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OBJECTIVE: To quantitatively evaluate visual evoked potentials (VEPs) in prosthetic vision and simulated visual reduction. METHODS AND ANALYSIS: Four blind patients implanted with the Argus II retinal prosthesis and seven sighted controls participated. VEPs were recorded with pattern-reversal stimuli (2 cycles of a horizontal square wave grating, 0.1 cycle/degree) at 1.07 reversals per second (rps) for Argus II subjects and 3.37 rps for controls. Argus II patients had both eyes patched, viewing the pattern solely through their implant. Controls viewed the pattern monocularly, either with their best-corrected vision or with simulated visual reduction (field restriction, added blur or reduced display contrast). RESULTS: VEPs recorded in Argus II patients displayed a similar shape to normal VEPs when controls viewed the pattern without simulated visual reduction. In sighted controls, adding blur significantly delayed the P100 peak time by 8.7 ms, 95% CI (0.9, 16.6). Reducing stimulus contrast to 32% and 6% of full display contrast significantly decreased P100 amplitude to 55% (37%, 82%) and 20% (13%, 31%), respectively. Restriction on the field of view had no impact on either the amplitude or the peak latency of P100. CONCLUSION: The early visual cortex in retinal prosthesis users remains responsive to retinal input, showing a similar response profile to that of sighted controls. Pattern-reversal VEP offers valuable insights for objectively evaluating artificial vision therapy systems (AVTSs) when selecting, fitting and training implant users, but the uncertainties in the exact timing and location of electrode stimulation must be considered when interpreting the results.
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Cegueira , Potenciais Evocados Visuais , Próteses Visuais , Humanos , Potenciais Evocados Visuais/fisiologia , Masculino , Feminino , Cegueira/fisiopatologia , Pessoa de Meia-Idade , Idoso , Acuidade Visual/fisiologia , AdultoRESUMO
Looming sounds are known to influence visual function in the brain, even as early as the primary visual cortex. However, despite evidence that looming sounds have a larger impact on cortical excitability than stationary sounds, the influence of varying looming strengths on visual ability remains unclear. Here, we aim to understand how these signals influence low-level visual function. Fourteen healthy undergraduate students participated. They were blindfolded and received transcranial magnetic stimulation (TMS) to the primary visual cortex following auditory stimulation with different strength looming sounds. Participants reported whether they perceived a phosphene, or an illusory visual percept, following TMS stimulation. We hypothesized that rates of phosphene activity would increase with increasing levels of looming strength. A linear mixed-effect model showed that phosphene activity was significantly higher at higher strength of looming (F(1, 69) = 5.33, p = .024) and at higher TMS pulse strength (F(1, 18) = 4.71, p = .043). However, there was also a significant interaction between looming strength and pulse strength (F(1, 69) = 4.33, p = .041). At lower levels of TMS strength, phosphene rate increased with looming strength, while at higher levels of TMS strength the effect was reversed. These results suggest a complex relationship between looming strength and cortical activity, potentially reflecting the mixed contribution of total auditory energy and the rate of changes. This work will enhance our ability to predict audiovisual interactions and may help improve auditory warning systems designed to capture visual attention.
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OBJECTIVE: To evaluate the benefit of integrating thermal imaging into an artificial vision therapy system, the Argus II retinal prosthesis, in simplifying a complex scene and improving mobility performance in the presence of other persons. APPROACH: Four Argus II retinal implant users were evaluated on two tasks: to locate and approach target persons in a booth, and to navigate a hallway while avoiding people. They completed the tasks using both the original Argus II system (the 'Argus II camera') and a thermal-integrated Argus II system (the 'thermal camera'). The safety and efficiency of their navigation were evaluated by their walking speed, navigation errors, and the number of collisions. MAIN RESULTS: Navigation performance was significantly superior when using the thermal camera compared to using the Argus II camera, including 75% smaller angle of deviation (p < 0.001), 48% smaller error of distance (p < 0.05), and 30% fewer collisions (p < 0.05). The thermal camera also brought the additional benefit of allowing the participants to perform the task in the dark as efficiently as in the light. More importantly, these benefits did not come at a cost of reduced walking speed. SIGNIFICANCE: Using the thermal camera in the Argus II system, compared to a visible-light camera, could improve the wearers' navigation performance by helping them better approach or avoid other persons. Adding the thermal camera to future artificial vision therapy systems may complement the visible-light camera and improve the users' mobility safety and efficiency, enhancing their quality of life.
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Retinose Pigmentar , Próteses Visuais , Humanos , Qualidade de Vida , Retina , Visão OcularRESUMO
AIM: To demonstrate the potential clinically meaningful benefits of a thermal camera integrated with the Argus II, an artificial vision therapy system, for assisting Argus II users in localising and discriminating heat-emitting objects. METHODS: Seven blind patients implanted with Argus II retinal prosthesis participated in the study. Two tasks were investigated: (1) localising up to three heat-emitting objects by indicating the location of the objects and (2) discriminating a specific heated object out of three presented on a table. Heat-emitting objects placed on a table included a toaster, a flat iron, an electric kettle, a heating pad and a mug of hot water. Subjects completed the two tasks using the unmodified Argus II system with a visible-light camera and the thermal camera-integrated Argus II. RESULTS: Subjects more accurately localised heated objects displayed on a table (p=0.011) and discriminated a specific type of object (p=0.005) presented with the thermal camera integrated with the Argus II versus the unmodified Argus II camera. CONCLUSIONS: The thermal camera integrated with the artificial vision therapy system helps users to locate and differentiate heat-emitting objects more precisely than a visible light sensor. The integration of the thermal camera with the Argus II may have significant benefits in patients' daily life.
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Cegueira/fisiopatologia , Eletrodos Implantados , Temperatura Alta , Retina/fisiopatologia , Acuidade Visual , Próteses Visuais , Pessoas com Deficiência Visual , Idoso , Cegueira/reabilitação , Feminino , Humanos , Masculino , Desenho de PróteseRESUMO
PURPOSE: To investigate the effect of a wider field-of-view (FOV) of a retinal prosthesis on the users' performance in locating objects. METHODS: One female and four male subjects who were blind due to end-stage retinitis pigmentosa and had been implanted with the Argus II retinal prosthesis participated (aged 63.4 ± 15.4). Thermal imaging was captured by an external sensor and converted to electrical stimulation to the retina. Subjects were asked to localize and to reach for heat-emitting objects using two different FOV mappings: a normal 1:1 mapping (no zoom) that provided 18° × 11° FOV and a 3:1 mapping (zoom out) that provided 49° × 35° FOV. Their accuracy and response time were recorded. RESULTS: Subjects were less accurate and took longer to complete the tasks with zoom out compared to no zoom. Localization accuracy decreased from 83% (95% confidence interval, 75%, 90%) with no zoom to 76% (67%, 83%) with zoom out (P = 0.07). Reaching accuracy differed between the two mappings only in one subject. Response time increased by 43% for the localization task (24%, 66%; P < 0.001) and by 20% for the reaching task (0%, 45%; P = 0.055). CONCLUSIONS: Argus II wearers can efficiently find heat-emitting objects with the default 18° × 11° FOV of the current Argus II. For spatial localization, a higher spatial resolution may be preferred over a wider FOV. TRANSLATIONAL RELEVANCE: Understanding the trade-off between FOV and spatial resolution in retinal prosthesis users can guide device optimization.
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PURPOSE: First, to evaluate inter-rater reliability when human raters estimate the reading performance of visually impaired individuals using the MNREAD acuity chart. Second, to evaluate the agreement between computer-based scoring algorithms and compare them with human rating. METHODS: Reading performance was measured for 101 individuals with low vision, using the Portuguese version of the MNREAD test. Seven raters estimated the maximum reading speed (MRS) and critical print size (CPS) of each individual MNREAD curve. MRS and CPS were also calculated automatically for each curve using two different algorithms: the original standard deviation method (SDev) and a non-linear mixed effects (NLME) modeling. Intra-class correlation coefficients (ICC) were used to estimate absolute agreement between raters and/or algorithms. RESULTS: Absolute agreement between raters was 'excellent' for MRS (ICC = 0.97; 95%CI [0.96, 0.98]) and 'moderate' to 'good' for CPS (ICC = 0.77; 95%CI [0.69, 0.83]). For CPS, inter-rater reliability was poorer among less experienced raters (ICC = 0.70; 95%CI [0.57, 0.80]) when compared to experienced ones (ICC = 0.82; 95%CI [0.76, 0.88]). Absolute agreement between the two algorithms was 'excellent' for MRS (ICC = 0.96; 95%CI [0.91, 0.98]). For CPS, the best possible agreement was found for CPS defined as the print size sustaining 80% of MRS (ICC = 0.77; 95%CI [0.68, 0.84]). Absolute agreement between raters and automated methods was 'excellent' for MRS (ICC = 0.96; 95% CI [0.88, 0.98] for SDev; ICC = 0.97; 95% CI [0.95, 0.98] for NLME). For CPS, absolute agreement between raters and SDev ranged from 'poor' to 'good' (ICC = 0.66; 95% CI [0.3, 0.80]), while agreement between raters and NLME was 'good' (ICC = 0.83; 95% CI [0.76, 0.88]). CONCLUSION: For MRS, inter-rater reliability is excellent, even considering the possibility of noisy and/or incomplete data collected in low-vision individuals. For CPS, inter-rater reliability is lower. This may be problematic, for instance in the context of multisite investigations or follow-up examinations. The NLME method showed better agreement with the raters than the SDev method for both reading parameters. Setting up consensual guidelines to deal with ambiguous curves may help improve reliability. While the exact definition of CPS should be chosen on a case-by-case basis depending on the clinician or researcher's motivations, evidence suggests that estimating CPS as the smallest print size sustaining about 80% of MRS would increase inter-rater reliability.
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Leitura , Transtornos da Visão/fisiopatologia , Testes Visuais/métodos , Algoritmos , Humanos , Variações Dependentes do ObservadorRESUMO
Evaluating the effects of print size and retinal eccentricity on reading speed is important for identifying the constraints faced by people with central-field loss. Previous work on English reading showed that 1) reading speed increases with print size until a critical print size (CPS) is reached, and then remains constant at a maximum reading speed (MRS), and 2) as eccentricity increases, MRS decreases and CPS increases. Here we extend this work to Korean, a language with more complex orthography. We recruited 6 Korean native speakers (mean ageâ¯=â¯22) and measured their reading speed in central vision (0°) and peripheral vision (10° in the lower field). 900 Korean sentences (average 8.25 words) were created with frequently-occurring beginner-level words, presented using a rapid serial visual presentation (RSVP) paradigm. Data for English reading were obtained from Chung, Mansfield & Legge, Vision Research, 1998, for comparison. MRS was similar for Korean and English at 0° (713 vs. 787â¯wpm), but decreased faster with eccentricity for Korean. CPS was larger for Korean than for English regardless of eccentricity, but increased with eccentricity similarly for both languages. From 0 to 10°, MRS decreased by a factor of 6.5 for Korean and 2.8 for English, and CPS increased by a factor of 11.7 for Korean and 10.2 for English. Korean reading speed is more affected by retinal eccentricity than English, likely due to additional within-character crowding from more complex orthography. Korean readers with central-field loss may experience more difficulty than English readers.
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Meios de Comunicação de Massa , Leitura , Retina/fisiologia , Percepção de Tamanho/fisiologia , Adolescente , Adulto , Feminino , Humanos , Idioma , Masculino , República da Coreia , Adulto JovemRESUMO
The visual span refers to the number of adjacent characters that can be recognized in a single glance. It is viewed as a sensory bottleneck in reading for both normal and clinical populations. In peripheral vision, the visual span for English characters can be enlarged after training with a letter-recognition task. Here, we examined the transfer of training from Korean to English characters for a group of bilingual Korean native speakers. In the pre- and posttests, we measured visual spans for Korean characters and English letters. Training (1.5 hours × 4 days) consisted of repetitive visual-span measurements for Korean trigrams (strings of three characters). Our training enlarged the visual spans for Korean single characters and trigrams, and the benefit transferred to untrained English symbols. The improvement was largely due to a reduction of within-character and between-character crowding in Korean recognition, as well as between-letter crowding in English recognition. We also found a negative correlation between the size of the visual span and the average pattern complexity of the symbol set. Together, our results showed that the visual span is limited by common sensory (crowding) and physical (pattern complexity) factors regardless of the language script, providing evidence that the visual span reflects a universal bottleneck for text recognition.
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Idioma , Reconhecimento Visual de Modelos/fisiologia , Leitura , Percepção Visual/fisiologia , Aglomeração , Feminino , Humanos , Coreia (Geográfico) , Masculino , Multilinguismo , Psicofísica , Adulto JovemRESUMO
Our purpose was to compare reading performance measured with the MNREAD Acuity Chart and an iPad application (app) version of the same test for both normally sighted and low-vision participants. Our methods included 165 participants with normal vision and 43 participants with low vision tested on the standard printed MNREAD and on the iPad app version of the test. Maximum Reading Speed, Critical Print Size, Reading Acuity, and Reading Accessibility Index were compared using linear mixed-effects models to identify any potential differences in test performance between the printed chart and the iPad app. Our results showed the following: For normal vision, chart and iPad yield similar estimates of Critical Print Size and Reading Acuity. The iPad provides significantly slower estimates of Maximum Reading Speed than the chart, with a greater difference for faster readers. The difference was on average 3% at 100 words per minute (wpm), 6% at 150 wpm, 9% at 200 wpm, and 12% at 250 wpm. For low vision, Maximum Reading Speed, Reading Accessibility Index, and Critical Print Size are equivalent on the iPad and chart. Only the Reading Acuity is significantly smaller (I. E., better) when measured on the digital version of the test, but by only 0.03 logMAR (p = 0.013). Our conclusions were that, overall, MNREAD parameters measured with the printed chart and the iPad app are very similar. The difference found in Maximum Reading Speed for the normally sighted participants can be explained by differences in the method for timing the reading trials.
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Computadores de Mão , Meios de Comunicação de Massa , Leitura , Testes Visuais/instrumentação , Baixa Visão/fisiopatologia , Acuidade Visual/fisiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Visão Ocular/fisiologia , Adulto JovemRESUMO
The visual span is hypothesized to be a sensory bottleneck on reading speed with crowding thought to be the major sensory factor limiting the size of the visual span. This proposed linkage between crowding, visual span, and reading speed is challenged by the finding that training to read crowded letters reduced crowding but did not improve reading speed (Chung, 2007). Here, we examined two properties of letter-recognition training that may influence the transfer to improved reading: the spatial arrangement of training stimuli and the presence of flankers. Three groups of nine young adults were trained with different configurations of letter stimuli at 10° in the lower visual field: a flanked-local group (flanked letters localized at one position), a flanked-distributed group (flanked letters distributed across different horizontal locations), and an isolated-distributed group (isolated and distributed letters). We found that distributed training, but not the presence of flankers, appears to be necessary for the training benefit to transfer to increased reading speed. Localized training may have biased attention to one specific, small area in the visual field, thereby failing to improve reading. We conclude that the visual span represents a sensory bottleneck on reading, but there may also be an attentional bottleneck. Reducing the impact of crowding can enlarge the visual span and can potentially facilitate reading, but not when adverse attentional bias is present. Our results clarify the association between crowding, visual span, and reading.
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Reconhecimento Visual de Modelos/fisiologia , Psicofísica/métodos , Leitura , Campos Visuais/fisiologia , Feminino , Humanos , Masculino , Adulto JovemRESUMO
PURPOSE: The continuous-text reading-acuity test MNREAD is designed to measure the reading performance of people with normal and low vision. This test is used to estimate maximum reading speed (MRS), critical print size (CPS), reading acuity (RA), and the reading accessibility index (ACC). Here we report the age dependence of these measures for normally sighted individuals, providing baseline data for MNREAD testing. METHODS: We analyzed MNREAD data from 645 normally sighted participants ranging in age from 8 to 81 years. The data were collected in several studies conducted by different testers and at different sites in our research program, enabling evaluation of robustness of the test. RESULTS: Maximum reading speed and reading accessibility index showed a trilinear dependence on age: first increasing from 8 to 16 years (MRS: 140-200 words per minute [wpm]; ACC: 0.7-1.0); then stabilizing in the range of 16 to 40 years (MRS: 200 ± 25 wpm; ACC: 1.0 ± 0.14); and decreasing to 175 wpm and 0.88 by 81 years. Critical print size was constant from 8 to 23 years (0.08 logMAR), increased slowly until 68 years (0.21 logMAR), and then more rapidly until 81 years (0.34 logMAR). logMAR reading acuity improved from -0.1 at 8 years to -0.18 at 16 years, then gradually worsened to -0.05 at 81 years. CONCLUSIONS: We found a weak dependence of the MNREAD parameters on age in normal vision. In broad terms, MNREAD performance exhibits differences between three age groups: children 8 to 16 years, young adults 16 to 40 years, and middle-aged to older adults >40 years.
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Leitura , Visão Ocular/fisiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Envelhecimento/fisiologia , Criança , Sensibilidades de Contraste/fisiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Caracteres Sexuais , Testes Visuais , Adulto JovemRESUMO
The visual span-the number of adjacent text letters that can be reliably recognized on one fixation-has been proposed as a sensory bottleneck that limits reading speed (Legge, Mansfield, & Chung, 2001). Like reading, searching for a face is an important daily task that involves pattern recognition. Is there a similar limitation on the number of faces that can be recognized in a single fixation? Here we report on a study in which we measured and compared the visual-span profiles for letter and face recognition. A serial two-stage model for pattern recognition was developed to interpret the data. The first stage is characterized by factors limiting recognition of isolated letters or faces, and the second stage represents the interfering effect of nearby stimuli on recognition. Our findings show that the visual span for faces is smaller than that for letters. Surprisingly, however, when differences in first-stage processing for letters and faces are accounted for, the two visual spans become nearly identical. These results suggest that the concept of visual span may describe a common sensory bottleneck that underlies different types of pattern recognition.
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Reconhecimento Facial/fisiologia , Fixação Ocular/fisiologia , Reconhecimento Visual de Modelos/fisiologia , Leitura , Feminino , Humanos , Masculino , PsicofísicaRESUMO
Crowding, the identification difficulty for a target in the presence of nearby flankers, is ubiquitous in spatial vision and is considered a bottleneck of object recognition and visual awareness. Despite its significance, the neural mechanisms of crowding are still unclear. Here, we performed event-related potential and fMRI experiments to measure the cortical interaction between the target and flankers in human subjects. We found that the magnitude of the crowding effect was closely associated with an early suppressive cortical interaction. The cortical suppression was reflected in the earliest event-related potential component (C1), which originated in V1, and in the BOLD signal in V1, but not other higher cortical areas. Intriguingly, spatial attention played a critical role in the manifestation of the suppression. These findings provide direct and converging evidence that attention-dependent V1 suppression contributes to crowding at a very early stage of visual processing.
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Atenção/fisiologia , Aglomeração , Potenciais Evocados Visuais/fisiologia , Córtex Visual/fisiologia , Campos Visuais/fisiologia , Adolescente , Adulto , Anisotropia , Mapeamento Encefálico , Eletroencefalografia , Feminino , Humanos , Processamento de Imagem Assistida por Computador , Imageamento por Ressonância Magnética , Masculino , Oxigênio/sangue , Estimulação Luminosa , Psicofísica , Córtex Visual/irrigação sanguínea , Vias Visuais/irrigação sanguínea , Vias Visuais/fisiologia , Adulto JovemRESUMO
Reading speed in normal peripheral vision is slow but can be increased through training on a letter-recognition task. The aim of the present study is to investigate the sensory and cognitive factors responsible for this improvement. The visual span is hypothesized to be a sensory bottleneck limiting reading speed. Three sensory factors-letter acuity, crowding, and mislocations (errors in the spatial order of letters)-may limit the size of the visual span. Reading speed is also influenced by cognitive factors including the utilization of information from sentence context. We conducted a perceptual training experiment to investigate the roles of these factors. Training consisted of four daily sessions of trigram letter-recognition trials at 10° in the lower visual field. Subjects' visual-span profiles and reading speeds were measured in pre- and posttests. Effects of the three sensory factors were isolated through a decomposition analysis of the visual span profiles. The impact of sentence context was indexed by context gain, the ratio of reading speeds for ordered and unordered text. Following training, visual spans increased in size by 5.4 bits of information transmitted, and reading speeds increased by 45%. Training induced a substantial reduction in the magnitude of crowding (4.8 bits) and a smaller reduction for mislocations (0.7 bits), but no change in letter acuity or context gain. These results indicate that the basis of the training-related improvement in reading speed is a large reduction in the interfering effect of crowding and a small reduction of mislocation errors.