Interocular Suppression and Selective Attention in Amblyopia

弱视的眼间抑制和选择性注意

• 批准号: 9197292
• 负责人: Chuan Hou
• 金额: $ 41.14万
• 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: 2016-01-01 至 2020-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9197292
• 关键词: Adult; Affect; Alternative Therapies; Amblyopia; Area; Attention; Blindness; Brain; Child; Clinical Treatment; Confusion; Coupled; Data; Defect; Depth Perception; Development; Diplopia; Electroencephalography; Esotropia; Eye; Failure; Frequencies; Functional Magnetic Resonance Imaging; Image; Individual; Knowledge; Lazy Eyes; Learning; Light; Link; Measurement; Measures; Monocular Vision; Patients; Perceptual learning; Play; Population; Quality of life; Recurrence; Regimen; Residual state; Role; Schedule; Source; Stimulus; Strabismus; Testing; Training; Treatment outcome; Vision; Visual; Visual Acuity; Visual Cortex; Visual Psychophysics; Visual attention; attentional modulation; conventional therapy; design; functional disability; improved; neglect; novel; public health relevance; relating to nervous system; response; selective attention; source localization; success; treatment strategy

 DESCRIPTION (provided by applicant): Amblyopia (`lazy eye'), the loss of visual acuity in one eye that cannot be corrected by glasses, is the most common cause of monocular vision loss worldwide and affects 3-5% of population. In addition to the acuity loss, a high proportion of amblyopic patients lack binocular function and depth perception. The combined loss of acuity and depth perception has a significant impact on the quality of life in amblyopes. The standard clinical treatment is to patch the non-amblyopic fellow eye to promote the use of the amblyopic eye in children. Adults are usually not treated, because amblyopia has long been considered untreatable in adults. With occlusion therapy, the success rate ranges from 60% to 80% with 20-25% recurrence following treatment, leaving about one third of affected children with amblyopia that persists into adulthood. This project seeks to understand the failure of current treatment approaches and proposes alternative therapies for those amblyopic patients who do not respond well to the conventional regimen. We believe that visual suppression, the fundamental factor in amblyopic visual loss, is a great barrier to treatment. We propose that visual suppression in amblyopia may be a form of long-term attentional neglect and that learning to attend to the amblyopic eye may overcome this neglect and improve visual function in the amblyopic eye. To test this hypothesis, Aim 1 will examine cortical suppression in amblyopic individuals with and without residual binocular function, because these two groups of patients have different treatment outcomes. Non-binocular amblyopes are more difficult to treat and often regress following treatment. Aim 2 will measure both the strength and the latency of selective visual attention in individuals with amblyopia, and will correlate these results with the suppression measurements in Aim 1. Aim 3 will investigate whether manipulating attention in the amblyopic eye can modulate cortical suppression. Aim 4 will test the hypothesis that suppression can be alleviated and visual function will be improved by training the amblyopic eye with high attention-demand tasks. We will use both conventional perceptual learning tasks (low attention-demand tasks) and high attention-demand tasks to train individuals with amblyopia. We will track and evaluate visual function (acuity and stereopsis), depth of suppression, and attentional modulation during training by using visual psychophysics coupled to frequency-tagged source-localized EEG measurements. The knowledge gained from this study will contribute significantly to a broader understanding of the neural basis of visual suppression and the development of amblyopia. Our results will shed light on why amblyopic therapy often fails, and will indicate more efficient treatment strategies, especially for those who do not response well to conventional treatment.

 描述（由申请人提供）：弱视（“懒眼”）是一只眼睛视力丧失，无法通过眼镜矫正，是全球单眼视力丧失的最常见原因，影响3-5%的人口。除了视力丧失之外，很大比例的弱视患者缺乏双眼功能和深度知觉。视敏度和深度知觉的联合丧失对弱视患者的生活质量有显著影响。标准的临床治疗是将非弱视的对侧眼贴上眼罩，以促进儿童弱视眼的使用。成人通常不治疗，因为弱视长期以来一直被认为是无法治疗的成人。使用遮盖疗法，成功率为60%至80%，治疗后复发率为20-25%，约三分之一的受影响儿童患有弱视，并持续到成年。该项目旨在了解目前治疗方法的失败，并为那些对传统治疗方案反应不佳的弱视患者提出替代疗法。我们认为，视觉抑制是弱视视力丧失的基本因素，是治疗的一大障碍。我们认为弱视的视觉抑制可能是一种长期的注意力忽视，学习关注弱视眼可能会克服这种忽视，改善弱视眼的视觉功能。为了验证这一假设，目标1将检查有和没有残余双眼功能的弱视个体的皮质抑制，因为这两组患者具有不同的治疗结果。非双眼性弱视更难治疗，并且在治疗后经常会退化。目标2将测量弱视个体选择性视觉注意的强度和潜伏期，并将这些结果与弱视的发生率相关联。 目标1中的抑制测量。目的3将探讨弱视眼的注意操作是否可以调节皮质抑制。目的4将检验通过训练弱视眼高注意力要求的任务可以减轻抑制并改善视功能的假设。我们将使用传统的知觉学习任务（低注意力需求任务）和高注意力需求任务来训练弱视患者。我们将跟踪和评估视觉功能（敏锐度和立体视觉），抑制的深度，并在训练过程中的注意力调节，通过使用视觉心理物理学耦合到频率标记的源定位EEG测量。从这项研究中获得的知识将有助于更广泛地了解视觉抑制和弱视发展的神经基础。我们的研究结果将揭示为什么弱视治疗经常失败，并将表明更有效的治疗策略，特别是对于那些对传统治疗反应不佳的人。