Afferent and Efferent Visual Systems During Abnormal Vision Development

视觉发育异常期间的传入和传出视觉系统

• 批准号: 10318666
• 负责人: Tawna Roberts
• 金额: $ 59.56万
• 依托单位: STANFORD UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-04-01 至 2024-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10318666
• 关键词: Adult; Afferent Pathways; Age; Age-Months; Amblyopia; Birth; Blindness; Caring; Child; Childhood; Clinical; Clinical Research; Communication; Complex; Detection; Development; Diplopia; Early Intervention; Efferent Pathways; Elements; Esotropia; Evidence based treatment; Eye; Future; Goals; Hyperopia; Infant; Knowledge; Lazy Eyes; Learning; Longitudinal Studies; Measures; Methodology; Modeling; Outcome; Patient-Focused Outcomes; Phase; Preventive measure; Process; Refractive Errors; Retina; Risk; Role; Sensory; Signal Transduction; Stimulus; Strabismus; System; Targeted Research; Testing; Time; Training; Vision; Visual; Visual system structure; clinically significant; crosslink; design; emmetropization; experience; fundamental research; high risk; improved; improved outcome; individualized medicine; infant outcome; lens; neurophysiology; oculomotor; relating to nervous system; response; retinal imaging; treatment strategy; vision development; visual motor

PROJECT SUMMARY/ABSTRACT Approximately 3% percent of infants and children 6 to <72 months have strabismus or amblyopia. The development of amblyopia and strabismus are proposed to be the result of abnormal visual experience. Normal visual experience depends on both good retinal image quality and eye alignment, which require complex interactions between the afferent and efferent visual systems. Understanding these interactions are critical to both the development of preventive measures and the accumulation of evidence-based treatment strategies for strabismus and amblyopia. Hyperopic infants who do not emmetropize are at risk for developing strabismus and amblyopia with as little as 2D spherical equivalent (SE), and that risk increases exponentially with every added diopter of uncorrected hyperopia. Moreover, the infants who are less likely to emmetropize, are the ones who do not accommodate well to a near stimulus. Specific Aim 1: To test the hypothesis that there is a deficit in or immaturity of the afferent visual system that causes poor blur detection which subsequently results in a decreased efferent accommodative response. We will examine retinal blur detection in infants with typical refractive error and with moderate/high hyperopia longitudinally at 3- and 9-months of age. Specific Aim 2: To test the hypothesis that the tonic adaptive components of accommodation are the primary factors responsible for the manifestation of accommodative esotropia in young children with clinically significant hyperopia. We will measure the phasic response and tonic adaptive components of the adult oculomotor control model in children ages 2 to <6 years with moderate/high hyperopia, including some with accommodative esotropia prior to refractive error correction. Long term Goal: Provide pediatric vision care practitioners with the ability to identify: [a] which infants with hyperopia will emmetropize and which will not and [b] of the infants who do not emmetropize, which ones will go on to develop strabismus and amblyopia. Improved ability to identify infants at highest risk will lead to improved patient outcomes.

项目总结/摘要 大约3%的6至<72个月的婴儿和儿童患有斜视或弱视。的 弱视和斜视的发展被认为是异常视觉体验的结果。正常 视觉体验取决于良好的视网膜图像质量和眼睛对准，这需要复杂的 传入和传出视觉系统之间的相互作用。了解这些相互作用对于 制定预防措施和积累循证治疗策略， 斜视和弱视。没有正视的远视婴儿有发生斜视的风险， 弱视与2D球镜当量（SE）一样小，并且随着每增加一个， 未矫正远视屈光度此外，那些不太可能正视的婴儿， 不能很好地适应近距离的刺激。 具体目标1：检验传入视觉系统存在缺陷或不成熟的假设， 导致较差的模糊检测，这随后导致降低的传出反射响应。我们 将检查具有典型屈光不正和中度/高度远视的婴儿的视网膜模糊检测 在3个月和9个月大时纵向地。 具体目标2：检验调节的紧张性适应成分是主要的调节成分这一假设。 有临床意义的儿童矫正性内斜视的临床表现 远视我们将测量成人眼神经控制的阶段性反应和紧张性适应成分 2至<6岁中度/高度远视儿童的模型，包括一些屈光不正儿童 屈光不正矫正前的内斜视。 长期目标：为儿科视力保健从业者提供识别以下各项的能力：[a]哪些婴儿患有 远视眼会正视，哪些不会正视，[B]没有正视的婴儿中，哪些会正视 患上斜视和弱视。提高识别高危婴儿的能力将改善 患者结局。