Behavioral Measures of Vision

描述（由申请人提供）：青光眼是一种进行性视神经病变，由构成从眼睛到大脑的视神经的视网膜神经元病理性缺失引起。在美国，青光眼是不可逆失明的主要原因;大约220万40岁以上的人患有该疾病，并且这些人中多达120，000人因青光眼而失明。随着人口老龄化，这种疾病将成为一个日益重要的公共卫生问题，但治疗方法在预防或减缓视力丧失方面是有效的，因此，重要的是要优化程序，以确定是否需要治疗以及治疗是否有效。由于青光眼的病因尚不清楚，因此疾病的诊断或进展需要眼科测试来识别和量化青光眼性神经病的临床特征，例如视野缺损的模式、视神经乳头的解剖学变化以及视网膜神经节细胞和轴突的损失。 拟议研究的目标是更好地了解青光眼神经和视觉损失的临床测量之间的关系，特别是结构和功能之间的心理生理联系。主要实验涉及猕猴实验性青光眼时间过程中的视觉功能行为研究（标准自动视野检查）和视网膜结构高分辨率成像（光学相干断层扫描）。来自实验性青光眼的研究的数据将用于1）开发将视网膜的特定区域中的视网膜神经元的损失与从相同视网膜区域进入视神经的轴突的数量相关联的定量模型，以及2）研究青光眼性神经病的临床体征的时间关系，所述临床体征涉及视觉灵敏度的损失、视神经乳头的杯状突起增加、以及内层视网膜的神经元层变薄。在最后阶段，从猴子实验性青光眼中得出的关系将用于评估人类患者青光眼的严重程度或阶段。 该研究方法是基于定义实验性青光眼的程序，其中对实验和测量变量有很好的控制，然后应用于人类患者以测试程序的临床相关性和有效性。这种从实验室到临床的方法应该最大限度地挖掘关于眼科测试的重要新信息，以用于青光眼的诊断和评估。 关键词：青光眼，视网膜神经节细胞，视网膜神经纤维层，视野检查，OCT，视神经乳头，猴，人

DESCRIPTION (provided by applicant): Glaucoma is a progressive optic neuropathy caused by a pathological loss of the retinal neurons that form the optic nerve from the eye to the brain. t is a leading cause of irreversible blindness in the United States; approximately 2.2 million people older than 40 years of age suffer from the disease and as many as 120,000 of these people are blind from glaucoma. As the population ages, the disease will become an increasingly important problem of public health, but treatments are effective in preventing or slowing vision loss and it is, therefore, important to optimize procedures for determining if treatment is needed and if it is effective. Because the cause of glaucoma is unknown, the diagnosis or progression of disease requires ophthalmic testing to identify and quantify clinical characteristics of glaucomatous neuropathy, such as the pattern of visual field defects, anatomical changes of the optic nerve head, and losses of retinal ganglion cells and axons. The goal of the proposed research is to gain a better understanding of the relationships between clinical measures of neural and visual losses from glaucoma, especially the psycho-physiological links between structure and function. The principal experiments involve behavioral studies of visual function (standard automated perimetry) and high resolution imaging of retinal structure (optical coherence tomography) over the time course of experimental glaucoma in macaque monkeys. The data from the investigations of experimental glaucoma will be used to 1) develop a quantitative model relating the loss of retinal neurons in a specific area of the retia to the number of axons entering the optic nerve from the same retinal area and 2) To investigate the temporal relationships of the clinical signs of glaucomatous neuropathy that involve losses in visual sensitivity, increased cupping of the optic nerve head, and thinning of the neuronal layers of the inner retina. In the final phase, the relationships that were derived from experimental glaucoma in monkeys will be applied to assess the severity, or stage, of glaucoma in human patients. The research method is based on defining procedures with experimental glaucoma where there are excellent controls for the experimental and measurement variables and, then, application to human patients to test the clinical relevance and validity of the procedures. This method of going from the laboratory to the clinic should maximize the potential for significant new information about ophthalmic testing for translation to the diagnosis and assessment of glaucoma. Key words: glaucoma, retinal ganglion cells, retinal nerve fiber layer, perimetry, OCT, optic nerve head, monkeys, humans