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Publications

Journal Article Ppublish

PubMed: 42657998 DOI: 10.1167/iovs.67.10.66

Abnormal Binocular Rivalry Dynamics in Amblyopia: A Potential Diagnostic Marker.

Invest Ophthalmol Vis Sci 67(10):66

Authors: Adrien Chopin, Aubrey Rossi, Preeti Verghese, Michael A Silver, Dennis M Levi

Affiliations

  • Smith-Kettlewell Eye Research Institute, San Francisco, California, United States.
  • Herbert Wertheim School of Optometry and Vision Science, University of California, Berkeley, California, United States.
  • Sorbonne Université, INSERM, CNRS, Institut de la Vision, Paris, France.
  • Herbert Wertheim School of Optometry and Vision Science, University of California, Berkeley, California, United States. Psychology Department, University of Oregon, Eugene, Oregon, United States.
  • Helen Wills Neuroscience Institute, University of California, Berkeley, California, United States.

Abstract

PURPOSE

Amblyopia is a neurodevelopmental disorder characterized by monocular deficits and interocular suppression. Binocular rivalry, where perception alternates between dissimilar images, is a powerful tool to probe this suppression. However, the dynamics of sustained binocular rivalry remain poorly characterized in amblyopia. This study aimed to comprehensively characterize these dynamics in individuals with amblyopia compared to visually-normal controls.

METHODS

Eleven adults with amblyopia and eight controls continuously reported their perception during a binocular rivalry task through keypresses. We used custom calibration to ensure stable fusion. Key metrics included complete reversal rates (transitions between differing monocular percepts), incomplete reversal rates (transitions to mixed percepts and back), and eye preference indexes.

RESULTS

Although most participants with amblyopia experienced sustained rivalry, their dynamics were severely abnormal. Complete reversal rates were profoundly reduced, and more time was spent seeing the fellow eye percept. Distinct signatures emerged for amblyopia subtypes, shedding light on underlying mechanisms: anisometropic patients exhibited higher incomplete reversal rates than strabismic/mixed patients, suggesting higher binocular noise levels in anisometropic amblyopia. Combining these metrics enabled perfect separation between groups (control, anisometropic, or strabismic/mixed), even with just four minutes of data, in our adult sample.

CONCLUSIONS

Binocular rivalry dynamics are fundamentally altered in amblyopia, revealing disrupted reversal mechanisms. These dynamics distinguish amblyopia from normal vision and differentiate between etiologies. The perfect separation achieved suggests that quantifying rivalry dynamics holds significant potential as a rapid noninvasive diagnostic tool.

MeSH

Eye, Ophthalmology, Amblyopia, Perception