Center for the Prevention and Treatment of Visual Loss

爱荷华州市视力丧失预防和治疗中心（CPTVL）专注于早期视力丧失。 检测退伍军人和普通人群中由眼部疾病引起的潜在致盲疾病 以及调节视觉感知、光敏感性、眼球运动、眨眼、瞳孔 运动、眼感觉和疼痛。该中心测试确定疾病最早迹象的新方法， 其进展和对治疗的反应。新的治疗创新是由一个专门的小组发现的， 研究疾病细胞机制的VA科学家和临床医生。关键发现利用机器 学习和人工智能与先进的眼部成像相结合，以阐明结构， 眼睛和中枢神经系统的功能。由此产生的发现提供了重要的，临床相关的 眼睛和神经系统疾病的生物标志物。这些包括眼睛、瞳孔、眼睑和 面部肌肉表情的三维客观诊断和治疗监测。许多 神经系统、心血管系统和免疫系统的疾病都表现在眼睛上， 它是检测、监测和开发眼部和全身性疾病新疗法的理想平台， 老兵该中心预防和治疗视力丧失的使命主要在以下三个领域开展： 研究方向：远程医疗、疾病的细胞机制和新疗法。 远程医疗：先进的技术被开发用于眼部结构的自动远程医疗评估 并有助于视觉障碍和相关中枢神经系统疾病的诊断、分期和治疗监测。 神经系统疾病。这包括一项创新努力，使智能手机设备能够评估视力 以及神经反射，这是影响眼睛和神经系统的许多疾病的重要读数。 CPTVL与眼睛成像设备制造商和制药公司合作， 临床实施的翻译框架，快速传播退伍军人的利益。 疾病的细胞机制：治疗发现沿着一个翻译框架是建立在 确定疾病的细胞机制。创伤性脑损伤之所以受到重视， 退伍军人中显著的感觉、精神和神经系统疾病发病率。 新的治疗方法：发现新的治疗方法来治疗涉及视觉系统的致残性疾病是一种新的治疗方法。 CPTVL康复的主要重点是改善退伍军人的视力和生活质量。当前治疗 高度优先目标包括青光眼、糖尿病周围神经病变、多发性硬化、创伤性脑 受伤偏头痛和对光敏感 CPTVL的一个重要的新举措是将视力和神经功能的读数与生活质量联系起来 退伍军人中的指标。通过这样做，我们打算发现哪些读数对质量影响最大， 生活和视觉质量。这将提供急需的洞察力，哪些视觉功能最重要， 作为结果的衡量标准。视力读数与生活质量的联系可以个性化， 个性化医疗倡议。 关键词：远程医疗，青光眼，黄斑变性，糖尿病视网膜病变，糖尿病周围 神经病、创伤性脑损伤、多发性硬化、光敏感、偏头痛、眼部成像。

The Iowa City VA Center for the Prevention and Treatment of Visual Loss (CPTVL) focuses on the early detection of potentially blinding disorders of the Veteran and general population caused by disorders of the eye and nervous system that mediate visual perception, light sensitivity, eye movements, blinking, pupil movements, ocular sensation, and pain. The Center tests new ways of determining the earliest sign of disease, its progression and response to treatment. New treatment innovations are discovered by a dedicated group of VA scientists and clinicians who study the cellular mechanisms of disease. Key discoveries utilize machine learning and artificial intelligence in combination with advanced ocular imaging to elucidate structure and function of the eye and central nervous system. Resulting discoveries provides important, clinically relevant biomarkers of eye and neurologic disorders. These include reflex movements of the eyes, pupils, eyelids and facial muscles of expression in three dimensions for objective diagnosis and monitoring of treatment. Many diseases of the nervous system, cardiovascular system and immune system are manifested in the eye, making it an ideal platform to detect, monitor and develop new treatments for ocular and systemic disorders affecting Veterans. The Center's mission of prevention and treatment of visual loss is carried out in 3 main spheres of research: Telemedicine, Cellular Mechanisms of Disease, and Novel Therapeutics. Telemedicine: Advanced technology is developed for automated telemedical assessment of ocular structure and function to facilitate diagnosis, staging, and monitoring of treatment of visual disorders and related central nervous system diseases. This includes an innovative effort to enable smartphone devices for assessing vision and neurologic reflexes which are important readouts of many disorders affecting the eye and nervous system. The CPTVL partners with manufacturers of eye imaging devices and pharmaceutical companies to provide a translational framework for clinical implementation, with rapid dissemination of benefits to Veterans. Cellular Mechanisms of Disease: Therapeutic discoveries along a translational framework are built upon the identification of cellular mechanisms of disease. Traumatic brain injury is being emphasized because of its significant sensory, psychiatric and neurologic morbidity in Veterans. Novel Therapeutics: The discovery of new treatments for disabling conditions involving the visual system is a major focus of CPTVL rehabilitation for improving vision and quality of life of Veterans. Current therapeutic targets of high priority include glaucoma, diabetic peripheral neuropathy, multiple sclerosis, traumatic brain injury, migraine, and light sensitivity. An important new initiative of the CPTVL is to link readouts of vision and neurologic function to quality of life metrics in Veterans. By doing so, we intend to discover which readouts have the largest impact on quality of life and quality of vision. This will provide much needed insight into which visual functions hold the greatest importance as outcome measures. The linking of readouts of vision to quality of life can be individualized for personalized medicine initiatives. Key Words: telemedicine, glaucoma, macular degeneration, diabetic retinopathy, diabetic peripheral neuropathy, traumatic brain injury, multiple sclerosis, light sensitivity, migraine, ocular imaging.