VISUAL FUNCTION IN GLAUCOMA AND OCULAR HYPERTENSION

本申请描述了一项为期五年的前瞻性纵向研究， 青光眼的视觉功能，建立在该领域的先前工作基础上 在上一个补助期。 本研究将使用各种 视觉功能的心理物理测试，以确定性质和程度 与这种疾病相关的功能丧失。 具体目标1）使用 视觉功能变化的多元分析方法 与青光眼相关，并进一步描述这些 改变与之相关的潜在生理机制， 大细胞和小细胞途径。 2)在临床上发展 相关的，可靠的和可重复的多变量方法， 原发性开角型青光眼的诊断及其监测 进展 3)确定时间进程以及 可识别的视神经损伤和可测量的视觉功能丧失， 同一组正常人、疑似青光眼和青光眼患者， 一项为期五年的纵向研究将有助于确定 这些功能的变化。 4)要使用多元方法， 提高进行性青光眼诊断的精确度， 使用该范例前瞻性地随访青光眼疑似患者， 5年的纵向研究，以确定其发展的风险， 疾病 5)为了确定各种孤立的年龄相关的变化， 正常健康的眼睛的视觉功能，谁也将作为正常的 心理物理测试的控制 科目 该研究将包括100名年龄匹配的正常对照。 方法. 心理物理测试旨在分离各种视觉 功能协调发展的 其中许多学科已经有了五年的成果， 短波长自动视野检查和标准视野检查， 这一提案的总人口的子集将有九年或十年的时间， 数据与这些。 此外，高通分辨率视野检查，空间 对比敏感度、运动知觉和时间调制闪烁 将被评估。 这些试验的结果沿着临床测定的发展 和青光眼的进展将使我们能够解决每一个具体的 上述目标，并提高对视觉变化的理解 这些变化背后的相关机制。

This application describe a five year prospective longitudinal study of visual function in glaucoma, which builds upon prior work in this area during the previous grant period. This study will use a variety of psychophysical tests of visual function to determine the nature and extent of functional loss associated with this disease. Specific Aims 1) To use a multivariate approach for analysis of the functional changes in vision associated with glaucoma and to delineate further the relationship of these changes to the underlying physiological mechanisms associated with magnocellular and parvocellular pathways. 2) To develop clinically relevant, reliable and reproducible multivariate methods for early diagnosis of primary open angle glaucoma and for monitoring its progression. 3) To determine the time course of and relationship between recognizable optic nerve damage and measurable loss of visual functions on the same group of normal, glaucoma suspect, and glaucomatous individuals in a prospective five year longitudinal study will help to define the nature of these functional change. 4) To use the multivariate approach to increase the precision with which progressive glaucoma can be diagnosed and to use this paradigm to follow glaucoma suspect patients in a prospective 5 year longitudinal study to determine their risk for development of the disease. 5) To determine the age-related change for a variety of isolated visual functions in normal healthy eyes, who will also serve as normal controls for the psychophysical tests. Subjects. The study will include 100 age-matched normal controls. Methods. The psychophysical tests are designed to isolate various visual functions. Many of these subjects already have five years of results on short-wavelength automated perimetry and standard perimetry, so that a subset of this proposal's total population will have nine or ten years of data with these. In addition, High-pass Resolution Perimetry, Spatial Contrast Sensitivity, Motion Perception, and Temporal Modulation Flicker will be evaluated. The results of these test along with clinical determinations of development and progression of glaucoma will allow us to address each of the specific aims outlined above, and to improve understanding of the changes in visual function and associated mechanisms underlying those changes.