Remapping the Visual Field to Aid Reading with Central Scotomas

项目摘要 老年性黄斑变性(AMD)通常会导致广泛的中央视力丧失，导致 阅读、导航和其他关键任务。目前的视觉辅助装置有中央暗点，而 前景看好，但效果有限。这项提案旨在通过促进对 重新映射，一种通过将信息从 在中央盲点(暗点)内至视野中完整的位置。只有少数几项过去的研究 检查了重新映射，包括只对患者进行的一项研究。我们的团队最近演示了这种方法的 承诺，这表明它可以显著提高具有模拟场损失的观察者的阅读能力。关键是， 患者的暗点形状和视野范围内的视觉质量差异很大。这 可变性对先前工作中使用的“一刀切”的重新映射方法施加了严重的限制，即 只需将图像从暗点中心移开即可。例如，如果患者的首选视网膜位置 (用于高清晰度任务)接近其暗点的左下边缘，向上或向右移动文本可能 与其说是阅读，不如说是向下移动，因为后者会将文本放在视觉敏锐度最高的区域。 这项提议将测试个性化重新映射的价值，它以一种优化的方式改变图像 对于每个患者的残余视力。重新映射是使用一种新的字母识别视野构建的 任务，它测量整个视野的性能：个性化的重新映射被构造为 移动文本以最大化观察者的总字母识别能力。拟议的工作将首先检验这样的假设 个性化重映射可以提高单字识别能力。单个单词的读数将使用 各种暗点大小、形状和PRL位置。个性化重新映射的性能将是 与传统的重新映射和不重新映射两种控制观测器相比 暗点和黄斑变性患者。拟议中的工作也将检验个性化的假设 重新定位可以提高自由阅读的质量。阅读速度、错误率和眼动模式 在句子阅读任务中测量，在包含文本的自然图像的自由阅读中测量。初步数据 总体上支持重新映射的价值，以及构建字母识别视野任务的潜力 个性化的重新映射。这项提案的结果将提供第一次彻底的重新映射测试，并将 也告知模型患者和对照组的外周读数。拟议的研究将发展和 评估一种帮助视力低下的人的新方法，为他们的个人剩余表现量身定做。 个性化的重新映射也可以结合到实用的视觉辅助工具中，以改善日常视觉功能和 生活质量。

Project Summary Age-related macular degeneration (AMD) typically produces extensive central vision loss, leading to difficulty in reading, navigating, and other critical tasks. Current assistive devices for vision with central scotomas, while promising, are limited in effectiveness. This proposal aims to fill this gap by advancing understanding of remapping, a method that improves the effectiveness of patients’ residual vision by shifting information from inside the central blind spot (scotoma) to intact locations in the visual field. Only a handful of past studies have examined remapping, including just a single study of patients. Our group recently demonstrated the method’s promise, showing that it can improve reading substantially in observers with simulated field loss. Critically, patients differ widely in the shape of their scotomas, and the quality of their vision across the visual field. This variability imposes severe limitations on the “one size fits all” remapping approaches used in prior work, that simply shift the image away from the scotoma center. If, for example, a patient’s preferred retinal location (used for high acuity tasks) is near the lower left edge of their scotoma, shifting text upward or rightward may not aid reading as much as shifting it downward, as the latter will place the text in regions of best visual acuity. This proposal will test the value of personalized remappings, which shift the image in a way that is optimized for each patient’s residual vision. The remappings are constructed using a novel letter recognition perimetry task, which measures performance across the visual field: The personalized remappings are constructed to shift text to maximize observers’ total letter recognition ability. Proposed work will first test the hypothesis that personalized remapping can improve single word recognition. Single word reading will be measured with a variety of scotoma sizes, shapes, and PRL locations. Performance with personalized remapping will be compared to that with traditional remapping and no remapping in both control observers with simulated scotomas and people with macular degeneration. Proposed work will also test the hypothesis that personalized remappings can improve free reading. Reading speed, error rates, and eye movement patterns will be measured in a sentence reading task, and in free reading of natural images containing text. Preliminary data support the value of remapping generally, and the potential of the letter recognition perimetry task for building personalized remappings. Results of this proposal will provide the first thorough testing of remapping, and will also inform models of peripheral reading in patients and controls. The proposed studies will develop and evaluate a novel method for assisting people with low-visions, tailored to their individual residual performance. Personlaized remapping may also be incorporated into practical visual aids to improve daily visual function and quality of life.