Efficient Assessment of Visual Deficits and Rehabilitation Methods in Amblyopia

描述(申请人提供)：弱视是儿童视力受损的主要原因，影响全球约3%-5%的人口。这种疾病导致单眼和双眼缺陷综合征，在没有可观察到的眼部病理的情况下，在光学矫正后仍然存在。目前弱视的治疗方法在25%-50%的病例中都不成功，而且很少能恢复正常的双眼视觉。弱视中观察到的广泛的缺陷，其不同的病因，以及对治疗的反应的个体差异， 提示多种功能缺陷是弱视视力损害的原因。这项建议旨在分离弱视视觉损害谱系下的核心缺陷，开发有效表征此类核心缺陷的新测试方法，并评估这些缺陷如何受到当前和新兴疗法的影响。虽然我们建议研究的核心缺陷清单可能不是详尽的，其他缺陷可能会导致弱视，但开发一个框架，改进单眼和双眼视觉评估方法，将有助于弱视和其他视觉障碍的诊断、治疗和管理。在目标1中，我们将开发和测试在个体水平上快速评估正常和弱视视力的对比敏感度、双眼交互作用和空间失真的新方法。在目标2中，我们将量化弱视中观察到的广泛视觉病理与对比敏感度、双眼组合和空间失真方面的核心缺陷的相关性。在目标3中，我们将评估传统的和新兴的弱视治疗如何补救每个核心缺陷。因此，拟议研究的总体目标是开发最先进的心理物理方法并将其转化为临床应用。这些目标的实现将为(1)量化正常和受损的单眼和双眼视力，(2)分析和诊断视力损害，以及(3)实施可定制的视力损害康复策略提供新的和改进的方法。弱视综合康复疗法的最终发展可以通过针对核心缺陷来实现。每个目标都涉及NEI的国家眼睛和视觉研究计划的一个目标。

DESCRIPTION (provided by applicant): Amblyopia is the leading cause of visual impairment in children and affects approximately 3-5% of the population worldwide. The disorder causes a syndrome of monocular and binocular deficits that persist after optical correction, in the absence of observable ocular pathology. Current treatment for amblyopia is unsuccessful in 25-50% of cases and rarely restores normal binocular vision. The broad range of deficits observed in amblyopia, its different etiologies, and the individual differences in responsiveness to treatment, suggest that multiple functional defects underlie amblyopic visual impairment. This proposal aims to isolate the core deficits that underlie the spectrum of amblyopic visual impairment, develop novel testing methods that efficiently characterize such core deficits, and evaluate how these deficits are affected by current and emerging therapies. Though the list of core deficits we propose to study may not be exhaustive, and other deficits may contribute to amblyopia, developing a framework that improves methods for monocular and binocular visual assessment will facilitate diagnosis, treatment and management of amblyopia and other visual impairments. In Aim 1, we will develop and test novel methods for rapidly assessing contrast sensitivity, binocular interaction, and spatial distortion in normal and amblyopic vision at the individual leve. In Aim 2, we will quantify the dependence of broad visual pathologies observed in amblyopia on core deficits in contrast sensitivity, binocular combination, and spatial distortion. In Aim 3, we will evaluate how conventional and emerging amblyopia treatments remediate each core deficit. The overall goal of the proposed research is therefore to develop and translate state-of-the-art psychophysical methods to clinical applications. Accomplishing the proposed aims will provide new and improved methods for (1) quantifying normal and impaired monocular and binocular vision, (2) analyzing and diagnosing visual impairment, and (3) implementing customizable rehabilitation strategies for visual impairment. The eventual development of comprehensive rehabilitative therapies for amblyopia could be achieved by targeting the core deficits. Each aim addresses a goal of the NEI's National Plan for Eye and Vision Research.