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Relationship Between Binocular Summation and Stereoacuity After Strabismus Surgery.

ABSTRACT: To describe the relationship between binocular summation and stereoacuity after strabismus surgery.Prospective case series.setting: Stein Eye Institute, University of California Los Angeles.Pediatric strabismic patients who underwent strabismus surgery between 2010 and 2015.Early Treatment Diabetic Retinopathy Study visual acuity, Sloan low-contrast acuity (LCA, 2.5% and 1.25%), and Randot stereoacuity 2 months following surgical correction of strabismus.The relationship between binocular summation (BiS), calculated as the difference between the binocular visual acuity score and that of the better eye, and stereoacuity.A total of 130 postoperative strabismic patients were studied. The relationship between binocular summation and stereoacuity was studied by Spearman correlation. There were significant correlations between BiS for 2.5% LCA with near and distance stereoacuity (P = .006 and P = .009). BiS for 1.25% LCA was also significantly correlated with near stereoacuity (P = .04). Near stereoacuity and BiS for 2.5% and 1.25% LCA were significantly dependent (Pearson ?(2), P = .006 and P = .026). Patients with stereoacuity demonstrated significantly more BiS in 2.5% LCA of 2.7 (P = .022) and 3.1 (P = .014) letters than did those without near or distance stereoacuity, respectively.These findings demonstrate that stereopsis and binocular summation are significantly correlated in patients who have undergone surgical correction of strabismus.

SUBMITTER: Kattan JM

PROVIDER: S-EPMC4870145 | biostudies-literature | 2016 May

REPOSITORIES: biostudies-literature

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Relationship Between Binocular Summation and Stereoacuity After Strabismus Surgery.

Kattan Jaffer M JM Velez Federico G FG Demer Joseph L JL Pineles Stacy L SL

American journal of ophthalmology 20160226

<h4>Purpose</h4>To describe the relationship between binocular summation and stereoacuity after strabismus surgery.<h4>Design</h4>Prospective case series.<h4>Methods</h4>setting: Stein Eye Institute, University of California Los Angeles.<h4>Patient population</h4>Pediatric strabismic patients who underwent strabismus surgery between 2010 and 2015.<h4>Observation procedures</h4>Early Treatment Diabetic Retinopathy Study visual acuity, Sloan low-contrast acuity (LCA, 2.5% and 1.25%), and Randot st ...[more]

PMID: 26921805

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Project description:Binocular summation (BiS) is defined as the superiority of visual function for binocular over monocular viewing. Binocular summation decreases with age and large interocular differences in visual acuity. To our knowledge, BiS has not heretofore been well studied as a functional measure of binocularity in strabismus.To evaluate the effect of strabismus on BiS using a battery of psychophysical tasks that are clinically relevant and easy to use and to determine whether strabismus is associated with binocular inhibition in extreme cases.Case-control study.University-based eye institute.Strabismic patients recruited during 2010 to 2012 from a preoperative clinic and control participants with no history of eye disease other than refractive error.A battery of psychophysical and electrophysiological tests including Early Treatment Diabetic Retinopathy Study visual acuity, Sloan low-contrast acuity (LCA) (2.5% and 1.25%), Pelli-Robson contrast sensitivity, and sweep visual evoked potential contrast sensitivity.Binocular summation was calculated as the ratio between binocular and better-eye individual scores.Sixty strabismic and 80 control participants were prospectively examined (age range, 8-60 years). Mean BiS was significantly lower in the strabismic patients than controls for LCA (2.5% and 1.25%, P = .005 and <.001, respectively). For 1.25% LCA, strabismic patients had a mean BiS score less than 1, indicating binocular inhibition (ie, the binocular score was less than that of the better eye's monocular score). There was no significant difference in BiS for contrast thresholds on Early Treatment Diabetic Retinopathy Study visual acuity, Pelli-Robson contrast sensitivity, or sweep visual evoked potential contrast sensitivity. Regression analysis revealed a significant worsening of BiS with strabismus for 2.5% (P = .009) and 1.25% (P = .002) LCA, after accounting for age.Strabismic patients demonstrate subnormal BiS and even binocular inhibition for LCA, suggesting that strabismus impairs visual function more than previously appreciated. This may explain why strabismic patients who are not diplopic close 1 eye in visually demanding situations. This finding clarifies the visual deficits impacting quality of life in strabismic patients and may represent a novel measure by which to evaluate and monitor function in strabismus.

Project description:ObjectiveTo determine the horizontal extent of the binocular visual field (BVF) in subjects with horizontal strabismus and whether the BVF falls below the driving standard.Methods and analysisAdults with congenital esotropia and infantile exotropia ≤45 Prism Dioptres (PD), and subjects with orthotropia were recruited. The manifest angle of deviation was measured using a simultaneous prism cover test. Monocular Visual Field (MVF) and BVF were measured using the Esterman visual field test. Subjects with diplopia or a manifest angle of strabismus that varied by>8PD or the present of a vertical tropia >8PD were excluded.ResultsForty-nine subjects were included: 10 with orthotropia, 20 with exotropia and 19 with esotropia. The horizontal extent of BVF (degrees) was significantly smaller in esotropes (122.8 ± 18.8) than in orthotropes (141 ± 6.6) or exotropes (138.3 ± 8.3) (p < 0.01). In 6 (31.6%) subjects with an esotropia, the BVF was below the driving standard. The horizontal extent of the visual field (VF) of the amblyopic eyes of patients with esotropia (98.70 degrees, SD 19.76) and exotropia (104.75 degrees, SD16.93) were significantly smaller than those with orthotropia (121.00 degrees SD 3.16) by 22.3 degrees (p = 0.004) and 16.25 degrees (p = 0.045), respectively. The difference between the summation of MVFs and the BVF was significantly greater in orthotropes (100.6 ± 2.7) than in exotropes (68.9 ± 34.4) and esotropes (74.2 ± 20.7) (p < 0.01).ConclusionThe horizontal extent of BVF is significantly smaller and more variable in adults with congenital esotropia and may fall below the driving standard.Strengths and limitationsLargest study on visual fields in subjects with horizontal strabismus including an orthotropic control group who do not have diplopia and who would otherwise meet the driving standard. Visual field quality was high but limitation is that visual field repeatability was not undertaken.How this study might affect research, practice, or policyThe findings of this study would suggest that people with an esotropia should be offered the opportunity to have a binocular visual field test before applying for a driving license. The DVLA may want to consider requesting people with an esotropia to have a binocular visual field test as is a requirement with other ophthalmic conditions such as glaucoma.

Dataset Information

Relationship Between Binocular Summation and Stereoacuity After Strabismus Surgery.

Publications

Relationship Between Binocular Summation and Stereoacuity After Strabismus Surgery.

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