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双眼功能平衡与可塑性
其他题名Functional balance between the two eyes and plasticity
贾武力
2015-11
摘要双眼功能平衡是具备正常双眼视觉功能的前提。视觉发育过程中的任何不利因素,如斜视、屈光参差、屈光不正、视神经损伤、白内障和青光眼等,可能会引起永久性眼间视觉功能差异和双眼视觉功能(如立体视)异常。且大多数视力正常人都有存在感觉优势眼,即在双眼协同中,某一眼睛在视知觉中更占优势一些,双眼功能也不是完全平衡的,这种现象被称为感觉眼优势(sensory eye dominance,SED)。在临床和实验室中,有很多方法能检测眼优势和双眼功能平衡,如纸洞法、笔尖法、四点灯、双眼竞争、立体视、双眼相位信息整合、双眼运动信息整合等。前人对部分测量方法之间的相关性进行了初步研究,发现检测结果之间通常有较大差异,尤其是临床测量(如四点灯)和实验室方法之间缺乏相关性,这提示我们双眼功能平衡可能具有多态性,现有测量方法测查的可能是不同神经心理过程。本研究将首次在较大样本范围内(正常和双眼功能不平衡的弱视病人)系统测量所有已知的双眼功能平衡任务,探讨不同测量任务之间的区别与联系(研究一) 。研究一得出了和前人类似的结果,相关分析证实(1)不同的双眼功能平衡测试间缺乏普遍的相关, 各测试所测量的可能是不同的神经心理过程; (2)在弱视群体中,双眼竞争测试与多个单眼功能(如弱视眼视力和对比敏感度等)相关显著,但与双眼相位整合、持续闪烁抑制相关不显著,很可能表
明双眼竞争虽然是一种典型的实验室双眼视觉测试,但它在本质很可能反应的是单眼功能之间的差异,或与相关单眼功能具有类似的底层机制。
双眼功能平衡是可以改变的。过往研究提示单眼知觉训练可显著提升训练眼的视觉功能,双眼训练(如双眼竞争和立体视知觉)可改变双眼在相关任务上的眼间优势,但单眼/双眼训练对单双眼功能的影响特性尚不清楚。本研究还将在研究一的基础上探索用单眼(研究二)和双眼(研究三)知觉训练改变弱视双眼功能平衡的有效途径。
研究二包括两个实验,实验一发现针对弱视进行的单眼对比度检测训练显著提高了弱视眼对比敏感度,在训练后,弱视患者的视锐度、对比敏感度(包括曲线下面积和截止频率)、立体视锐度、弱视眼在双眼竞争中的占优势次数和时间均改善显著;但在双眼对比敏感度整合比率、双眼相位整合平衡点、弱视眼突破持续闪烁抑制所需能量等指标上并没有显著变化。 实验二发现通过长期遮盖弱视眼可使得视锐度达到临床治愈标准,立体视锐度接近正常标准,双眼竞争中原弱视眼与原好眼相比在占优势次数和占优势时间上无显著差异,但在对比敏感度函数和双眼相位整合测试中弱视眼仍然显著低于相对好眼,表明现有临床方法对于弱视患者的治疗,并未使其完全恢复原弱视眼功能,双眼功能并未完全平衡。这提示我们,系统的单、双眼训练对于弱视患者视功能的全面恢复是非常必要的。 
研究三考察了双眼竞争训练、立体视训练和眼间亮度差异对双眼功能平衡的影响。弱视患者进行的双眼竞争训练后,弱视眼视锐度、立体视锐度和双眼相位整合成绩均提高显著;立体视知觉学习能够显著改善弱视的立体视功能和弱视眼视力,但立体视锐度的改善与视锐度的提高之间并无显著相关。这表明双眼功能的改善与单眼功能的提高可能是互相独立的过程。 这些结果进一步提示弱视单双眼功能的全面恢复可能需要有计划地进行结构化的单双眼训练。 对正常与弱视两种被试群体的研究发现, 在双眼信息整合中降低单眼平均光强会显著影响眼间平衡:降低正常被试左眼刺激亮度会使被试在任务表现出“弱视化”模式,而降低弱视被试好眼刺激亮度则会使弱视在双眼相位整合中显得“正常化”。对弱视而言,本研究对双眼整合中眼间功能权重的调制提供了一种简单、有效的方式来控制方式,具有潜在的临床应用前景。
其他摘要Functional balance between the two eyes  is a prerequisite for normal binocular ision.  Adverse  factors  in the development of visual system, such as strabismus, anisometropia, ametropia, visual nerve injury, cataract and glaucoma, may cause permanent  abnormal binocular visual functions.  Even for normal population, functions in one eye is usually  superior over those in the other eye , a phenomenon called sensory eye dominance (SED). A lot of clinical, e.g. visual acuity, stereoacuity, Worth’s 4-dot, Hole-in-card test (the Dolman method), and point-a-finger test (Porta test)Porta’s test, and  laboratory, e.g. psychophysical contrast sensitivity function test, binocular rivalry, binocular phase combination, and continuous flash suppression, tests have been developed to index functional balance between the two eyes in varied populations. Anecdotal evidence suggested weak correlation among different binocular fucntions, indicating that  binocular vision may be multi-facet and  those functional indexes might reflect different aspects of  binocular processes. In the present The present  research first systematically evaluated a series of clinical and laboratory functional balance tests in a relatively large sample of both normal and amblyopic subjects (Project 1), aiming to explore the differences and relations among different measurements.  Correlation analysis revealed 1) the lackness of general correlations among different functional binocular balance tests, indicating that these tests may reflect different neural and psychological mechanisms; 2) that the imbalance between the two eyes in binocular rivalry significantly correlated with monocular functions in the amblypic eye instead of other binocular measurements, indicating binocular rivalry, a widely-use binocular test, is likely to share at least partially same mechanisms as monocular tests.    
Functional balance between the two eyes is plastic.  Intensive  monocular  and binocular  training has been found to be effective in improving monocular functions, e.g. visual acuity, contrast sensitivity, and vernier acuity, and binocular function, e.g.sensory eye dominance or stereopsis, respectively. However, most previous studies focused on either monocular or binocular training and tests and the exact impact of training on both monocular and binocular functions has rarely been investigaged. Project 2 and 3 will systematically evaluate the effectness of mocular (Project 2) and binocular (Project 3) training experience on a variety of visual fucntions.  
Project 2 consisted of two experiments. The first experiment found that monocular training of contrast detection at cutoff spatial frequency in the amblyopic eye can significantly improve contrast sensitivity and visual acuity in the trained eye, stereo vision, the amblyopic dominance ratio in binocular rivalry but not the binocular contrast sensitivity summation ratio, balance point in binocular phase combination, and the break time in continuous flash suppression. The second experiment mapped a set of monocular and binocular functions in clinical “treated” amblyopia and found that long-term monocular patching  essentially normalized visual acuity in the amblyopic eye and dominance ratio in binocular rivalry,  largely  recovered near stereoacuity, left contrast sensitivity (especially at high spatial frequency) and binocular phase combination untreated. Our results suggested that structured monocular and binocular training are vital to fully restore deficient visual functions in amblyopia.
Project 3 evaluated the effect(s) of binocular rivalry training, stereo training, and introduce of interocular luminance difference on mocular and/or binocular functions. We found that binocular rivalry training can significantly improve visual acuity in the amblyopic eye, stereopsis, and balance point in binocular phase combination, with no correlation among the magnitude of improvements in different measures. Although perceptual learning of stereo judgment can significantly improve stereoacuity and visual acuity in the amblyopic eye, the improvements in the two tests didn’t correlate with each other. These results further suggested that  visual functions might be intrinsically heterogeneous and both monocular and binocular training are needed to fully treat amblyopia. In the last section of the thesis, we proposed and tested a simple and yet effective method to modulate sensory dominance in binocular phase combination, i.e. introduce of luminance difference between the two eyes. We found that attenuation of luminance in the fellow eye can  “normlize” amblyopic eye in performing binocular phase combination, which finding is of potential clinical interest.  
学科领域基础心理学
关键词双眼功能平衡 脑可塑性 弱视 知觉学习 功能训练
学位类型博士
语种中文
学位专业心理学
学位授予单位中国科学院研究生院
学位授予地点北京
文献类型学位论文
条目标识符http://ir.psych.ac.cn/handle/311026/19598
专题认知与发展心理学研究室
作者单位中国科学院心理研究所
推荐引用方式
GB/T 7714
贾武力. 双眼功能平衡与可塑性[D]. 北京. 中国科学院研究生院,2015.
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