Diagnostic Innovations in Glaucoma Study: Visual Function

青光眼是一种进行性疾病，已知影响200多万美国人的视力。这个估计很低，因为患有青光眼的人通常不知道自己患有这种疾病。随着人类寿命的延长，到2020年，这一数字将增加到300多万，其中美国将有12万人失明。这项研究已经确定了几种早期诊断这种疾病并更有效地跟踪它的方法。目的：在即将到来的资助周期中，我们建议研究应该进一步表征青光眼的丧失，使用视觉功能特异性测试和新的分析技术，以帮助我们防止导致生活质量大幅下降的破坏性视力丧失。目的：进一步完善青光眼发病和进展的检测方法，并利用视功能的心理物理指标评价治疗效果。参与者：至少346例原发性开角型青光眼患者，209例因该疾病有视力丧失风险，100例年龄匹配的健康对照。已有419例患者进行了平均超过7年的长期随访，以协助分析疾病的进展。方法：1)评估几种视觉功能特异性测试，以进一步了解对视力重要的视网膜细胞的潜在损伤，并确定与视网膜细胞功能障碍和死亡相关的进行性丧失。2)采用新的检测模式和分析技术，缩短青光眼进展的诊断时间。重要性：如果这项应用的目的得以实现，我们将提高我们对原发性开角型青光眼相关的不同潜在病理的理解，能够更好地监测进展和治疗的有效性，并更有效地预测大量患者的预后。这将导致我们对青光眼概念的重大改变，进一步增强临床实践中用于该病诊断和随访的方法，并改进青光眼治疗临床试验的临床方案。

DESCRIPTION: Glaucoma is a progressive disease known to affect the vision in more than 2 million Americans. This estimate is low as individuals with glaucoma are often unaware they have the disease. As people live longer, this number will increase to more than 3 million by 2020 with 120,000 becoming blind in the US. This study has already identified several methods to diagnose the disease earlier and to follow it more effectively. Purpose: In the upcoming grant cycle we propose studies that should further characterize glaucomatous loss using visual function specific testing and new analysis techniques to help us prevent the devastating loss of vision that leads to a substantial drop in quality of life. Aims: To further improve measures to detect the onset and progression of glaucoma and to assess treatment effectiveness using psychophysical measures of visual function. Participants: At least 346 patients with primary open angle glaucoma, 209 at risk for vision loss due to the disease and 100 healthy age-matched controls. A mean long-term follow up of over 7 years is already available for 419 patients to assist in analyses of progressive disease. Methods: 1) Evaluation of several visual function specific tests to further understand the underlying damage to retinal cells important for vision and to determine the progressive loss associated with retinal cell dysfunction and death. 2) Implementation of new testing paradigms and analysis techniques to shorten the time necessary to identify progression of glaucoma. Importance: If the aims of this application are achieved, we will improve our understanding of the different underlying pathologies associated with primary open angle glaucoma, be better able to monitor progression and conversely the effectiveness of treatment, and predict the outcome more effectively for a large number of patients. This should lead to significant changes in our concepts of glaucoma, further enhancements of the methods used in clinical practice to diagnose and follow this disease, and improved clinical protocols for clinical trials of glaucoma therapies.