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Kadé Diallo, Lyne Racette, Evan Hansen, Allison Young, Amanda Gosch; Investigating the Impact of Primary Open-Angle Glaucoma on the Visual Perception of Higher-Order Motion. Invest. Ophthalmol. Vis. Sci. 2017;58(8):2853.
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Glaucoma is commonly thought of as a neurodegenerative disease. However, a growing body of evidence suggests that there may be negative neurological effects associated with primary open-angle glaucoma (POAG) beyond the optic nerve. The purpose of this study was to determine whether deficits in the higher-order motion perception occur in POAG.
Ten participants were included in this prospective cross-sectional study. Participants were at least 40 years of age, had visual acuity of 20/40 or better, and had normal cognitive function. Of these, four had POAG and 6 served as controls. For patients, the eye that was most healthy was tested if the visual field was abnormal but had at least one quadrant with normal total deviation value at 12 degree of eccentricity and at all surrounding locations. First-order and second-order motion were presented foveally and peripherally in randomized order. A two alternative forced choice method was used in which participants reported the direction of motion (either left or right). Lower-level motion was assessed using six luminance-defined (first-order) contrast levels: central assessed using 0.04, 0.02, 0.01, 0.005, 0.0025, and 0, peripheral assessed with 0.05, 0.03, 0.02, 0.01, 0.005, and 0.0025. Higher-level motion was assessed using five textured-defined (second-order) contrast levels: central assessed using 1, 0.333, 0.143, 0.111, and 0.059, peripheral assessed with 1, 0.666, 0.5, 0.333, and 0.111. Data were analyzed using unpaired one-tailed t-tests.
No difference in age was found between the groups (mean age: 51.7 years for controls and 58.0 years for patients; p=0.22). The detection of first-order motion was significantly lower centrally in patients (97.50%) compared to controls (100%) at contrast levels 0.01 (p=0.03) and 0.0025 (POAG: 46.25%; controls: 60.83%; p=0.04), and peripherally at contrast level 0.01 (POAG: 78.75%; controls: 96.67%; p=0.03). The detection of second-order motion was significantly lower centrally in patients (47.50%) compared to controls (68.57%) at contrast level 0.143 (p=0.01), and peripherally only the contrast level 1 (0.049).
Patients with glaucoma exhibited deficits in processing first- and second-order motion in areas of normal vision. This suggests that glaucoma may affect areas beyond the optic nerve, including the cortical visual areas involved in processing motion.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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