+Psychometric evaluation of the MacDQoL individualised measure of the impact of macular degeneration on quality of life

Background: The MacDQoL is an individualised measure of the impact of macular degeneration (MD) on quality of life (QoL). There is preliminary evidence of its psychometric properties and sensitivity to severity of MD. The aim of this study was to carry out further psychometric evaluation with a larger sample and investigate the measure's sensitivity to MD severity. Methods: Patients with MD (n = 156: 99 women, 57 men, mean age 79 ± 13 years), recruited from eye clinics (one NHS, one private) completed the MacDQoL by telephone interview and later underwent a clinic vision assessment including near and distance visual acuity (VA), comfortable near VA, contrast sensitivity, colour recognition, recovery from glare and presence or absence of distortion or scotoma in the central 10° of the visual field. Results: The completion rate for the MacDQoL items was 99.8%. Of the 26 items, three were dropped from the measure due to redundancy. A fourth was retained in the questionnaire but excluded when computing the scale score. Principal components analysis and Cronbach's alpha (0.944) supported combining the remaining 22 items in a single scale. Lower MacDQoL scores, indicating more negative impact of MD on QoL, were associated with poorer distance VA (better eye r = -0.431 p < 0.001; worse eye r = -0.350 p < 0.001; binocular vision r = -0.419 p < 0.001) and near VA (better eye r -0.326 p < 0.001; worse eye r = -0.226 p < 0.001; binocular vision r = -0.326 p < 0.001). Poorer MacDQoL scores were associated with poorer contrast sensitivity (better eye r = 0.392 p < 0.001; binocular vision r = 0.423 p < 0.001), poorer colour recognition (r = 0.417 p < 0.001) and poorer comfortable near VA (r = -0.283, p < 0.001). The MacDQoL differentiated between those with and without binocular scotoma (U = 1244 p < 0.001). Conclusion: The MacDQoL 22-item scale has excellent internal consistency reliability and a single-factor structure. The measure is acceptable to respondents and the generic QoL item, MD-specific QoL item and average weighted impact score are related to several measures of vision. The MacDQoL demonstrates that MD has considerable negative impact on many aspects of QoL, particularly independence, leisure activities, dealing with personal affairs and mobility. The measure may be valuable for use in clinical trials and routine clinical care. © 2005 Mitchell et al; licensee BioMed Central Ltd.

The effect of monocular and binocular cataract blur on postural stability among older adults

Purpose: First-eye cataract surgery can reduce the rate of falls among older adults, yet the effect of second-eye surgery on the rate of falling remains unclear. The present study investigated the effect of monocular and binocular simulated cataract blur on postural stability among older adults. Methods: Postural stability was assessed on 34 healthy older adults (mean 68.2 years, SD 3.5) with normal vision, using a portable force platform (BT4, HUR Labs, Finland) which collected data on centre of pressure (COP) displacement. Stability was assessed on firm and foam surfaces under four binocular viewing conditions using Vistech filters to simulate cataract blur: [1] best-corrected vision both eyes; [2] blur over non-dominant eye, [3] blur over dominant eye and [4] blur over both eyes. Binocular logMAR visual acuity, Pelli-Robson contrast sensitivity and stereoacuity were also measured under these viewing conditions and ocular dominance measured using the hole-in-card test. Generalized estimating equations with an exchangeable correlation structure examined the effect of the surface and vision conditions on postural stability. Results: Visual acuity and contrast sensitivity were significantly reduced under monocular and binocular cataract blur compared to normal viewing. All blur conditions resulted in loss of stereoacuity. Binocular cataract blur significantly reduced postural stability compared to normal vision on the firm (COP path length; p=0.013) and foam surface (anterior-posterior COP RMS, COP path length and COP area; p<0.01). However, no significant differences in postural stability were found between the monocular blur conditions compared to normal vision, or between the dominant and non-dominant monocular blur conditions on either the firm or foam surfaces. Conclusions: Findings indicate that binocular blur significantly impairs postural stability, and suggests that improvements in postural stability may justify first-eye cataract surgery, particularly during somatosensory disruption. Postural stability was not significantly impaired in the monocular cataract blur conditions compared to the normal vision condition, nor was there any effect of ocular dominance on postural stability in the presence of monocular cataract blur.

Binocular summation improves performance to defocus-induced blur

PURPOSE. To assess whether there are any advantages of binocular over monocular vision under blur conditions. METHODS. We measured the effect of defocus, induced by positive lenses, on the pattern reversal Visual Evoked Potential (VEP) and on visual acuity (VA). Monocular (dominant eye) and binocular VEPs were recorded from thirteen volunteers (average age: 28±5 years, average spherical equivalent: -0.25±0.73 D) for defocus up to 2.00 D using positive powered lenses. VEPs were elicited using reversing 10 arcmin checks at a rate of 4 reversals/second. The stimulus subtended a circular field of 7 degrees with 100% contrast and mean luminance 30 cd/m2. VA was measured under the same conditions using ETDRS charts. All measurements were performed at 1m viewing distance with best spectacle sphero-cylindrical correction and natural pupils. RESULTS. With binocular stimulation, amplitudes and implicit times of the P100 component of the VEPs were greater and shorter, respectively, in all cases than for monocular stimulation. Mean binocular enhancement ratio in the P100 amplitude was 2.1 in-focus, increasing linearly with defocus to be 3.1 at +2.00 D defocus. Mean peak latency was 2.9 ms shorter in-focus with binocular than for monocular stimulation, with the difference increasing with defocus to 8.8 ms at +2.00 D. As for the VEP amplitude, VA was always better with binocular than with monocular vision, with the difference being greater for higher retinal blur. CONCLUSIONS. Both subjective and electrophysiological results show that binocular vision ameliorates the effect of defocus. The increased binocular facilitation observed with retinal blur may be due to the activation of a larger population of neurons at close-to-threshold detection under binocular stimulation.

Binocular rivalry and visuospatial ability in individuals with schizophrenia

Visual abnormalities, both at the sensory input and the higher interpretive levels, have been associated with many of the symptoms of schizophrenia. Individuals with schizophrenia typically experience distortions of sensory perception, resulting in perceptual hallucinations and delusions that are related to the observed visual deficits. Disorganised speech, thinking and behaviour are commonly experienced by sufferers of the disorder, and have also been attributed to perceptual disturbances associated with anomalies in visual processing. Compounding these issues are marked deficits in cognitive functioning that are observed in approximately 80% of those with schizophrenia. Cognitive impairments associated with schizophrenia include: difficulty with concentration and memory (i.e. working, visual and verbal), an impaired ability to process complex information, response inhibition and deficits in speed of processing, visual and verbal learning. Deficits in sustained attention or vigilance, poor executive functioning such as poor reasoning, problem solving, and social cognition, are all influenced by impaired visual processing. These symptoms impact on the internal perceptual world of those with schizophrenia, and hamper their ability to navigate their external environment. Visual processing abnormalities in schizophrenia are likely to worsen personal, social and occupational functioning. Binocular rivalry provides a unique opportunity to investigate the processes involved in visual awareness and visual perception. Binocular rivalry is the alternation of perceptual images that occurs when conflicting visual stimuli are presented to each eye in the same retinal location. The observer perceives the opposing images in an alternating fashion, despite the sensory input to each eye remaining constant. Binocular rivalry tasks have been developed to investigate specific parts of the visual system. The research presented in this Thesis provides an explorative investigation into binocular rivalry in schizophrenia, using the method of Pettigrew and Miller (1998) and comparing individuals with schizophrenia to healthy controls. This method allows manipulations to the spatial and temporal frequency, luminance contrast and chromaticity of the visual stimuli. Manipulations to the rival stimuli affect the rate of binocular rivalry alternations and the time spent perceiving each image (dominance duration). Binocular rivalry rate and dominance durations provide useful measures to investigate aspects of visual neural processing that lead to the perceptual disturbances and cognitive dysfunction attributed to schizophrenia. However, despite this promise the binocular rivalry phenomenon has not been extensively explored in schizophrenia to date. Following a review of the literature, the research in this Thesis examined individual variation in binocular rivalry. The initial study (Chapter 2) explored the effect of systematically altering the properties of the stimuli (i.e. spatial and temporal frequency, luminance contrast and chromaticity) on binocular rivalry rate and dominance durations in healthy individuals (n=20). The findings showed that altering the stimuli with respect to temporal frequency and luminance contrast significantly affected rate. This is significant as processing of temporal frequency and luminance contrast have consistently been demonstrated to be abnormal in schizophrenia. The current research then explored binocular rivalry in schizophrenia. The primary research question was, "Are binocular rivalry rates and dominance durations recorded in participants with schizophrenia different to those of the controls?" In this second study binocular rivalry data that were collected using low- and highstrength binocular rivalry were compared to alternations recorded during a monocular rivalry task, the Necker Cube task to replicate and advance the work of Miller et al., (2003). Participants with schizophrenia (n=20) recorded fewer alternations (i.e. slower alternation rates) than control participants (n=20) on both binocular rivalry tasks, however no difference was observed between the groups on the Necker cube task. Magnocellular and parvocellular visual pathways, thought to be abnormal in schizophrenia, were also investigated in binocular rivalry. The binocular rivalry stimuli used in this third study (Chapter 4) were altered to bias the task for one of these two pathways. Participants with schizophrenia recorded slower binocular rivalry rates than controls in both binocular rivalry tasks. Using a ‘within subject design’, binocular rivalry data were compared to data collected from a backwardmasking task widely accepted to bias both these pathways. Based on these data, a model of binocular rivalry, based on the magnocellular and parvocellular pathways that contribute to the dorsal and ventral visual streams, was developed. Binocular rivalry rates were compared with performance on the Benton’s Judgment of Line Orientation task, in individuals with schizophrenia compared to healthy controls (Chapter 5). The Benton’s Judgment of Line Orientation task is widely accepted to be processed within the right cerebral hemisphere, making it an appropriate task to investigate the role of the cerebral hemispheres in binocular rivalry, and to investigate the inter-hemispheric switching hypothesis of binocular rivalry proposed by Pettigrew and Miller (1998, 2003). The data were suggestive of intra-hemispheric rather than an inter-hemispheric visual processing in binocular rivalry. Neurotransmitter involvement in binocular rivalry, backward masking and Judgment of Line Orientation in schizophrenia were investigated using a genetic indicator of dopamine receptor distribution and functioning; the presence of the Taq1 allele of the dopamine D2 receptor (DRD2) receptor gene. This final study (Chapter 6) explored whether the presence of the Taq1 allele of the DRD2 receptor gene, and thus, by inference the distribution of dopamine receptors and dopamine function, accounted for the large individual variation in binocular rivalry. The presence of the Taq1 allele was associated with slower binocular rivalry rates or poorer performance in the backward masking and Judgment of Line Orientation tasks seen in the group with schizophrenia. This Thesis has contributed to what is known about binocular rivalry in schizophrenia. Consistently slower binocular rivalry rates were observed in participants with schizophrenia, indicating abnormally-slow visual processing in this group. These data support previous studies reporting visual processing abnormalities in schizophrenia and suggest that a slow binocular rivalry rate is not a feature specific to bipolar disorder, but may be a feature of disorders with psychotic features generally. The contributions of the magnocellular or dorsal pathways and parvocellular or ventral pathways to binocular rivalry, and therefore to perceptual awareness, were investigated. The data presented supported the view that the magnocellular system initiates perceptual awareness of an image and the parvocellular system maintains the perception of the image, making it available to higher level processing occurring within the cortical hemispheres. Abnormal magnocellular and parvocellular processing may both contribute to perceptual disturbances that ultimately contribute to the cognitive dysfunction associated with schizophrenia. An alternative model of binocular rivalry based on these observations was proposed.

A high precision instrument to measure angular and binocular deviation introduced by aircraft windscreens by using a shadow casting technique

Objects viewed through transparent sheets with residual non-parallelism and irregularity appear shifted and distorted. This distortion is measured in terms of angular and binocular deviation of an object viewed through the transparent sheet. The angular and binocular deviations introduced are particularly important in the context of aircraft windscreens and canopies as they can interfere with decision making of pilots especially while landing, leading to accidents. In this work, we have developed an instrument to measure both the angular and binocular deviations introduced by transparent sheets. This instrument is especially useful in the qualification of aircraft windscreens and canopies. It measures the deviation in the geometrical shadow cast by a periodic dot pattern trans-illuminated by the distorted light beam from the transparent test specimen compared to the reference pattern. Accurate quantification of the shift in the pattern is obtained by cross-correlating the reference shadow pattern with the specimen shadow pattern and measuring the location of the correlation peak. The developed instrument is handy to use and computes both angular and binocular deviation with an accuracy of less than +/- 0.1 mrad (approximate to 0.036 mrad) and has an excellent repeatability with an error of less than 2%. (C) 2012 American Institute of Physics. http://dx.doi.org/10.1063/1.4769756]

Control mechanisms in the human binocular oculomotor system

A study of human eye movements was made in order to elucidate the nature of the control mechanism in the binocular oculomotor system.

We first examined spontaneous eye movements during monocular and binocular fixation in order to determine the corrective roles of flicks and drifts. It was found that both types of motion correct fixational errors, although flicks are somewhat more active in this respect. Vergence error is a stimulus for correction by drifts but not by flicks, while binocular vertical discrepancy of the visual axes does not trigger corrective movements.

Second, we investigated the non-linearities of the oculomotor system by examining the eye movement responses to point targets moving in two dimensions in a subjectively unpredictable manner. Such motions consisted of hand-limited Gaussian random motion and also of the sum of several non-integrally related sinusoids. We found that there is no direct relationship between the phase and the gain of the oculomotor system. Delay of eye movements relative to target motion is determined by the necessity of generating a minimum afferent (input) signal at the retina in order to trigger corrective eye movements. The amplitude of the response is a function of the biological constraints of the efferent (output) portion of the system: for target motions of narrow bandwidth, the system responds preferentially to the highest frequency; for large bandwidth motions, the system distributes the available energy equally over all frequencies. Third, the power spectra of spontaneous eye movements were compared with the spectra of tracking eye movements for Gaussian random target motions of varying bandwidths. It was found that there is essentially no difference among the various curves. The oculomotor system tracks a target, not by increasing the mean rate of impulses along the motoneurons of the extra-ocular muscles, but rather by coordinating those spontaneous impulses which propagate along the motoneurons during stationary fixation. Thus, the system operates at full output at all times.

Fourth, we examined the relative magnitude and phase of motions of the left and the right visual axes during monocular and binocular viewing. We found that the two visual axes move vertically in perfect synchronization at all frequencies for any viewing condition. This is not true for horizontal motions: the amount of vergence noise is highest for stationary fixation and diminishes for tracking tasks as the bandwidth of the target motion increases. Furthermore, movements of the occluded eye are larger than those of the seeing eye in monocular viewing. This effect is more pronounced for horizontal motions, for stationary fixation, and for lower frequencies.

Finally, we have related our findings to previously known facts about the pertinent nerve pathways in order to postulate a model for the neurological binocular control of the visual axes.

The Role of Attention in Binocular Rivalry as Revealed Through Optokinetic Nystagmus

When stimuli presented to the two eyes differ considerably, stable binocular fusion fails, and the subjective percept alternates between the two monocular images, a phenomenon known as binocular rivalry. The influence of attention over this perceptual switching has long been studied, and although there is evidence that attention can affect the alternation rate, its role in the overall dynamics of the rivalry process remains unclear. The present study investigated the relationship between the attention paid to the rivalry stimulus, and the dynamics of the perceptual alternations. Specifically, the temporal course of binocular rivalry was studied as the subjects performed difficult nonvisual and visual concurrent tasks, directing their attention away from the rivalry stimulus. Periods of complete perceptual dominance were compared for the attended condition, where the subjects reported perceptual changes, and the unattended condition, where one of the simultaneous tasks was performed. During both the attended and unattended conditions, phases of rivalry dominance were obtained by analyzing the subject"s optokinetic nystagmus recorded by an electrooculogram, where the polarity of the nystagmus served as an objective indicator of the perceived direction of motion. In all cases, the presence of a difficult concurrent task had little or no effect on the statistics of the alternations, as judged by two classic tests of rivalry, although the overall alternation rate showed a small but significant increase with the concurrent task. It is concluded that the statistical patterns of rivalry alternations are not governed by attentional shifts or decision-making on the part of the subject.

A Binocular, Foveated Active Vision System

This report documents the design and implementation of a binocular, foveated active vision system as part of the Cog project at the MIT Artificial Intelligence Laboratory. The active vision system features a three degree of freedom mechanical platform that supports four color cameras, a motion control system, and a parallel network of digital signal processors for image processing. To demonstrate the capabilities of the system, we present results from four sample visual-motor tasks.

Multi-scale 3D Scene Flow from Binocular Stereo Sequences

Scene flow methods estimate the three-dimensional motion field for points in the world, using multi-camera video data. Such methods combine multi-view reconstruction with motion estimation approaches. This paper describes an alternative formulation for dense scene flow estimation that provides convincing results using only two cameras by fusing stereo and optical flow estimation into a single coherent framework. To handle the aperture problems inherent in the estimation task, a multi-scale method along with a novel adaptive smoothing technique is used to gain a regularized solution. This combined approach both preserves discontinuities and prevents over-regularization-two problems commonly associated with basic multi-scale approaches. Internally, the framework generates probability distributions for optical flow and disparity. Taking into account the uncertainty in the intermediate stages allows for more reliable estimation of the 3D scene flow than standard stereo and optical flow methods allow. Experiments with synthetic and real test data demonstrate the effectiveness of the approach.

Multi-Scale 3D Scene Flow from Binocular Stereo Sequences

Scene flow methods estimate the three-dimensional motion field for points in the world, using multi-camera video data. Such methods combine multi-view reconstruction with motion estimation. This paper describes an alternative formulation for dense scene flow estimation that provides reliable results using only two cameras by fusing stereo and optical flow estimation into a single coherent framework. Internally, the proposed algorithm generates probability distributions for optical flow and disparity. Taking into account the uncertainty in the intermediate stages allows for more reliable estimation of the 3D scene flow than previous methods allow. To handle the aperture problems inherent in the estimation of optical flow and disparity, a multi-scale method along with a novel region-based technique is used within a regularized solution. This combined approach both preserves discontinuities and prevents over-regularization – two problems commonly associated with the basic multi-scale approaches. Experiments with synthetic and real test data demonstrate the strength of the proposed approach.

Foreground Object Segmentation from Binocular Stereo Video

Moving cameras are needed for a wide range of applications in robotics, vehicle systems, surveillance, etc. However, many foreground object segmentation methods reported in the literature are unsuitable for such settings; these methods assume that the camera is fixed and the background changes slowly, and are inadequate for segmenting objects in video if there is significant motion of the camera or background. To address this shortcoming, a new method for segmenting foreground objects is proposed that utilizes binocular video. The method is demonstrated in the application of tracking and segmenting people in video who are approximately facing the binocular camera rig. Given a stereo image pair, the system first tries to find faces. Starting at each face, the region containing the person is grown by merging regions from an over-segmented color image. The disparity map is used to guide this merging process. The system has been implemented on a consumer-grade PC, and tested on video sequences of people indoors obtained from a moving camera rig. As can be expected, the proposed method works well in situations where other foreground-background segmentation methods typically fail. We believe that this superior performance is partly due to the use of object detection to guide region merging in disparity/color foreground segmentation, and partly due to the use of disparity information available with a binocular rig, in contrast with most previous methods that assumed monocular sequences.

How Does Binocular Rivalry Emerge from Cortical Mechanisms of 3D Vision?

Under natural viewing conditions, a single depthful percept of the world is consciously seen. When dissimilar images are presented to corresponding regions of the two eyes, binocular rivalyr may occur, during which the brain consciously perceives alternating percepts through time. How do the same brain mechanisms that generate a single depthful percept of the world also cause perceptual bistability, notably binocular rivalry? What properties of brain representations correspond to consciously seen percepts? A laminar cortical model of how cortical areas V1, V2, and V4 generate depthful percepts is developed to explain and quantitatively simulate binocualr rivalry data. The model proposes how mechanisms of cortical developement, perceptual grouping, and figure-ground perception lead to signle and rivalrous percepts. Quantitative model simulations include influences of contrast changes that are synchronized with switches in the dominant eye percept, gamma distribution of dominant phase durations, piecemeal percepts, and coexistence of eye-based and stimulus-based rivalry. The model also quantitatively explains data about multiple brain regions involved in rivalry, effects of object attention on switching between superimposed transparent surfaces, and monocular rivalry. These data explanations are linked to brain mechanisms that assure non-rivalrous conscious percepts. To our knowledge, no existing model can explain all of these phenomena.

Does Binocular Rivalry Emerge from Cortical Mechanisms of 3D Vision

Under natural viewing conditions, a single depthful percept of the world is consciously seen. When dissimilar images are presented to corresponding regions of the two eyes, binocular rivalry may occur, during which the brain consciously perceives alternating percepts through time. Perceptual bistability can also occur in response to a single ambiguous figure. These percepts raise basic questions: What brain mechanisms generate a single depthful percept of the world? How do the same mechanisms cause perceptual bistability, notably binocular rivalry? What properties of brain representations correspond to consciously seen percepts? How do the dynamics of the layered circuits of visual cortex generate single and bistable percepts? A laminar cortical model of how cortical areas V1, V2, and V4 generate depthful percepts is developed to explain and quantitatively simulate binocular rivalry data. The model proposes how mechanisms of cortical development, perceptual grouping, and figure-ground perception lead to single and rivalrous percepts.

The role of binocular vision in primate locomotion.

Dissertation