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

描述（由申请人提供）：弱视被认为是由生命早期的视觉体验异常引起的永久性视力下降，影响总人口的2-3%。在过去的250年里，儿童弱视的主要治疗方法是给另一只眼睛打眼罩。贴片被认为对成人无效，很少使用。我们的主要目的是开发新的干预措施，将视觉训练嵌入到主动和奖励的视觉运动任务中，以恢复成人和儿童弱视患者的视力和立体视觉，并将其与传统的补片治疗进行比较。第一个这样的干预是玩动作电子游戏。这种活动增强了年轻健康眼睛的某些方面的视力，而这些方面在弱视眼睛中是已知缺乏的。我们想知道动作视频游戏是否有助于恢复弱视的视觉功能。具体来说，我们将开发和测试一个定制的视频游戏，它可以呈现“设计师”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接口，使用过滤来降低发送到另一只眼睛的图像，以匹配弱视眼睛的水平。因此，训练将要求患者玩一款双目输入大致平衡的动作视频游戏。虽然动作游戏对视力正常的年轻人最有效，但这些游戏并不适合儿童人群，因此我们也建议使用相同的原则开发和测试一款“儿童友好”的电子游戏。第二种干预，直接关注于立体视觉的再训练，是在虚拟现实环境中视觉引导手部运动，我们可以操纵不同的深度线索，患者接受嵌入任务的隐性表现反馈。我们想知道，这种虚拟现实训练是否可以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起来支持深度感知的工作。加州大学伯克利分校和罗切斯特大学联合提议的优势在于我们的结果衡量。我们将评估和量化弱视受试者的广泛视觉功能，包括立体视觉。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可以实现的目标。与游戏设计师合作，一款商业电子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。

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.