VISUAL FIELD EXPANSION THROUGH INNOVATIVE MULTIPLEXING PRISM DESIGN

描述（由申请人提供）：严重的外周视野丧失（PFL）有时被称为隧道视力，是视网膜色素变性和相关疾病以及青光眼的结果。目前还没有有效的视觉辅助工具来帮助这些严重影响行动能力的患者。视觉多路复用的新概念作为低视力设备的设计原则，为众多视场损失设备的开发提供了指导。移位空间多路复用与双目多路复用相结合，已被证明是治疗同义性偏视的有效方法。这种方法，被称为EP棱镜，使用单侧棱镜，并应用于外周视野，双重视力是很好的容忍，并已发展成为一种成功的光学治疗。在许多研究中，有一半或更多的患者长期佩戴和使用该设备，并报告其活动能力得到改善。对于PFL， Trifield棱镜眼镜，一种用于隧道视力（例如，由于RP）患者中心视觉混淆的双目多路复用设备，已被证明要困难得多。尽管没有可替代的辅助药物，尽管它对25%的患者有效，但它并没有在市场上取得进展。它的构造非常复杂，而且大多数患者发现它所施加的中心双重视觉令人不安。考虑到这两种方法的成功和局限性，严重PFL患者的主要需求，以及行走情况的动态，我们设计了一种新的视觉辅助，Quadrafield晶状体（创造人工外周视觉岛）。这是通过应用近外围场扩展来实现的，同时避免了先前设计的中心混乱和场权衡。我们还发明了一种新的光学元件，一种“多路棱镜”，可以应用于这个和其他设备。多路棱镜提供同时（单眼）叠加视图的移位和直接透视视野。保持透视视野可以治疗单眼患者。它还允许安装棱镜更接近中央视野，即使偶尔侵犯，由于头部运动，中央凹的视野不会完全被阻挡。此外，我们还找到了一种将常规的垂直头部摆动运动转换为通过棱镜的横向扫描的方法，实现了时间复用。在这里，我们建议实施、调整和测试多路棱镜作为PFL辅助工具的有效性，当在实验室研究中用于Quadrafield晶状体时，并最终在多中心随机对照临床试验中完成。

DESCRIPTION (provided by applicant): Severe peripheral field loss (PFL) sometimes called tunnel vision is a result of retinitis pigmentosa and related diseases as well as glaucoma. Currently there are no effective visual aids for these patients whose mobility is seriously affecte by this impairment. The novel concept of vision multiplexing as a design principle for low vision devices has provided guidance for the development of numerous devices for visual field losses. Spatial multiplexing by shifting, combined with biocular multiplexing, has been a proven effective aid for homonymous hemianopia. This approach, known as EP Prisms, uses unilateral prisms, and is applied to the peripheral field where double vision is well tolerated, and has evolved into a successful optical treatment. In numerous studies half or more of patients fitted with the EP prisms continue to wear and use the device over a long term and reported improved mobility. For PFL, Trifield prism spectacles, a biocular multiplexing device that applied central visual confusion to patients with tunnel vision (e. g., due to RP) has proven much more difficult. Despite there being no alternative aids available, and despite it being effective for 25% of patients, it has not made inroads in the marketplace. It is very complicated to construct and most patient find the central double vision it imposes disturbing. In considering the successful and limiting aspects of both approaches, the main requirements of patients with severe PFL, and the dynamic of a walking situation, we have designed a new visual aid, Quadrafield lens (creating artificial peripheral visual islands). This is achieved by applying near peripheral fiel expansion while avoiding the central confusion and fields tradeoffs of prior designs. We also invented a new optical element, a "multiplexing prism" that can be applied to this and other devices. Multiplexing prisms provide simultaneous (monocularly) superimposed views of the shifted and direct see-through fields of view. The maintenance of the see through view permits treatment of monocular patients. It also permits fitting the prisms closer to the central field, a even with occasional encroachment, due to head movements, foveal vision is not completely blocked. In addition we have found a way to convert the regular vertical head bobbing motion into a lateral scanning through the prisms, implementing temporal multiplexing. Here we propose to implement, tune, and test the effectiveness of the multiplexing prisms as an aid for PFL, when used in the Quadrafield lens in laboratory studies and culminating in a multicenter randomized control clinical trial.