Investigating Optical and Neural Causes of Vision Loss

描述(由申请人提供)： 项目摘要/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。老年性黄斑变性(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AMD。众所周知，有中心性视力丧失的AMD患者使用首选视网膜区域(PRL)进行日常活动，如阅读。PRL是邻近中心凹的周边视网膜区域。然而，即使是健康的眼睛，周边视力也是有限的，因为与中心凹相比，神经采样密度降低了。此外，由于退行性疾病的过程，患者的外周视网膜功能可能会进一步降低。这些神经底物的损失与视网膜上光学图像质量的损失相结合。与沿着眼睛的光轴观察相比，随着年龄的增长和离轴观察，光学缺陷增加。这些因素的结合在降低偏心注视患者的视觉表现方面起着重要作用。该项目的长期目标是通过开发创新的方法来优化视力康复技术的好处，以改善中央视力丧失的退伍军人的视觉表现。在目前的提案中，将使用新技术评估中心视力丧失的AMD患者的光学和神经损失。通过波前分析技术，可以确定由于年龄增长和眼睛偏离光轴观看而增加的光学损失。PRL因视网膜功能障碍而增加的神经损失将基于模糊刺激下的视力测量来确定。在使用我们的自适应光学系统补偿光学损失后，将评估读取速度的改善，条件是PRL处的神经损失和/或PRL的稳定性。这些发现将提供有关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，这些方法训练患者更好地使用他们的PRL。此外，定制矫正眼睛的光学缺陷，以有效地改善视觉表现，可以作为一种更好的患者视力康复的方法。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.