Afferent and Efferent Visual Systems During Abnormal Vision Development

项目摘要/摘要 在6至72个月的婴儿和儿童中，约有3%患有斜视或弱视。这个 弱视和斜视的发展被认为是异常视觉体验的结果。正常 视觉体验依赖于良好的视网膜图像质量和眼睛对准，这需要复杂的 传入和传出视觉系统之间的相互作用。了解这些相互作用对于 预防措施的制定和循证治疗策略的积累 斜视和弱视。不正视化的远视婴儿有发生斜视和 弱视的2D等效球镜(SE)，而且这种风险随着每增加一个 未矫正远视的屈光度。此外，不太可能发生正视化的婴儿也是这样做的。 不能很好地适应近乎刺激。 具体目标1：检验关于传入视觉系统存在缺陷或不成熟的假设 导致较差的模糊检测，从而导致传出调节反应降低。我们 将检查患有典型屈光不正和中/高度远视的婴儿的视网膜模糊检测 纵向在3个月和9个月龄。 具体目标2：检验调节的紧张性适应成分是主要调节成分的假设 影响儿童调节性内斜视临床表现的因素 远视。我们将测量成人眼动控制的时相反应和紧张性适应成分。 2岁至6岁患有中/高度远视的儿童的模型，包括一些有调节能力的儿童 矫正屈光不正前的内斜视。 长期目标：为儿科视力护理从业者提供以下能力：[a]哪些婴儿患有 远视眼会正视，哪些不会，不正视的婴儿，哪些会正视 会发展成斜视和弱视。提高识别高危婴儿的能力将带来改善 病人的结果。

PROJECT SUMMARY/ABSTRACT Approximately 3% percent of infants and children 6 to <72 months have strabismus or amblyopia. The development of amblyopia and strabismus are proposed to be the result of abnormal visual experience. Normal visual experience depends on both good retinal image quality and eye alignment, which require complex interactions between the afferent and efferent visual systems. Understanding these interactions are critical to both the development of preventive measures and the accumulation of evidence-based treatment strategies for strabismus and amblyopia. Hyperopic infants who do not emmetropize are at risk for developing strabismus and amblyopia with as little as 2D spherical equivalent (SE), and that risk increases exponentially with every added diopter of uncorrected hyperopia. Moreover, the infants who are less likely to emmetropize, are the ones who do not accommodate well to a near stimulus. Specific Aim 1: To test the hypothesis that there is a deficit in or immaturity of the afferent visual system that causes poor blur detection which subsequently results in a decreased efferent accommodative response. We will examine retinal blur detection in infants with typical refractive error and with moderate/high hyperopia longitudinally at 3- and 9-months of age. Specific Aim 2: To test the hypothesis that the tonic adaptive components of accommodation are the primary factors responsible for the manifestation of accommodative esotropia in young children with clinically significant hyperopia. We will measure the phasic response and tonic adaptive components of the adult oculomotor control model in children ages 2 to <6 years with moderate/high hyperopia, including some with accommodative esotropia prior to refractive error correction. Long term Goal: Provide pediatric vision care practitioners with the ability to identify: [a] which infants with hyperopia will emmetropize and which will not and [b] of the infants who do not emmetropize, which ones will go on to develop strabismus and amblyopia. Improved ability to identify infants at highest risk will lead to improved patient outcomes.