Peripheral optical and neural contributions to myopia development

摘要 近视(近视)是世界范围内导致视力损害的主要原因之一，严重近视 与几种可能导致永久性失明的严重眼病有关。近视的流行程度 一直在增加，估计到2050年将影响到世界50%的人口。尽管有身份证明 近视进展的许多危险因素，如发病年龄、遗传、视觉环境和外周 散焦、近视的原因尚不完全清楚。目前的干预措施取得了一些成功，但 对它们的作用机制没有明确的解释。因此，研究这些机制是至关重要的。 潜在的近视发展，以便设计有效的干预措施来控制近视的进展 在儿童中，并延迟或最终完全防止发病。我们的长期目标是了解 外周光学和神经因素对近视发生的影响这样做的具体目标是 建议对人类周围视觉的光学和神经各向异性这一中心假设进行检验 系统在轴向伸长率中起重要作用。为了实现这些目标，我们将制定和实施 创新的光学工具，包括紧凑型扫描目镜波前传感器、开放式扫描 自适应光学视觉模拟器，以及个人定制的隐形眼镜。目标1旨在刻画 不同像差分布如何影响通过焦点的视网膜图像质量和神经功能。第一, 测量视网膜偏心的低阶和高阶像差将表征个体 视网膜图像质量和方向模糊。然后将评估在相同偏心率下的神经各向异性 通过在使用扫描自适应光学装置绕过眼睛光学装置的同时实施心理物理任务 视觉模拟器。目标2将专注于确定固有的外周像差特征和眼睛形状 学龄儿童随着时间的推移而发生变化。为此，我们将开发一种紧凑型便携式扫描波前传感器 可以运输到诊所并用于测量学龄儿童视力的纵向变化 穿过视网膜偏心处。这将使我们能够描述外围设备变化之间的关系 近视儿童近视发育关键阶段的像差。目标3是 建议进一步研究模糊方向在检测散焦和改变迹象中的作用 外周视网膜的定向神经敏感性。为了实现这一目标，视网膜反应在以下方面 脉络膜层厚度(短期)和神经敏感性(长期)的变化将在 在外围视网膜暴露于特定的模糊方向之后。

Abstract Myopia (nearsightedness) is one of the foremost causes of visual impairment worldwide, with severe myopia being linked to several serious eye diseases that can result in permanent blindness. The prevalence of myopia has been increasing and is estimated to affect 50% of the world’s population by 2050. Despite the identification of many risk factors for myopia progression such as age of onset, genetics, visual environment, and peripheral defocus, causes of myopia are not fully understood. Current interventions have shown some success, but without a clear explanation for their mechanism of action. It is therefore critical to investigate the mechanisms underlying myopia development in order to design effective interventions to control the progression of myopia in children, and to delay or ultimately prevent onset altogether. Our long-term goal is to understand the influence of peripheral optical and neural factors on myopia development. The specific objective of this proposal is to test the central hypothesis that optical and neural anisotropy in the human peripheral visual system plays an important role in axial elongation. To achieve these goals we will develop and implement innovative optical tools including a compact scanning ocular wavefront sensor, an open-view scanning adaptive optics vision simulator, and individually-customized contact lenses. Aim 1 is directed at characterizing how different aberration profiles impact through-focus retinal image quality and neural functions. First, measuring lower and higher order ocular aberrations across retinal eccentricity will characterize individual retinal image quality and blur orientations. Neural anisotropy at the same eccentricities will then be evaluated by administering psychophysical tasks while bypassing the ocular optics using a scanning adaptive optics vision simulator. Aim 2 will focus on determining how intrinsic peripheral aberration profiles and eye shape change over time in school children. To do this, we will develop a compact portable scanning wavefront sensor that can be transported to and used in a clinic for measuring longitudinal changes of school children’s optics across retinal eccentricity. This will allow us to delineate relationships between changes in peripheral aberrations at the crucial stages of myopia development, in those children who develop myopia. Aim 3 is proposed to further investigate a role of blur orientations in detecting the sign of defocus and altering directional neural sensitivity in the peripheral retina. To achieve this goal, the retinal response in term of changes in choroidal layer thickness (short-term) and neural sensitivity (long-term) will be examined during and after the peripheral retina is exposed to specific blur orientations.