The Significance of Retina as Brain Tissue in the Context of Amblyopia


Academy San Antonio

Although recreation and relaxation in Arizona predominated for me this year over attending the meeting of the American Academy of Optometry in San Antonio, I would have loved to attend the session that was held yesterday afternoon.  From the program description:

Binocular Vision, Perception & Pediatric Optometry Section and Vision Science SIG Symposium: Lasker / IRRF Amblyopia Initiative – Where We’ve Been, Where We Are, and Where We’re Going.  This symposium will feature speakers involved in the Lasker/IRRF Initiative: Amblyopia – Challenges and Opportunities. The speakers will discuss recent progress on amblyopia research, the scientific hurdles that have been overcome, and what major questions now confront the field. Moderator: Susan Cotter, OD, MS, FAAO. Speakers: Kevin Duffy, PhD, Earl Smith, III, OD, PhD, FAAO, Benjamin Thompson, PhD, Ewa Niechwiej-Szwedo, PhD, and Ruth Manny, OD, PhD, FAAO.

You can gain a feel for what was discussed from a report published by the Lasker/IRRF Amblyopia Initiative last year — Amblyopia: Challenges and Opportunities.

Lasker Report Cover

There are several sections of the report that have particularly valuable sound bites.  The first relates to an appreciation of the retina as part of the brain.  I’m still hopeful that one of these days we’ll stop referring to “the eye and the brain”, and realize the significance of the eye as integral part of the brain.  So our first sound bit comes from the Concluding Remarks by John Dowling of Harvard’s Center for Brain Science (pages 111-112), who begins as follows:

“All agree that amblyopia is a disorder that affects visual structures beyond the eye. Many say simply that amblyopia is a brain disorder. But the retina is part of the brain, pushed out into the eye during development. As someone who has long studied the retina, I wonder if the retina is at all affected. At first glance, retinal function appears normal in amblyopia, but is it totally unaltered? I am not convinced …”

The second section involves the role of movement in amblyopia therapy (page 97):

“The potential of physical activity to promote amblyopic recovery has caught the attention of the clinical field. Adult subjects who intermittently cycled on a stationary bicycle while watching a movie showed enhanced effects of transient eye patching compared to those subjects who watched the movie while sitting still (Lunghi and Sale, 2015). Moreover, tasks that directly engage both visual and motor circuits have achieved great success in reversing amblyopia. For example, recovery from amblyopia is expedited by tasks requiring coordination of hand and eye movements, such as having patients manipulate objects during visual training (reviewed in Daw, 2013).”

Lastly, with the bolded emphasis mine (page 102):

  • “Novel visual training paradigms that exploit our increased understanding of the biological underpinnings of amblyopia recovery are needed. Future work should continue to seek training strategies that are tailored to the individual patient to engage attentional, emotional, and visuomotor circuits for faster and more effective recovery.”

 

 

4 thoughts on “The Significance of Retina as Brain Tissue in the Context of Amblyopia

  1. As our knowledge expands it is so good that those in the forefront of these efforts are making this knowledge more available to the masses of practitioners. Thanks for opening our brains,

  2. Len,
    Other conditions are recognized to be on a spectrum. What we learn about amblyopia will have other applications.
    Gary

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