Rapid Quantification of the Binocular Visual Field for Clinical Trials: Performance of a Modified Esterman Supra-Threshold Test Implemented with the Open Perimetry Interface.

Purpose: We aimed to assess the performance of the modified-Esterman test (mET) as a rapid suprathreshold binocular quantification tool for the assessment of peripheral visual fields. The mET consists of an even spread of test points across the visual field. Materials and Methods: The mET was implemented on the Octopus 0900 perimeter using the Open Perimetry Interface (OPI) and consisted of 160 points. Patients with choroideremia, a rod-cone dystrophy, Stargardt disease, a cone-rod dystrophy, and healthy volunteers underwent both the mET and the standard Esterman tests twice. Disease severity (mild/moderate/severe) was graded on both tests independently. Voronoi tessellation was utilised to compare the tests. Results: The Voronoi visualisation was able to demonstrate that the mET was able to provide more information about the disease state at all stages of diseases. This was confirmed by the agreement statistic, which showed that the mET detected 27% more points of visual field loss compared to the Esterman test, being most useful in patients with rod-cone dystrophies. Conclusion: The mET provides a speedy quantitative measure of the peripheral visual field loss, which can be used in clinical trials to monitor longitudinal assessment of peripheral visual function. The mET provides a more even coverage across the visual field compared to the Esterman test points, making it more suitable for this purpose. This is a key part of safety monitoring in retinal clinical trials. The mET can easily be implemented on commercially available perimeters that allow Open Perimetry.

A low-cost telescope for enhanced stimulus visual field coverage in functional MRI.

BACKGROUND: A common limitation of typical projection systems used for visual fMRI is the limited field of view that can be presented to the observer within the scanner. A wide field of view over which stimuli can be presented is critical when investigating peripheral visual function, in particular visual disorders or diseases that lead to the loss of peripheral vision. NEW METHOD: We present a relatively low-cost Galilean telescopic device that can be used in most MRI scanners to double the effective visual field being presented. The system described is non-ferromagnetic, and compatible with most standard methods of visual presentation in MRI environments. The increase in area of visual cortex activation was quantified by comparing the extent of visual activity evoked by observing flickering checkerboards with and without the telescope in place. RESULTS: In all three observers that reported image fusion from the telescope, the extent of cortical activation was greater with the telescope, while in the fourth observer there was no difference between the two methods due to a lack of fusion. CONCLUSION: The telescope is a low cost, easy to implement solution in situations where changes to the existing equipment or setup are not feasible.

Emergence of symmetry selectivity in the visual areas of the human brain: fMRI responses to symmetry presented in both frontoparallel and slanted planes.

Symmetry is effortlessly perceived by humans across changes in viewing geometry. Here, we re-examined the network subserving symmetry processing in the context of up-to-date retinotopic definitions of visual areas. Responses in object selective cortex, as defined by functional localizers, were also examined. We further examined responses to both frontoparallel and slanted symmetry while manipulating attention both toward and away from symmetry. Symmetry-specific responses first emerge in V3 and continue across all downstream areas examined. Of the retinotopic areas, ventral occipital VO1 showed the strongest symmetry response, which was similar in magnitude to the responses observed in object selective cortex. Neural responses were found to increase with both the coherence and folds of symmetry. Compared to passive viewing, drawing attention to symmetry generally increased neural responses and the correspondence of these neural responses with psychophysical performance. Examining symmetry on the slanted plane found responses to again emerge in V3, continue through downstream visual cortex, and be strongest in VO1 and LOB. Both slanted and frontoparallel symmetry evoked similar activity when participants performed a symmetry-related task. However, when a symmetry-unrelated task was performed, fMRI responses to slanted symmetry were reduced relative to their frontoparallel counterparts. These task-related changes provide a neural signature that suggests slant has to be computed ahead of symmetry being appropriately extracted, known as the "normalization" account of symmetry processing. Specifically, our results suggest that normalization occurs naturally when attention is directed toward symmetry and orientation, but becomes interrupted when attention is directed away from these features.