DEVELOPMENT AND MAINTENANCE OF BINOCULAR VISION

弱视和相关的双眼功能缺陷估计为 影响了2%的美国人口。关于视觉的最新研究 动物模型的发展表明，这些缺陷中的许多是 出生后早期异常视觉体验的直接后果 几个月，因此可以通过适当的措施预防或逆转 早期干预。在之前的授权期内，优惠- 观察、操作和视觉诱发电位技术被用于 研究人类视觉发育的正常过程和视觉 双眼不平衡婴儿的发育。 对大约200名婴儿进行持续的前瞻性随访 婴儿内斜视或单眼白内障，在前4个月登记 多年的拨款，将提供5-5年的感觉和定位结果数据 9岁。这些数据将阐明相对疗效和 早期双眼不平衡治疗方案的疗效分析。新的 前瞻性研究将评估优先的预后价值- 寻找成功的闭塞治疗的敏锐度和结果随访 婴幼儿单眼白内障的手术治疗。 斜视和视觉诱发电位的联合测量 立体视觉和融合将检查发育中的中枢和外周 婴儿内斜视的双眼缺陷。未来的单目游标 视力测量将提供一种灵敏的新的发育指标 空间缺陷和对治疗的反应。一种修改后的范例 双目亮度求和在瞳孔响应中将被用于 测量言语前患者的中枢抑制。 视力成熟延迟的婴儿可能会也可能不会长期 视力受损。早期识别预后不良的患者 很重要，因为他们有很高的神经后遗症风险，而且 用于康复工作、遗传咨询和社会服务。 对优先外观和视觉唤起的前瞻性评估 这一人群的潜在敏感度应该确定一个最佳的治疗方案 视力发育迟缓的婴儿。

Amblyopia and associated deficits in binocular function are estimated to affect 2% of the American population. Recent studies of visual development in animal models suggest that many of these deficits are direct results of abnormal visual experience during early postnatal months and, therefore may be preventable or reversible with appropriate early intervention. During the previous grant period, preferential- looking, operant, and visually evoked potential techniques were used to study the normal course of human visual development and visual development of infants with binocular imbalance. Continued prospective follow-up of approximately 200 infants with infantile esotropia or unilateral cataract, enrolled during the first 4 years of the grant, will provide sensory and alignment outcome data at 5- 9 years of age. These data will clarify the relative efficacy and effectiveness of treatment regimens for early binocular imbalance. New prospective studies will evaluate the prognostic value of preferential- looking acuity for success of occlusion therapy and for outcome following surgery for infantile unilateral cataract. Combined measures of preferential-looking and visually evoked potential stereoacuity and fusion will examine developing central and peripheral binocular deficits in infantile esotropia. Prospective monocular vernier acuity measurement will provide a sensitive new index of developing spatial deficits and of response to treatment. A modified paradigm for binocular luminance summation in the pupil response will be used to measure central suppression in pre-verbal patients. Infants with delayed visual maturation may or may not suffer long-term visual impairment. Early identification of those with a poor prognosis is important because they are at high risk for neurological sequelae, and for rehabilitation efforts, genetic counseling, and social services. Prospective evaluation of preferential-looking and visually evoked potential acuity in this population should define an optimum protocol for infants with delayed visual maturation.