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Spatial-Frequency–Dependent Changes in Cortical Activation before and after Patching in Amblyopic Children

From the Division of Ophthalmology, Children’s Hospital and Regional Medical Center, and the Department of Ophthalmology, University of Washington, Seattle, Washington.

PURPOSE. To examine the cortical response under transient stimulus conditions in amblyopic children before and after eye patching. To determine whether improvement in acuity is associated with spatial-frequency–dependent changes in specific peaks of the cortical response.

METHODS. Visual evoked potentials (VEPs) to check reversal (163–18 arc min) and onset of sine wave gratings (0.5–4 cyc/deg) were measured in 24 amblyopic children (<7 years of age) before eye patching. VEPs were repeated in nine subjects with 20/40 or better acuity after patching. Age, severity of amblyopia, and VEP amplitudes of positive peak (P)100, P1, and negative peak (N)2 were analyzed by multivariate statistics.

RESULTS. Before patching, the amblyopic eye showed decreasing amplitude with increasing spatial frequencies (P < 0.05) when compared with the nonamblyopic eye. Reduced amplitudes occurred at frequencies well below acuity. Latencies were mildly prolonged. After patching, amplitudes increased in the amblyopic eye across all spatial frequencies (ANCOVA; P < 0.0001 for each peak). However, a spatial-frequency–dependent increase in amplitude was significant only for a late negative peak (N2). The patched eye showed no significant changes.

CONCLUSIONS. Recovery of acuity after eye patching is associated with an overall increase in cortical activation across a wide range of spatial frequencies below the acuity threshold. A spatial-frequency–dependent increase in a late negative peak suggests that the cortical generator of this peak demonstrates plasticity of acuity recovery.

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