Interplay between multifocal optics and accommodation: implications for myopia progression

多焦点光学器件与调节之间的相互作用：对近视进展的影响

• 批准号: 10637313
• 负责人: Susana Marcos
• 金额: $ 53.7万
• 依托单位: UNIVERSITY OF ROCHESTER
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-07-01 至 2028-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10637313
• 关键词: Address; Affect; Asian; Blindness; Cataract; Child; Clinical; Clinical Trials; Compensation; Contact Lenses; Crystalline Lens; Custom; Data; Diameter; Effectiveness; Engineering; Eye; Eye diseases; Eyeglasses; Failure; Focal Adhesions; Future; Glaucoma; Goals; Grant; Growth; Health; Image; Individual; Intervention; Knowledge; Length; Light; Link; Location; Macular degeneration; Maps; Measurement; Methods; Monitor; Myopia; Operative Surgical Procedures; Optics; Outcome; Pattern; Peripheral; Physiological; Population; Presbyopia; Psychophysics; Pupil; Refractive Errors; Relaxation; Reporting; Retina; Retinal Detachment; Role; Schools; Signal Transduction; Societies; Technology; Testing; Traction; Vision; Visual; Visual Acuity; Work; adaptive optics; design; experimental study; high risk; improved; innovation; lens; novel; operation; personalized strategies; response; retinal imaging; simulation; success; visual optics; young adult

ABSTRACT Myopia is a refractive error type of eye disorder where light is focused in front of the retina, requiring optical corrections to recover the resulting loss in visual acuity. It is a broadly significant health condition: it is estimated that by 2050 50% of the world population will be myopic. Moreover, even if myopia is compensated with spectacles, contact lenses or surgery, high myopia is linked to a higher risk of retinal detachment, glaucoma, and cataract. Strategies to halt the progression of myopia are therefore an urgent need. Myopia arises from a mismatch between ocular axial length and optical power, but the signals that prompt excessive eye growth are not well understood. Among various strategies developed for myopia control, the use of multifocal contact lenses (MCL) is gaining significant traction. A generalized working principle behind MCL design is that induced myopic defocus in the peripheral retina is protective for foveal axial growth. Initial clinical trials report encouraging reduction of myopia progression in children fitted with MCLs (generally, center-distance and high add powers) however they are still far from the desired effectiveness. Unlike MCL for presbyopia, MCLs for myopia control are prescribed on subjects that can accommodate. However, we currently do not have a good understanding of how accommodation interacts with MCLs in determining retinal image quality. This is a critical gap in knowledge as accommodation affects the very central feature of MCL design — the degree and the sign of retinal defocus. For example, depending on MCL design and individual physiological parameters, some subjects could rely on the near zones of the MCL for near vision, potentially exposing the retina to hyperopic defocus and triggering eye growth. We, a diverse team of optical engineers, physicists and neuroscientists will make use of adaptive optics simulation technologies and psychophysical paradigms to map non-invasively MCL lens patterns onto the subject’s pupil and systematically address key outstanding questions on the interplay between MCL design, accommodation, image quality and visual function with MCLs in young myopes. The group has previously developed adaptive optics technologies to test presbyopia corrections, novel methods based on wavefront sensing to quantify the accommodative response, IOL designs for presbyopia and psychophysical paradigms suited for young subjects. We are now using these capabilities, expanded to binocular simulation and testing, to understand factors underlying accommodative and binocular mechanisms of MCL-based interventions to slow down myopia. The long-term goal is to develop a mechanistic understanding that can help guide the design and personalization of MCL myopia control interventions. We plan to 1) determine the accommodative response with multifocal patterns in young myopes and emmetropes, 2) quantify the effects of various multifocal designs on foveal visual function and 3) test the role of accommodative response on the outcome success in children that have been clinically treated with multifocal contact lenses

抽象的 近视是眼睛疾病的折射率误差类型，光聚焦在视网膜前，需要光学 恢复视力损失的校正。这是一个广泛的健康状况：估计 到2050年，世界人口的50％将是近视。而且，即使近视被补偿 眼镜，隐形眼镜或手术，高近视与残留脱离的风险更高有关 和白内障。因此，阻止近视进展的策略是迫切需要的。近视来自 眼部轴向长度和光学功率之间的不匹配，但是迅速超级眼睛生长的信号是 不太了解。在用于近视控制的各种策略中，使用多灶性隐形眼镜 （MCL）正在获得显着的牵引力。 MCL设计背后的一般工作原理是诱导的近视 外围视网膜中的散焦受到凹凹轴向生长的保护。最初的临床试验报告鼓励 降低装有MCL的儿童的近视进展（通常是中心距离和高添加力） 但是，它们仍然远离所需的效力。与MCL的长老会不同，MCL用于近视控制 规定可以容纳的主​​题。但是，我们目前对 住宿如何与MCL相互作用，以确定永久的图像质量。这是知识的关键差距 随着住宿影响MCL设计的主要特征，即永久散焦的程度和迹象。 例如，根据MCL设计和单个物理参数，某些受试者可以依靠 MCL的近区域近视，可能将视网膜暴露于远视散焦并触发 眼睛生长。我们，由光学工程师，物理学家和神经科学家组成的潜水团队将利用自适应 光学仿真技术和心理物理范例可将非侵入性MCL镜头模式映射到 受试者的学生和系统地解决了有关MCL设计之间相互作用的关键问题， 在年轻近视中使用MCL的住宿，图像质量和视觉功能。该小组以前有 开发的自适应光学技术测试长期校正，基于波前的新方法 感知要量化适应性响应的IOL设计用于长期和心理物理范例 适合年轻主题。我们现在正在使用这些功能，扩展到双眼模拟和测试， 了解基于MCL的干预措施的适应性和双目机制的基础因素 下近视。长期目标是建立一种机械理解，以帮助指导设计和 MCL Myopia控制干预措施的个性化。我们计划1）确定适应性响应 具有幼小近视和膜的多灶性模式，2）量化各种多灶性设计的效果 关于中央凹的视觉功能和3）测试适应性反应对儿童结果成功的作用 用多灶性隐形眼镜在临床上处理的