Altered spatial summation optimizes visual function in axial myopia

Stapley, Victoria; Anderson, R. H.; Saunders, Kathryn; Mulholland, Pádraig J.

doi:10.1038/s41598-020-67893-8

Cited by 7 publications

(12 citation statements)

References 77 publications

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“…Moreover, the accuracy of the described models in cases of high refractive error was not tested, given the limited range of refractive errors included in this study. Inclusion of additional ocular parameters such as axial length into future models would greatly aid model refinement, especially in the light of reported variations in both inner retinal thickness and spatial summation characteristics with axial length 77–79 . Finally, the manner in which the normative models were tested means that the relative contributions of each component, cluster analysis‐aided pooling, age correction and tilt correction were not assessed, and it may be useful in future studies to isolate each component to determine their importance in applications of future normative comparisons.…”

Section: Discussionmentioning

confidence: 99%

Prediction of visual field defects from macular optical coherence tomography in glaucoma using cluster analysis

Tong

Alonso‐Caneiro

Kalloniatis

et al. 2022

Ophthalmic Physiologic Optic

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Purpose To assess the accuracy of cluster analysis‐based models in predicting visual field (VF) defects from macular ganglion cell‐inner plexiform layer (GCIPL) measurements in glaucomatous and healthy cohorts. Methods GCIPL measurements were extracted from posterior pole optical coherence tomography (OCT), from locations corresponding to central VF test grids. Models incorporating cluster analysis methods and corrections for age and fovea to optic disc tilt were developed from 493 healthy participants, and 5th and 1st percentile limits of GCIPL thickness were derived. These limits were compared with pointwise 5th and 1st percentile limits by calculating sensitivities and specificities in an additional 40 normal and 37 glaucomatous participants, as well as applying receiver operating characteristic (ROC) curve analyses to assess the accuracy of predicting VF results from co‐localised GCIPL measurements. Results Clustered models demonstrated globally low sensitivity, but high specificity in the glaucoma cohort (0.28–0.53 and 0.77–0.91, respectively), and high specificity in the healthy cohort (0.91–0.98). Clustered models showed similar sensitivities and superior specificities compared with pointwise methods (0.41–0.65 and 0.71–0.98, respectively). There were significant differences in accuracy between clusters, with relatively poor accuracy at peripheral macular locations (p < 0.0001 for all comparisons). Conclusions Cluster analysis‐based models incorporating age correction and holistic consideration of fovea to optic disc tilt demonstrated superior performance in predicting VF results to pointwise methods in both glaucomatous and healthy eyes. However, relatively low sensitivity and poorer performance at the peripheral macula indicate that OCT in isolation may be insufficient to predict visual function across the macula accurately. With modifications to criteria for abnormality, the concepts suggested by the described normative models may guide prioritisation of VF assessment requirements, with the potential to limit excessive VF testing.

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Section: Discussionmentioning

confidence: 99%

Prediction of visual field defects from macular optical coherence tomography in glaucoma using cluster analysis

Tong

Alonso‐Caneiro

Kalloniatis

et al. 2022

Ophthalmic Physiologic Optic

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“…While no study, to our knowledge, has investigated temporal summation in myopia, previous work 5,7 has reported an enlarged area of complete spatial summation (RA) under the same conditions used in this study. Taken together, the findings of altered spatial summation but preserved temporal summation provides further insights as to the likely source of altered spatial summation in non-pathological myopia.…”

Section: Discussionmentioning

confidence: 69%

“…No change in temporal summation was observed in participants with myopia compared with non-myopic controls, despite a previous finding of altered spatial summation under identical experimental conditions. 7 This indicates that although RGC density (cells/mm 2 ) changes in myopia, RGC function does not. Given that temporal summation is altered in glaucoma, but not in myopia, perimetric strategies optimised to identify deficits in temporal summation may improve the accuracy with which glaucoma-related visual deficits due to RGC loss and/or pre-morbid dysfunction may be differentiated from myopia-related changes in visual function due to altered RGC density.…”

Section: Discussionmentioning

confidence: 99%

“…Recently, our group has also demonstrated an enlarged area of complete spatial summation (Ricco's area, RA) in axial myopia when interindividual differences in retinal image size are accounted for. 7 Such changes in spatial visual function in myopia have been attributed to the reduction in the density (cells/ mm 2 ) of photoreceptors and retinal ganglion cells (RGCs) that results from axial elongation of the myopic eye. 2,4,[7][8][9] Alterations in the structure and/or function of higher visual centres, [10][11][12] in addition to the concentration of circulating dopamine and dopamine antagonists, 7,13 have also been hypothesised to underpin such changes.…”

Section: Introductionmentioning

confidence: 99%

“…Such changes in spatial visual function in myopia have been attributed to the reduction in the density (cells/mm 2 ) of photoreceptors and retinal ganglion cells (RGCs) that results from axial elongation of the myopic eye 2,4,7–9 . Alterations in the structure and/or function of higher visual centres, 10–12 in addition to the concentration of circulating dopamine and dopamine antagonists, 7,13 have also been hypothesised to underpin such changes.…”

Section: Introductionmentioning

confidence: 99%

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Temporal summation in myopia and its implications for the investigation of glaucoma

Stapley

Anderson

Redmond

et al. 2023

Ophthalmic Physiologic Optic

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Purpose We have previously demonstrated the upper limit of complete spatial summation (Ricco's area) to increase in non‐pathological axial myopia compared to non‐myopic controls. This study sought to investigate whether temporal summation is also altered in axial myopia to determine if this aspect of visual function, like in glaucoma, is influenced by reductions in retinal ganglion cell (RGC) density. Methods Achromatic contrast thresholds were measured for a GIII‐equivalent stimulus (0.43° diameter) of six different stimulus durations (1–24 frames, 1.1–187.8 ms) in 24 participants with axial myopia (mean spherical refractive error: −4.65D, range: −1.00D to −11.25D, mean age: 34.1, range: 21–57 years) and 21 age‐similar non‐myopic controls (mean spherical refractive error: +0.87D, range: −0.25D to +2.00D, mean age: 31.0, range: 18–55 years). Measurements were performed at 10° eccentricity along the 90°, 180°, 270° and 360° meridians on an achromatic 10 cd/m2 background. The upper limit of complete temporal summation (critical duration, CD) was estimated from the data with iterative two‐phase regression analysis. Results There was no significant difference (p = 0.90, Mann–Whitney U‐test) in median CD between myopes (median: 44.3 ms; IQR: 26.5, 51.2) and non‐myopes (median: 41.6 ms; IQR: 27.3, 48.5). Despite RGC numbers underlying the stimulus being significantly lower in the myopic group (p < 0.001), no relationship was observed between the CD estimate and co‐localised RGC number (Pearson's r = −0.13, p = 0.43) or ocular length (Pearson's r = −0.08, p = 0.61). Conclusions Unlike spatial summation, temporal summation is unchanged in myopia. This contrasts with glaucoma where both temporal and spatial summation are altered. As such, perimetric methods optimised to test for anomalies of temporal summation may provide a means to differentiate between conditions causing only a reduced RGC density (e.g., myopia), and pathological processes causing both a reduced RGC density and RGC dysfunction (e.g., glaucoma).

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Implications of myopia in diagnosis and screening of open angle glaucoma

Iwase,

Araie

2024

Current Opinion in Ophthalmology

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Purpose of review Rapid increase in the prevalence of myopia has been documented worldwide. Myopia, especially high myopia, is not only an important risk factor for having open angle glaucoma (OAG), but also has a strong linking with the progression of OAG. Since myopic axial length (AXL) elongation is associated with nonglaucomatous optic nerve head (ONH) and visual field abnormalities, myopia poses a challenge in differential diagnosis of OAG. This review provides an overview of literature studying relationships between myopic AXL-elongation and diagnosis and prognosis of OAG, and functional and structural changes in the eye. Recent findings Studies using optical coherence tomography (OCT), OCT-angiography, those using standard automated perimetry (SAP), other perimetric or electrophysiological methods showed dose-dependent effects of myopic AXL elongation on the structural changes in the ONH and parapapillary tissues, and functional abnormalities of an eye. Large cohort studies showed approximately one quarter of eyes with nonpathologic high myopia were complicated with various patterns of visual field defects including glaucoma-like ones. Summary Findings of cross-sectional and longitudinal studies obtained using various fundus imaging devices must be integrated to perimetric results to improve differential diagnosis of OAG in myopic eyes, in which artificial intelligence technology may be useful.

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Altered spatial summation optimizes visual function in axial myopia

Cited by 7 publications

References 77 publications

Prediction of visual field defects from macular optical coherence tomography in glaucoma using cluster analysis

Prediction of visual field defects from macular optical coherence tomography in glaucoma using cluster analysis

Temporal summation in myopia and its implications for the investigation of glaucoma

Implications of myopia in diagnosis and screening of open angle glaucoma

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