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

描述（由申请人提供）：弱视被认为是一种永久性视力下降，由生命早期的异常视觉经历引起，影响2-3%的普通人群。在过去的250年里，儿童弱视的主要治疗方法是修补对侧眼睛。修补被认为是无效的成年人，很少，如果曾经使用。我们的主要目的是开发新的干预措施，将视觉训练嵌入主动和有益的视觉任务中，以恢复弱视成人和儿童的视敏度和立体视觉，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。这种活动增强了年轻健康眼睛的视力方面，这些眼睛是弱视眼的缺陷。我们问是否动作视频游戏可能有助于恢复弱视眼的视觉功能。具体来说，我们将开发和测试一个定制的视频游戏，使介绍“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，因此我们将开发一个新的界面，使用过滤来降低发送到对侧眼睛的图像，以匹配弱视眼的水平。因此，训练将要求患者玩具有大致平衡的双眼输入的动作视频游戏。虽然动作游戏在增强视力正常的年轻人的视力方面似乎最有效，但这些游戏不适合儿童人群，因此我们还建议使用相同的原则开发和测试一种“儿童友好”的视频游戏。第二个干预，直接集中在重新训练立体视觉，是视觉引导的手运动在虚拟现实环境中，我们可以操纵不同的线索的深度，并在其中患者接受嵌入在任务中的隐式性能反馈。我们问这种虚拟现实训练，它利用我们以前的工作，如何单眼和立体提示联合收割机，以支持深度感知，可能会促进融合和立体视觉。加州大学伯克利分校和罗切斯特大学联合提议的一个优点是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，改善视力和立体视觉也是一个可以实现的目标。与游戏设计师合作，一款商业视频游戏已经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。幼儿弱视的主要治疗方法包括对侧眼进行遮盖，然而，遮盖在年龄较大的儿童和成人中被认为是无效的。该项目的相关性在于开发新的、有效的干预措施，以恢复患有弱视的成人和儿童的视力和立体视觉。

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.