Efficient Assessment of Visual Deficits and Rehabilitation Methods in Amblyopia

描述（由申请人提供）：弱视是儿童视力损害的主要原因，影响全球约3-5%的人口。该疾病引起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，在光学矫正后持续存在。目前弱视的治疗在25-50%的病例中是不成功的，并且很少恢复正常的双眼视觉。在弱视中观察到的广泛缺陷、其不同的病因以及对治疗反应的个体差异， 提示弱视视觉损害是多功能缺陷的基础。该提案旨在分离弱视视觉障碍谱的核心缺陷，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列表可能并不详尽，其他缺陷可能导致弱视，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，我们将开发和测试新的方法，用于快速评估个体水平上正常和弱视视觉的对比敏感度、双眼相互作用和空间畸变。在目标2中，我们将量化弱视中观察到的广泛视觉病理对对比敏感度、双眼组合和空间失真的核心缺陷的依赖性。在目标3中，我们将评估传统和新兴弱视治疗如何修复每一个核心缺陷。因此，拟议研究的总体目标是开发和翻译最先进的心理物理方法的临床应用。实现所提出的目标将提供新的和改进的方法，用于（1）量化正常和受损的单眼和双眼视觉，（2）分析和诊断视力障碍，以及（3）实施针对视力障碍的定制康复策略。针对弱视核心缺陷的综合康复治疗方法的最终发展是可以实现的。每一个目标都涉及NEI的国家眼睛和视力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.