Étude électrophysiologique de la suppression interoculaire : implication pour l'amblyopie
Amblyopia is a developmental dysfunction of binocular vision. It is typically characterized by visual acuity and stereopsis deficits. However, presence of more spread deficits such as problems in visual attention and reading are beginning to be reported in literature. Amblyopia is generally explained by interocular suppression at cortical level, which is considered to be chronic or permanent outside the developmental period. Nevertheless, a growing body of evidence suggests that normal binocular interactions are still present in amblyopic adults. In the first study, we tried to establish an electrophysiological marker of binocular vision. Visual evoked potentials (VEPs) were recorded in normal observers for whom binocular dysfunction was induced. Patterns of binocular interaction were categorized (facilitation, averaging or suppression) by comparing monocular and binocular responses. Quantitative and continuous indexes of binocular integration were also calculated (binocular response minus the sum of monocular responses). Results indicated that patterns of interaction were not optimal to account for stereoscopic performance. The latter was, however, best explained by binocular integration indexes. This study shows evidence of predicting binocular vision based on a novel index that allows continuous quantification of binocular transient-VEP responses. In the second study, we examined the behavioural and neural correlates of interocular suppression in amblyopic adults and controls using a flash suppression paradigm while recording steady-state visual evoked potentials (ssVEP). The strength of suppression was manipulated by changing the contrast (10, 20, 30 or 100%) of the "flash", or the suppressor, and the stimulus was presented either in the dominant (or fellow) or non-dominant (or amblyopic) eye. At the behavioural level, interocular suppression was found regardless the eye origin of the flash for normal observers, but was asymmetric in the amblyopes, so that the suppression from the fellow eye was stronger, supporting a putative chronic suppression. Interestingly, the amblyopic eye suppressed the dominant eye at the highest contrast level. At the electrophysiology level, interocular suppression effects found over the occipital region were equivalent in both groups. However, ssVEP responses over the frontal region in the amblyopic observers were not modulated as those in controls; suppression of the amblyopic eye was manifest even at low contrast levels. Our findings support the existence of functional binocular interaction in adult amblyopia and the implication of a widespread cortical network in interocular suppression. To conclude, amblyopia is a complex condition with widespread cortical and functional deficits. It seems clear that it can’t be limited to a primary visual cortex dysfunction. Interocular suppression seems a core mechanism of the problematic, but more studies are necessary to determine more precise mechanisms implicated.
vision suppression amblyopia strabismus binocular interaction electrophysiology evoked potentials electroencephalography