Abstract
Purpose :
Children with amblyopia show deficits in higher-order executive functions that are processed beyond the primary visual pathway, however whether deficits persist into adulthood is not known. This study investigates visual attention and visuo-cognitive search and scanning ability in adults with and without amblyopia and/or strabismus and considers the visual contributions to executive function outcomes.
Methods :
Participants aged 18 to 40 years included: 75 with amblyopia (20 anisometropic, 20 strabismic, 20 mixed, 15 deprivation), 20 non-amblyopic with strabismus and 20 with normal visual development (controls). Vision assessment comprised visual acuity (VA; EDTRS chart), and binocular function score (BFS; Randot preschool stereoacuity, Worth 4 Dot). Visual attention and processing speed were assessed by both Stroop (OFF+ON) and Useful Field of View (UFOV; divided and selective attention tasks), and visuo-cognitive search and scanning by Dynamic Trail Making Test A and B (D-TMT). Performance was compared between the groups and multiple regression models were used to determine the predictive ability of VA and BFS on executive functional performance.
Results :
Both amblyopic and non-amblyopic strabismic adults had poorer performance than controls on all executive function tests. Both amblyopic and non-amblyopic strabismic groups showed reduced visual attention and processing speed using the Stroop test (OFF+ON: 162.12(4.33) vs. 159.39(7.16) vs. 138.54(4.96) sec; p=0.03) and the UFOV (divided attention: 84.62 (6.78) vs. 81.94 (11.57) vs. 42.73 (4.03) ms; p=0.02; selective attention: 160.23(8.94) vs. 172.52(17.43) vs. 102.35 (10.42) ms; p=0.01). Further, both abnormal binocular vision groups took longer than controls to complete the D-TMT-A (59.95 (2.95) vs. 51.44 (3.34) vs. 45.23 (1.76) sec; p=0.02) and the D-TMT-B (82.79(5.24) vs. 67.08(3.39) vs. 56.26(3.35) sec; p=0.01). Performance on these tests was partially attributable to VA of the amblyopic/non-dominant eye and BFS (about 19-23%).
Conclusions :
Executive functional performance of adults with either amblyopia or strabismus was reduced for tests comprising visual processing speed, visual attention and visuo-cognitive search and scanning tasks. Performance was partially related to severity of VA and/or binocular function loss.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.