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The effect of hypercapnia on the sensitivity to flicker defined stimuli
  1. A M Shahidi1,
  2. C Hudson1,2,
  3. S R Patel1,
  4. J G Flanagan1,2
  1. 1Toronto Western Research Institute, University Health Network, Toronto, Ontario, Canada
  2. 2School of Optometry and Vision Science, University of Waterloo, Waterloo, Ontario, Canada
  1. Correspondence to Professor John G Flanagan, Department of Ophthalmology and Vision Sciences, University Health Network, Toronto Western Hospital, 399 Bathurst Street, Toronto, ON, Canada M5T 2S8; jgflanag{at}


Background/Aims To investigate the effect of increased CO2 levels on flicker defined stimuli.

Methods The sensitivity of two flicker defined tasks was measured in nine healthy, trained observers using the Flicker Defined Form (FDF) stimulus of the Heidelberg Edge Perimeter (HEP; Heidelberg Engineering) and Frequency Doubling Technology (FDT) stimulus of the Matrix perimeter (Carl Zeiss Meditec) during normoxia and 15% hypercapnia (end-tidal CO2 increased by 15% relative to baseline). HEP-FDF and Matrix-FDT sensitivities were analysed for the global field, superior and inferior hemifields and at specific matched eccentricities, using repeated measures analysis of variance. The main effect of hypercapnia on flicker sensitivity was analysed using regression models.

Results Higher flicker sensitivity outcomes with increasing CO2 values were found for HEP-FDF and Matrix-FDT with a statistically significant main effect for HEP-FDF global, superior and inferior hemifields (p<0.01 for all) as well as 6°, 18°, 12° and 24° eccentricities (p=0.03, 0.04, 0.01, 0.05, respectively). When comparing mean sensitivity values between normocapnia and hypercapnia conditions, no statistically significantly different results were found for HEP-FDF and Matrix-FDT (p>0.05).

Conclusions As CO2 levels were increased in healthy young individuals, there was an associated increase in visual sensitivity that was only significant for HEP-FDF stimuli, highlighting the different mechanisms involved in processing each of HEP-FDF and Matrix-FDT stimuli. Mean visual sensitivity outcomes were found to be similar for normocapnia and hypercapnia suggesting that a capability to compensate for a mild and stable increase in systemic CO2 levels may exist.

  • Physiology
  • Field of vision
  • Visual pathway

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