Novel perimetry for identifying changes in visual field sensitivity in glaucoma

用于识别青光眼视野敏感性变化的新型视野检查

• 批准号: MR/V038516/1
• 负责人: Tony Redmond
• 金额: $ 189.69万
• 依托单位: CARDIFF UNIVERSITY
• 依托单位国家: 英国
• 项目类别: Research Grant
• 财政年份: 2021
• 资助国家: 英国
• 起止时间: 2021 至 无数据
• 项目状态: 未结题
• 来源: https://gtr.ukri.org/projects?ref=MR%2FV038516%2F1
• 关键词: Novel; perimetry; identifying; changes; visual

Glaucoma, a chronic, progressive, age-related degeneration of retinal ganglion cells, is characterised by a slow, irreversible loss of visual field. It is the world's leading cause of irreversible blindness, affecting approximately 500,000 people in England and Wales, and 80 million people worldwide. With an ageing population, prevalence of glaucoma is rising. The peripheral visual field is slowly lost first, often going unnoticed by patients until advanced. Perimetry, the clinical method for identifying visual field loss involves presenting stimuli (spots of light) to the retina and determining the dimmest that can be detected at multiple locations in the field. However, the current standard perimetry test was designed >40 years ago, before the disease mechanisms in glaucoma were understood. A test design that was largely imported from the predecessor of the current standard (Goldmann kinetic perimetry) when tests became more automated, and high associated measurement variability, make it difficult to identify glaucomatous loss in the first instance and detect signs of progression. In fact, it can take many years of repeated measures to identify even moderate rates of deterioration. There is a timely need to redesign perimetry with 40 years of knowledge and understanding from basic science (physiological, psychophysical) and clinical studies, as well as with more accessible and affordable technology, in order to increase accessibility to testing, detect visual loss sooner, treat sooner, and improve prognosis for vision. In this multi-disciplinary, multi-site project, we will initiate the path to translation of a novel, more evidence-based form of perimetry from the laboratory to the clinical setting on the basis of two recently discovered functional biomarkers for glaucoma. We propose a stage 1 programme of research in which we will optimise various test parameters to maximise the accuracy, precision, and efficiency of the novel test for identification of glaucomatous visual field loss.

青光眼是一种慢性、进行性、与年龄相关的视网膜神经节细胞变性，其特征是视野缓慢、不可逆的丧失。它是世界上导致不可逆转失明的主要原因，影响着英格兰和威尔士约 50 万人，以及全世界 8000 万人。随着人口老龄化，青光眼的患病率不断上升。周边视野首先慢慢丧失，通常直到晚期才被患者注意到。视野检查是一种识别视野丧失的临床方法，涉及向视网膜提供刺激（光点）并确定视野中多个位置可检测到的最暗程度。然而，当前的标准视野检查是 40 多年前设计的，当时青光眼的疾病机制还没有被了解。当测试变得更加自动化时，测试设计很大程度上是从当前标准的前身（戈德曼动态视野检查）引入的，并且相关的测量变异性很高，使得很难在第一时间识别青光眼损失并检测进展迹象。事实上，即使是中等程度的恶化速度也可能需要多年的重复测量才能确定。迫切需要利用 40 年来基础科学（生理学、心理物理学）和临床研究的知识和理解，以及更容易获得和负担得起的技术来重新设计视野检查，以提高检测的可及性，更快地发现视力丧失，更快地治疗，并改善视力预后。在这个多学科、多地点的项目中，我们将基于最近发现的两种青光眼功能性生物标志物，启动将一种新颖的、更循证的视野检查形式从实验室转化为临床环境的道路。我们提出了第一阶段的研究计划，其中我们将优化各种测试参数，以最大限度地提高识别青光眼视野缺损的新颖测试的准确性、精确度和效率。