CATARACT AND ARM EFFECTS ON VISUAL PERFORMANCE

老年性黄斑病变(ARM)是导致严重视力的主要原因 老年人的心理障碍。从基于人口的研究来看， 据估计，超过一半的有手臂的眼睛也有白内障。超过了 在过去的二十年里，白内障手术的进步导致了一种手术 这是非常有效的，涉及的风险非常低。但通常情况下 ARM患者的手术被推迟，因为人们认为 摘除白内障的可能性微乎其微，甚至超过了适度的 因手术并发症导致视力丧失的风险。对…的测定 白内障手术的益处通常主要基于视力。 敏锐度。但人们普遍认为，人们还需要考虑 白内障对患者基本功能的影响 与自我照顾和职业需求有关的活动。相当多的工作 已经做了一些工作来确定白内障手术对患者的好处 没有视网膜病变。但我们仍然对此知之甚少 视网膜病变患者行白内障手术的好处。这个 该项目的总体目标是开发一套能够 使我们能够确定白内障手术的潜在好处 有手臂的病人。计划进行一系列心理物理研究，以 更好地描述核晶状体和皮质晶状体的视觉效果 不透明。白内障将被建模为与空间频率相关的 视网膜图像对比度的降低和视网膜的降低 照明。这一模型的有效性将在患者身上建立。 正在接受常规的白内障手术。白内障和白内障的联合作用 手臂在阅读、人脸识别、其他日常视觉活动上，以及 与健康相关的生活质量将通过以下组合进行评估 目的：基于绩效的测试和问卷调查。一个全面的 将开发一组视力测试来区分ARM患者 谁的白内障对ARM患者有显著的致残影响 视功能不受白内障的影响。结果是 这些研究将为未来的发展提供合理的依据 ARM患者白内障摘除手术指南。

Age-related maculopathy (ARM) is the leading cause of severe visual impairment among older persons. From population-based studies it is estimated that over half of eyes with ARM also have cataract. Over the past two decades advances in cataract surgery have resulted in a procedure that is highly effective and involves very low risk. But frequently the surgery is postponed for ARM patients because it is felt that the benefits of removing the cataract would be minimal and outweighed by even a modest risk of vision loss due to surgical complications. The determination of the benefit of cataract surgery is usually based primarily on visual acuity. But is widely recognized that one also needs to consider the impact of the cataract on the patient's ability to perform essential activities related to self care and vocational needs. Considerable work has been done to establish the benefits of cataract surgery for patients without retinal pathology. But we still know very little about the benefits of cataract surgery in patients with retinal pathology. The overall goal of this project is to develop a set of techniques that will allow us to determine the potential benefits of cataract surgery in patients with ARM. A series of psychophysical studies is planned that will better characterize the visual effects of nuclear and cortical lens opacities. Cataracts will be modelled as a spatial-frequency dependent reduction in retinal image contrast and as a reduction in retinal illumination. The validity of this model will be established in patients undergoing routine cataract surgery. The combined effects of cataracts and ARM on reading, face recognition, other everyday visual activities, and health-related quality of life will be assessed by a combination of objective performance-based tests and questionnaires. A comprehensive battery of vision tests will be developed to differentiate ARM patients in whom cataract has a significant disabling impact from ARM patients whose visual function is not limited by the presence of cataract. The results of these studies will provide a rational basis for the development of surgical guidelines for cataract extraction in patients with ARM.