Perceptual mechanisms underlying reading difficulties in glaucoma

项目摘要 以视网膜神经节进行性变性为特征的原发性开角型青光眼 细胞和相关的视野缺陷，在美国是导致失明的主要原因。这个 主流观点一直认为，青光眼直到末期才能恢复中心视觉功能。然而， 越来越多的证据表明，黄斑甚至参与了早期青光眼的损害，包括 视网膜神经纤维层和/或神经节细胞层厚度明显减少。与...并行 生理证据，行为证据表明，各种中央视觉任务中的功能缺陷， 例如阅读和人脸识别，经常出现在青光眼患者身上。令人惊讶的是，阅读 问题被认为是青光眼患者焦虑的主要来源。不过，目前， 我们不了解青光眼损害如何阻碍假想-到-的模式识别 保留中心视野。我们也不知道缓解这些赤字的有效方法。即使是在 治疗控制着疾病的进展，患有现有视野缺陷的人需要应对 视力受损。因此，了解限制日常视觉功能的机制 从临床和基础科学的角度来看，青光眼都很重要。拟议的研究将建立在 我们的前期工作和几十年人类理论工作的经验发现 为了在我们对中枢视觉功能的理解上取得根本性的进展 青光眼。这项拟议研究的主要目标是了解青光眼是如何损害中枢神经系统的 并将这一知识应用于指导制定有效的康复策略 优化青光眼患者的剩余视力。特别是，我们的具体目标是：(1)了解 青光眼损害对中枢模式识别的影响，(2)了解空间认知的作用 视野缺陷的模式，(3)将知觉学习应用于阅读康复 青光眼。到目前为止，对这类研究的关注还很少。当前的结果是 研究提案有望帮助我们了解日常视觉功能的限制因素 青光眼和确定潜在的康复干预措施。此外，从 拟议的研究将为视网膜神经节细胞病理如何影响人类模式提供新的见解 承认。

PROPJECT SUMMARY Primary open angle glaucoma (POAG), characterized by progressive neurodegeneration of retinal ganglion cells and associated visual field defects, is a leading cause of blindness in the United States. The predominant view has been that glaucoma spares central visual function until the end-stages. However, accumulating evidence shows that the macula is involved in even early glaucomatous damage, including a significant reduction in retinal nerve fiber layer and/or ganglion cell layer thickness. In parallel with physiological evidence, behavioral evidence shows that functional deficits in various central vision tasks, such as reading and face recognition, often appear in individuals with glaucoma. Surprisingly, reading problems have been cited as a main source of anxiety among people with glaucoma. However, at present, we have no understanding of how glaucomatous damage impedes pattern recognition in the assumed-to- be-preserved central visual field. Nor do we know of effective means to alleviate these deficits. Even when treatment controls disease progression, individuals with existing visual field defects need to cope with compromised vision. Therefore, understanding the mechanisms limiting everyday visual function in glaucoma is important from both clinical and basic science perspectives. The proposed study will build on the empirical findings from our preliminary work and theoretical work from several decades of human pattern vision in order to make fundamental advances in our understanding of central visual function of glaucoma. The major goals of the proposed research are to understand how glaucoma undermines central pattern vision and to apply this knowledge to guiding the development of effective rehabilitative strategies to optimize the remaining vision of people with glaucoma. In particular, our specific aims are (1) To understand the impact of glaucomatous damage on central pattern recognition, (2) To understand the role of the spatial pattern of visual field defects, (3) To apply perceptual learning to reading rehabilitation of individuals with glaucoma. To date, very little attention has been paid to such research. The outcome of the current research proposal is expected to help us understand the limiting factors underlying daily visual function in glaucoma and identify potential rehabilitative interventions. Furthermore, the knowledge obtained from the proposed research will provide new insights on how retinal ganglion cell pathology affects human pattern recognition.