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The Journal of Neurophysiology Vol. 86 No. 2 August 2001, pp. 651-661
Copyright ©2001 by the American Physiological Society
1Yerkes Regional Primate Research Center and Department of Neurology, Emory University, Atlanta, Georgia 30322; 2Department of Anatomy and Neuroscience, University of Texas Medical Branch, Galveston, Texas 77555; and 3Department of Physiology and Biophysics, University of Washington, Seattle, Washington 98195
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ABSTRACT |
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Tusa, Ronald J., Michael J. Mustari, Andrew F. Burrows, and Albert F. Fuchs. Gaze-Stabilizing Deficits and Latent Nystagmus in Monkeys With Brief, Early-Onset Visual Deprivation: Eye Movement Recordings. J. Neurophysiol. 86: 651-661, 2001. The normal development and the capacity to calibrate gaze-stabilizing systems may depend on normal vision during infancy. At the end of 1 yr of dark rearing, cats have gaze-stabilizing deficits similar to that of the newborn human infant including decreased monocular optokinetic nystagmus (OKN) in the nasal to temporal (N-T) direction and decreased velocity storage in the vestibuloocular reflex (VOR). The purpose of this study is to determine to what extent restricted vision during the first 2 mo of life in monkeys affects the development of gaze-stabilizing systems. The eyelids of both eyes were sutured closed in three rhesus monkeys (Macaca mulatta) at birth. Eyelids were opened at 25 days in one monkey and 40 and 55 days in the other two animals. Eye movements were recorded from each eye using scleral search coils. The VOR, OKN, and fixation were examined at 6 and 12 mo of age. We also examined ocular alignment, refraction, and visual acuity in these animals. At 1 yr of age, visual acuity ranged from 0.3 to 0.6 LogMAR (20/40-20/80). All animals showed a defect in monocular OKN in the N-T direction. The velocity-storage component of OKN (i.e., OKAN) was the most impaired. All animals had a mild reduction in VOR gain but had a normal time constant. The animals deprived for 40 and 55 days had a persistent strabismus. All animals showed a nystagmus similar to latent nystagmus (LN) in human subjects. The amount of LN and OKN defect correlated positively with the duration of deprivation. In addition, the animal deprived for 55 days demonstrated a pattern of nystagmus similar to congenital nystagmus in human subjects. We found that restricted visual input during the first 2 mo of life impairs certain gaze-stabilizing systems and causes LN in primates.
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INTRODUCTION |
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The human infant has
limited gaze-stabilizing abilities at birth, but rapidly develops
better control over the next 6 mo (Aslin 1987
;
Naegele and Held 1982
; Shupert and Fuchs
1988
). Normal development and the capacity to calibrate these
gaze-stabilizing systems may depend on normal vision during infancy.
Monocular deprivation of pattern vision from lid suture for the first 2 wk of life or artificial induction of esotropia induced during early
infancy in monkeys results in decreased monocular optokinetic nystagmus (OKN) in the nasal to temporal (N-T) direction (Kiorpes
et al. 1996
; Sparks et al. 1986
; Tychsen
et al. 1996
). In addition, strabismic humans with infantile
esotropia syndrome and infant monkeys with surgical strabismus often
show latent nystagmus (LN) when viewing monocularly (Kiorpes et
al. 1996
; Kommerell and Mehdorn 1982
; Schor 1983
; Tychsen et al. 1996
). This
immature pattern of OKN is found when cortical binocularity is
disrupted early in simian or human development (see Schor
1983
for review). These types of deprivation result in
significant competition between the two eyes. Psychophysical and
physiological studies in visual cortex in monkeys show that sensory
deficits caused by abnormal early visual experience as a result of
monocular form deprivation in monkeys is much more severe than those
associated with bilateral form deprivation (Crawford et al.
1993
; Harwerth et al. 1991
). The differences in
the severity of visual deficits have been attributed to the
consequences of binocular competition associated with unilateral form
deprivation. There is no information on ocular motor behavior in
monkeys with early binocular deprivation where there is no competition
between the two eyes. Based on a study in cats, we believe that
gaze-holding deficits can occur even with binocular deprivation. At the
end of 1 yr of dark rearing, cats have gaze-stabilizing deficits
similar to those of the newborn human infant including decreased
monocular OKN in the N-T direction and decreased velocity storage in
the vestibuloocular reflex (VOR) (Cynader 1985
).
In the current study, we have examined the VOR, optokinetic
response, and fixation of three monkeys with binocular lid suture initiated within 1 day of birth. We also examined ocular alignment, refraction, and visual acuity in these animals. We examined monkeys deprived for 25, 40, and 55 days of life to determine the duration of
deprivation critical for causing ocular motor defects. The overall
objective of this study was to determine to what extent the development
of gaze-stabilization in monkeys depends on normal visual input during
infancy, and to what extent visual deprivation results in irreversible
gaze-stabilizing deficits and spontaneous nystagmus. Brief reports of
some of these results have been presented elsewhere (Tusa et al.
1992
, 1994
).
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METHODS |
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Subjects and general rearing conditions
Three infant rhesus monkeys (Macaca mulatta, 1 male and 2 females) born on the Johns Hopkins Primate Farm were used.
All of the experimental and animal care procedures were in strict
adherence with the National Institutes of Health Guide for the Care and Use of Laboratory Animals. Eyelids were sutured closed similar to the
method of Raviola and Wiesel (1985)
. The animals were
sedated with tiletamine and zolazepam and ketamine, and
then the epithelial margins of the upper and lower eyelid lateral to
the lacrimal papilla were trimmed. The cut surfaces of the lids of both
eyes were joined by 4-0 nylon mattress sutures from the lateral
canthus to the lacrimal papilla. After 7-10 days the sutures were
removed. After 25, 40, and 55 days, the eyelids were opened with sharp dissection. The ocular motor behavior of these three monkeys was compared with that of six normal control rhesus monkeys.
Ocular examination
These methods were previously described (Repka and Tusa
1995
; Tusa et al. 1991
). In brief, ocular
alignment, refraction of the eyes, axial length of the eye, and
clinical examination of spontaneous eye movements during binocular and
monocular viewing were assessed in all animals on the first day of
birth, and repeated at 3, 6, and 12 mo of age. Ocular alignment was
measured using a cover test with the monkey fixating on a toy at 33 cm
combined with a Krimsky corneal light reflex test. A photographic
determination of ocular alignment was also performed. Refractive error
was measured by retinoscopy with the pupils dilated with
cyclopentolate and the animal sedated with ketamine. Visual
spatial acuity was measured using Teller Acuity Cards (VisTech
Consultants, Dayton, OH).
Eye movement recordings
Eye movement recordings using the magnetic-field search coil
technique began at day 60. A 14-mm eye coil was implanted
around each eye, and the end of each wire was soldered to a small
electrical plug anchored onto the skull with a small inverted flat-head
screw (Judge et al. 1980
). The entire skull assembly
including plug, cement, and screw weighed 5 g. For the first few
months of life, the eye movement recording system was calibrated by
rotating the magnetic field coils 20° in each horizontal direction
around the stationary animal in the dark while measuring average eye
position. Calibration was also checked by rotating the field coils at a fixed velocity (30°/s) around the animal in the dark. We were usually
able to record eye movements for 20-30 min before the infants became
drowsy, at which time they were returned to their cages. Eye movements
were recorded while the monkey sat in a small adjustable, primate
chair. During eye movement recordings, the head was held stationary by
lightly padded braces and Velcro straps attached to the chair. By 6 mo
of age, the skull sutures were fused, and the skull was thick enough to
accept a light-weight, removable aluminum halo, of the type used on
human beings, to fix the head to the chair. The halos were removed
every 2 wk for at least 1 wk to prevent infection and skull erosion. By
6 mo of age, the monkeys stayed alert in the chair for 1-2 h and were easily trained to fixate and follow a small target light rear-projected onto a tangent screen located 75 cm in front of the animal. The animal's performance was reinforced with a sweetened liquid.
Spontaneous eye movements, OKN, and VOR were measured at 90, 180, and
365 days of age.
SPONTANEOUS EYE MOVEMENTS. These were measured while the monkey viewed a stationary OKN drum or a Ganzfeld (1/2 of a clean Ping-Pong ball placed over the eye).
FIXATION. Fixation was measured while the monkey viewed a 0.5° target light that was located in the primary and eccentric positions of gaze. The target light was always surrounded by a full-field grating background. In addition, fixation was measured while the monkey viewed a blinking 0.5° target light (0.5 Hz, duration 50 ms) in an otherwise dark room. This test was done to avoid visual stabilization by retinal-slip mediated tracking eye movements.
VOR. The VOR was generated by rotating the monkey chair and the magnetic field coils en bloc at a constant velocity (60°/s and 240°/s) in the dark. Four trials were done to the left and four to the right at each speed. Velocity of the chair was measured by a tachometer. The VOR gain (eye velocity/chair velocity) for each trial was measured as the average of three consecutive peak slow-phase eye velocities, once maximum chair speed was obtained. The VOR time constant was measured as the time taken for the slow-phase eye velocity (SPEV) to decrease to one-third of its peak value.
OKN. OKN was generated by rotating a full-field drum around the animal. The drum contained a random pattern of black circles each subtending a visual angle of 8-16° on a white background. Optokinetic response gain (SPEV/drum velocity) under both monocular and binocular viewing conditions was measured. The drum moved at a constant velocity ranging from 5 to 180°/s for 60 s or until eye velocity reached a steady-state value based on a chart-recorder printout. OKN gain was measured during its initial rapid rise in slow-phase velocity (peak SPEV during the 1st second the light was turned on), and during steady state (the average velocity of the last 5 slow phases before the light was turned off). The initial value OKAN (optokinetic after nystagmus) was also examined (the average velocity of the 1st 3 slow phases beginning 1 s after the light was turned off).
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RESULTS |
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Ocular examination
Table 1 summarizes the ocular findings for the three rhesus monkeys that had binocular eyelid suture (BD) for the first 25, 40, and 55 days of life and the six controls. Visual acuity was measured in cycles per degree and was displayed in both LogMAR (Log10 [1/decimal]) and its snellen equivalent. Visual acuity was measured with both eyes open. Visual acuity was better at 12 mo compared with 6 mo of age in each animal, but less than normal controls. The visual acuity for the animal with the longest deprivation was not as good as that of the animal with the shortest deprivation. The 25-day monkey had an esotropia of 10 prism diopters when the eyelids were opened, but it resolved 35 days later (2 mo of age). The 40- and 55-day monkeys developed a persistent exotropia. The 55-day animal also developed a persistent hyperopia in both eyes. The refractions of each eye of the controls were combined.
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LN
GENERAL PROPERTIES.
All animals had a jerk nystagmus, which persisted through the duration
of the study (Fig. 1). When the right eye
was covered there was a conjugate, left-beating nystagmus. The term
left beating is used here based on the direction of the quick phases of
the nystagmus. When the left eye was covered, there was a right-beating nystagmus. When both eyes were open, all animals had a
low-amplitude, horizontal nystagmus. This combination of a
low-amplitude horizontal nystagmus with both eyes viewing, and a
strong horizontal nystagmus when only one eye was viewing (with slow
phases always toward the nose in the viewing eye) resembles "manifest
latent nystagmus" found in some human subjects (Dell'Osso et
al. 1979
). We will to refer to this as latent nystagmus (LN)
throughout the paper. LN was not seen at birth in any of the animals,
but LN was noted as soon as the eyes were opened after binocular
deprivation.
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SENSORY CONDITIONS THAT INITIATE AND MAINTAIN LN. The stimulus that initiates LN does not appear to depend on retinal slip information in the viewing eye as the nystagmus could occur even when the monkeys viewed a Ganzfeld. Figure 3A shows the mean and 1 SD of SPEV recorded approximately every 10 s in the 55-day monkey when this animal viewed a stationary OKN drum (A) and a Ganzfeld (B). The average of the last five data points before the patch was moved to the other eye was determined for each condition (plateau). There was no significant difference (P > 0.01, t-test) between conditions A and B. The plateau velocity of LN partly depends on the luminance of the Ganzfeld stimulus (Fig. 4). As luminance was increased, velocity of LN increased until eye velocity saturated at ~110°/s.
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ADAPTATION OF LN. The maximum velocity of LN decreased in the viewing eye if the animal wore a patch over the other eye continuously for at least 1 day. Figure 5 shows the mean and 1 SD of SPEV in the 55-day monkey during monocular viewing before and after 1 and 3 days of continuous occlusion of the left eye. Before occlusion, SPEV reached a plateau of 172°/s when the left eye was covered and 31°/s when the right eye was covered (Fig. 5A). The plateau was defined when there was no significant change in SPEV over a period of 10 s or more. After 1 day of occlusion of the left eye, SPEV was 94°/s when the left eye was covered and 110°/s when the right eye was covered, both of which represented significant changes from baseline (P < 0.001, t-test). After 3 days of occlusion (C), SPEV decreased further when the left was covered and increased when the right eye was covered compared with condition B (P < 0.001, t-test). In summary, a velocity bias of approximately 100°/s to the right developed when the left eye had been continuously occluded. Before occlusion, this animal fixated primarily from the left eye, which explains why SPEV was initially lowest when the right eye was covered during testing of LN. Thus the maximum SPEV of the habitually viewing eye decreases over the course of several days.
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Other forms of nystagmus
GAZE-EVOKED NYSTAGMUS. All monkeys had a conjugate, horizontal gaze-evoked nystagmus, which was quantified by having the animals fixate a blinking target (0.5 Hz, duration 50 ms) in a dark room to avoid reduction of the nystagmus from visual-tracking mechanisms. When the 25-day animal fixated targets to the left, slow phases of nystagmus moved the eyes back toward the right (Fig. 6A). This testing was performed during binocular viewing to evaluate gaze-evoked nystagmus without LN. Similarly, when the animal fixated targets to the right, slow phases of nystagmus were directed to the left. The SPEV decreased during each single slow phase as the fixation target was positioned closer to the center of gaze. Figure 6B shows the eye velocity of each slow phase while the animal fixated a small target located at different eccentricities. The estimates of SPEV decreased exponentially with decreases in the eccentricity of the fixation target. To determine the time constant (Tc) of the gaze-holding integrator, we fitted an exponential curve through the data. The Tc for the gaze-holding integrator in this animal was 15 s. A similar analysis in the 40-day animal revealed a Tc of 12 s. Eye velocity was frequently not symmetric across the midline due to a small amount of spontaneous nystagmus in primary gaze. Vertical gaze-evoked nystagmus was not present in any of the animals while they fixated targets that moved vertically. The waveform of the slow phases of LN was velocity decreasing in the 25- and 40-day animals, and SPEV varied with orbital eye position (Fig. 6C). Gaze-evoked nystagmus was not observed at birth and was observed immediately after the eyelids were opened, but it was not quantified in a dark room at these times.
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VELOCITY-INCREASING JERK NYSTAGMUS. In contrast to both the 25- and 40-day animals, the eye velocity of the 55-day animal had velocity-increasing slow phases in eccentric gaze. This was most apparent in the light when the animal fixated a small target light (arrows in Fig. 7). This animal also had a spontaneous left-beating nystagmus in the dark, which primarily had linear or velocity-increasing slow phases.
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PENDULAR NYSTAGMUS. All monkeys had a low-amplitude, conjugate pendular nystagmus. This is illustrated in Fig. 7 (horizontal bars) for the 55-day monkey and Fig. 8 for the 25-day monkey. The peak-to-peak amplitude was 0.5-2.0°, and the frequency was 7-10 Hz. Pendular nystagmus was not readily apparent when the eyelids were first opened, but did become apparent by age 1 yr.
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VOR
All monkeys had mildly reduced VOR gains but normal time constants for 60 and 240°/s constant-velocity chair rotations compared with six normal monkeys tested at 1 yr of age (Table 2). The gain was measured as the average of the three consecutive peak slow-phase eye velocities once chair velocity reached peak velocity.
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OKN
A robust OKN response was elicited in all three animals when both eyes were viewing, but the response was severely impaired in the N-T direction during monocular viewing. The rapid rise, steady-state OKN and OKAN for the 25-day monkey is plotted in Fig. 9. For both eyes viewing there was a good response to constant velocity steps (Fig. 9A). During monocular viewing, OKN was reduced in the N-T direction, especially for OKAN (Fig. 9, C and D). Table 3 compares the OKN responses in both the 25- and 55-day monkeys to six normal controls tested at 1 yr of age. For the 25-day monkey, steady-state OKN was slightly reduced in the N-T direction, and OKAN was significantly reduced in the N-T direction compared with controls. It is likely that the LN present during monocular viewing contributed to this reduced response in the N-T direction. The OKN response for the 55-day monkey was more severely impaired (Table 3). For both eyes viewing, steady-state OKN and OKAN was reduced at high target velocities. During monocular viewing, OKN was severely impaired for all drum velocities in the N-T direction for all three components of OKN. In the T-N direction, OKN was impaired for high drum velocities.
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When OKN is tested to constant velocity steps, a high retinal-slip velocity is delivered. To determine whether the reduced OKN response of the 55-day monkey to N-T velocity steps was due to an impairment in the processing of high retinal-slip velocities, we measured steady-state OKN to a stimulus that started out at a velocity slightly greater than the animal's LN velocity and then decremented in 5°/s steps at 15-s intervals (Fig. 10). The mean and 1 SD of SPEV of LN every 50 s is plotted during right eye view (A) and left eye view (B). The staircase line represents the velocity of the OKN drum. There was small trend in SPEV in response to the stimulus (eye velocity = 0.07 times target velocity in A and 0.06 times target velocity in B), but there was no significant change in SPEV (t > 0.01, Pearson correlation). This helped confirm that there was no significant monocular OKN response in the N-T direction in the 55-day monkey.
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DISCUSSION |
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Images are stabilized on the retina by several gaze-stabilizing
systems, including the VOR, OKN, and fixation (Leigh et al. 1988
). Table 4 summarizes our
findings on gaze-stabilizing systems and fixation instability in the BD
monkeys tested at 12 mo of age. The most significant defect was the
impaired monocular OKN response in the N-T direction and the presence
of nystagmus.
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OKN
In human infants, OKN is depressed in the N-T direction compared
with the T-N direction during monocular viewing at birth and becomes
symmetric by 6 mo of age (Naegele and Held 1982
). If
normal visual development is disrupted by unequal visual inputs from
the two eyes due to strabismus, anisometropia, or a congenital cataract
in one eye, then monocular OKN asymmetry persists (Maurer et al.
1983
; Schor and Levi 1980
; Shawkat et al.
1995
; Westall and Schor 1985
). This monocular
OKN asymmetry has also been found in monkeys following 14 days of
monocular eyelid suture starting at 7-14 days of age (Sparks et
al. 1986
). Our study has extended these findings. We have
examined both the rapid rise and the velocity storage components of OKN
(OKAN). Our results suggest that the velocity-storage component of OKN
in the N-T direction is the component most impaired by binocular
deprivation in monkeys. When the duration of deprivation increases, the
rapid rise component of OKN is also impaired in the N-T direction and
eventually, OKN deficits may start to occur in the T-N direction at
high target velocities, as was found in the 55-day monkey. It is likely
that the reduced OKN in the N-T direction is partially due to the
presence of LN. We chose not to subtract the LN from OKN, as these
visual tracking systems may be nonlinear. Our testing using a moving OKN drum that changed speeds in small steps indicates that these deficits in OKN were not simply due to an inability to process high
retinal-slip velocities, but represented a true deficit in generating
an OKN response.
A schematic diagram illustrating the possible basis for a
decreased monocular OKAN response in the nasal-to-temporal direction is
shown in Fig. 11. Neural activation of
the nucleus of the optic tract (NOT) evokes ipsiversive eye movements
(dashed lines above NOT) (Mustari and Fuchs 1990
;
Schiff et al. 1988
). NOT neurons are activated by
ipsilaterally directed retinal slip. Normally, NOT receives inputs
directly from the contralateral eye (T-N motion) and indirectly (via
cerebral cortex) from the ipsilateral eye (Mustari and Fuchs
1990
). In the BD monkey, NOT loses its input from the
ipsilateral eye (cortical input) and responds only to T-N motion viewed
from the contralateral eye. Consequently, the BD monkey cannot generate
OKN to N-T stimuli during monocular viewing. This loss of visual input
to NOT from the ipsilateral eye may be due to a defect in any number of
sites indicated by the "X" marks.
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VOR gain
Human infants have VOR gains similar to adults (Ornitz et
al. 1985
; Weissman et al. 1989
). In contrast,
VOR velocity storage is poorly developed at birth, although it improves
rapidly over the course of 2 mo and then slowly reaches adult values
over the course of 2 yr (Ornitz et al. 1985
;
Weissman et al. 1989
). In cats reared for 1 yr in the
dark, VOR gain is reduced, and the VOR velocity-storage is poor
(Cynader 1985
; Harris and Cynader 1981
).
These deficits endure despite subsequent exposure to a normal visual
environment. VOR gain has not been previously examined in visually
deprived monkeys. In our study, 25-55 days of binocular derivation
beginning at birth resulted in a small decrease in VOR gain and no
change in the velocity storage system compared with normally reared
monkeys. These results suggest that the vestibular system still
received adequate retinal-slip information to be maintained and
calibrated in these animals despite the presence of the monocular OKN deficits.
Nystagmus
CRITICAL PERIOD.
Based on our study along with others, it appears that
deprivation-induced nystagmus in monkeys only occurs if deprivation is
initiated during the first few weeks of life. Furthermore, nystagmus
may persist even with as little as 25 days of deprivation. Nystagmus
resembling LN occurs in monkey following artificial induction of
esotropia within the first 2 wk of life (Kiorpes et al.
1996
), and nystagmus resembling congenital nystagmus occurs following monocular lid suture initiated within 1 day of life as long
as the fellow eye is suture closed within 3 wk (Tusa et al.
1991
). Spontaneous nystagmus has not been reported in monkeys reared with monocular or bilateral eyelid suture starting 30 days or
later after birth for up to 4-18 mo of deprivation (Crawford et
al. 1993
; Harwerth et al. 1991
).
CHARACTERISTICS OF LN IN BD MONKEYS.
Certain features of LN in monkeys are similar to LN in human
subjects. First is the presence of horizontal nystagmus elicited by
closing one eye whose direction depends on which eye is closed (slow
phases are directed toward the closed eye). Second, the maximum
velocity of LN decreases in the viewing eye if the animal wears a patch
over the other eye continuously for a few days, similar to that
reported by patients with LN (Simonsz 1989
). This reduction of SPEV by patching one eye continuously appears to be due to
the development of a constant velocity bias whose slow phases are
directed toward the habitually viewing eye. The direction of this bias
can be reversed after patching the eye for 1 day. Remarkably, this
reduction in SPEV occurred even in the 55-day monkey, which suggests
that this animal can still decrease SPEV of LN even without any
monocular OKN in the N-T direction. Thus this type of adaptation may
not rely solely on retinal-slip in the viewing eye.
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ACKNOWLEDGMENTS |
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We are grateful for the technical assistance of J. R. Economides.
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FOOTNOTES |
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Address for reprint requests: R. J. Tusa, Yerkes Research Center, 954 Gatewood Rd. NE, Emory University, Atlanta, GA 30322 (E-mail: rtusa{at}rmy.emory.edu).
Received 3 November 2000; accepted in final form 10 April 2001.
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REFERENCES |
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