title: Disclosing disease mechanisms with a spatio-temporal summation paradigm.
abstract: BACKGROUND
  We develop the logic for a stimulus that can evaluate cone-dependent spatial summation and detail the modelling and interpretation of thresholds obtained with this stimulus.
  
  
  METHODS
  Fifteen observers participated, including two young normals tested extensively in control experiments, and a clinical trial based on four observers with age-related macular degeneration (AMD), four age-similar controls and five young observers. Monocular spatial summation functions were measured with contrast-modulated Gabor targets that approximated the optimal visual contrast detector. Thresholds were returned from a yes/no adaptive psychophysical algorithm. By fine titration along the size domain it was demonstrated that the spatial summation of normal observers can be adequately described by a two-component model. A reduced set of variables are proposed for clinical applications and the model was applied to data derived using these variables in persons with AMD and age-similar controls.
  
  
  RESULTS
  We do not find a significant age-related loss of contrast sensitivity in our normal group. On the other hand, persons with early AMD exhibited a 0.41 log unit loss of sensitivity (P=0.04) from age-similar controls, without any change in their maximum summation area (A(max)).
  
  
  CONCLUSIONS
  The nature of the spatial summation is consistent with the interpretation that early AMD produces a decrease in cone input to post-receptoral mechanisms in the absence of neural remodelling.
authors.affiliation: Department of Optometry and Vision Sciences, The University of Melbourne, Melbourne, Victoria, Australia.
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Zele
authors.forename: Rebecca K
authors.initials: RK
authors.lastname: O'Loughlin
authors.forename: Robyn H
authors.initials: RH
authors.lastname: Guymer
authors.forename: Algis J
authors.initials: AJ
authors.lastname: Vingrys
mesh_terms: D000328:Adult; D000368:Aged; D015350:Contrast Sensitivity / Q000502:physiology*; D006801:Humans; D008268:Macular Degeneration / Q000503:physiopathology*; D008875:Middle Aged; D010775:Photic Stimulation; D017949:Retinal Cone Photoreceptor Cells / Q000503:physiopathology*; D012684:Sensory Thresholds / Q000502:physiology*