Luis A. Lesmes

Bayesian adaptive estimation of the contrast sensitivity function: the quick CSF method.

The contrast sensitivity function (CSF) predicts functional vision better than acuity, but long testing times prevent its psychophysical assessment in clinical and practical applications. This study presents the quick CSF (qCSF) method, a Bayesian adaptive procedure that applies a strategy developed to estimate multiple parameters of the psychometric function (A. B. Cobo-Lewis, 1996; L. L. Kontsevich & C. W. Tyler, 1999). Before each trial, a one-step-ahead search finds the grating stimulus (defined by frequency and contrast) that maximizes the expected information gain (J. V. Kujala & T. J. Lukka, 2006; L. A. Lesmes et al., 2006), about four CSF parameters. By directly estimating CSF parameters, data collected at one spatial frequency improves sensitivity estimates across all frequencies. A psychophysical study validated that CSFs obtained with 100 qCSF trials ( approximately 10 min) exhibited good precision across spatial frequencies (SD < 2-3 dB) and excellent agreement with CSFs obtained independently (mean RMSE = 0.86 dB). To estimate the broad sensitivity metric provided by the area under the log CSF (AULCSF), only 25 trials were needed to achieve a coefficient of variation of 15-20%. The current study demonstrates the methods value for basic and clinical investigations. Further studies, applying the qCSF to measure wider ranges of normal and abnormal vision, will determine how its efficiency translates to clinical assessment.

Spatial attention excludes external noise at the target location.

To investigate the nature of external noise exclusion, we compared central spatial precuing effects in 16 conditions that varied the amount of external noise, the number of signal stimuli, the number of locations masked by external noise, and the number and style of frames surrounding potential target locations. In the absence of external noise, precuing produced only marginal performance improvements in a small number of display conditions. In the presence of high external noise, precuing improved task performance in all the display conditions. The magnitude of these spatial attention effects, as gauged by contrast threshold reduction, is nearly constant across all the display conditions. This suggests that spatial attention mostly excludes external noise at the target location; the presence of external noise and/or signal stimuli in non-target regions has little effect on spatial performance when location uncertainty is eliminated by report cues. However, the presence of other potential locations for the target is critical, because if target location is known in advance, attention can be focused on that location with or without a cue.

Relationships between Brain Morphology and Behavioral Measures of Hemispheric Asymmetry and Interhemispheric Interaction

Thirty adult males identified consonant-vowel-consonant nonword trigrams projected briefly to the left visual field (right hemisphere), the right visual field (left hemisphere) or to both visual fields (and hemispheres) simultaneously. Magnetic resonance images of the brains of these same individuals provided measurements of the length of the Sylvian fissure and surface area of the planum temporale within each hemisphere as well as measurements of the midsagittal area of the corpus callosum. Both behavioral and morphological asymmetries were consistent with those found in previous studies. In addition, there were several relationships between brain morphology and trigram naming. For example, as the length of the right-hemisphere Sylvian fissure increased to become more like the typical length of the left-hemisphere Sylvian fissure, there were fewer errors of trigram identification and attention was distributed more quickly or evenly across the three letters contained in the display. In addition, as the midsagittal area of the corpus callosum increased, the percentage of errors increased on left visual field trials, but not on right visual field or bilateral trials, suggesting that an increase in corpus callosum size may be indicative of greater functional isolation of the two hemispheres.

Rapid and reliable assessment of the contrast sensitivity function on an iPad

PURPOSE Letter acuity, the predominant clinical assessment of vision, is relatively insensitive to slow vision loss caused by eye disease. While the contrast sensitivity function (CSF) has demonstrated the potential to monitor the slow progress of blinding eye diseases, current tests of CSF lack the reliability or ease-of-use to capture changes in vision timely. To improve the current state of home testing for vision, we have developed and validated a computerized adaptive test on a commercial tablet device (iPad) that provides an efficient and easy-to-use assessment of the CSF. METHODS We evaluated the reliability, accuracy, and flexibility of tablet-based CSF assessment. Repeated tablet-based assessments of the spatial CSF, obtained from four normally-sighted observers, which each took 3 to 5 minutes, were compared to measures obtained on CRT-based laboratory equipment; additional tablet-based measures were obtained from six subjects under three different luminance conditions. RESULTS A Bland-Altman analysis demonstrated that tablet-based assessment was reliable for estimating sensitivities at specific spatial frequencies (coefficient of repeatability 0.14-0.40 log units). The CRT- and tablet-based results demonstrated excellent agreement with absolute mean sensitivity differences <0.05 log units. The tablet-based test also reliably identified changes in contrast sensitivity due to different luminance conditions. CONCLUSIONS We demonstrate that CSF assessment on a mobile device is indistinguishable from that obtained with specialized laboratory equipment. We also demonstrate better reliability than tests used currently for clinical trials of ophthalmic therapies, drugs, and devices.

qCSF in Clinical Application: Efficient Characterization and Classification of Contrast Sensitivity Functions in Amblyopia

PURPOSE The qCSF method is a novel procedure for rapid measurement of spatial contrast sensitivity functions (CSFs). It combines Bayesian adaptive inference with a trial-to-trial information gain strategy, to directly estimate four parameters defining the observers CSF. In the present study, the suitability of the qCSF method for clinical application was examined. METHODS The qCSF method was applied to rapidly assess spatial CSFs in 10 normal and 8 amblyopic participants. The qCSF was evaluated for accuracy, precision, test-retest reliability, suitability of CSF model assumptions, and accuracy of amblyopia screening. RESULTS qCSF estimates obtained with as few as 50 trials matched those obtained with 300 Ψ trials. The precision of qCSF estimates obtained with 120 and 130 trials, in normal subjects and amblyopes, matched the precision of 300 Ψ trials. For both groups and both methods, test-retest sensitivity estimates were well matched (all R > 0.94). The qCSF model assumptions were valid for 8 of 10 normal participants and all amblyopic participants. Measures of the area under log CSF (AULCSF) and the cutoff spatial frequency (cutSF) were lower in the amblyopia group; these differences were captured within 50 qCSF trials. Amblyopia was detected at an approximately 80% correct rate in 50 trials, when a logistic regression model was used with AULCSF and cutSF as predictors. CONCLUSIONS The qCSF method is sufficiently rapid, accurate, and precise in measuring CSFs in normal and amblyopic persons. It has great potential for clinical practice.

Development of pattern vision following early and extended blindness

Significance Deprivation of vision during typical age-defined critical periods results in seemingly irreversible changes in neural organization and behavior in animals and humans. We describe visual development in a unique population of patients who were blind during typical critical periods before removal of bilateral cataracts. The rarity of such cases has previously limited empirical investigations of this issue. Surprisingly, we find substantial improvement after sight onset in contrast sensitivity, a basic visual function that has well-understood neural underpinnings. Our results show that the human visual system can retain plasticity beyond critical periods, even after early and extended blindness. Visual plasticity peaks during early critical periods of normal visual development. Studies in animals and humans provide converging evidence that gains in visual function are minimal and deficits are most severe when visual deprivation persists beyond the critical period. Here we demonstrate visual development in a unique sample of patients who experienced extended early-onset blindness (beginning before 1 y of age and lasting 8–17 y) before removal of bilateral cataracts. These patients show surprising improvements in contrast sensitivity, an assay of basic spatial vision. We find that contrast sensitivity development is independent of the age of sight onset and that individual rates of improvement can exceed those exhibited by normally developing infants. These results reveal that the visual system can retain considerable plasticity, even after early blindness that extends beyond critical periods.

Sensory adaptation as optimal resource allocation

Visual adaptation is expected to improve visual performance in the new environment. This expectation has been contradicted by evidence that adaptation sometimes decreases sensitivity for the adapting stimuli, and sometimes it changes sensitivity for stimuli very different from the adapting ones. We hypothesize that this pattern of results can be explained by a process that optimizes sensitivity for many stimuli, rather than changing sensitivity only for those stimuli whose statistics have changed. To test this hypothesis, we measured visual sensitivity across a broad range of spatiotemporal modulations of luminance, while varying the distribution of stimulus speeds. The manipulation of stimulus statistics caused a large-scale reorganization of visual sensitivity, forming the orderly pattern of sensitivity gains and losses. This pattern is predicted by a theory of distribution of receptive field characteristics in the visual system.

Using 10AFC to further improve the efficiency of the quick CSF method.

The contrast sensitivity function (CSF) provides a fundamental characterization of spatial vision, important for basic and clinical applications, but its long testing times have prevented easy, widespread assessment. The original quick CSF method was developed using a two-alternative forced choice (2AFC) grating orientation identification task (Lesmes, Lu, Baek, & Albright, 2010), and obtained precise CSF assessments while reducing the testing burden to only 50 trials. In this study, we attempt to further improve the efficiency of the quick CSF method by exploiting the properties of psychometric functions in multiple-alternative forced choice (m-AFC) tasks. A simulation study evaluated the effect of the number of alternatives m on the efficiency of the sensitivity measurement by the quick CSF method, and a psychophysical study validated the quick CS method in a 10AFC task. We found that increasing the number of alternatives of the forced-choice task greatly improved the efficiency of CSF assessment in both simulation and psychophysical studies. The quick CSF method based on a 10-letter identification task can assess the CSF with an averaged standard deviation of 0.10 decimal log unit in less than 2 minutes.

Evaluating the performance of the quick CSF method in detecting contrast sensitivity function changes

The contrast sensitivity function (CSF) has shown promise as a functional vision endpoint for monitoring the changes in functional vision that accompany eye disease or its treatment. However, detecting CSF changes with precision and efficiency at both the individual and group levels is very challenging. By exploiting the Bayesian foundation of the quick CSF method (Lesmes, Lu, Baek, & Albright, 2010), we developed and evaluated metrics for detecting CSF changes at both the individual and group levels. A 10-letter identification task was used to assess the systematic changes in the CSF measured in three luminance conditions in 112 naïve normal observers. The data from the large sample allowed us to estimate the test–retest reliability of the quick CSF procedure and evaluate its performance in detecting CSF changes at both the individual and group levels. The test–retest reliability reached 0.974 with 50 trials. In 50 trials, the quick CSF method can detect a medium 0.30 log unit area under log CSF change with 94.0% accuracy at the individual observer level. At the group level, a power analysis based on the empirical distribution of CSF changes from the large sample showed that a very small area under log CSF change (0.025 log unit) could be detected by the quick CSF method with 112 observers and 50 trials. These results make it plausible to apply the method to monitor the progression of visual diseases or treatment effects on individual patients and greatly reduce the time, sample size, and costs in clinical trials at the group level.

A hierarchical Bayesian approach to adaptive vision testing: A case study with the contrast sensitivity function.

Measurement efficiency is of concern when a large number of observations are required to obtain reliable estimates for parametric models of vision. The standard entropy-based Bayesian adaptive testing procedures addressed the issue by selecting the most informative stimulus in sequential experimental trials. Noninformative, diffuse priors were commonly used in those tests. Hierarchical adaptive design optimization (HADO; Kim, Pitt, Lu, Steyvers, & Myung, 2014) further improves the efficiency of the standard Bayesian adaptive testing procedures by constructing an informative prior using data from observers who have already participated in the experiment. The present study represents an empirical validation of HADO in estimating the human contrast sensitivity function. The results show that HADO significantly improves the accuracy and precision of parameter estimates, and therefore requires many fewer observations to obtain reliable inference about contrast sensitivity, compared to the method of quick contrast sensitivity function (Lesmes, Lu, Baek, & Albright, 2010), which uses the standard Bayesian procedure. The improvement with HADO was maintained even when the prior was constructed from heterogeneous populations or a relatively small number of observers. These results of this case study support the conclusion that HADO can be used in Bayesian adaptive testing by replacing noninformative, diffuse priors with statistically justified informative priors without introducing unwanted bias.