Investigating Optical and Neural Causes of Vision Loss

研究视力丧失的光学和神经原因

• 批准号: 7888183
• 负责人: Mahnaz Shahidi
• 金额: --
• 依托单位: JESSE BROWN VA MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-01-01 至 2014-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7888183
• 关键词: Age; Age related macular degeneration; Age-Years; Aging; Area; Arthritis; Automobile Driving; Baby Booms; Blindness; Caring; Cell Density; Clinical; Coma; Coupled; Degenerative Disorder; Development; Disease; Elderly; Eye; Eye diseases; Eyeglasses; Face; Financial compensation; Fracture; Functional disorder; Goals; Growth; Heart Diseases; Image; Knowledge; Letters; Measurement; Measures; Mental Depression; Methods; Monitor; Optics; Outcome; Patient Education; Patients; Peripheral; Photoreceptors; Plant Roots; Play; Population; Prevalence; Process; Productivity; Psychophysics; Public Health; Quality of life; Reading; Rehabilitation therapy; Relative (related person); Research; Research Project Grants; Research Proposals; Retina; Retinal; Retinal Cone; Risk Factors; Role; Sampling; Speed; Staging; Stimulus; System; Techniques; Technology; Testing; United States; Veterans; Vision; Visual Acuity; Visual impairment; Visual system structure; Visually Impaired Persons; Width; abstracting; adaptive optics; base; daily functioning; density; experience; falls; fovea centralis; ganglion cell; improved; innovation; lens; new technology; novel; optical imaging; public health relevance; relating to nervous system; sample fixation; visual performance; visual stimulus

DESCRIPTION (provided by applicant): Project Summary / Abstract: Vision loss has become a major public health problem due to the growth and aging of the population. Age-related macular degeneration (AMD) is the most common cause of vision loss in people over 50 years of age. In the United States, over 10 million people have AMD and over 1.6 million people age 50 and older have late-stage advanced AMD. It is well established that AMD patients with central vision loss use preferred retinal loci (PRL) which are peripheral retinal areas adjacent to the fovea for performing daily activities, such as reading. However, even in healthy eyes, peripheral vision is limited due to reduced neural sampling density compared to the fovea. Additionally, the function of the peripheral retina can be further reduced in patients, owing to degenerative disease processes. These neural substrate losses are coupled with losses in the quality of the optical image on the retina. Optical imperfections increase with age and off-axis viewing, compared to viewing along the optical axis of the eye. The combination of these factors plays a significant role in reducing visual performance of patients with eccentric fixation. The long term goal of the project is to improve the visual performance of veterans with central vision loss by development of innovative approaches that will optimize the benefit of vision rehabilitation techniques. In the current proposal, optical and neural losses will be assessed in AMD patients with central vision loss using novel techniques. Increased optical losses due to age and viewing off the optical axis of the eye will be established with wavefront analysis technology. Increased neural losses due to retinal dysfunction at PRL will be determined based on measurement of visual acuity with blurred stimuli. Improvement in reading speed will be evaluated, conditional on neural losses at PRL and/or the stability of PRL, after compensating for optical losses with our adaptive optics system. The findings will provide knowledge of PRL function and stability that is beneficial for improving the outcome of available vision rehabilitation methods that train patients to better use their PRLs. Also, customized correction of optical imperfections of the eye for effectively improving visual performance can be developed as an approach for better vision rehabilitation of patients. Optimizing vision rehabilitation of our veterans will allow them to maintain function and productivity. PUBLIC HEALTH RELEVANCE: Project Narrative With the aging of the population, the prevalence of age-related macular degeneration (AMD) eye disease has resulted in a large number of people suffering from central vision loss. In fact, the most prevalent cause of blindness among veterans is AMD. Since the number of elderly veterans is expected to double in the next 10 years, loss of vision due to AMD is also expected to proportionally and considerably escalate. People with impaired vision have difficulty with daily activities, such as, reading, driving, and recognizing faces. The goal of the research project is to provide information on factors that contribute to visual impairment. This knowledge is necessary for the development of innovative approaches that will optimize the benefit of vision rehabilitation techniques, aimed at improving vision, thus allowing our veterans to maintain function and productivity. The findings from the proposed research will benefit our veterans and all aging people.

描述（由申请人提供）： 项目概要/摘要：由于人口增长和老龄化，视力丧失已成为一个重大的公共卫生问题。年龄相关性黄斑变性 (AMD) 是 50 岁以上人群视力丧失的最常见原因。在美国，超过 1000 万人患有 AMD，超过 160 万名 50 岁及以上的人患有晚期晚期 AMD。众所周知，中心视力丧失的 AMD 患者使用首选视网膜位点 (PRL)，即邻近中央凹的周边视网膜区域来进行日常活动，例如阅读。然而，即使在健康的眼睛中，由于与中央凹相比神经采样密度降低，周边视力也受到限制。此外，由于退行性疾病过程，患者周边视网膜的功能可能进一步降低。这些神经基质损失与视网膜上光学图像质量的损失相结合。与沿眼睛光轴观看相比，光学缺陷随着年龄和离轴观看而增加。这些因素的结合在降低偏心注视患者的视觉功能方面发挥着重要作用。该项目的长期目标是通过开发创新方法来改善中心视力丧失的退伍军人的视觉表现，从而优化视力康复技术的益处。在当前的提案中，将使用新技术评估患有中央视力丧失的 AMD 患者的光学和神经损失。通过波前分析技术可以确定由于年龄和偏离眼睛光轴观看而导致的光学损失增加。 PRL 时因视网膜功能障碍导致的神经损失增加将根据模糊刺激下的视敏度测量来确定。在使用我们的自适应光学系统补偿光学损失后，将根据 PRL 的神经损失和/或 PRL 的稳定性来评估读取速度的改进。研究结果将提供有关 PRL 功能和稳定性的知识，这有助于改善现有视力康复方法的结果，从而训练患者更好地使用其 PRL。此外，可以开发定制眼睛光学缺陷矫正以有效改善视觉表现，作为患者更好的视力康复的方法。优化退伍军人的视力康复将使他们能够保持功能和生产力。 公共卫生相关性： 项目叙述 随着人口老龄化，年龄相关性黄斑变性（AMD）眼病的流行导致大量人群中央视力丧失。事实上，退伍军人中最常见的失明原因是AMD。由于老年退伍军人的数量预计在未来 10 年内将增加一倍，因此 AMD 导致的视力丧失预计也会成比例且大幅增加。视力受损的人难以进行日常活动，例如阅读、驾驶和识别面孔。该研究项目的目标是提供有关导致视力障碍的因素的信息。这些知识对于开发创新方法是必要的，这些方法将优化视力康复技术的益处，旨在改善视力，从而使我们的退伍军人能够保持功能和生产力。拟议研究的结果将使我们的退伍军人和所有老年人受益。