected in the central 20° visual field was greater than previously reported with low spatial sampling and stimulus size dependent: 6 CSIs for GI, 4 CSIs for GII and GIII, and 3 CSIs for GIV and GV. CSI number and distribution were preserved with age. Use of CSIs to assess visual function in age-related macular degeneration (AMD) found CSI guided analysis detected a significantly greater deviation in sensitivity of AMD eyes from normal compared to a standard clinical pointwise comparison (−1.40 ± 0.15 dB vs −0.96 ± 0.15 dB; p

Purpose To quantify the central visual field (VF) loss patterns in glaucoma using artificial intelligence. Design Retrospective study. Participants VFs of 8712 patients with 13 951 Humphrey 10-2 test results from 13 951 eyes for cross-sectional analyses, and 824 patients with at least 5 reliable 10-2 test results at 6-month intervals or more from 1191 eyes for longitudinal analyses. Methods Total deviation values were used to determine the central VF patterns using the most recent 10-2 test results. A 24-2 VF within a 3-month window of the 10-2 tests was used to stage eyes into mild, moderate, or severe functional loss using the Hodapp-Anderson-Parrish scale at baseline. Archetypal analysis was applied to determine the central VF patterns. Cross-validation was performed to determine the optimal number of patterns. Stepwise regression was applied to select the optimal feature combination of global indices, average baseline decomposition coefficients from central VFs archetypes, and other factors to predict central VF mean deviation (MD) slope based on the Bayesian information criterion (BIC). Main Outcome Measures The central VF patterns stratified by severity stage based on 24-2 test results and a model to predict the central VF MD change over time using baseline test results. Results From cross-sectional analysis, 17 distinct central VF patterns were determined for the 13 951 eyes across the spectrum of disease severity. These central VF patterns could be divided into isolated superior loss, isolated inferior loss, diffuse loss, and other loss patterns. Notably, 4 of the 5 patterns of diffuse VF loss preserved the less vulnerable inferotemporal zone, whereas they lost most of the remaining more vulnerable zone described by the Hood model. Inclusion of coefficients from central VF archetypical patterns strongly improved the prediction of central VF MD slope (BIC decrease, 35; BIC decrease of >6 indicating strong prediction improvement) than using only the global indices of 2 baseline VF results. Eyes with baseline VF results with more superonasal and inferonasal loss were more likely to show worsening MD over time. Conclusions We quantified central VF patterns in glaucoma, which were used to improve the prediction of central VF worsening compared with using only global indices.

Humans actively sample their environment with saccadic eye movements to bring relevant information into high-acuity foveal vision. Despite being lower in resolution, peripheral information is also available prior to each saccade. How pre-saccadic extrafoveal preview of a visual object influences its post-saccadic processing is still an unanswered question. Here, we investigated this question by simultaneously recording behavior and fixation-related brain potentials while human subjects made saccades to face stimuli. We manipulated the relationship between pre-saccadic “previews” and post-saccadic images to explicitly isolate the influences of the former. Subjects performed a gender discrimination task on a newly foveated face under three preview conditions: phase-scrambled face, incongruent face (different identity from the foveated face), and congruent face (same identity). As expected, reaction times were faster after a congruent-face preview compared to the phase-scrambled and incongruent conditions. Importantly, a face preview (either incongruent or congruent) resulted in a strong reduction of post-saccadic neural responses. Specifically, we analyzed the classic face-selective N170 component at occipito-temporal EEG electrodes, which was still present in our experiments with active looking. We found that this component was strongly attenuated for face preview conditions compared to scrambled conditions. This large and long-lasting decrease in evoked activity is consistent with an active prediction mechanism influencing category-specific neural processing at the start of a new fixation. These findings constrain theories of visual stability and show that the extrafoveal preview methodology can be a useful tool to investigate its underlying mechanisms.Significance StatementNeural correlates of object recognition have traditionally been studied by flashing stimuli to the central visual field. This procedure differs in fundamental ways from natural vision, where viewers actively sample the environment with eye movements and also obtain a low-resolution preview of soon-to-be-fixated objects. Here we show that the N170, a classic electrophysiological marker of the structural processing of faces, also occurs during a more natural viewing condition but is massively reduced due to extrafoveal preprocessing (preview benefit). Our results therefore highlight the importance of peripheral vision during trans-saccadic processing in building a coherent and stable representation of the world around us.

In our environment our senses are bombarded with a myriad of signals, only a subset of which is relevant for our goals. Using sub-millimeter-resolution fMRI at 7T we resolved BOLD-response and activation patterns across cortical depth in early sensory cortices to auditory, visual and audiovisual stimuli under auditory or visual attention. In visual cortices, auditory stimulation induced widespread inhibition irrespective of attention, whereas auditory relative to visual attention suppressed mainly central visual field representations. In auditory cortices, visual stimulation suppressed activations, but amplified responses to concurrent auditory stimuli, in a patchy topography. Critically, multisensory interactions in auditory cortices were stronger in deeper laminae, while attentional influences were greatest at the surface. These distinct depth-dependent profiles suggest that multisensory and attentional mechanisms regulate sensory processing via partly distinct circuitries. Our findings are crucial for understanding how the brain regulates information flow across senses to interact with our complex multisensory world.

To explore the correlation of local macular ganglion cell/inner plexiform layer (GC/IPL) thickness measurements with sensitivity at individual test locations on the central 10-2 visual fields (VFs) in patients with glaucoma.One hundred thirty-seven eyes of 125 patients with spectral domain optical coherence tomography (OCT) and 10-2 VFs were included. The exported thickness matrices (200×200) of GC/IPL measurements were centred on the fovea. Total deviation values at each test location were correlated with the 20 000 GC/IPL thickness measurements in the corresponding inferior or superior hemiretina, and areas of highest correlation were plotted. Macular structure-function relationships were also examined between six wedge-shaped GC/IPL sectors and the corresponding VF clusters. A multivariate model was built to identify the 10-2 VF test locations associated with each GC/IPL sector thickness.Average mean deviation on 10-2 VFs was -9.2±6.1 dB. The 10-2 VF test points demonstrated correlations with GC/IPL thickness in localised arcuate patterns mostly limited within the central 4.8×4.0 mm measurement ellipse (ρ=0.43-0.74, p0.05 for all). Twenty-one test points of the 10-2 VF were the best predictors of sectoral GC/IPL thickness. Sectoral VF-OCT correlations were high (ρ=0.53-0.66, p0.001) and did not significantly change after adjusting for retinal GC displacement (p0.05).Macular OCT/VF relationships have localised arcuate characteristics in the central region of the macula. Given the overlapping nature of structure-function relationships, a smaller number of VF test locations may be used to summarise macular functional damage.NCT01742819.

Purpose. To evaluate clinically activated retinal astrocytes and Müller cells (ARAM) regarding retinal sensitivity and retinal nerve fiber layer (RNFL) thickness in primary open-angle glaucoma (POAG). Methods. Central visual field (VF; i.e., retinal sensitivity) was measured with a custom-made macular pattern by microperimetry and correlated with the presence (ARAM+) or absence (ARAM−) of ARAM on red-free fundus photography and with the corresponding RNFL by optical coherence tomography (OCT). Results. In the eyes of POAG patients, ARAM+ had overall a significantly lower retinal sensitivity (ARAM+: 7.34 dB, ARAM−: 11.9 dB; p<0.001) and lower RNFL thickness in the inferior peripapillary quadrants compared to ARAM− (RNFL superior: ARAM+ 74.2 μm, ARAM− 77.5 μm; RNFL temporal: ARAM+ 46.8 μm, ARAM− 53.0 μm, p<0.001; and RNFL inferior: ARAM+ 63.2 μm, ARAM− 73.1 μm, p<0.001). Within the same eye, ARAM+ showed a lower retinal sensitivity compared to ARAM− ([ARAM− (11.13 dB)] − [ARAM+ (9.56 dB) = 1.57 dB; p=0.25). The proportion of ARAM+ per eye correlated strongly with reduced retinal light sensitivity (p=0.02), corresponding lower peripapillary RNFL thickness (p=0.02), and lower RNFL temporal quadrant thickness (p<0.01), but not with greater age (p=0.45). Conclusion. ARAM was more frequently identified in the eyes with a lower retinal sensitivity and peripapillary RNFL thickness and may be a clinical sign in the macula for an advanced stage of POAG.

Purpose To investigate the use of ganglion cell inner plexiform layer (GC-IPL) thickness, as measured by spectral domain optical coherence tomography, to detect central visual field (VF) progression. Methods This study included 384 eyes from 384 patients (219 preperimetric and 165 perimetric glaucomatous eyes; average follow-up, 4.3 years). Photographic assessment of retinal nerve fiber layer (RNFL) and serial VF analysis were performed to detect glaucoma progression in the central (within 10°) area. Study inclusion required at least five serial spectral domain optical coherence tomography exams at different visits. The long-term test-retest variability of average GC-IPL thicknesses was calculated in 110 stable preperimetric glaucomatous eyes. The sensitivity and specificity of GC-IPL measurements for the detection of central VF progression were calculated in an event-based analysis using the calculated variability as a cut-off and were compared with those of central RNFL photographic assessment. Results The intersession test-retest variability, defined as the 95% confidence interval, was 1.76 µm for average GC-IPL thickness. The sensitivity and specificity of the average GC-IPL thickness for detecting central VF progression were 60.7% and 78.9%, respectively. Among six sectors, the inferonasal GC-IPL sector showed the highest sensitivity (53.6%). The sensitivity of the ≥1 sector GC-IPL to detect central VF progression was significantly higher than that of central RNFL photographic progression (p = 0.013). Other GC-IPL parameters showed comparable sensitivity and specificity to detect central VF progression compared with RNFL photographic progression. Conclusions Serial GC-IPL measurements show comparable performance in the detection of central glaucomatous VF progression to RNFL photographic assessment.

Population receptive field (pRF) analysis is a popular method to infer spatial selectivity of voxels in visual cortex. However, it remains largely untested how stable pRF estimates are over time. Here we measured the intersession reliability of pRF parameter estimates for the central visual field and near periphery, using a combined wedge and ring stimulus containing natural images. Sixteen healthy human participants completed two scanning sessions separated by 10–114 days. Individual participants showed very similar visual field maps for V1-V4 on both sessions. Intersession reliability for eccentricity and polar angle estimates was close to ceiling for most visual field maps (r>.8 for V1-3). PRF size and cortical magnification (CMF) estimates showed strong but lower overall intersession reliability (r≈.4–.6). Group level results for pRF size and CMF were highly similar between sessions. Additional control experiments confirmed that reliability does not depend on the carrier stimulus used and that reliability for pRF size and CMF is high for sessions acquired on the same day (r>.6). Our results demonstrate that pRF mapping is highly reliable across sessions., Highlights • We assess the intersession reliability of population receptive field (pRF) estimates. • Reliability of visual field position estimates in V1-3 is excellent (r >.8). • Reliability of pRF size and local cortical magnification factor are good (r≈.3-.6), especially when tested on the same day (r>.6). • Natural images are an effective stimulus for visual field mapping.

Purpose: Perimetry is increasingly being used to measure sensitivity at central visual field locations. For many tasks, the central (0°, 0°) location is functionally the most important, however threshold estimates at this location may be affected by masking by the nearby spatial structure of the fixation target. We investigated this effect. Methods: First we retrospectively analysed microperimetry (MAIA-2; CenterVue, Padova, Italy) data from 60 healthy subjects, tested on a custom grid with 1° central spacing. We compared sensitivity at (0°, 0°) to the mean sensitivity at the eight adjacent locations. We then prospectively tested 15 further healthy subjects on the same instrument using a cross-shaped test pattern with 1° spacing. Testing was carried out with and without the central fixation target, and sensitivity estimates at (0°, 0°) were compared. We also compared sensitivity at (0°, 0°) to the mean of the adjacent four locations in each condition. Three subjects undertook 10 repeated tests with the fixation target in place to assess within-subject variability of the effect. Results: In the retrospective analysis, central sensitivity was median 2.8 dB lower (95% range 0.1–8.8 dB lower, p < 0.0001) than the mean of the adjacent locations. In the prospective study, central sensitivity was median 2.0 dB lower with the fixation target vs without (95% range 0.4–4.7 dB lower, p = 0.0011). With the fixation target in place central sensitivity was median 2.5 dB lower than mean sensitivity of adjacent locations (95% range 0.8–4.2 dB lower, p = 0.0007), whilst without the fixation target there was no difference (mean 0.4 dB lower, S.D. 0.9 dB, p = 0.15). These differences could not be explained by reduced fixation stability. Mean within subject standard deviation in the difference between central and adjacent locations' sensitivity was 1.84 dB for the repeated tests. Conclusions: Perimetric sensitivity estimates from the central (0°, 0°) location are, on-average, reduced by 2 to 3 dB, corresponding to a 60–100% increase in stimulus luminance at threshold. This effect can be explained by masking by the nearby fixation target. The considerable within- and between-subject variability in magnitude, and the unknown effects of disease may hamper attempts to compensate threshold estimates for this effect. Clinicians should interpret central perimetric sensitivity estimates with caution, especially in patients with reduced sensitivity due to disease.

PURPOSE The purpose of this study was to characterize the extent to which central visual field (VF) loss reflects peripheral VF loss in patients with varying degrees of glaucoma severity. METHODS A total of 232 patients with glaucoma or suspect glaucoma completed static central VF testing using the 24-2 pattern and peripheral VF testing using the suprathreshold 30-60 pattern. Points from 24-2 tests were reclassified as normal/abnormal based on pattern deviation values. RESULTS Strong positive correlations (r ≥ 0.7) were observed between the proportion of abnormal central and peripheral points for the full VF, superior hemifield, and inferior hemifield, although the percentage of total central and peripheral abnormal points differed by ≥10% in 45% of eyes. In eyes with an average of 10%-40% abnormal points in the central and peripheral VFs, 12.0% more abnormal peripheral points were noted compared with the percentage of abnormal central points (P < 0.001; SD, 16.7%; range, 61% more to 37% less). In eyes with an average of 60%-90% abnormal points in the central and peripheral VFs, 16.4% fewer abnormal peripheral points were noted compared with the percentage of abnormal central points (P = 0.04; SD, 20.9%; range, 19% more to 49% less). CONCLUSIONS Central 24-2 testing generally reflects the extent of damage to the more peripheral VF in glaucoma, although significant disagreement exists for individual eyes. Further work is needed to determine whether integration of peripheral test points can improve detection of true VF loss in early glaucoma or be useful in monitoring progressive glaucomatous damage to areas of preserved VF in advanced glaucoma.

Examination of the central visual field is currently required for glaucoma diagnosis. Modern computer perimeters make it possible to qualitatively and quantitatively evaluate defects of light sensitivity. Perimetric indices are calculated showing the severity of the defects. This allows the use of perimetric results to create universal classifications of glaucoma. Recently, new perimeter programs based on optical coherence tomography data have appeared. The possibility of personalizing perimeter programs are being tested. This review attempts to systematize data on the capabilities of computer perimeters in assessing functional defects, presents the widely used glaucoma classifications, and describes ways of developing static perimetry programs for earlier diagnosis of glaucoma with respect to structural and functional correlations.Исследование центрального поля зрения в настоящее время является обязательным при обследовании пациентов с подозрением на глаукому. Современные компьютерные периметры позволяют качественно и количественно оценивать дефекты светочувствительности. Рассчитываются периметрические индексы, показывающие выраженность дефектов. Это позволяет использовать результаты периметрии для создания универсальных классификаций глаукомы. В последнее время появляются новые периметрические программы, основанные на данных оптической когерентной томографии. Тестируются возможности персонализации периметрических программ. В настоящем обзоре систематизированы данные о возможностях компьютерных периметров в оценке дефектов светочувствительности. Приведены наиболее популярные классификации глаукомы. С учетом структурно-функциональной корреляции описаны пути развития программ статической периметрии для более ранней диагностики глаукомы.

Static automated perimetry is an indispensable tool in the diagnosis of glaucoma. It is used to study the differential light sensitivity of the retina in different points of the visual field. The most important is the central zone of the visual field, many perimetric programs and strategies have been developed for its examination. Using standard background brightness, we can vary sizes, location methods and the type of stimulus delivery. The proper use of standard achromatic perimetry is crucial for the correct management of glaucoma patients. This review analyzes literature on the basic principles of static perimetry in the examination of differential photosensitivity of the retina.Статическая периметрия в настоящее время является незаменимой методикой в диагностике глаукомы. Ее используют для исследования дифференциальной световой чувствительности сетчатки в различных точках поля зрения. Наиболее важной является центральная зона поля зрения, для тестирования которой разработано множество периметрических программ и стратегий. При стандартной яркости фона они различаются размерами, способами расположения и характером подачи стимулов. Правильное использование стандартной, ахроматической, периметрии крайне важно для корректного ведения пациентов с глаукомой. В обзоре проанализированы данные литературы о базовых принципах статической периметрии в исследовании дифференциальной светочувствительности сетчатки.

The ability to detect visual targets in complex background varies across individuals and are affected by factors such as stimulus saliency and top-down attention. Here, we investigated how the saliency of visual background (naturalistic cartoon video vs. blank screen) and top-down attention (single vs. dual tasks) separately affect individual ability to detect visual targets. Behaviorally, we found that target detection accuracy decreased and reaction time elongated when the background was salient or during dual tasking. The EEG response to visual background was recorded using a novel stimulus tagging technique. This response was strongest in occipital electrodes and was sensitive to background saliency but not dual tasking. In contrast, the event-related potential (ERP) evoked by the visual target was strongest in central electrodes, and was affected by both background saliency and dual tasking. With a cartoon background, the EEG responses to visual targets, presented in the central visual field, and the EEG responses to peripheral visual background could both predict individual target detection performance. When these two responses were combined, better prediction was achieved. These results suggest that neural processing of visual targets and background jointly contribute to individual visual target detection performance.

Central visual field (CVF) loss has been linked to poorer vision-related quality of life in eyes with open-angle glaucoma (OAG) and can occur even in early-stage OAG eyes. The present study investigated whether the detection of choroidal microvasculature dropout (CMvD) during follow-up, which may be a sign of perfusion deficiency in the optic nerve head, is associated with rapid rate of CVF loss in early-stage OAG eyes. This study included 44 Korean OAG eyes with CMvD, identified by optical coherence tomography angiography, and 44 Korean OAG eyes without CMvD matched for age and severity of visual field loss at initial presentation. The rates of mean threshold changes in global and CVF were compared in eyes with and without CMvD using a linear mixed model. Clinical variables associated with rapid rate of CVF progression were also identified using a linear mixed model. The CVF progression rate was significantly higher in eyes with CMvD than in those without CMvD (−0.584 dB/year vs. −0.190 dB/year; P

Localized decibel loss in central visual field usually suggests maculopathy. Inconsistencies between visual acuity and visual field change, between disease severity and visual field damage, or between symptoms and signs could usually be noticed, due to the complexity of the diseases in the macula. Besides, a proper visual field examination strategy is also very important for the evaluation of disease.

Posterior vitreous detachment (PVD) is commonly seen in the aging eye [1]. Although the majority of PVDs occur without complication, a small proportion can be associated with excessive traction on the macula, resulting in retinal anatomic changes. These eyes are characterized as having vitreomacular traction (VMT). VMT can lead to functional changes such as metamorphopsia and blurring of visual acuity with central visual field defects.

Stargardt disease is also called juvenile macular degeneration, and its main ocular manifestations are bilateral vision decrease and central visual field defects. Three cases are discussed in this section, among which the patient was a descendant from consanguineous marriage in two cases. This phenomenon highlights the importance of the family planning work.

The impact of visual field defects on conducting Activities of Daily Living (ADL) is significant. These defects include central and peripheral visual field loss. Many studies have revealed that patients of visual field defects need to increase visual scanning on performing visual tasks. Compensation training of eye movements has been shown to be effective to improve the visual exploration and extent the visual search fields. However, since it takes sufficiently long and intense period, the training needs to incorporate easy and fun tasks to promote an ongoing effort to patients. This study proposes a compensatory visual field training using game-like dynamic scenes presented by a head-mounted display eye tracker (HMD-ET). The head mounted display will eliminate the necessity of head movements during visual exploration. Each scene induces saccadic eye movements to complete given tasks. To simulate the patient of central scotoma, the participant’s central visual field was masked while performing a training consists of obstacle course game. On the other hand, to simulate the patient with peripheral vision defects, the participant’s peripheral visual field was partly masked. During training, eye movements were recorded at 240 Hz, which enable the detection of saccadic eye movements. Experiments using the proposed training conducted by 10 participants with normal visual acuity were able to reveal the differences in patterns of visual exploration between participants with simulated central scotoma and peripheral visual field defects. Questioners taken after the training shows that tasks and scenes used for the training are relatively easy and may encourage patients to continue the training.

Purpose To compare the performance of the pattern standard deviation (PSD) values derived from the central 12 locations of the 24-2 visual field test (C24-2) to the entire 10-2 test for detecting central visual field abnormalities in eyes with, suspected of having, or at risk of having glaucoma. Design Cross-sectional case-control study. Methods Eyes with, suspected of having, or at risk of having glaucoma, based on masked grading of optic disc stereophotographs and/or ocular hypertension (intraocular pressure ≥ 22 mm Hg) were included as cases (n = 523). Eyes from healthy participants were included as controls (n = 107) to allow the 2 tests to be compared at matched specificities. The sensitivity to detect cases at 95% specificity using PSD values derived from the entire 10-2 test and C24-2 were compared. Results The sensitivity of the 10-2 and C24-2 PSD values was not significantly different between the 10-2 and C24-2 at matched specificities (35.9% and 35.4% respectively; P = .900). There was also a substantial agreement between the cases detected by both methods (kappa = 0.80 ± 0.04), and a very strong association between the PSD values from the 2 methods (R2 = 0.91). Conclusions 10-2 and 24-2 tests identified a similar number of eyes with, suspected of having, or at risk of having glaucoma as having central visual field abnormalities using PSD values. These findings do not mean that 10-2 tests are not useful, but highlight the need for further studies to determine the potential advantages of 10-2 tests through equivalent comparisons against 24-2 tests to ensure appropriate recommendations are made about its incorporation into the glaucoma standard of care.

Background: To characterize the axial and off-axis refraction across four meridians of the retina in myopic eyes before and after Orthokeratology (OK) and LASIK surgery. Methods: Sixty right eyes with a spherical equivalent (M) between − 0.75 to − 5.25 D (cylinder 0.05) from the post-treatment RPRE within 30° and 20° of the central visual field after LASIK and OK, respectively. These results demonstrated that the treatment zone warrants an optimal central field of vision. Conclusions: The present study gives an overview of RPRE after refractive corneal reshaping treatments (OK and LASIK) across vertical, horizontal and two oblique meridians together. This allows a 3D representation of RPRE at the retina and shows that the myopic shift induced by both treatments is more relevant in horizontal directions., Supported in part by a grant to AQ (SFRH/BD/61768/2009), projects PTDC/ SAU-BEB/098391/2008, PTDC/SAU-BEB/098392/2008 and the Strategic Project PEST-C/FIS/UI607/2011 from the Science and Technology Foundation of Portuguese Ministry of Science and Higher Education., info:eu-repo/semantics/publishedVersion

In the field of visual rehabilitation of patients with central visual field loss (CFL), knowledge on how peripheral visual function can be improved is essential. This study presents measurements of peripheral dynamic contrast sensitivity (with optical correction) for off-axis viewing angles in subjects with CFL.Subjects with CFL rely on a peripheral preferred retinal locus (PRL) for many visual tasks. It is therefore important to ascertain that contrast sensitivity (CS) is maximized in the PRL. This study evaluates the effect of stimulus motion, in combination with optical correction, on CS in subjects with CFL.The off-axis refractive errors in the PRL of five young CFL subjects were measured with a COAS open-view Hartmann-Shack aberrometer. Low-contrast (25% and 10%) and high-contrast resolution acuity for stationary gratings was assessed with and without optical correction. High-contrast resolution was also measured for gratings drifting at 7.5 Hz (within a fixed Gaussian window). Furthermore, resolution CS was evaluated for both stationary and moving gratings with optical correction for a total of two to three spatial frequencies per subject.High-contrast resolution acuity was relatively insensitive to stimulus drift motion of 7.5 Hz, whereas CS for gratings of 0.5 cycles per degree improved with drift for all subjects. Furthermore, both high- and low-contrast static resolution improved with optical correction.Just as for healthy eyes, stimulus motion of 7.5 Hz enhances CS for gratings of low spatial frequency also in the PRL of eyes with CFL. Concurrently, high-contrast resolution is unaffected by the 7.5-Hz drift but improves with off-axis optical correction. This highlights the importance of providing optimal refractive correction for subjects with CFL and that stimulus motion can be used to further enhance CS at low spatial frequencies.

PurposeCentral visual field (VF) damage in glaucoma patients can significantly hinder daily activities. The present study investigates whether the presence of localized baseline damage to the central 10 degrees of the VF is predictive of faster global mean deviation (MD) progression.DesignProspective cohort study.MethodsEyes from the multicenter African Descent and Glaucoma Evaluation Study (ADAGES) with established glaucoma and VF loss and a minimum of 5 24-2 VFs were eligible. Baseline central 24-2 damage was defined as any of the 12 central-most points with total deviation (TD) values at P < 0.5% on 2 consecutive examinations. Progression was determined using trend-based and event-based criteria: (1) rates of MD change significantly faster than zero and (2) >-5 dB MD loss over the entire follow-up.ResultsA total of 827 eyes of 584 patients were studied. Mean rate of MD change of the entire sample was-0.15 dB/year (95% CI:-0.19 to-0.12, P&nbsp

Purpose. To describe a case of optic disk pit (ODP) with sudden central visual field scotoma. Methods. A 49-year-old woman presented, reporting sudden painless central visual field loss 3 months prior to presentation. Neuroophthalmologic, systematic, and laboratory evaluation and full imaging processes were performed. Results. Fundoscopy and color photography demonstrated an optic disk pit inferotemporally. Perimetry identified central visual field horizontal scotoma. OCT revealed absence of serous retinal detachment, but disclosed inner retina thinning corresponding to the area of the visual field loss. Fluorescein angiography demonstrated delay in the cilioretinal arteries and also disclosed a relative delay in the perfusion of an arterial branch off the inferior retinal arcade. Clinical and laboratory evaluations were negative for any related pathology. Conclusion. Sudden central visual field scotoma in patients with ODP may be associated with delayed vascular filling of CRA and retinal arterioles within the optic disc anomaly region.

Purpose - to compare the ease of use, the comfort for persons to be tested, the examination rate, as well as the variability of repeated results obtained using four methods of computerized perimetry. Materials and methods. This clinical study included three groups of patients with open-angle glaucoma (OAG). The 1st group included patients with OAG stage I, the 2nd group - with OAG stage II, the 3rd group - with OAG stage III. The control group included healthy individuals. All tested persons underwent examinations by 4 computerized methods (HFA II, Tomey AP-1000, Pericom, and the FDT-perimetry modification developed at the Ophthalmology Department of the Military Medical Academy). Results. FDT-perimetry appeared to be the shortest, easiest test and most comfortable for tested persons. Perimetry using Tomey AP-1000, Pericom and HFA II was more time-consuming and more difficult to perform. Repeated results of all four methods were better than the first one due to the “learning curve” effect, and showed different variability. Conclusion. To obtain reliable computerized perimetry results, taking into account the possible “learning curve” effect, we recommend repeating the perimetric test at least 2-3 times at same conditions. It is important for the selected perimetric test to be easy to perform, comfortable for persons to be tested, and quite fast to perform.

Microperimetry, also referred to as fundus perimetry or fundus-driven perimetry, enables simultaneous acquisition of visual sensitivity and eye movement data. We present sensitivity data collected from 60 participants with normal vision using gaze-contingent perimetry. A custom designed spatially dense test grid was used to collect data across the visual field within 13° of fixation. These data are supplemental to a study in which we demonstrated a spatial interpolation method that facilitates comparison of acquired data from any set of spatial locations to normative data and thus screening of individuals with both normal and non-foveal fixation “Methods for normative data comparison in gaze-contigent microperimetry” (Denniss and Astle, 2016) [1].

Aim. To detect abnormality of the visual function in naïve patients with cystoid diabetic macular edema (DME) using M-charts, Amsler test, and white on white (W/W) and blue on yellow (B/Y) perimetry. Methods. There were 64 eyes included in the study: 30 eyes with DME, 22 eyes with diabetes without DME, and 12 eyes of normal subjects. Conventional W/W perimetry and B/Y perimetry were performed within the central 10° of the visual field. To assess metamorphopsia, Amsler test and M-charts were used. Results. The rate of detection of metamorphopsia was 37% with Amsler test examination and 50% with M-charts. Specificity of both tests was 100%. We found a significant difference between vertical scores of M-charts in all groups, but not in horizontal scores (p<0.0001). Mean defect (MD) was 8.9 dB and 3.6 dB and loss variance (LV) 4.8 dB and 3.3 dB (p<0.0001). Conclusions. M-chart is more sensitive than Amsler test method for detection of metamorphopsia. The MD and LV are higher in b/y in comparison to W/W perimetry. B/Y perimetry and M-charts are more sensitive than conventional methods for detecting the visual function loss in cystoid DME.

The aim of this study is to determine the progress of the visual field defects obtained by the Humphrey Field Analyzer 10-2 program (HFA 10-2) in patients with retinitis pigmentosa (RP). The medical records of 45 eyes of 45 RP patients who had at least 3 visual field tests were reviewed. Linear mixed models were used to follow the changes of the mean deviation and the average sensitivity of 4, 12, and 20 points in three concentric squares, designated as S4, S12, and S20. The median follow-up time was 3.86 years [range: 1.93 to 9.86, IQR (Interquartile range): 3.01 to 4.93]. The median number of the visual field tests was 3 (range: 3 to 15, IQR: 3 to 4). The mean change of the MD was −0.46 dB/year (−5.80%/year). When the patients were grouped by the average initial MD, the less advanced group had slower progressions than the more advanced group in S4, S12, and S20. These results should be useful in understanding the pathological changes of RP in the central visual field.

It is generally acknowledged that structural loss can precede functional loss in some patients with early glaucoma. However, conventional standard automated perimetry (SAP) has limitations in the detection of functional loss, especially in the macular area. This study explores visual field loss in the macular areas of patients with preperimetric glaucoma exhibiting structural thinning in the area by examining the correlations between the ganglion cell-inner plexiform layer (GCIPL) and the results of matrix frequency-doubling technology (FDT) 10-2 tests. The structure-function relationships between the GCIPL thicknesses and the mean sensitivities (MSs) of the corresponding areas based on conventional SAP 24-2, FDT 10-2, and FDT 24-2 were examined in 62 patients. The highest correlation was found for FDT 10-2 (r = 0.544, P P = 0.002) and SAP (r = 0.346, P = 0.007). The correlation coefficients between each GCIPL sector and the corresponding central MS according to FDT 24-2 and 10-2 were all statistically significant, and the correlations were significantly stronger for FDT 10-2 than 24-2 in the inferior and inferonasal sectors. In conclusion, preperimetric glaucoma patients with structural loss in the macula as indicated by GCIPL thinning also exhibited functional loss as revealed by FDT 10-2, and the functional loss was less evident with conventional SAP.

Purpose To determine the locus of test locations that exhibit statistically similar age-related decline in sensitivity to light increments and age-corrected contrast sensitivity isocontours (CSIs) across the central visual field (VF). We compared these CSIs with test point clusters used by the Glaucoma Hemifield Test (GHT). Methods Sixty healthy observers underwent testing on the Humphrey Field Analyzer 30-2 test grid using Goldmann (G) stimulus sizes I-V. Age-correction factors for GI-V were determined using linear regression analysis. Pattern recognition analysis was used to cluster test locations across the VF exhibiting equal age-related sensitivity decline (age-related CSIs), and points of equal age-corrected sensitivity (age-corrected CSIs) for GI-V. Results There was a small but significant test size-dependent sensitivity decline with age, with smaller stimuli declining more rapidly. Age-related decline in sensitivity was more rapid in the periphery. A greater number of unique age-related CSIs was revealed when using smaller stimuli, particularly in the mid-periphery. Cluster analysis of age-corrected sensitivity thresholds revealed unique CSIs for GI-V, with smaller stimuli having a greater number of unique clusters. Zones examined by the GHT consisted of test locations that did not necessarily belong to the same CSI, particularly in the periphery. Conclusions Cluster analysis reveals statistically significant groups of test locations within the 30-2 test grid exhibiting the same age-related decline. CSIs facilitate pooling of sensitivities to reduce the variability of individual test locations. These CSIs could guide future structure-function and alternate hemifield asymmetry analyses by comparing matched areas of similar sensitivity signatures.

IMPORTANCE: Although the central visual field (VF) in end-stage glaucoma may substantially vary among patients, structure-function studies and quality-of-life assessments are impeded by the lack of appropriate characterization of end-stage VF loss. OBJECTIVE: To provide a quantitative characterization and classification of central VF loss in end-stage glaucoma. DESIGN, SETTING, AND PARTICIPANTS: This retrospective cohort study collected data from 5 US glaucoma services from June 1, 1999, through October 1, 2014. A total of 2912 reliable 10-2 VFs of 1103 eyes from 1010 patients measured after end-stage 24-2 VFs with a mean deviation (MD) of −22 dB or less were included in the analysis. Data were analyzed from March 28, 2018, through May 23, 2019. MAIN OUTCOMES AND MEASURES: Central VF patterns were determined by an artificial intelligence algorithm termed archetypal analysis. Longitudinal analyses were performed to investigate whether the development of central VF defect mostly affects specific vulnerability zones. RESULTS: Among the 1103 patients with the most recent VFs, mean (SD) age was 70.4 (14.3) years; mean (SD) 10-2 MD, −21.5 (5.6) dB. Fourteen central VF patterns were determined, including the most common temporal sparing patterns (304 [27.5%]), followed by mostly nasal loss (280 [25.4%]), hemifield loss (169 [15.3%]), central island (120 [10.9%]), total loss (91 [8.3%]), nearly intact field (56 [5.1%]), inferonasal quadrant sparing (42 [3.8%]), and nearly total loss (41 [3.7%]). Location-specific median total deviation analyses partitioned the central VF into a more vulnerable superonasal zone and a less vulnerable inferotemporal zone. At 1-year and 2-year follow-up, new defects mostly occurred in the more vulnerable zone. Initial encroachments on an intact central VF at follow-up were more likely to be from nasal loss (11 [18.4%]; P

Purpose To investigate the clinical manifestations and prognosis of eyes with cilioretinal artery sparing central retinal artery occlusion (CRAO). Methods A retrospective study was conducted on 90 eyes diagnosed with complete CRAO, including 16 cases of cilioretinal artery sparing CRAO. Clinical features, visual outcome, papillomacular bundle involvement, and remnant visual field were analyzed according to cilioretinal artery sparing. Results Among eyes with complete CRAO, the proportion of cilioretinal artery sparing CRAO was 17.8% (16 / 90). Mean initial best-corrected visual acuities (BCVAs) (2.04 ± 0.69 vs. 2.34 ± 0.47, p = 0.039) and final BCVAs (1.65 ± 0.87 vs. 2.22 ± 0.84, p = 0.001) were significantly better in eyes of the cilioretinal artery sparing group than the non-sparing group. The proportion with poor visual outcome (final BCVA

Preservation of visual functions in patients with chiasmo-sellar region compression (CSRC) is possible with early diagnosis and surgical decompression.To analyze the parameters of optical coherence tomography (OCT) and optical coherence tomography-angiography (OCTA) in patients with CSRC.The study included 10 patients (20 eyes) with CSRC, 15 healthy volunteers (30 eyes). OCT, OCTA was performed on Cirrus HD-OCT 5000 AngioPlex™ (Carl Zeiss Meditec, U.S.A.) with AngioVue system.Patients with CSRC were revealed to have decreased thickness of ILM-RPE in the nasal sector of outer circle (In CSRC, changes can be seen in OCT and OCTA parameters recorded in the macular and peripapillary regions before the changes in the central visual field. Informative diagnostic OCT and OCTA criteria can help diagnose the pathology early, expand the indications for decompression, and preserve the visual funcitons.Сохранение зрительных функций при компрессии в хиазмально-селлярной области (КХСО) возможно при ранней диагностике и проведении хирургической декомпрессии.Анализ параметров оптической когерентной томографии (ОКТ) и оптической когерентной томографии-ангиографии (ОКТА) у пациентов с КХСО.Обследовано 10 пациентов (20 глаз) с КХСО и 15 здоровых добровольцев (30 глаз). ОКТ и ОКТА выполняли при помощи прибора Cirrus HD-OCT 5000 AngioPlex™ (Carl Zeiss Meditec, США) с функцией AngioVue.У пациентов с КХСО выявлены изменения ряда параметров, определяемых с помощью ОКТ и ОКТА, в макулярной области: уменьшаются толщина сетчатки ILM-RPE в назальном секторе наружного кольца (Заключение. При КХСО регистрируются изменения параметров ОКТ и ОКТА в макулярной и перипапиллярной областях до формирования нарушений центрального поля зрения. Информативные диагностические ОКТ- и ОКТА-критерии позволят своевременно диагностировать патологию, расширить показания для проведения декомпрессии, сохранить зрительные функции.

Purpose To test the hypothesis whether semi-automated kinetic perimetry (SKP) provides additional information to static automated perimetry (SAP) in the assessment of the remaining visual field in end-stage glaucoma, as defined by disc appearance (cup-to-disc ratio worse than 0.9) and SAP criteria (MD worse than 20 dB). Methods Fifty eyes of 44 patients presenting with end-stage glaucoma were examined first with SAP within the central 30° using stimulus size III, followed by SKP within 90° using test targets III4e and V4e. Results Overall, SKP provided additional information over SAP in more than half (54%) of the cases. In 16 instances (32%), SKP revealed visual field island beyond 30° that was undetected by SAP. In eight cases (16%), SKP showed both a central island and peripheral island of visual field. In three cases (6%) altitudinal scotomatous loss was found using SKP, but not in SAP. In 23 cases (46%) the central visual field island was defined both with SAP and SKP. The mean examination duration was 4 min for SAP and 9 min for SKP. Conclusions In clinical practice, SKP with III4e and V4e test targets provides more information than 30° SAP regarding the remaining peripheral VF in patients with end-stage glaucoma; however, a longer test time is required for SKP.

Background Driving is a highly demanding task which presents itself with various unpredictable and potentially hazardous situations. The failure to visually scan the driving environment and strategically search for potential road hazards, can be considered as unsafe driving practices. Little is known about how licensed drivers with Autism Spectrum Disorder (ASD) visually scan the roads while driving. The present study assessed the visual scanning and fixation patterns of drivers with and without ASD during a simulated drive. Methods Twenty-eight licensed drivers between the age of 18–40 years old, including 14 drivers with ASD (male = 13) driving at least 2 h per week participated in a simulated drive with 14 matched controls. Psychometric profiles and visual scanning patterns on various objects of interest were analysed between groups. Results Drivers with ASD were found to fixate and spend significantly more time focusing on the central visual field and less time scanning where hazards potentially emerge. They also tended to allocate less visual attention on social stimuli (i.e., involving a person), and failed to stop in time at the red lights. Psychometric profiles confirmed poorer visual scanning and motor processing speed but less risk-taking behaviour in drivers with ASD. Conclusion Licensed drivers with ASD were found to allocate visual attention differently compared to licensed drivers without ASD. Poor scanning patterns with an over-focus on the road ahead and less scanning of the road side and periphery may possibly result in unsafe driving. However, risk-taking behaviour was not prevalent in these drivers. Effective visual scanning strategies could be incorporated in the driver training of individuals with ASD.

Although in experimental psychology the fixation/saccadic sequence is a main topic of debate, so far in the clinical ophthalmological field such an argument has raised relatively few interest. Nevertheless, studying the possible alterations of the saccadic rate and of the positioning of fixations when analyzing a visual scene may illuminate on the source of reading difficulty in a variety of patients, like dyslexic children or those affected by hemianopia as well as central visual field impairment. Recently, new light has been shed on the saccadic/fixation dynamics, both in the temporal and spatial domain. In addition, according to recent findings a visuoperceptive distortion could potentially affect the saccades/fixation sequence, making the matter much more complex than expected. The aim of this article is therefore to describe the saccadic/fixation seesaw under the temporal and spatial perspective and to disclose the possible influence of visuoperceptive impairments.

Vision is of paramount importance in regulating adaptive gait. Using three-dimensional motion analysis, the current study investigated how central visual field loss (CFL) affects step ascent. Ten patients with chronic CFL (77 ± 10 years) and 13 visual normal participants (72 ± 6 years) walked up to and ascended a single step (of varying height). Movement kinematics assessed the period immediately prior to and during step ascent. Compared to visual normal participants, patients with CFL exhibited a lower lead foot horizontal crossing velocity, increased lead limb swing time and increased head flexion (looking down at more immediate areas of the ground/step). They also took longer to initiate the step up, transfer weight to the lead foot upon landing on the upper level and increased trail limb swing time when negotiating the medium and high step height. Increased variability was also shown in a number of dependent measures. Data indicate that during step ascent, patients with CFL exhibit a cautious stepping strategy when compared to visual normal participants. This cautious strategy becomes increasingly evident when negotiating higher step heights, as shown by an increased planning time prior to entering the relatively unstable period of single support during the step up. The increased variability among CFL patients increases their likelihood of experiencing dynamic instability and falling during step ascent.