Strabismic amblyopia affects decision processes preceding saccadic response

Amblyopia is a developmental disorder of vision associated with abnormal visual stimulation during early childhood. It is known that amblyopia may affect not only spatial vision parameters but also oculomotor behavior. Several previous studies showed that increased saccadic reaction time (latency) may be present in amblyopic subjects. In our recent work, we have demonstrated that not only amblyopic but also a dominant eye may show increased saccadic latency in strabismic individuals. Since saccadic latency can be considered as a decision time, we have applied LATER (Linear Approach to Threshold with Ergodic Rate) decision model to find out how developmental impairment of visual input affects visual decision-making processes, as well as to verify whether amblyopia affects also the cortical ability to inhibit more primitive, early saccadic responses during our modified delayed saccade task. Ten subjects with strabismic amblyopia and twelve control subjects were examined. As we expected, strabismic amblyopes showed decreased rate of rise of the neural decision signal for all viewing conditions as compared to controls. In addition, the comparison between the strabismic and anisometropic groups revealed that the amblyopic eye in strabismic subjects showed decreased rate of rise of the decision signal as compared to amblyopic eye in anisometropic subjects. Although we speculated that amblyopia may reduce the ability of cortical control and favor more reflexive, early saccadic actions to occur, our findings did not confirm this hypothesis. This study provide further evidence that amblyopia is associated with cortical deficits which affect the cortical decision about saccade initiation.