Objective: To investigate the relationship between the characteristics of spatial vision deficit and the degree of amblyopia in monocular amblyopes, and to analyze its mechanism with the theory of Magnocellular and Parvocellular pathways.
Methods: One hundred and eleven patients with monocular amblyopes aged 7-34 were included in this study. Distance best corrected visual acuity (BCVA) in logMAR units and contrast sensitivity function test were performed on both eyes in all patients with ETDRS digital visual chart and functional test system OPTECR 6500. The spatial vision of amblyopic and non-amblyopic eyes was evaluated by the AULCSF, Smax, Frmax and cutSF derived from the curve of contrast sensitivity function.
Results: The degree of amblyopia was significantly correlated with the difference of AULCSF between the amblyopic and non-amblyopia eyes (r=-0.83, P<0.01). BCVA of amblyopic eyes was significantly correlated with AULCSF, CutSF, Smax, Frmax(r=-0.68, -0.80, -0.73, -0.56, respectively; P<0.01). In amblyopic eyes, significant difference in BCVA, AULCSF, Smax, Frmax and CutSF was seen among different amblyopic groups (P<0.01), which was defined by the degree of amblyopia. In non-amblyopic eyes,no significant difference in BCVA, AULCSF, Smax, Frmax and CutSF was noted among different amblyopic groups (P>0.05). In mild amblyopes, no significant difference in AULCSF and Frmax was found between the amblyopic eyes and non-amblyopic eyes (P>0.05), while Smax and CutSF were significantly different. However, in moderate and severe amblyopes, significant differences in BCVA, AULCSF, Smax, Frmax and CutSF was seen between the amblyopic and non-amblyopic eyes (P<0.01). In amblyopic eyes, significant difference in contrast sensitivity was noted in all kinds of spatial frequencies among different amblyopic groups (P<0.01), and in non-amblyopic eyes, significant differences in contrast sensitivity was not seen in all kinds of spatial frequencies among different amblyopic groups.
Conclusions: The AULCSF, CutSF, Smax and Frmax are accorded with visual acuity for evaluation of the spatial vision of amblyopia. As the severity of amblyopia increases, the overall function of spatial vision in amblyopic eyes gradually decreases, the resolution ability of high spatial frequency is gradually weaken, the peak of contrast detection function gradually descends, and the optimal spatial frequency for contrast detection offsets toward low level of spatial frequency. Mild monocular amblyopia produces spatial contrast sensitivity loss in high spatial vision, suggesting there may be decreased sensitivity of the Parvocellular pathway, and no significant anomalous processing of Magnocellular Pathway. Whereas, in moderate and severe amblyopes, a generalized loss of sensitivity is observed at each spatial frequency. This result shows that both Magnocellular and Parvocellular pathways are damaged in different degrees, especially in Parvocellular pathway.