Peripheral optical and neural contributions to myopia development

摘要 近视是世界范围内视力损害的主要原因之一， 与几种严重的可导致永久失明的眼病有关。近视患病率 一直在增加，估计到2050年将影响世界50%的人口。尽管身份 近视进展的许多危险因素，如发病年龄，遗传，视觉环境和周边 离焦，近视的原因还没有完全了解。目前的干预措施取得了一些成功，但 没有明确解释其作用机制。因此，研究其机制至关重要 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，并延迟或最终完全预防发作。我们的长期目标是了解 周边光学和神经因素对近视发生影响其具体目标是 一项研究的目的是检验中心假设，即人类周边视觉系统中的光学和神经各向异性 系统在轴向伸长中起重要作用。为了实现这些目标，我们将制定和实施 创新的光学工具，包括一个紧凑的扫描眼波前传感器，一个开放的视图扫描 自适应光学视觉模拟器和个性化定制的隐形眼镜。目标1旨在描述 不同的像差轮廓如何影响离焦视网膜图像质量和神经功能。第一、 通过测量视网膜偏心率的低阶和高阶眼像差将表征个体 视网膜图像质量和模糊方向。然后将评估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器件绕过眼睛光学器件的同时管理心理物理任务， 视觉模拟器目标2将集中于确定固有周边像差轮廓和眼睛形状 随着时间的推移，在学校的孩子。为此，我们将开发一种紧凑的便携式扫描波前传感器 它可以被运送到诊所并用于测量学龄儿童光学的纵向变化 与视网膜偏心率有关这将使我们能够描绘外周血中的变化之间的关系， 在近视发展的关键阶段，在那些发展近视的儿童中，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 周边视网膜的方向神经敏感性。为了实现这一目标，视网膜反应的条款， 在脉络膜层厚度（短期）和神经敏感性（长期）的变化将在 在周边视网膜暴露于特定的模糊取向之后。

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.