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Human vision combines oriented filters to compute edges.

The experiments examined the perceived spatial structure of plaid patterns, composed of two or three sinusoidal gratings of the same spatial frequency, superimposed at different orientations. Perceived structure corresponded well with the pattern of zero crossings in the output of a circular spatial filter applied to the image. This lends some support to Marr & Hildreth's (Proc. R. Soc. Lond. B 207, 187 (1980)) theory of edge detection as a model for human vision, but with a very different implementation. The perceived structure of two-component plaids was distorted by prior exposure to a masking or adapting grating, in a way that was perceptually equivalent to reducing the contrast of one of the plaid components. This was confirmed by finding that the plaid distortion could be nulled by increasing the contrast of the masked or adapted component. A corresponding reduction of perceived contrast for single gratings was observed after adaptation and in some masking conditions. I propose the outlines of a model for edge finding in human vision. The plaid components are processed through cortical, orientation-selective filters that are subject to attenuation by forward masking and adaptation. The outputs of these oriented filters are then linearly summed to emulate circular filtering, and zero crossings (zcs) in the combined output are used to determine edge locations. Masking or adapting to a grating attenuates some oriented filters more than others, and although this changes only the effective contrast of the components, it results in a geometric distortion at the zc level after different filters have been combined. The orientation of zcs may not correspond at all with the orientation of Fourier components, but they are correctly predicted by this two-stage model. The oriented filters are not 'orientation detectors', but are precursors to a more subtle stage that locates and represents spatial features.

Adaptation, Ocular

[Disorders of binocular vision in amblyopic patients working at computer terminals].

For the first time two cases are described with disturbances of binocular vision caused by subjective perception of positive scotomata in the amblyopic eye. The visual strain of working at a terminal leads to a slight increase in the squint angle; as a result, a paracentral scotoma may shift into the middle of the binocular visual field and impair the image quality of the fixing eye. Amblyopic subjects presenting with these symptoms are disqualified from working at VDUs. However, not every amblyopic is affected.

Adult

Residual vision in patients with retrogeniculate lesions of the visual pathways.

Twenty-five subjects have been studied who, as a result of damage to the striate cortex, were 'blind' in extensive areas (scotomata) of the visual fields. Of these 25 subjects, 5 exhibited residual vision in response to transient lights presented within the scotoma, which enabled them to locate the stimuli by hand-reaching or by eye movements; the latter have been measured by electro-oculography. The residual vision underlying their responses was characterized by low flicker-fusion and by sensitivity in detection of movement which increased as target speed was raised. Discrimination for the direction of target movement was poor, but spatial resolution in the discrimination of target displacement was essentially normal. The subjects were unable to recognize or discriminate the spatial structure of targets located within the 'blind' field, and the observed dissociation between spatial discrimination of displacement and pattern is examined in relation to the 'two systems' hypothesis of visual function. There is no obvious correlation between the extent of neuronal damage as revealed by CT scans and the existence of residual vision.

Adult

Carotid artery occlusion and ocular ischemia: therapy control with evoked potentials.

We present a patient with internal carotid artery occlusion and ischemic oculopathy in whom extracranial-intracranial arterial bypass improved vision. Visual evoked potentials were studied to obtain objective criteria for indication and follow-up evaluation and confirmed that the improved vision was due to improved retinal function.

Brain Ischemia

Transient visual loss in ornithine transcarbamoylase deficiency.

We examined a 32-year-old, previously healthy man who developed episodic bilateral visual impairment and confusion. Coincident hyperammonemia led to the diagnosis of ornithine transcarbamoylase deficiency, which was established by enzymatic analysis of a liver biopsy specimen. The available data were insufficient to determine if the metabolic derangement impaired vision at the level of the optic nerves or at the cerebral level.

Adult

Ocular involvement in Castleman's disease. Response to radiotherapy.

A 21-year-old man with known Castleman's disease, a lymphoproliferative disorder with both local and systemic manifestations, presented with decreased vision in the left eye and chromatopsia. He had infiltration of the left disc and choroid with elevation of the retina, multiple bilateral depigmented areas at the level of the choroid or retinal pigment epithelium (RPE) (also thought to represent infiltrates), and left exophthalmos. A serious retinal detachment (RD) evolved, but then responded to radiotherapy, with recovery of good vision. Occult leptomeningeal involvement resolved during a period of observation. There was no systemic evidence of malignant lymphoma.

Adult

Intracranial hypertension causing visual failure in cryptococcus meningitis.

Thirty four patients with cryptococcal meningitis seen in the University of Malaya medical centre since 1980 were reviewed. Eleven patients had bilateral papilloedema and visual impairment but eventually survived. Seven patients had intensive aggressive measures, including shunting to reduce intracranial hypertension irrespective of ventricular size shown in CT scan, and showed substantial improvement in vision. It is concluded that papilloedema and visual failure in cryptococcal meningitis reflects raised intracranial pressure and that this should be treated vigorously.

Adolescent

Clinical features of occipital infarction.

Occipital infarction may only cause visual symptoms. A homonymous visual field defect of various configurations is the most common clinical finding. Additionally, central vision, color vision and visual associative function also may be impaired. In this paper three cases of occipital infarction are presented and the clinical features of this condition discussed.

Aged

A 16 year old boy with poor vision and nasal obstruction.

A 16 year old boy presented with visual deterioration and nasal obstruction. Investigations revealed a destructive pituitary tumour with extension into his skull base and nasopharynx. This unusual prolactin-secreting adenoma was treated by both surgery and bromocriptine.

Adenoma

Infarction of FSH-secreting pituitary adenoma.

A patient with an FSH-producing adenoma is reported. Two hours after LRH administration (100 microgram iv) the clinical signs of tumour infarction developed. The patient followed a severe clinical course. FSH levels normalised but further deterioration of pituitary function was documented. Worsening of the vision without improvement after surgical resection of the adenoma was observed. The role of LRH testing in adenoma infarction is discussed.

Adenoma

Syndrome of agitated delirium and visual impairment: a manifestation of medial temporo-occipital infarction.

Three patients presented with sudden visual impairment followed by agitated delirium one to three days later. Examination revealed marked agitation, dementia, and loss of vision. Computerised axial tomography demonstrated temporo-occipital infarctions. All recovered from the agitated state in four days to two months, but their visual impairment and dementia persisted one to four years later.

Adult

Acute monocular blindness secondary to fibrous dysplasia of the skull: a case report.

An unusual case of acute monocular visual loss secondary to fibrous dysplasia is presented. Orbital and optic canal decompression restored vision completely. A review of the pertinent literature revealed that operative intervention may be curative in patients with acute monocular visual loss. This finding contrasts with the chronic visual decline found secondary to fibrous dysplasia of the skull.

Adult

Contusion injuries of the optic nerve.

Indirect trauma to the optic nerve with secondary optic atrophy may result from minor trauma and has traditionally been associated with a poor visual prognosis. The case of a 32-year-old man who suffered a blow to his left supraorbital region and eyebrow in an automatic closing door is reported to draw attention to the uncommon but trivial nature of this injury which may result in profound visual loss. He suffered an initial inferonasal visual field loss which was related to vascular changes in the optic nerve head. Over the ensuing year there was deterioration in his central vision and visual field due to arachnoiditis. Current trends in the management of optic nerve contusion injuries are discussed. There is currently a move towards primary medical management with high-dose corticosteroids as in this case; surgery is reserved for those patients who fail to respond to steroids or deteriorate as the steroid dose is reduced.

Adult

Optic nerve involvement in Graves' ophthalmopathy: a case report and review.

Optic neuropathy in Graves' disease is an uncommon, but potentially treatable cause of disabling visual loss. Optic nerve damage is probably secondary to compression by swollen extraocular muscles at the apex of the orbit. The visual loss is usually bilateral and insidiously progressive, although accelerated visual loss, fluctuations in vision, and features mimicking orbital cellulitis may occur. Ocular congestive symptoms and proptosis have no direct relationship to the severity of visual loss. Early diagnosis is facilitated by orbital CT scanning. Oral corticosteroids and radiotherapy, alone or in combination, are the primary modalities of medical treatment. Surgical decompression of the orbit can be used where medical approaches have failed.

Aged

Primary intracranial plasma-cell granuloma. Case report.

The authors report the fourth case of primary intracranial plasma-cell granuloma. The patient was a 16-year-old girl who presented with loss of vision as the major clinical feature. The tumor resembled a meningioma both preoperatively and grossly at surgery. Because the tumor did not respond to steroid treatment following subtotal surgical excision, radiation therapy was administered to the affected area. Major considerations in the differential diagnosis of this neoplasm are discussed.

Adolescent

Intravascular thrombosis as a possible cause of transient cortical brain lesions: CT and MRI.

Cortical brain lesions were identified on MRI and CT in 14 patients with a variety of diseases. Each of these patients developed neurologic symptoms, the most prominent of which were seizures, depressed mental status, and blurred vision or cortical blindness. Both the imaging and the neurologic abnormalities resolved spontaneously within a period ranging from 5 to 30 days. Due to location and evolution of the lesions over time we hypothesize that they are secondary to small cortical venous thromboses.

Adolescent

Optic nerve shadow enlargement in the Klippel-Trenaunay-Weber syndrome.

A 10-year-old girl with Klippel-Trenaunay-Weber syndrome (KTWS) showed neuroradiologic signs of enlarged optic nerve and medial rectus shadows. In 3 years of follow-up, her vision has remained normal. This is the first report of optic nerve enlargement in this syndrome. The case demonstrates that enlargement of the optic nerve shadows is not inevitably associated with visual deterioration. Optic nerve enlargement may be part of a hamartomatous process that involves other orbital contents.

Angiomatosis

Vision despite tomographic absence of the occipital cortex.

A 14-month-old boy with developmental delay showed microcephaly, spastic diplegia, central visual fixation and an esotropia. A head tomographic scan disclosed absence of normal occipital cortex and electroencephalography showed markedly reduced voltages over the occipital region. Visual development in this patient may be related to heterotopic occipital cortex of a functioning non-striate system of visual processing. Visual function cannot be predicted when severe developmental anomalies of the occipital cortex are detected with computerized tomography.

Abnormalities, Multiple