Coordination of Eye and Head Movements in Central Field Loss

中心场丢失时眼睛和头部运动的协调

• 批准号: 9360137
• 负责人: Natela M. Shanidze
• 金额: $ 9.31万
• 依托单位: SMITH-KETTLEWELL EYE RESEARCH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-09-30 至 2018-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9360137
• 关键词: Accidents; Address; Affect; Age; Age related macular degeneration; Animals; Behavior; Blindness; Calibration; Categories; Central Scotomas; Crowding; Dangerousness; Darkness; Dependence; Diagnostic Procedure; Dizziness; Elderly; Environment; Evolution; Eye; Eye Movements; Functional disorder; Future; Head; Head Movements; Image; Impairment; Incidence; Individual; Injury; Lead; Life Style; Mechanics; Mentors; Motion; Motion Perception; Movement; Ocular orbit; Outcome; Participant; Pathway interactions; Patient-Focused Outcomes; Patients; Performance; Phase; Planet Earth; Population; Positioning Attribute; Ramp; Reflex action; Research; Retina; Retinal; Rotation; Short Interspersed Nucleotide Elements; Smooth Pursuit; Source; Spottings; Stimulus; Sum; System; Testing; Therapeutic; Training; Translating; Translations; Vision; Visual; Visual Acuity; Visual Fields; Visual impairment; Visual system structure; Volition; Work; central visual field; disability; falls; fovea centralis; gaze; improved; interest; meter; oculomotor; oculomotor behavior; patient population; public health relevance; rehabilitation strategy; research clinical testing; response; sample fixation; senescence; vestibulo-ocular reflex; visual feedback; visual information; visual stimulus; visual-vestibular

ABSTRACT Age-related macular degeneration is the most common cause of vision loss in the central visual field, making central field loss (CFL) a major problem in the world today. Two-thirds of patients with CFL complain of vestibular problems, such as dizziness and instability, leading to a high incidence of potentially fatal accidents and falls. The problem is exacerbated by the patient population's advanced age, due to the documented decline in vestibular function in senescence. Vestibular deficits in CFL patients are likely due to miscalibrated or non-optimal stabilizing eye movements - many essential oculomotor behaviors are highly reliant on retinal input. Individuals with compromised vestibular responses have difficulties with visual field stability, navigation, and self- and external motion perception. These limitations are particularly true for CFL patients, whose visual acuity is already compromised and for whom the vestibular system becomes the predominant source of motion information. Furthermore, vestibular deficits likely affect patients' use of head movements to compensate for oculomotor limitations due to eccentric viewing and a patchy visual field. Despite the day-to-day importance of visual and vestibular interaction, these behaviors have not been comprehensively studied in CFL. This proposal seeks to address this gap. The first aim examines the contribution of head movements to smooth pursuit in CFL patients. This aim extends previous work quantifying smooth pursuit deficits in CFL to a more natural, head-unrestrained condition to determine if head movements are helpful or detrimental in CFL. Understanding the contribution of head movements can guide future rehabilitation strategies and clinical testing in this population. The second aim examines the effect of CFL on the angular vestibuloocular reflex (VOR). The reflex has little foveal dependence and is thus likely to be unaffected in CFL. However, foveal vision is known to contribute to both the calibration of this reflex and to its suppression when the head movement follows target motion. A deficit in any aspect of angular VOR will have consequences on the visual instability and vestibular discomfort of the affected individuals. Understanding these problems would inform necessary treatments in this population. The final aim examines the effects of CFL on translational VOR, a behavior that is completely fovea-dependent and is essential when body movement is present. Determining the degree of its impairment and exact influences of CFL is key to understanding vestibular dysfunction due to this visual deficit. VOR responses will be studied during passive and volitional, active motion. Previous research suggests fundamental differences in the processing of these two types of behavior, which indicates that they might be affected differently by central vision loss. If present, this dichotomy could have implications on how patients are advised and trained to interact with their environment while maintaining an active and productive lifestyle. Active behaviors (including head-free smooth pursuit) will be examined during the mentored portion of this project, while passive vestibular studies make up the bulk of the independent research.

摘要 视网膜相关性黄斑变性是中央视野视力丧失的最常见原因， 中心场损耗（CFL）是当今世界的一个主要问题。三分之二的CFL患者抱怨 前庭问题，如头晕和不稳定，导致潜在致命事故的发生率很高 然后福尔斯。由于记录在案的疾病， 衰老时前庭功能下降。CFL患者的前庭功能障碍可能是由于校准错误 或非最佳的稳定眼球运动-许多基本的眼科行为高度依赖于视网膜 输入.前庭反应受损的个体在视野稳定性，导航， 以及自我和外部运动感知。这些局限性对于CFL患者尤其如此， 敏锐度已经受损，并且对于前庭系统成为运动的主要来源的人， 信息.此外，前庭缺陷可能会影响患者使用头部运动来补偿 由于偏心观察和斑片状视野而导致的视力限制。尽管日常生活的重要性， 视觉和前庭的相互作用，这些行为还没有在CFL中进行全面的研究。 本提案旨在弥补这一差距。第一个目的是研究头部运动对平滑运动的贡献。 在CFL患者中进行追踪。这一目标扩展了以前的工作量化平稳追求赤字CFL到一个更 自然，头部不受约束的条件，以确定头部运动是有益的还是有害的CFL。 了解头部运动的贡献可以指导未来的康复策略和临床 在这个人群中测试。第二个目的是检查CFL对前庭眼角反射的影响 （VOR）。该反射几乎没有中央凹依赖性，因此在CFL中可能不受影响。然而，中央凹 已知视觉有助于这种反射的校准和当头部 运动跟随目标运动。角VOR的任何方面的缺陷都会对视觉产生影响。 不稳定和前庭不适的受影响的个人。了解这些问题将有助于 在这个人群中进行必要的治疗最后的目的是检查CFL对翻译VOR的影响， 完全依赖于中央凹的行为，当身体运动时是必不可少的。确定 其损害程度和CFL的确切影响是理解前庭功能障碍的关键， 视力缺陷VOR反应将在被动和意志，主动运动进行研究。以前的研究 表明这两种行为的处理方式存在根本差异，这表明它们 可能会受到中央视力丧失的不同影响。如果存在这种二分法， 建议并训练患者与环境互动，同时保持积极和富有成效的 生活方式主动行为（包括头部自由平稳追求）将在指导部分进行检查， 这个项目，而被动前庭研究弥补了大部分的独立研究。