Daily dose-response from short-term monocular deprivation in adult humans.

Short-term monocular deprivation (MD) shifts sensory eye balance in favour of the previously deprived eye. The effect of MD on eye balance is significant but brief in adult humans. Recently, researchers and clinicians have attempted to implement MD in clinical settings for adults with impaired binocular vision. Although the effect of MD has been studied in detail in single-session protocols, what is not known is whether the effect of MD on eye balance deteriorates after repeated periods of MD (termed 'perceptual deterioration'). An answer to this question is relevant for two reasons. Firstly, the effect of MD (i.e., dose-response) should not decrease with repeated use if MD is to be used therapeutically (e.g., daily for weeks). Second, it bears upon the question of whether the neural basis of the effects of MD and contrast adaptation, a closely related phenomenon, is the same. The sensory change from contrast adaptation depends on recent experience. If the observer has recently experienced the same adaptation multiple times for consecutive days, then the adaptation effect will be smaller because contrast adaptation exhibits perceptual deterioration, so it is of interest to know if the effects of MD follow suit. This study measured the effect of 2-h MD for seven consecutive days on binocular balance of 15 normally sighted adults. We found that the shift in eye balance from MD stayed consistent, showing no signs of deterioration after subjects experienced multiple periods of MD. This finding shows no loss of effectiveness of repeated daily doses of MD if used therapeutically to rebalance binocular vision in otherwise normal individuals. Furthermore, ocular dominance plasticity, which is the basis of the effects of short-term MD, does not seem to share the property of 'perceptual deterioration' with contrast adaptation, suggesting different neural bases for these two related phenomena.

Metaplasticity: Dark exposure boosts local excitability and visual plasticity in adult human cortex.

An interlude of dark exposure for about 1 week is known to shift excitatory/inhibitory (E/I) balance of the mammalian visual cortex, promoting plasticity and accelerating visual recovery in animals that have experienced cortical lesions during development. However, the translational impact of our understanding of dark exposure from animal studies to humans remains elusive. Here, we used magnetic resonance spectroscopy as a probe for E/I balance in the primary visual cortex (V1) to determine the effect of 60 min of dark exposure, and measured binocular combination as a behavioural assay to assess visual plasticity in 14 normally sighted human adults. To induce neuroplastic changes in the observers, we introduced 60 min of monocular deprivation, which is known to temporarily shift sensory eye balance in favour of the previously deprived eye. We report that prior dark exposure for 60 min strengthens local excitability in V1 and boosts visual plasticity in normal adults. However, we show that it does not promote plasticity in amblyopic adults. Nevertheless, our findings are surprising, given the fact that the interlude is very brief. Interestingly, we find that the increased concentration of the excitatory neurotransmitter is not strongly correlated with the enhanced functional plasticity. Instead, the absolute degree of change in its concentration is related to the boost, suggesting that the dichotomy of cortical excitation and inhibition might not explain the physiological basis of plasticity in humans. We present the first evidence that an environmental manipulation that shifts cortical E/I balance can also act as a metaplastic facilitator for visual plasticity in humans. KEY POINTS: A brief interlude (60 min) of dark exposure increased the local concentration of glutamine/glutamate but not that of GABA in the visual cortex of adult humans. After dark exposure, the degree of the shift in sensory eye dominance in favour of the previously deprived eye from short-term monocular deprivation was larger than that from only monocular deprivation. The neurochemical and behavioural measures were associated: the magnitude of the shift in the concentration of glutamine/glutamate was correlated with the boost in perceptual plasticity after dark exposure. Surprisingly, the increase in the concentration of glutamine/glutamate was not correlated with the perceptual boost after dark exposure, suggesting that the physiological mechanism of how E/I balance regulates plasticity is not deterministic. In other words, an increased excitation did not unilaterally promote plasticity.

A brief light reduction induces a significant delay in the previously dimmed eye.

PURPOSE: We investigated how a short-term luminance reduction in one eye can influence temporal processing of that eye after luminance is restored by measuring the relative delay between the eyes. METHODS: A paradigm based on the Pulfrich effect, which is a visual illusion of depth when no depth cue is present, was used to measure relative delay in visual processing between the eyes. We deprived the monocular luminance in adults with normal vision across different intensities. In the first experiment, the ratio of the light level between the eyes stayed constant, whereas the absolute value was allowed to vary. In the second experiment, both the ratio and the absolute light level stayed constant, by controlling the environmental light level. In both experiments, we measured the changes in relative delay before and after 60 min of light deprivation. RESULTS: Our results indicated that short-term monocular deprivation of luminance slows the processing in the previously dimmed eye and that the magnitude of the delay is correlated with the degree of luminance reduction. In addition, we observed that the absolute luminance difference, rather than the absolute luminance levels seen by the dimmed eye, is important in determining the magnitude of delay in the previously dimmed eye. These findings differ from what has been reported previously for the monocular deprivation of contrast. CONCLUSIONS: Taken together, these findings support the view that short-term deprivation of visual information could affect two distinct mechanisms (contrast gain and temporal dynamics) of neural plasticity.

Some psychophysical tasks measure ocular dominance plasticity more reliably than others.

In the recent decade, studies have shown that short-term monocular deprivation strengthens the deprived eye's contribution to binocular vision. However, the magnitude of the change in eye dominance after monocular deprivation (i.e., the patching effect) has been found to be different between different methods and within the same method. There are three possible explanations for the discrepancy. First, the mechanisms underlying the patching effect that are probed by different measurement tasks might exist at different neural sites. Second, the test-retest variability of the same test can produce inconsistent results. Third, the magnitude of the patching effect itself within the same observer can vary across separate days or experimental sessions. To explore these possibilities, we assessed the test-retest reliability of the three most commonly used tasks (binocular rivalry, binocular combination, and dichoptic masking) and the repeatability of the shift in eye dominance after short-term monocular deprivation for each of the task. Two variations for binocular phase combination were used, at one and many contrasts of the stimuli. Also, two variations for dichoptic masking were employed; the orientation of the mask grating was either horizontal or vertical. Thus, five different tasks were evaluated. We hoped to resolve some of the inconsistencies reported in the literature concerning this form of visual plasticity. In this study, we also aimed to recommend a measurement method that would allow us to better understand its physiological basis and the underpinning of visual disorders.

Melatonin MT1 and MT2 Receptors Exhibit Distinct Effects in the Modulation of Body Temperature across the Light/Dark Cycle.

Melatonin (MLT) is a neurohormone that regulates many physiological functions including sleep, pain, thermoregulation, and circadian rhythms. MLT acts mainly through two G-protein-coupled receptors named MT1 and MT2, but also through an MLT type-3 receptor (MT3). However, the role of MLT receptor subtypes in thermoregulation is still unknown. We have thus investigated the effects of selective and non-selective MLT receptor agonists/antagonists on body temperature (Tb) in rats across the 12/12-h light-dark cycle. Rectal temperature was measured every 15 min from 4:00 a.m. to 9:30 a.m. and from 4:00 p.m. to 9:30 p.m., following subcutaneous injection of each compound at either 5:00 a.m. or 5:00 p.m. MLT (40 mg/kg) had no effect when injected at 5 a.m., whereas it decreased Tb during the light phase only when injected at 5:00 p.m. This effect was blocked by the selective MT2 receptor antagonist 4P-PDOT and the non-selective MT1/MT2 receptor antagonist, luzindole, but not by the α1/MT3 receptors antagonist prazosin. However, unlike MLT, neither the selective MT1 receptor partial agonist UCM871 (14 mg/kg) nor the selective MT2 partial agonist UCM924 (40 mg/kg) altered Tb during the light phase. In contrast, UCM871 injected at 5:00 p.m. increased Tb at the beginning of the dark phase, whereas UCM924 injected at 5:00 a.m. decreased Tb at the end of the dark phase. These effects were blocked by luzindole and 4P-PDOT, respectively. The MT3 receptor agonist GR135531 (10 mg/kg) did not affect Tb. These data suggest that the simultaneous activation of both MT1 and MT2 receptors is necessary to regulate Tb during the light phase, whereas in a complex but yet unknown manner, they regulate Tb differently during the dark phase. Overall, MT1 and MT2 receptors display complementary but also distinct roles in modulating circadian fluctuations of Tb.

Applying Resampling and Visualization Methods in Factor Analysis to Model Human Spatial Vision.

Purpose: Studies have reported different numbers of spatial frequency channels for chromatic and achromatic vision. To resolve the difference, we performed factor analysis, a multivariate modeling technique, on population data of achromatic and chromatic sensitivity. In addition, we included resampling and visualization methods to evaluate models from factor analysis. These routines are complex but widely useful. Therefore we have archived our analysis routines by building smCSF, an open-source software package in R (https://smin95.github.io/dataviz/). Methods: Data of 103 normally-sighted adults were analyzed. They included blue-yellow, red-green, and achromatic contrast sensitivity. To obtain the confidence interval of relevant statistical parameters, factor analysis was performed using a resampling method. Then exploratory models were developed. We then performed model selections by fitting them against the empirical data and quantifying the quality of the fits. Results: During the exploratory factor analysis, different statistical tests supported different factor models. These could partially be reasons for why there have been conflicting reports. However, after the confirmatory analysis, we found that a model that included two spatial channels was adequate to approximate the chromatic sensitivity data, whereas that with three channels was so for the achromatic sensitivity data. Conclusions: Our findings provide novel insights about the spatial channels for chromatic and achromatic contrast sensitivity from population data. Also, the analysis and visualization routines have been archived in a computational package to boost the transparency and replicability of science.

Corrigendum: Binocular balance across spatial frequency in anisomyopia.

[This corrects the article DOI: 10.3389/fnins.2024.1349436.].

Binocular balance across spatial frequency in anisomyopia.

Purpose: Anisomyopia is prevalent in myopia and studies have reported it exhibits impaired binocular function. We investigated the binocular balance across spatial frequency in adults with anisomyopia and compared it to in individuals with less differences in refractive error, and examined whether ocular characteristics can predict binocular balance in anisomyopia. Methods: Fifteen anisomyopes, 15 isomyopes and 12 emmetropes were recruited. Binocular balance was quantitatively measured at 0.5, 1, 2 and 4 c/d. The first two groups of the observers were tested with and without optical correction with contact lenses. Emmetropes were tested without optical correction. Results: Binocular balance across spatial frequency in optically corrected anisomyopes and isomyopes, as well as emmetropes were found to be similar. Their binocular balance nevertheless still got worse as a function of spatial frequency. However, before optical correction, anisomyopes but not isomyopes showed significant imbalance at higher spatial frequencies. There was a significant correlation between the dependence on spatial frequency of binocular imbalance in uncorrected anisomyopia and interocular difference in visual acuity, and between the dependence and interocular difference in spherical equivalent refraction. Conclusion: Anisomyopes had intact binocular balance following correction across spatial frequency compared to those in isomyopes and emmetropes. Their balance was weakly correlated with their refractive status after optical correction. However, their binocular balance before correction and binocular improvement following optical correction were strongly correlated with differences in ocular characteristics between eyes.

Reduced Monocular Luminance Promotes Fusion But Not Mixed Perception in Amblyopia.

Purpose: The purpose of this study was to understand how monocular luminance reduction affects binocular balance and examine whether it differentially influences fusion and mixed perception in amblyopia. Methods: Twenty-three normally sighted observers and 12 adults with amblyopia participated in this study. A novel binocular rivalry task was used to measure the phase duration of four perceptual responses (right- and left-tilts, fusion, and mixed perception) before and after a neutral density (ND) filter was applied at various levels to the dominant eye (DE) of controls and the fellow eye (FE) of patients with amblyopia. Phase durations were analyzed to assess whether the duration of fusion or mixed perception shifted after monocular luminance reduction. Moreover, we quantified ocular dominance and adjusted monocular contrast and luminance separately to investigate the relationship between changes in ocular dominance induced by the two manipulations. Results: In line with previous studies, binocular balance shifted in favor of the brighter eye in both normal adults and patients with amblyopia. As a function of the ND filter's density, the duration of fusion and mixed perception decreased in normal controls, whereas that of fusion but not mixed perception increased significantly in patients with amblyopia. In addition, changes in binocular balance from luminance reduction were more significant in more balanced amblyopes or normal observers. Furthermore, shifts in binocular balance after contrast and luminance modulation were correlated in both normal and amblyopic observers. Conclusions: The duration of fusion but not mixed perception increased in amblyopia after monocular luminance reduction in the FE. Moreover, our findings demonstrate that changes in ocular dominance from contrast-modulation and luminance-modulation are correlated in both normal and amblyopic observers.

Stereo-anomaly is found more frequently in tasks that require discrimination between depths.

Within the population of humans with otherwise normal vision, there exists some proportion whose ability to perceive depth from binocular disparity is poor or absent. The prevalence of this "stereo-anomaly" has been reported to be as small as 2%, or as great as 30%. We set out to investigate this discrepancy. We used a digital tool to measure stereoacuity in tasks requiring either the detection of disparity or the discrimination of the direction of disparity. In a cohort of 228 participants, we found that 98% were able to consistently perform the detection task. Of these, only 69% consistently performed the discrimination task. The 31% of participants who had difficulty with the discrimination task could further be divided into 17% who were consistently unable to perform the task and 14% who showed limited ability. This suggests that identification of the direction of disparity requires further processing beyond merely detecting its presence.

Spatial frequency channels depend on stimulus bandwidth in normal and amblyopic vision: an exploratory factor analysis.

The Contrast Sensitivity Function (CSF) is the measure of an observer's contrast sensitivity as a function of spatial frequency. It is a sensitive measure to assess visual function in fundamental and clinical settings. Human contrast sensitivity is subserved by different spatial frequency channels. Also, it is known that amblyopes have deficits in contrast sensitivity, particularly at high spatial frequencies. Therefore, the aim of this study was to assess whether the contrast sensitivity function is subtended by the same spatial frequency channels in control and amblyopic populations. To determine these spatial frequency channels, we performed an exploratory factor analysis on five datasets of contrasts sensitivity functions of amblyopic and control participants measured using either gratings or noise patches, taken from our previous studies. In the range of 0.25-10 c/d, we identified two spatial frequency channels. When the CSF was measured with noise patches, the spatial frequency channels presented very similar tuning in the amblyopic eye and the fellow eye and were also similar to what was observed in controls. The only major difference was that the weight attributed to the high frequency channel was reduced by approximately 50% in the amblyopic eye. However, when the CSF was measured using gratings, the spatial frequency channels of the amblyopic eye were tuned toward lower spatial frequencies. These findings suggest that there is no mechanistic deficit for contrast sensitivity in amblyopia and that amblyopic vision may just be subjected to excessive internal noise and attenuation at higher spatial frequencies, thereby supporting the use of therapeutic strategies that involve rebalancing contrast.

A clinically convenient test to measure binocular balance across spatial frequency in amblyopia.

Amblyopia is a visual disorder that originates from the brain. It exhibits no pathology in the eye. Studies have shown that measuring both visual acuity and binocular balance for assessing amblyopia could be more helpful. However, tests that measure binocular balance are time-consuming, often exceeding 30 min. Their long test durations prevent them from being used in the clinic. For this reason, we have developed a quick (i.e., about 7 min) and precise tool that quantitatively measures binocular balance of patients with amblyopia. The new test can capture binocular imbalance that is typically exhibited at high spatial frequency in amblyopes. In addition, it has an excellent test-retest reliability and repeatability between two experimental sessions. We hope that our newly developed test can pave the road for physicians and researchers to better assess and diagnose amblyopia and other visual disorders that disrupt binocular balance beyond the laboratory.

Modulation of mean luminance improves binocular balance across spatial frequencies in amblyopia.

Amblyopia is a visual impairment that perturbs binocular balance at high spatial frequencies in favor of the fellow eye. Studies reveal that amblyopes who had been treated with monocular therapies still show imbalance. Binocular balance is achieved when both eyes' inputs are weighed equally. A reduced light can diminish the dimmed eye's weight in binocular combination. In this study, we examined if binocular balance across spatial frequencies could be improved by reducing the luminance of the fellow eye in adult amblyopes. By doing so, we relieved their binocular imbalance across spatial frequencies. Also, normal observers showed amblyopic binocular imbalance when the dominant eye's light level was dimmed. Therefore, reducing the luminance in the unaffected eye in amblyopia mitigated the binocular imbalance, whereas doing so in normal adults simulated the amblyopic imbalance across spatial frequencies.

Issues Revisited: Shifts in Binocular Balance Depend on the Deprivation Duration in Normal and Amblyopic Adults.

INTRODUCTION: Recent studies indicate that short-term monocular deprivation increases the deprived eye's contribution to binocular fusion in both adults with normal vision and amblyopia. In this study, we investigated whether the changes in visual plasticity depended on the duration of deprivation in normal and amblyopic adults. METHODS: Twelve anisometropia amblyopic observers (aged 24.8 ± 2.3 years) and 12 age-matched normal observers (aged 23.9 ± 1.2 years) participated in the study. The non-dominant eye of normal observers or amblyopic eye of amblyopic observers was deprived for 30, 120, and 300 min in a randomized order. Their eye balance was measured with a phase combination task, which is a psychophysical test, before and after the deprivation. This design enabled us to measure changes induced in binocular balance as an index visual plasticity due to monocular deprivations. RESULTS: By comparing the ocular dominance changes as a result of monocular deprivation with different deprivation durations, we found evidence that the ocular dominance changes are slightly larger after longer deprivations in both normal and amblyopic observers, albeit with a statistical significance. The changes from 120-min were significantly greater than those from 30-min deprivation in both groups. The magnitude of changes in sensory eye balance was significantly larger in normal observers than that in the amblyopic observers; however, the longevity of changes in visual plasticity was found to be more long-lasting in amblyopic observers than the normal counterparts. CONCLUSIONS: The duration of deprivation matters in both normal and amblyopic observers. Ocular dominance imbalance that is typically observed in amblyopia can be more ameliorated with a longer duration of deprivation.

A Joint Lateral Motion-Stereo Constraint.

Purpose: We developed a stereo task that is based on a motion direction discrimination to examine the role that depth can play in disambiguating motion direction. Methods: In this study, we quantified normal adults' static and dynamic (i.e., laterally moving) stereoscopic performance using a psychophysical task, where we dichoptically presented randomly arranged, limited lifetime Gabor elements at two depth planes (one plane was at the fixation plane and the other at an uncrossed disparity relative to the fixation plane). Each plane contained half of the elements. For the dynamic condition, all elements were vertically oriented and moved to the left in one plane and to the right in another plane; for the static condition, the elements were horizontally oriented in one plane and vertically oriented in another plane. Results: For the range of motion speed that we measured (from 0.17°/s to 5.33°/s), we observed clear speed tuning of the stereo sensitivity (P = 3.0 × 10-5). The shape of this tuning did not significantly change with different spatial frequencies. We also found a significant difference in stereo sensitivity between stereopsis with static and laterally moving stimuli (speed = 0.67°/s; P = 0.004). Such difference was not evident when we matched the task between the static and moving stimuli. Conclusions: We report that lateral motion modulates human global depth perception. This motion/stereo constraint is related to motion velocity not stimulus temporal frequency. We speculate that the processing of motion-based stereopsis of the kind reported here occurs in dorsal extrastriate cortex.

smplot: An R Package for Easy and Elegant Data Visualization.

R, a programming language, is an attractive tool for data visualization because it is free and open source. However, learning R can be intimidating and cumbersome for many. In this report, we introduce an R package called "smplot" for easy and elegant data visualization. The R package "smplot" generates graphs with defaults that are visually pleasing and informative. Although it requires basic knowledge of R and ggplot2, it significantly simplifies the process of plotting a bar graph, a violin plot, a correlation plot, a slope chart, a Bland-Altman plot and a raincloud plot. The aesthetics of the plots generated from the package are elegant, highly customisable and adhere to important practices of data visualization. The functions from smplot can be used in a modular fashion, thereby allowing the user to further customise the aesthetics. The smplot package is open source under the MIT license and available on Github (https://github.com/smin95/smplot), where updates will be posted. All the example figures in this report are reproducible and the codes and data are provided for the reader in a separate online guide (https://smin95.github.io/dataviz/).

Binocular visual deficits at mid to high spatial frequency in treated amblyopes.

Amblyopia (lazy eye) is a neurodevelopmental disorder of vision with no ocular pathology. The loss of vision in the amblyopic eye is assumed to be the main deficit in amblyopia, which has resulted in visual acuity (VA) being the primary outcome measure for treatment. Here we used a binocular orientation combination task to quantitatively assess the binocular status by measuring the binocular balance. We set out to determine whether amblyopes who reach the acuity-based end point have a residual binocular imbalance. Our results suggest that even amblyopes who have regained normal acuity have residual binocular deficits over a wide range of spatial frequencies. A further control study suggests that these binocular deficits could not be explained by any residual contrast sensitivity deficits of the amblyopic eye. Consequently, amblyopia is not the primary problem and VA is not the appropriate end point measure.

A Randomized Clinical Trial Comparing Eyetronix Flicker Glass and Patching for Treatment of Amblyopia in Children Reveals Similar Improvements in Vision.

PURPOSE: Recently, Eyetronix Flicker Glass (EFG) has been introduced as a novel treatment for amblyopia. It alternatively deprives the visual input of each eye rapidly (e.g., 7 Hz). However, whether it is comparable with standard patching therapy is unclear. In this randomized clinical trial, we evaluate the efficacy of an EFG therapy as treatment for amblyopia in children and compare it to the patching therapy. METHODS: We tested 31 children (aged 4-13 years) with amblyopia. They were assigned into one of the two treatment groups and were treated for 12 weeks. The first group was treated with EFG for 1 h/day (Flicker Group) and the latter with a standard patch (Patching Group) for 2 h/day. We designated changes from baseline in best-corrected visual acuity (BCVA) of the amblyopic eye as our primary outcome. Changes from baseline in other visual outcomes, such as contrast sensitivity, stereopsis, and fusional vergence range were measured as secondary outcome. RESULTS: BCVA improved significantly at 12 weeks relative to baseline in both the Flicker (0.13 ± 0.11 logMAR; mean ± SD) and Patching Groups (0.21 ± 0.14 logMAR). However, the improvements were not significantly different between groups (p = 0.13). Contrast sensitivity also significantly improved at 3 and 12 cycles/degree between baseline and 12 weeks in both groups (p's < 0.05). However, stereopsis and fusion range did not improve significantly in both groups. CONCLUSION: An EFG therapy and patching improved BCVA similarly for children with amblyopia at 12 weeks. Both therapies improved the contrast sensitivity at 3 and 12 cycles per degree (cpd); however, only patching improved the contrast sensitivity at 6 cpd. Both therapies did not benefit binocular visual functions (stereopsis and fusional vergence range). We believe that EFG can be an additional choice for therapy. CLINICAL TRIAL REGISTRATION: chictr.org number: ChiCTR2000034436.

Interocular Differences in Spatial Frequency Influence the Pulfrich Effect.

The Pulfrich effect is a stereo-motion phenomenon. When the two eyes are presented with visual targets moving in fronto-parallel motion at different luminances or contrasts, the perception is of a target moving-in-depth. It is thought that this percept of motion-in-depth occurs because lower luminance or contrast delays the speed of visual processing. Spatial properties of an image such as spatial frequency and size have also been shown to influence the speed of visual processing. In this study, we use a paradigm to measure interocular delay based on the Pulfrich effect where a structure-from-motion defined cylinder, composed of Gabor elements displayed at different interocular phases, rotates in depth. This allows us to measure any relative interocular processing delay while independently manipulating the spatial frequency and size of the micro elements (i.e., Gabor patches). We show that interocular spatial frequency differences, but not interocular size differences of image features, produce interocular processing delays.

Binocular Imbalance in Amblyopia Depends on Spatial Frequency in Binocular Combination.

Purpose: To assess the role of spatial frequency on binocular imbalance in binocular combination in adults with amblyopia. Methods: Ten amblyopes (23 ± 4.9 [SD] years old; one deprivation, two mixed, seven anisometropia patients) and 10 age-matched normal adults (23 ± 2.3 years old) participated. The interocular contrast ratio (fellow eye/amblyopic eye, i.e., the balance point [BP]) that resulted in an equal contribution of both eyes in binocular combination was measured using a binocular orientation combination task at 0.5, 1, 2, and 4 cycles per degree (c/d). The extent of binocular imbalance was quantified as the absolute value of the BP on log scale (i.e., |logBP|). Results: When the base contrast of the amblyopic eye was set at 100% (Experiment 1), the |logBP| was found to be significantly affected by stimulus spatial frequency (F(1.44, 26.01) = 51.6, P < 0.001, \({\rm{\eta }}_g^2\)= 0.40) and group (F(1, 18) = 66.97, P < 0.001, \({\rm{\eta }}_g^2\) = 0.74), the interaction between spatial frequency and group was also significant (F(1.44, 26.01) = 38.12, P < 0.001, \({\rm{\eta }}_g^2\)= 0.33). Such spatial frequency-dependent binocular imbalance remained present, even when the base contrast of the amblyopic eye was set at equal suprathreshold contrast levels across spatial frequencies (Experiment 2). Conclusions: Binocular balance was more disrupted at higher spatial frequencies in binocular combination in amblyopia. This imbalance might not originate solely from the amblyopic eye's deficit in contrast sensitivity but is likely to be related to the difference in contrast sensitivity between the eyes.