Applications of dynamic gratings in neuro-ophthalmic disorders

Traditional static vision-based assessment evaluate only stationary, spatial modulated resolution, leaving early and pathway-specific visual impairments undetected. Dynamic gratings are periodically modulating bright-dark stripe stimuli with precisely controllable spatiotemporal parameters that preferentially engage magnocellular and parvocellular visual pathways. Despite this, dynamic grating has not been applied in routine practice due to a lack of standardized protocols, normative databases, and clearly defined clinical indications. This is a narrative review which comprehensively summarizes the motion patterns of dynamic gratings and their clinical utility in neuro-ophthalmic disorders. The five primary motion patterns include phase-alternating oscillation, drift, translation, appearance-disappearance, and rapid serial visual presentation. Through parameter modulation of dynamic gratings, psychophysical and neurophysiological responses are collected, to provide multidimensional evidence for disease mechanism elucidation, diagnosis, and treatment evaluation. These applications are reviewed spanning a spectrum of ophthalmic and neuro-ophthalmic conditions, including glaucoma, amblyopia, strabismus, Graves' ophthalmopathy, diabetic retinopathy, multiple sclerosis, Parkinson's disease, and schizophrenia. The current research provided a foundation for the application of dynamic gratings in clinical ophthalmology. Potential future research should focus on establishing disease-specfic parameter sets and developing an integrated platform to enable standardized clinical implementation.