Learning to see (better): improving visual deficits with perceptual learning

Cover image for research topic "Learning to see (better): improving visual deficits with perceptual learning"
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Original Research
03 November 2014
The challenges of developing a contrast-based video game for treatment of amblyopia
Zahra Hussain
2 more and 
Paul V. McGraw
(A) Calibration screen showing central pattern matched to half-tone background using method of adjustment. Top: before adjustment, Bottom: adjusted pattern. (B) Calibration data for 18 displays, showing luminance adjustments (scaled from 0 to 1) against actual luminance increments (see text for details). (C) Contrast staircase from one level of the game for a child (top) and adult (bottom). (D) Correlation between contrast threshold calculated using iterative method (see text) and four other methods. From left to right: average contrast shown in final 30 s and final 20 s of the level, average of final four and final six contrast reversals.

Perceptual learning of visual tasks is emerging as a promising treatment for amblyopia, a developmental disorder of vision characterized by poor monocular visual acuity. The tasks tested thus far span the gamut from basic psychophysical discriminations to visually complex video games. One end of the spectrum offers precise control over stimulus parameters, whilst the other delivers the benefits of motivation and reward that sustain practice over long periods. Here, we combined the advantages of both approaches by developing a video game that trains contrast sensitivity, which in psychophysical experiments, is associated with significant improvements in visual acuity in amblyopia. Target contrast was varied adaptively in the game to derive a contrast threshold for each session. We tested the game on 20 amblyopic subjects (10 children and 10 adults), who played at home using their amblyopic eye for an average of 37 sessions (approximately 11 h). Contrast thresholds from the game improved reliably for adults but not for children. However, logMAR acuity improved for both groups (mean = 1.3 lines; range = 0–3.6 lines). We present the rationale leading to the development of the game and describe the challenges of incorporating psychophysical methods into game-like settings.

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Original Research
29 October 2014

Perceptual learning has been shown to produce an improvement of visual acuity (VA) and contrast sensitivity (CS) both in subjects with amblyopia and refractive defects such as myopia or presbyopia. Transcranial random noise stimulation (tRNS) has proven to be efficacious in accelerating neural plasticity and boosting perceptual learning in healthy participants. In this study, we investigated whether a short behavioral training regime using a contrast detection task combined with online tRNS was as effective in improving visual functions in participants with mild myopia compared to a 2-month behavioral training regime without tRNS (Camilleri et al., 2014). After 2 weeks of perceptual training in combination with tRNS, participants showed an improvement of 0.15 LogMAR in uncorrected VA (UCVA) that was comparable with that obtained after 8 weeks of training with no tRNS, and an improvement in uncorrected CS (UCCS) at various spatial frequencies (whereas no UCCS improvement was seen after 8 weeks of training with no tRNS). On the other hand, a control group that trained for 2 weeks without stimulation did not show any significant UCVA or UCCS improvement. These results suggest that the combination of behavioral and neuromodulatory techniques can be fast and efficacious in improving sight in individuals with mild myopia.

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