Development of a Multi-sensory Rehabilitation Program for People with Ultra Low Vision

项目摘要 在低视力连续体中，术语超低视力（ULV）定义的视力足够好，可以发挥功能，但也 仅限于看到详细的形状，即使是视力表上50 cm处的最大字母（VA<20/1600或1.9 log MAR）。 目前约有100万美国人患有严重的视力障碍， 由于人口老龄化和视力恢复治疗（例如， 视网膜和皮质假体、干细胞疗法、基因疗法）， 超低压水平。事实上，到2050年，ULV患者的数量预计将翻一番。当前的视觉实践 ULV的康复基于感觉替代训练。然而，视觉输入是否可以增强功能 使用听觉和触觉输入的性能？在这项研究中，我们将评估活动的范围 可以用不同水平的ULV进行;对于这些活动中的哪一个，多感觉整合可以 增强功能表现;测试试点多感官康复计划;并开发和验证 基于多感觉整合的ULV康复计划。在培训阶段，我们将评估 使用虚拟现实的视觉表现（约翰霍普金斯大学的ULV实验室）;使用提示组合范例来评估 如果使用多感觉整合（华盛顿大学的VisCog实验室， 西雅图）;并设计和实施一个试点多感官康复计划（CRIR在蒙特利尔大学， 加拿大）。在独立阶段，我将扩大我的培训，以开发一个基于证据的多感官 将验证用于ULV人群的ULV康复计划。这项研究的结果 将对提高视觉能力和视觉，听觉和触觉的整合具有重要意义。 一个更适合ULV需求的计划将对ULV个人的生活质量产生重大影响。目前， 患有ULV的人没有得到可用的视力康复计划的良好服务，部分原因是 缺乏评估任何特定ULV个体视觉能力的工具。一般鼓励患有ULV的人 忽视他们剩余的视力，以加强他们的非视觉技能。他们中的许多人对此感到沮丧 和不必要的，成为幻灭，并避免进一步的康复训练。使用开发的方法 在这项研究中，我们将能够测量功能性视力，并验证视力康复计划的人， 用多感官的方法制造超低温这项研究将弥补在该领域的关键知识差距， 为ULV患者提供康复服务。

Project Summary On the low vision continuum, the term ultra-low vision (ULV) defines vision good enough to be functional, but too limited to see detailed shapes, even the largest letters on the eye chart at 50 cm (VA<20/1600 or 1.9 log MAR). Approximately 1 million Americans currently suffer from severe visual impairment, and the number of individuals with ULV is expected to grow, both due to an aging population and due to vision restoration treatments (e.g., retinal and cortical prosthesis, stem cell therapy, gene therapy) that restore vision from total blindness to the ULV level. Indeed, the number of patients with ULV is expected to double by 2050. The current practice of visual rehabilitation in ULV is based on sensory substitution training. However, can visual input enhance functional performance using inputs from auditory and tactile senses? In this study we will evaluate the range of activities that can be performed with different levels of ULV; for which of these activities multisensory integration can enhance functional performance; test a pilot multisensory rehabilitation program; and develop and validate a rehabilitation program for ULV based on multisensory integration. During the mentored phase, we will assess visual performance using virtual reality (ULV lab at Johns Hopkins); use cue combination paradigms to assess if there is enhancement of performance using multisensory integration (VisCog lab at University of Washington, Seattle); and design and conduct a pilot multisensory rehabilitation program (CRIR at Université de Montreal, Canada). During the independent phase, I will expand my training to develop an evidence-based multisensory rehabilitation program for ULV that will be validated for use in ULV population. The outcomes of this research will have important implications on improving visual ability and integration of visual, auditory and haptic senses. A program better suited to ULV needs will have a significant impact on ULV individuals' quality of life. Currently, individuals with ULV are not served well by the vision rehabilitation programs that are available, in part because of the lack of tools to assess visual ability in any given ULV individual. People with ULV are generally encouraged to ignore their remaining vision in order to strengthen their non-visual skills. Many of them find this frustrating and unnecessary, become disillusioned, and avoid further rehabilitation training. Using the methods developed in this study, we will be able to measure functional vision and validate a vision rehabilitation program for people with ULV built on a multisensory approach. This study will bridge a critical knowledge gap in the field of rehabilitation for people with ULV.