Investigating Optical and Neural Causes of Vision Loss

描述（由申请人提供）： 项目概要/摘要：由于人口的增长和老龄化，视力丧失已成为一个主要的公共卫生问题。视网膜相关性黄斑变性（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160万50岁及以上的人患有晚期晚期AMD。已经确定，具有中心视力丧失的AMD患者使用优选的视网膜位点（PRL）进行日常活动，例如阅读，所述优选的视网膜位点是与中央凹相邻的周边视网膜区域。然而，即使在健康的眼睛中，由于与中央凹相比降低的神经采样密度，周边视觉也是有限的。此外，由于退行性疾病过程，患者外周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。与沿着眼睛的光轴沿着相比，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固视患者的视觉表现中起着重要作用。该项目的长期目标是通过开发创新方法来改善患有中心视力丧失的退伍军人的视觉表现，这些方法将优化视力康复技术的益处。在目前的建议中，光学和神经损失将评估AMD患者的中央视力损失使用新的技术。由于年龄和偏离眼睛光轴观看而增加的光学损失将通过波前分析技术来确定。PRL时由于视网膜功能障碍引起的神经损失增加将根据模糊刺激下的视敏度测量结果确定。阅读速度的提高将被评估，条件是PRL的神经损失和/或PRL的稳定性，在用我们的自适应光学系统补偿光学损失之后。这些发现将提供PRL功能和稳定性的知识，这有利于改善现有视力康复方法的结果，训练患者更好地使用他们的PRL。此外，可以开发用于有效改善视觉性能的眼睛的光学缺陷的定制矫正，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。

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.