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VISUAL EVOKED RETINAL AND OCCIPITAL POTENTIALS.
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Potential vision testing--the relationship between visual acuity and Vernier acuity in the presence of simulated cataract.
To evaluate the utility of a computer controlled two-bar Vernier acuity measurement as a predictor of visual function in the presence of cataract we measured logMAR visual acuity and Vernier acuity in a group of 40 young normal observers under various levels of dioptric blur (0-3 D in dioptre steps). The Vernier thresholds were resistant to dioptric blur up to 2 D, but performance degraded with blur of 3 D for non-optimised Vernier stimulus parameters. The stimulus parameters, bar length and bar separation, were further investigated in two subjects under conditions of blur. By extending the Vernier bar length and increasing the bar separation the effect of blur could be further reduced even under the most blurred condition. The relationship between visual acuity and Vernier acuity was determined. Vernier acuity was measured in the presence of Vistech cataract simulating lenses and a prediction of visual acuity was made for three observers, two with no ocular abnormality and one with age-related maculopathy. The cataract simulating lenses affected the measured visual acuity in all three subjects, but had less effect on Vernier acuity. Predicted visual acuities were all within six letters (0.12 log units) of the visual acuity without the simulated cataract. As expected, the subject sufferng from age-related maculopathy, whilst showing similar levels of Vernier acuity to the two ocularly healthy subjects at 1.5 degrees of retinal eccentricity, showed much poorer Vernier acuity for stimuli presented at fixation.
[Evoked visual responses in children with normal and poor vision].
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The physical impact of computers and electronic game use on children and adolescents, a review of current literature.
Children using computers and electronic games may adopt the kinds of sustained and awkward postures that are associated with musculoskeletal disorders in working adults. If they do, the physical demands of extensive use could lead to a wide range of adverse effects on developing children, including visual, neurological and physical changes. This article reviews the literature related to media use, ergonomics, epidemiology and pediatrics that address the physical impact of computer use by children. The literature establishes that computer use is common, but does not demonstrate a causal or statistical association with any physical disorders. Laboratory studies on vision, case reports of game-related tendonitis and ergonomic analyses of classroom computers suggest that concern is warranted.
Head mounted video magnification devices for low vision rehabilitation: a comparison with existing technology.
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Blackout detection as a multiobjective optimization problem.
We study new fast computational procedures for a pilot blackout (total loss of vision) detection in real time. Their validity is demonstrated by data acquired during experiments with volunteer pilots on a human centrifuge. A new systematic class of very fast suboptimal group filters is employed. The utilization of various inherent group invariancies of signals involved allows us to solve the detection problem via estimation with respect to many performance criteria. The complexity of the procedures in terms of the number of computer operations required for their implementation is investigated. Various classes of such prediction procedures are investigated, analyzed and trade offs are established. Also we investigated the validity of suboptimal filtering using different group filters for different performance criteria, namely: the number of false detections, the number of missed detections, the accuracy of detection and the closeness of all procedures to a certain bench mark technique in terms of dispersion squared (mean square error). The results are compared to recent studies of detection of evoked potentials using estimation. The group filters compare favorably with conventional techniques in many cases with respect to the above mentioned criteria. Their main advantage is the fast computational processing.
Visual control of isometric force in Parkinson's disease.
The current article reports an investigation of the influence of visual feedback on force production in Parkinson's disease (PD) that required subjects to maintain a constant amount of isometric force with their index finger and thumb with and without visual feedback. Eight PD and eight matched control subjects produced force at 5, 25 and 50% of their maximal voluntary contraction for 20 s. In conditions of full vision, the force trajectory and force target were viewed on the computer monitor. In the no visual feedback condition, visual feedback of the force trajectory vanished after the initial 8 s of the trial. The results showed that under the vision condition PD subjects produced levels of maximal and submaximal force that were similar to controls. Approximately 1.5-2.5 s following the removal of visual feedback, the force level in both subject groups decreased to steady-state levels. There was no difference in the time between visual feedback removal and the beginning of force decay in PD. There was a larger amount and faster rate of force decay after visual feedback removal in PD subjects compared to the controls. It is proposed that the increased force decay in PD does not result from sensory reflex deficits but from higher order sensory-motor memory processes.
Changes in regional cerebral blood flow related to line bisection discrimination and visual attention using HMPAO-SPECT.
Behavioral tasks requiring visual-spatial discrimination such as line bisection are used clinically to assess right hemisphere function, yet the anatomical substrate of line bisection has yet to be elucidated by functional imaging. In the current study, nine right-handed, healthy adult subjects underwent split-dose technetium-99m-hexamethylpropylene amine oxime single photon emission tomography during performance of two visual tasks. Statistical parametric maps that represented significant changes in regional cerebral blood flow (rCBF) for each task were generated. Increases in rCBF were seen in the right dorsolateral prefrontal cortex, the insula, and the superior temporal lobe with a line-bisection discrimination task, whereas increases in the visual association areas, the posterior cingulate gyrus bilaterally, and the anterior cingulate gyrus on the right were seen with a similar control task which required sustained visual attention, but no visual spatial discrimination. We conclude that distinct areas in the nondominant hemisphere can be shown to be active during performance of line-bisection discrimination and sustained visual attention.
A unified neural network [corrected] model of spatiotemporal processing in X and Y retinal ganglion cells. I. Analytical results.
This work presents unified analyses of spatial and temporal visual information processing in a feed-forward network of neurons that obey membrane, or shunting equations. The feed-forward shunting network possesses properties that make it well suited for processing of static, spatial information. However, it is shown here that those same properties of the shunting network that lead to good spatial processing imply poor temporal processing characteristics. This article presents an extension of the feed-forward shunting network model that solves this problem by means of preprocessing layers. The anatomical interpretation of the resulting model is structurally analogous to recently discovered data on a retinal circuit connecting cones to retinal ganglion cells through pairs of push-pull bipolar cells. Mathematical analysis of the lumped model leads to the hypothesis that X and Y retinal ganglion cells may consist of a single mechanism acting in different parameter ranges. This hypothesis is confirmed in the companion article, wherein the model--in conjunction with a nonlinear temporal adaptation mechanism--is used to reproduce experimental data of both X and Y cells by simple changes in morphological and physiological parameters.
[First experiences with an instrument for TV display of digitally encoded text information for the visually handicapped (author's transl)].
An instrument was developed which allows the display, in enlarged form--especially for visually handicapped persons--of text information as used in modern data-acquisition systems such as writing automats, screen editing devices, and television text display (in England, Ceefax). With the aid of electronic character generators, the text is displayed continually, moving from right to left in one line on the screen of a commercial TV set. Rate of movement, size, brightness, and color of the characters (and/or the background) can be selected arbitrarily. We performed a preliminary reading test with visually handicapped subjects from a rehabilitation center for blind persons. The resulting optimal parameters for text display and the achieved reading speed with the system are discussed.
Experience in management of 51 non-functioning pituitary adenomas: indications for post-operative radiotherapy.
OBJECT: The indications for additional radiotherapy (RT) after surgery for non-functioning pituitary adenoma are controversial. The goal of this retrospective study was to evaluate the outcome of surgically treated patients, with or without post- operative irradiation. METHODS: Review of cases treated for non-functioning pituitary adenoma. Fifty-one patients were identified, with a mean post-operative follow-up of 6.4+/-3.5 yr. Twenty-nine patients showed residual tumor after surgery and 22 did not. Serial endocrine, visual and radiological evaluations were made after treatment to assess the efficacy and toxicity of surgery and RT. Twenty-seven patients with residual tumor after surgery received RT (22 of them during the post-operative period and 5 after an interval of several yr: 3 because of increased tumor size and 2 with stable residual lesion); tumors in 14 of these patients decreased in size, 11 appeared to be stable on imaging and one patient showed some increase in tumor size (one patient was not followed-up). The residual tumors of the 2 non-irradiated patients remained stable after 5 and 7 yr, respectively. Twenty-two patients without residual disease after surgery (11 with post-operative irradiation, 1 with RT 5 yr after transsphenoidal surgery because of tumor recurrence, and 10 without RT) have shown no evidence of tumor regrowth on serial images. CONCLUSIONS: Radiotherapy can be avoided in patients with complete macroscopic resection and absence of residual tumor in post-operative images; they must be carefully followed using imaging techniques and, in the case of recurrence, they should be re-operated and/or irradiated.
[Accuracy of lens power calculation and centration of an aspheric intraocular lens].
BACKGROUND: Aspherical intraocular lenses (IOLs) are presumed to optimize the optical characteristics of IOLs. In order to profit from these characteristics, exact calculation of the IOL power and good centration of the lens are essential. METHODS: In all, 43 eyes of 43 patients with an average age of 70.9+/-8.3 years underwent implantation of a Tecnis IOL (AMO, Ettlingen) after uneventful cataract surgery with topical anesthesia. IOL power calculation was performed using the Holladay, Haigis, and SRK II formulas. Spherical equivalent refraction and centration and position of the implanted IOLs were measured 6 months postoperatively. Centration of the IOL was analyzed using digital slit lamp photographs and an image analysis program. RESULTS: Best corrected visual acuity (BCVA) increased from 0.47+/-0.25 (LogMAR) preoperatively to 0.1+/-0.11 6 months postoperatively (spherical equivalent +0.3+/-0.6 D). The intraindividual difference between target refraction and achieved postoperative refraction was 0.64+/-0.11 D for the Holladay formula, -0.21+/-0.11 D for the Haigis formula, and 0.97+/-0.15 D for the SRK II formula. The mean decentration of the IOL from the center of the corneal limbus was 0.4+/-0.1 mm. CONCLUSIONS: For the aspherical Tecnis IOL very good postoperative functional results are reported, which are supported by an accurate calculation of the IOL power and a good centration of the IOL inside the capsular bag. In this study the Haigis formula showed the lowest difference between target refraction and achieved postoperative refraction.
[Validity of a web-based color vision test for screening examinations of color vision].
BACKGROUND: With standardized examination conditions, a web-based color vision test using pseudoisochromatic color plates can deliver test results comparable to those yielded by conventional color vision tests. The aim of the study is to analyze to what extent a web-based color vision test can be used as a screening test on the internet after visual monitor calibration. METHODS: A German-language web-based color vision test with 25 pseudoisochromatic color plates based on the color plates of Velhagen and Broschmann and of Ishihara was developed, which can be seen at http://www.farbsehtest.de. Volunteers were recruited by means of specific information distributed on the internet, in various print media, and on the radio. RESULTS: Over a period of 12 months, 2,126 of the initial volunteers [541 women and 1,588 men; mean age 34.27 (+/-14.1) years] with a valid test result for 25 color plates performed the web-based color vision test, 1,700 (506 women and 1,194 men) of whom passed it. Of the 426 volunteers who did not pass the test, 32 were women and 394, men. Counter-testing was performed on 101 volunteers (34 women and 67 men) with a mean age of 36.74 (+/-11.6) years. CONCLUSIONS: The results recorded in the patients who underwent counter-testing suggest that, if handled correctly, the web-based color vision test can be used as a color vision screening test on the internet.
[Controversies and current status of therapy of optic nerve damage in craniofacial traumatology and surgery].
In craniomaxillofacial traumatology, surgical oncology and craniomaxillofacial reconstruction, a surgeon's aim may interfere with the prechiasmatic visual pathway. Precise concepts and therapeutic strategies are mandatory to detect and deal with anterior visual pathway disorders. In order to develop these strategies, knowledge of the pathomechanisms of potential optic nerve trauma, primary radiological investigations, and further diagnostic measures are important. Due to the difficulties in neuroophthalmological testing of visual pathway functioning in severely injured patients or even during craniomaxillofacial reconstructions, we established flash-evoked visual potentials (VEP) and the electroretinogram (ERG) as reliable electrophysiological methods to gather specific information as to whether the visual pathway function is intact, even if pathological, but still present or absent. Case reports show that subjectively or objectively confirmed unilateral amaurosis does not necessarily mean irreversible vision loss. The electrophysiological evaluation together with multiplanar computer tomography (CT) are important for the immediate identification of optic nerve trauma. The results of this evaluation will provide the diagnostic information on whether surgical intervention and/or conservative therapy is required to prevent secondary optic nerve damage. The conservative therapy of choice for the treatment of traumatic optic nerve lesions is the methylprednisolone-megadosis regimen (30 mg Urbason/kg bodyweight i.v. and 5.4 mg/kg bodyweight/h i.v. for the following 47 h). Surgical therapy involves decompression of the orbital compartment in case of retrobulbar hematoma or decompression of the intracanalicular part of the optic nerve in the traumatized optic canal or posterior orbit as confirmed by CT. Prospective analysis of our trauma patients and the international literature on traumatic optic nerve lesions show that the time factor in when to start therapy has been greatly underestimated. To fulfill modern treatment concepts in craniomaxillofacial surgery, sound diagnostic and therapeutic knowledge on the maintenance of visual pathway function is required.
Computed tomography in penetrating injury to the eye.
We used computed tomography to detect and localize foreign bodies in two unusual cases of penetrating injury to the eyes. In one case, a large broken twig appeared to have penetrated the globe and the inferior rectus muscle; in the other, the globe was ruptured by many glass shards . In the first case surgery showed the computed tomographic impression to be incorrect. The globe and the inferior rectus muscle were intact and vision and motility were normal postoperatively. In the second case, swelling made direct visualization impossible, and computed tomography was used to locate the foreign bodies.
Classification of chromatic visual evoked potentials with the aid of a neural net.
Twelve normal subjects, and six color blind (three protanopes and three deuteranopes) individuals were used in this study. Visual evoked potentials (50-150 msec post-stimulus) were recorded in response to three stimuli: (a) three horizontal, achromatic bars alternating in luminosity between bright and dim, (b) bars alternating between blue and red, and (c) bars alternating between green and red. The resulting waveforms were normalized in amplitude and submitted to a commercial neural net program for classification. The network correctly identified 24 of the 36 normal responses. (2) The network was also asked to distinguish between the responses of normal and color blind individuals. Based upon the blue/red response, the network correctly classed 12 of 18 responses, and based upon the green/red response correctly classified 14 of 18 (including all 6 color blinds). (3) These results are statistically highly significant and suggest that the VEP elicited by chromatic stimulation is substantially different from that elicited by achromatic stimuli.
Dynamic properties of vision. II. Theoretical relationships between flicker and flash thresholds.
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