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Biomedical subjects

K D Cocker

Publications and source records attributed to K D Cocker.

5 recordsLinked to original sources
PubMed1998

Delayed visual maturation: pupillary responses implicate subcortical and cortical visual systems.

Vision in very early infancy is probably subserved by subcortical pathways, with many cortical processes only fully emerging by 3 months of age. The improvement of vision in delayed visual maturation (DVM) occurs around this time, and this has given rise to the suggestion that the condition may have a subcortical basis that resolves with the appearance of cortical function. To explore further the role of cortical and subcortical visual systems in DVM we studied the visual development in identical twins, one of whom had type 1b DVM. Two non-invasive methods of investigating visual pathway function were employed: the acuity card procedure (a behavioural response) and luminance and grating pupillometry. While the former reflects both subcortical and cortical function and can be detected at birth, pupil responses to gratings reflect cortical activity alone and normally become measurable at 1 month of age. Development of both behavioural and pupillary responses was delayed in DVM, indicating that although the underlying defect is primarily subcortical, secondarily it delays the emergence of cortically mediated responses. The observed rapidity of improvement--over a very few days and within a narrow age range--suggests a discrete rather than a widespread structural abnormality, the improvement of which is closely linked to postmenstrual age.

Failure to Thrive↗
PubMed1996

Development of pupillary responses to grating stimuli.

Pupillary responses to stationary, achromatic sine wave gratings were measured in adults and in 1- and 3-month-old infants. Measurements of behaviourally determined contrast sensitivity were also obtained from the infant subjects. Contrast sensitivity functions were typical of those previously described: band-pass in nature with sensitivity increasing markedly with age. The pupil grating response amplitudes also exhibited a spatial frequency and age dependence similar to that observed for contrast sensitivity. These findings provide further evidence that the neural mechanisms which underlie visual sensitivity to contrast also mediate pupillary responses to spatial structure.

Adult↗
PubMed1995

Compliance in amblyopia therapy: objective monitoring of occlusion.

AIM/BACKGROUND: This study aimed to determine the feasibility of objective compliance monitoring of amblyopia therapy in clinical research. Occlusion has been the mainstay of amblyopia therapy for over 250 years, yet it has never been subjected to rigorous evaluation. Treatment regimens range arbitrarily from a few minutes to most of the waking hours of the day. Compliance is problematic and as, hitherto, accurate objective monitoring has been impossible it is not known how much occlusion is required to effect an improvement in vision. METHODS: An occlusion dose monitor (ODM) has been developed. The ODM consists of a modified occlusion patch and a miniature battery driven datalogger which periodically monitors patch skin contact. The patch is a standard disposable item with two miniature electrocardiogram electrodes attached to its undersurface. The datalogger comprises a high speed static RAM and a clock driven address counter. Data are retrieved using an IBM PC/AT computer. Fifteen child amblyopes were randomly allocated unilateral occlusion of 1, 4, or 8 hours per day for 4 weeks. Owing to data loss, presumed because of accumulation and discharge of static electricity, an additional child was included in the 8 hour group. Outcome measures were objective (ODM) and subjective (diary) compliance with treatment, logMAR visual acuity, and contrast sensitivity. RESULTS: Objective monitoring of occlusion is technically feasible and clinically informative. CONCLUSION: Objective monitoring of occlusion has opened up new research opportunities which, it is hoped, will enable the dose-effect relation of occlusion therapy in the various types of amblyopia to be investigated objectively, and facilitate the design of effective therapeutic regimens.

Amblyopia↗
PubMed1994

Visual acuity and pupillary responses to spatial structure in infants.

PURPOSE: To determine the age of onset of the pupil grating response (PGR). To compare estimates of resolution acuity obtained by pupillometric and behavioral methods in early infancy. METHODS: Dynamic infrared pupillometry was undertaken on 19 newborn infants while they fixated a uniform background upon which a 0.1 c/deg sine wave grating was briefly presented. Pupillary responses were also recorded to an increment in luminance of a spatially homogeneous target. Longitudinal measurements of PGRs were obtained from a subset of eight infants between 3.5 and 38 weeks of age. In this group, behavioral estimates of visual resolution obtained using the acuity card procedure were compared with the highest spatial frequency grating to elicit a PGR. RESULTS: When presented with the pattern stimulus, newborn infants did not show any pupil reaction indicative of a PGR. This finding could not be attributed to immaturity of pupillomotor function: All infants showed marked pupillary construction to diffuse light stimulation. By 1 month of age, pupillary responses to pattern stimuli were reliably present. For these and older infants, the spatial frequency of the finest grating to elicit a PGR was comparable to the behaviorally determined resolution threshold: mean difference (+/- 95% confidence interval) = 0.28 +/- 0.23 octaves. CONCLUSIONS: A PGR could not be detected in newborn infants. From 1 month of age, responses to spatial structure can provide objective estimates of visual acuity comparable to those determined by established methods.

Age of Onset↗