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.

父级赠款摘要 有视野丧失的人报告与其他行人或物体相撞，被障碍物绊倒，以及 通常是不允许开车的。所有这些因素都严重制约了他们的独立性和生活质量。 在中风、创伤或肿瘤等脑损伤后，视野丧失是常见的(偏盲视野丧失， HFL)，或者可能是由于视网膜疾病，如视网膜色素变性、脉络膜血症和晚期青光眼 (周边场损失，PFL)。为扩大油田规模而开发的大多数视觉教具收效甚微。棱镜 用于将场景的一部分从盲区转换到剩余视场的设计是最简单、最轻和 为视野丧失患者提供最具成本效益的设备。这些棱镜设备创造了人造视觉孤岛 可以帮助PFL和HFL患者检测和避免碰撞风险。在碰撞路线上的行人将停留在 患者视野内的固定位置。我们最近的分析发现，与其他人发生碰撞的风险 当迎面而来的行人以45度的角度靠近时，行人最多。常规棱镜 设备可以将图像移动高达30°，但不会达到碰撞风险最高的区域。此外，移位的图像 在空间上(缩小)和颜色上扭曲，对比度低。当病人扫视(看)盲人时 另一方面，根据目前的棱镜设计，有效的扩展效益仅限于5°。因此，实际的油田扩展 现有设备的效益低于可能达到的最佳理论预期。为了克服这些限制， 我们发明了一种新的光学器件--多透镜(MPP)，它使用级联的半五棱镜 (通常用于双筒望远镜)。传统的棱镜使用折射，而MPP使用两次反射， 导致45°图像移位(比当前棱镜提高50%)，而没有折射效果 缩小、颜色失真或对比度降低。MPP涵盖峰值碰撞风险偏心率和 允许15°有效的眼睛扫描进入盲侧(比当前棱镜宽3倍)。我们开发了 这种新型设备的原型和初步配置能够在HFL和PFL患者中实现视野扩展。 这一领域的扩展旨在促进检测步行时的行人碰撞，或在 驾驶时的交叉口(HFL)。我们已经为PFL患者提出了设备的配置，以允许 眼睛向下扫描和检测绊倒危险。在这里，我们建议迭代地实现其他 改进、微调和测试MPP作为HFL或PFL患者的辅助工具的有效性。这将是 首先在实验室进行可行性测试，最后进行随机对照的多中心临床试验。我们会 患者行人碰撞检测性能与新型MPP装置和现有棱镜的比较 并评估他们的设备首选项。在多中心临床试验中，我们将使用创新的虚拟 真实行人碰撞检测测试系统，可以很容易地在诊所实施使用标准 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驾驶中的有效性。