Binocular Vision, Amblyopia, and Refractive Development

项目总结/摘要 弱视是一种神经发育性视力障碍，影响3%的儿童。它源于不和谐 儿童时期的视觉经验，最常见于斜视或屈光参差。Strabbelles和 屈光参差性弱视损害一只眼睛的视敏度和对比敏感度。通常，中断 双眼视觉（立体视锐度降低或为零和眼间抑制）和眼运动异常。 也在场。这些缺陷与精细运动技能和阅读速度的降低有关，即使在 双目观察反过来，这些相关的缺陷可能会影响儿童的学业成功和自尊。 在目前的项目期间，我们确定了异常的双眼视觉和固定之间的联系 不稳定，发现眼间抑制先于弱视发作， 抑制与弱视的深度相关，双眼弱视时抑制减少 治疗，并研究了新的双眼弱视治疗，旨在减少抑制和改善 视觉敏锐度虽然我们的双眼治疗导致了视力的持续改善，但这些早期研究 局限于4个方面：1）治疗方案设计为短期治疗试验，持续时间<4 因此双眼治疗的最大改善是未知的，2）没有治疗方案 专门设计用于改善立体视敏度，3）视力是所有患者的主要结局指标， 研究，所以我们对修补与双眼治疗的相对有效性知之甚少， 恢复精细运动死亡，阅读速度和自尊，以及4）治疗仅适用于 4岁及以上弱视儿童。我们的合作研究小组现在准备解决这些问题 关键问题。在目标1中，我们将评估增强型双眼弱视治疗的有效性 实现更全面、更稳定的恢复。在目标2中，我们将评估成功弱视的效果 精细运动技能、阅读速度和自我感知的治疗（修补或双眼治疗）。在目标3中， 我们将评估一种新的视力测量<3岁的儿童使用的设备， 测量反射性眼球运动（OKN）到消失视标的移动场。在结束时，我们 弱视治疗对儿童弱视的影响 日常任务的表现将为设计新的，更有效的弱视治疗方法提供信息， 临床试验采用新的结果测量（阅读、精细运动技能和自尊）。此外，本发明还提供了一种方法， 我们将有一个准确的方法来诊断和监测1至3岁儿童的弱视， 我们希望在这个年龄段进行未来的弱视治疗试验。

Project Summary/Abstract Amblyopia is a neurodevelopmental vision disorder that affects 3% of children. It results from discordant visual experience during childhood, most often from strabismus or anisometropia. Strabismic and anisometropic amblyopia impair the visual acuity and contrast sensitivity of one eye. Typically, disrupted binocular vision (reduced or nil stereoacuity and interocular suppression), and ocular motor abnormalities are also present. These deficits are associated with reduced fine motor skills and reading speed even during binocular viewing. In turn, these associated deficits may affect academic success and self-esteem in children. During the current project period, we identified an association between abnormal binocular vision and fixation instability, discovered that interocular suppression precedes the onset of amblyopia, that the severity of suppression is correlated with the depth of amblyopia, that suppression is reduced with binocular amblyopia treatment, and investigated new binocular amblyopia treatments designed to reduce suppression and improve visual acuity. While our binocular treatment led to sustained improvement in visual acuity, these early studies were limited in 4 respects: 1) the treatment protocols were designed for short-term treatment trials, lasting <4 weeks so the maximum improvement with binocular treatment is unknown, 2) none of the treatment protocols were specifically designed to improve stereoacuity, 3) visual acuity was the primary outcome measure in all of the studies, so we know little about the relative effectiveness of patching versus binocular treatment in rehabilitating fine motor kills, reading speed, and self-esteem, and 4) the treatments have only been applied to amblyopic children age 4 years and older. Our collaborative research group is now poised to address these critical issues. In Aim 1, we will evaluate the effectiveness of enhanced binocular amblyopia treatments in achieving a more complete and stable recovery. In Aim 2, we will evaluate the effects of successful amblyopia treatment (patching or binocular treatment) on fine motor skills, reading speed, and self-perception. In Aim 3, we will evaluate a novel visual acuity measurement for <3-year-old children using a device that induces and measures reflexive eye movements (OKN) to moving fields of vanishing optotypes. Upon conclusion, our investigation of enhanced binocular treatment protocols and the effects of amblyopia treatment on the performance of everyday tasks will inform the design of new, more effective amblyopia treatments and the adoption of new outcome measures (reading, fine motor skills, and self-esteem) for clinical trials. In addition, we will have an accurate method to diagnose and monitor amblyopia in 1- to 3-year old children that will allow us to conduct future amblyopia treatment trials in this age range.