Behavioral Measures of Vision

青光眼是一种进行性视神经病变，由形成从眼睛到大脑的视神经的视网膜神经元的病理性丧失引起。在美国，它是导致不可逆转失明的主要原因；大约有220万40岁以上的人患有这种疾病，其中多达12万人因青光眼而失明。随着人口老龄化，这种疾病将成为一个日益重要的公共卫生问题，但治疗在预防或减缓视力丧失方面是有效的，因此，优化程序以确定何时需要治疗和何时有效是很重要的。由于青光眼的病因不明，该病的诊断或进展需要眼科检查来识别和量化青光眼神经病变的临床特征，如视野缺损的模式、视神经头的解剖改变、视网膜神经纤维层变薄等。这项研究的目的是为了更好地理解青光眼引起的神经和视力损失的临床测量之间的关系。主要实验包括猕猴实验性青光眼的视觉功能行为学研究（标准自动视距测量）和视网膜结构的高分辨率成像（光学相干断层扫描）。来自实验性青光眼研究的数据将用于建立一个定量模型，将视网膜特定区域视网膜神经元的损失与从同一视网膜区域进入视神经的轴突数量联系起来。在最后阶段，从猴子身上获得的结构和功能关系将用于评估人类青光眼患者的严重程度或分期。该研究方法的基础是确定实验性青光眼的程序，其中对实验和测量变量有良好的控制，然后应用于人类患者，以测试程序的临床相关性和有效性。这种从实验室到临床的方法可以最大限度地为青光眼的诊断和评估提供重要的眼科检查新信息。

DESCRIPTION: Glaucoma is a progressive optic neuropathy caused by a pathological loss of the retinal neurons that form the optic nerve from the eye to the brain. It is a leading cause of irreversible blindness in the United States; approximately 2.2 million people older than 40 years of age suffer from the disease and as many as 120,000 of these people are blind from glaucoma. As the population ages, the disease will become an increasingly important problem of public health, but treatment is effective in preventing or slowing vision loss and it is, therefore, important to optimize procedures for determining when treatment is needed and when it is effective. Because the cause of glaucoma is unknown, the diagnosis or progression of the disease requires ophthalmic testing to identify and quantify clinical characteristics of glaucomatous neuropathy, such as the pattern of visual field defects, anatomical changes of the optic nerve head, and thinning of the retinal nerve fiber layer. The goal of the proposed research is to gain a better understanding of the relationships between clinical measures of neural and visual losses from glaucoma. The principal experiments involve behavioral studies of visual function (standard automated perimetry) and high resolution imaging of retinal structure (optical coherence tomography) over the time course of experimental glaucoma in macaque monkeys. The data from the investigations of experimental glaucoma will be used to develop a quantitative model relating the loss of retinal neurons in a specific area of the retina to the number of axons entering the optic nerve from the same retinal area. In the final phase, the structure and function relationships that were derived from monkeys will be applied to assess the severity, or stage, of glaucoma in human patients. The research method is based on defining procedures with experimental glaucoma where there are excellent controls for the experimental and measurement variables and, then, application to human patients to test the clinical relevance and validity of the procedures. This method of going from the laboratory to the clinic should maximize the potential for significant new information about ophthalmic testing for diagnosis and assessment of glaucoma.