VISUAL FIELD EXPANSION THROUGH INNOVATIVE MULTIPLEXING PRISM DESIGN

描述(申请人提供)：严重的周边视野丧失(PFL)，有时被称为隧道视力，是视网膜色素变性和相关疾病以及青光眼的结果。目前还没有有效的视觉辅助设备来帮助这些患者，他们的行动能力受到这种损害的严重影响。视觉多路复用作为低视力设备的一种设计原则，为众多视野损失设备的开发提供了指导。通过移位的空间多路传输，结合双眼多路传输，已被证明是一种有效的同名性偏盲的辅助。这种方法被称为EP棱镜，使用单边棱镜，应用于对复视有很好耐受性的外围领域，并已演变为一种成功的光学治疗方法。在众多研究中，一半或更多佩戴EP棱镜的患者继续长期佩戴和使用该设备，并报告说活动能力有所改善。对于PFL，Trifield棱镜眼镜，一种将中枢视觉混乱应用于隧道视力患者(例如，由于RP)的双目多路复用器已被证明要困难得多。尽管没有替代的辅助手段，尽管它对25%的患者有效，但它并没有进入市场。它的构造非常复杂，大多数患者发现它强加的中央复视令人不安。考虑到这两种方法的成功和局限性，严重PFL患者的主要要求，以及行走情况的动态化，我们设计了一种新的视觉辅助装置，Quadrafield透镜(创建人工周边视岛)。这是通过应用近外围场扩展来实现的，同时避免了先前设计的中心混淆和场权衡。我们还发明了一种新的光学元件，一种可以应用于这种设备和其他设备的“多路复用棱镜”。多路复用棱镜提供移动和直接透视视场的同时(单目)叠加视图。保持透明视野可以治疗单眼患者。它还允许将棱镜安装在更靠近中央视野的位置，即使偶尔受到侵犯，由于头部的运动，中心凹的视觉也不会完全受阻。此外，我们还找到了一种方法，将规则的垂直头部摆动运动转换为通过棱镜的横向扫描，实现了时间多路复用。在这里，我们建议实施、调整和测试多路复用棱镜作为PFL辅助设备的有效性，将其用于实验室研究中的四倍视野透镜，并最终在多中心随机对照临床试验中达到顶峰。

DESCRIPTION (provided by applicant): Severe peripheral field loss (PFL) sometimes called tunnel vision is a result of retinitis pigmentosa and related diseases as well as glaucoma. Currently there are no effective visual aids for these patients whose mobility is seriously affecte by this impairment. The novel concept of vision multiplexing as a design principle for low vision devices has provided guidance for the development of numerous devices for visual field losses. Spatial multiplexing by shifting, combined with biocular multiplexing, has been a proven effective aid for homonymous hemianopia. This approach, known as EP Prisms, uses unilateral prisms, and is applied to the peripheral field where double vision is well tolerated, and has evolved into a successful optical treatment. In numerous studies half or more of patients fitted with the EP prisms continue to wear and use the device over a long term and reported improved mobility. For PFL, Trifield prism spectacles, a biocular multiplexing device that applied central visual confusion to patients with tunnel vision (e. g., due to RP) has proven much more difficult. Despite there being no alternative aids available, and despite it being effective for 25% of patients, it has not made inroads in the marketplace. It is very complicated to construct and most patient find the central double vision it imposes disturbing. In considering the successful and limiting aspects of both approaches, the main requirements of patients with severe PFL, and the dynamic of a walking situation, we have designed a new visual aid, Quadrafield lens (creating artificial peripheral visual islands). This is achieved by applying near peripheral fiel expansion while avoiding the central confusion and fields tradeoffs of prior designs. We also invented a new optical element, a "multiplexing prism" that can be applied to this and other devices. Multiplexing prisms provide simultaneous (monocularly) superimposed views of the shifted and direct see-through fields of view. The maintenance of the see through view permits treatment of monocular patients. It also permits fitting the prisms closer to the central field, a even with occasional encroachment, due to head movements, foveal vision is not completely blocked. In addition we have found a way to convert the regular vertical head bobbing motion into a lateral scanning through the prisms, implementing temporal multiplexing. Here we propose to implement, tune, and test the effectiveness of the multiplexing prisms as an aid for PFL, when used in the Quadrafield lens in laboratory studies and culminating in a multicenter randomized control clinical trial.