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Invest Ophthalmol Vis Sci. 2020 Feb 7;61(2):21. doi: 10.1167/iovs.61.2.21.
Optical treatment can improve visual function in anisometropic amblyopia, but there is no electrophysiological evidence, and the underlying change in visual pathway remains unknown. Our aims were to characterize the functional loss in magnocellular and parvocellular visual pathways in anisometropic amblyopia at baseline and to investigate the effect of optical treatment on the 2 visual pathways.
Using isolated-check visual-evoked potential, we measured the magnocellular- and parvocellular-biased contrast response functions in 15 normal controls (20.13 ± 3.93 years; mean ± standard deviation), 16 patients with anisometropic amblyopia (18.00 ± 6.04 years) who were fully refractive corrected before and 29 (19.41 ± 7.41 years) who had never been corrected. Twelve previously uncorrected amblyopes received optical treatment for more than 2 months and finished the follow-up measurement.
Both the magnocellular- and parvocellular-biased contrast response functions in the amblyopic eye exhibited significantly reduced response and weaker contrast gains. We also found that the uncorrected amblyopes showed a more severe response reduction in magnocellular-biased, but not parvocellular-biased condition when compared with those corrected, with a weaker initial contrast gain and lower maximal response. After optical treatment, 12 uncorrected amblyopes demonstrated improved visual acuity of the amblyopic eye and a significant response gain to magnocellular-biased but not parvocellular-biased stimuli.
We demonstrated deficits to both magnocellular- and parvocellular-biased stimuli in subjects with anisometropic amblyopia. Optical treatment could produce neurophysiological changes in visual pathways even in older children and adults, which may be mediated through the magnocellular pathway.
光学治疗可改善屈光参差性弱视的视觉功能,但尚无电生理证据,视觉通路的潜在变化仍不清楚。我们的目的是在基线时描述屈光参差性弱视中大细胞和小细胞视通路的功能丧失,并研究光学治疗对 2 种视通路的影响。
使用分离检查视觉诱发电位,我们测量了 15 名正常对照者(20.13±3.93 岁;平均值±标准差)、16 名屈光参差性弱视患者(18.00±6.04 岁,在完全矫正屈光不正之前)和 29 名从未矫正过的患者的大细胞和小细胞优势对比反应功能。12 名未经矫正的弱视患者接受了超过 2 个月的光学治疗,并完成了随访测量。
弱视眼的大细胞和小细胞优势对比反应功能均表现出明显的反应降低和较弱的对比增益。我们还发现,与矫正者相比,未经矫正的弱视者在大细胞优势条件下表现出更严重的反应降低,但在小细胞优势条件下则不然,其初始对比增益较弱,最大反应较低。经过光学治疗后,12 名未经矫正的弱视患者的弱视眼视力明显提高,对大细胞优势刺激的反应增益显著,但对小细胞优势刺激的反应增益则不显著。
我们在屈光参差性弱视患者中发现了对大细胞和小细胞优势刺激的缺陷。即使在年龄较大的儿童和成人中,光学治疗也能产生视觉通路的神经生理变化,这可能是通过大细胞通路介导的。