Flash Suppression Reveals an Additional Nonvisual Extrastriate Contribution for Amblyopic Suppression

A growing body of evidence suggests that anomalous binocular interactions underlie the deficits in amblyopia, but their nature and neural basis are still not fully understood.

We examined the behavioral and neural correlates of interocular suppression in 13 adult amblyopes and 13 matched controls using a flash suppression paradigm while recording steady-state visual evoked potentials. The strength of suppression was manipulated by changing the contrast (10%, 20%, 30%, or 100%) of the flash stimulus, or the suppressor, presented either in the dominant (fellow) or nondominant (amblyopic) eye.

At the behavioral level, interocular suppression in normal observers was found, regardless of the eye origin of the flash onset. However, the pattern of suppression in the amblyopes was not symmetric, meaning that the suppression from the dominant eye was stronger, supporting a putative chronic suppression of the amblyopic eye. Interestingly, the amblyopic eye was able to suppress the dominant eye but only at the highest contrast level. At the electrophysiology level, suppression of the steady-state visual evoked potential responses in both groups in all conditions was similar over the occipital region, but differed over the frontal region.

Our findings suggest that, although suppression in amblyopia involves an imbalanced interaction between the inputs to the two eyes in the visual cortex, there is also involvement of nonvisual extrastriate areas.