Visual Field Expansion Through Innovative Multi-periscopic Prism Design

通过创新的多潜望棱镜设计扩展视野

• 批准号: 10334699
• 负责人: ELI PELI
• 金额: $ 8.3万
• 依托单位: SCHEPENS EYE RESEARCH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-09-30 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10334699
• 关键词: 3D Print; Area; Automobile Driving; Brain Injuries; Choroideremia; Clinic; Clinical Trials; Color; Computers; Detection; Devices; Eye; Eyeglasses; Glaucoma; Homonymous Hemianopia; Image; Individual; Island; Judgment; Lateral; Measures; Multi-Institutional Clinical Trial; Optics; Outcome Measure; Patient Preferences; Patients; Pentas; Performance; Peripheral; Positioning Attribute; Quality of life; Randomized; Reaction Time; Reporting; Residual state; Retinal Diseases; Retinitis Pigmentosa; Risk; Scanning; Side; Stroke; System; Techniques; Testing; Time; Trauma; Visual; Visual Aid; Visual Fields; Walking; base; blind; clinical research site; cost effective; design; detection test; effectiveness testing; efficacy study; expectation; falls; feasibility testing; hazard; improved; innovation; novel; parent grant; preference; primary outcome; prototype; secondary outcome; success; tumor; virtual reality

Parent Grant Abstract Individuals with visual field loss report collisions with other pedestrians or objects, tripping over obstacles, and are commonly not permitted to drive. All of these factors severely restrict their independence and quality of life. Visual field loss is common following brain injuries such as stroke, trauma, or tumors (hemianopic field loss, HFL) or it may be due to retinal diseases such as retinitis pigmentosa, choroideremia, and advanced glaucoma (peripheral field loss, PFL). Most visual aids developed for field expansion have had limited success. Prisms designed to shift portions of a scene from the blind field to the residual seeing field are the simplest, lightest, and most cost-effective devices for visual field loss patients. These prism devices create artificial visual islands that can help PFL and HFL patients detect and avoid collision risks. A pedestrian on a collision course will stay at a fixed position in the visual field of the patient. Our recent analysis found that the risk of a collision with other pedestrians is highest when the oncoming pedestrian approaches from an angle of 45. Conventional prism devices can shift images up to 30° but do not reach this area of peak collision risk. Further, the shifted images are distorted spatially (minified) and in color and have low contrast. When patients scan (look) toward the blind side the effective expansion benefit is limited to only 5° by current prism designs. Thus, the actual field expansion benefit of current devices falls below the best possible theoretical expectation. To overcome these limitations, we invented a new optical device, the “multi-periscopic prism (MPP)”, which uses cascaded half-penta prisms (typically used in binoculars). Whereas conventional prisms use refraction, the MPP uses two reflections, resulting in a 45° image shift (improvement of 50% over current prisms) without the refraction effects of minification, color distortion, or contrast reduction. The MPP covers the peak collision risk eccentricity and permits 15° of effective eye scanning into the blind side (3 times wider than current prisms). We developed prototypes and preliminary configurations of this novel device to enable field expansion in HFL and PFL patients. This field expansion is intended to facilitate detection of pedestrian collisions when walking, or hazards at intersections when driving (HFL). We have proposed configurations of the device for PFL patients to allow for downward eye scanning and detection of tripping hazards. Here we propose to iteratively implement additional refinements, fine-tune, and test the effectiveness of the MPP as an aid for patients with HFL or PFL. This will begin with feasibility tests in the lab and culminate in a randomized controlled multicenter clinical trial. We will compare patients’ pedestrian collision detection performance with the novel MPP devices and current prism devices and evaluate their device preferences. In the multicenter clinical trial, we will use an innovative virtual reality pedestrian collision detection test system that can be easily implemented at clinics using standard computers and large screen TVs. We will also conduct a lab test during the multi-center clinical trial to further study the efficacy of the MPP in HFL driving.

家长补助金摘要 视野丧失的人报告与其他行人或物体碰撞，绊倒障碍物， 一般不允许开车。所有这些因素都严重限制了他们的独立性和生活质量。 视野丧失在脑损伤如中风、创伤或肿瘤后是常见的（偏盲视野丧失， HFL）或可能是由于视网膜色素变性、无脉络膜和晚期青光眼等视网膜疾病所致 （外围场损失，PFL）。大多数为扩大视野而开发的视觉辅助工具都取得了有限的成功。棱镜 被设计成将场景的部分从盲场移动到剩余视场的是最简单、最轻并且 最具成本效益的设备，为视野丧失的病人。这些棱镜装置创造了人工视觉岛， 可以帮助PFL和HFL患者检测和避免碰撞风险。一个行人在碰撞过程中将停留在一个 在患者视野中的固定位置。我们最近的分析发现， 当迎面而来的行人从45 °角接近时，行人的反射率最高。常规棱镜 设备可以将图像偏移高达30°，但无法达到碰撞风险最高的区域。此外，移位的图像 在空间上（缩小）和颜色上失真，并且具有低对比度。当病人看向盲人时， 另一方面，通过当前的棱镜设计，有效的扩展益处仅限于5°。因此，实际的场扩展 当前装置的益处福尔斯低于最佳可能的理论预期。为了克服这些局限性， 我们发明了一种新的光学器件，“多潜望镜棱镜（MPP）"，它使用级联的半五棱镜 （通常用于双筒望远镜）。传统棱镜使用折射，而MPP使用两次反射， 导致45°的像移（比当前棱镜提高50%），而没有折射效应， 缩小、色彩失真或对比度降低。MPP涵盖碰撞风险峰值偏心率， 允许15°的有效眼睛扫描到盲侧（比当前棱镜宽3倍）。我们开发 该新型装置的原型和初步配置，以使HFL和PFL患者的场扩展成为可能。 此字段扩展旨在促进检测步行时的行人碰撞，或 驾驶时的交叉路口（HFL）。我们为PFL患者提出了器械配置， 向下的眼睛扫描和绊倒危险的检测。在这里，我们建议迭代地实现额外的 改进、微调和测试MPP作为HFL或PFL患者辅助手段的有效性。这将 开始于实验室的可行性测试，并以随机对照多中心临床试验为高潮。我们将 比较患者的行人碰撞检测性能与新型MPP设备和当前棱镜 设备并评估其设备偏好。在多中心临床试验中，我们将使用一种创新的虚拟 现实行人碰撞检测测试系统，可以很容易地实现在诊所使用标准 电脑和大屏幕电视。我们还将在多中心临床试验期间进行实验室测试，以进一步 研究MPP在HFL驾驶中的功效。