A new approach to restoring visual acuity and stereopsis in adults and children w

描述(申请人提供)：弱视被认为是一种永久性的视力下降，由生命早期的异常视觉经验引起，影响到2%-3%的总人口。在过去的250年里，儿童弱视的主要治疗方法是修补同伴的眼睛。打补丁被认为对成年人无效，即使使用过，也很少使用。我们的主要目标是开发新的干预措施，将视觉训练嵌入到积极和有效的视觉运动任务中，以恢复成人和儿童弱视的视力和立体视，并将其与传统的修补治疗进行比较。第一个这样的干预是动作视频游戏。这项活动增强了已知弱视眼睛有缺陷的年轻、健康眼睛的视力。我们问，玩动作视频游戏是否有助于弱视眼睛的视觉功能恢复。具体地说，我们将开发和测试一款定制的视频游戏，该游戏能够呈现“设计师”的目标。一个重要的目标是促进两只眼睛之间的协调，因此我们将开发一种新的接口，使用过滤来降低发送给另一只眼睛的图像，以匹配弱视眼睛的水平。因此，培训将要求患者玩一款动作视频游戏，双眼输入大致平衡。虽然动作游戏似乎对视力正常的年轻人来说是最有效的增强视力的方法，但这些游戏并不适合儿科人群，因此我们还建议使用同样的原则开发和测试一款对儿童友好的视频游戏。第二种干预直接集中在再训练立体视觉上，是在虚拟现实环境中视觉引导的手部运动，在这种环境中，我们可以操纵不同的深度线索，患者可以接受嵌入任务中的隐含的表现反馈。我们问，这种虚拟现实训练是否会促进融合和立体视觉，它利用了我们之前关于单目和立体线索如何结合来支持深度知觉的工作。加州大学伯克利分校和罗切斯特大学的这项联合提案的优势在于我们的结果衡量标准。我们将评估和量化广泛的视觉功能，包括弱视受试者的立体视觉。我们的试验数据表明，即使在成年患者中，改善视力和立体视也是一个可以实现的目标。一款商业化的视频游戏已经与游戏设计者合作，适应了这个项目的需要，如果项目成功，将免费提供给眼科诊所进行随机临床试验。 公共卫生相关性：弱视是婴幼儿视力丧失的最常见原因。幼童弱视的主要治疗方法是修补同伴的眼睛，然而，修补被认为对年龄较大的儿童和成年人无效。该项目的相关性在于开发新的、有效的干预措施，以恢复成人和儿童弱视的视力和立体视。

DESCRIPTION (provided by applicant): Amblyopia is considered to be a permanent reduction in vision that arises from abnormal visual experience early in life, affecting 2-3% of the general population. The primary treatment for amblyopia in children, for the last 250 years has consisted of patching the fellow eye. Patching is considered to be ineffective in adults and is seldom, if ever used. Our main aim is to develop new interventions that embed visual training in active and rewarding visuomotor tasks for restoring both visual acuity and stereopsis in adults and children with amblyopia and to compare it to the traditional treatment of patching. The first such intervention is action videogame playing. This activity enhances aspects of vision in young healthy eyes that are known to be deficient in amblyopic eyes. We ask whether action video game playing may be useful in restoring visual functions in amblyopic eyes. Specifically we will develop and test a customized videogame which enables the presentation of "designer" targets. An important goal is to promote coordination between the two eyes, therefore we will develop a new interface that uses filtering to degrade the image being sent to the fellow eye in order to match the level of the amblyopic eye. Training will therefore require patients to play an action video game with roughly balanced binocular input. While action games appear most effective in enhancing vision in young adults with normal vision, these games are not appropriate for pediatric populations, thus we also propose to develop and test a videogame that is "child friendly" using the same principles. The second intervention, focused directly on retraining stereopsis, is visually guided hand movements in a virtual-reality environment in which we can manipulate different cues to depth and in which patients receive implicit performance feedback embedded in the task. We ask whether this virtual reality training, which capitalizes on our previous work on how monocular and stereo cues combine to support depth perception, may promote fusion and stereopsis. A strength of this joint proposal between UC Berkeley and U of Rochester is in our outcome measures. We will evaluate and quantify a broad range of visual functions including stereopsis in amblyopic subjects. Our pilot data suggests that improving visual acuity and stereopsis is an achievable goal even in adult patients. A commercially available video game has been adapted to the needs of this project in collaboration with game designers, and will be made freely available to eye clinics for a randomized clinical trial if the project is successful. PUBLIC HEALTH RELEVANCE: Amblyopia is the most frequent cause of vision loss in infants and young children. The primary treatment for amblyopia in young children consists of patching the fellow eye, however, patching is considered to be ineffective in older children and adults. The relevance of this project is in developing new, effective interventions for restoring visual acuity and stereopsis in adults and children with amblyopia.