Investigating Optical and Neural Causes of Vision Loss

项目摘要/摘要 由于老年人的增长和老龄化，视力丧失已成为一个主要的公共卫生问题 人口。老年性黄斑变性(AMD)是导致视力丧失的最常见原因 在50岁以上的人中。在美国，超过1000万人患有AMD或以上 160万50岁及以上的人患有晚期AMD。众所周知， 有中心性视力丧失的AMD患者使用首选视网膜位置(PRL)，即周边视网膜 与中心凹相邻的区域，用于进行日常活动，如阅读。然而，即使在 与健康眼相比，由于神经采样密度降低，周边视力受限 中心凹。此外，患者的外周视网膜功能可能会进一步降低， 由于退化性疾病的过程。这些神经基质的损失与 视网膜上的光学图像质量下降。光学缺陷随年龄增长而增加 以及与沿着眼睛的光轴观察相比的离轴观察。这两种技术的结合 这些因素在降低偏心性视障患者的视觉表现中起着重要作用。 定格。该项目的长期目标是改善退伍军人的视觉表现 通过开发创新的方法使中心视力损失，从而使 视力康复技术。在目前的提案中，光学和神经损失将是 使用新技术对中心视力丧失的AMD患者进行评估。提高了光学性能 由于年龄和眼睛光轴以外的观察造成的损失将通过波前建立 分析技术。PRL因视网膜功能障碍而增加的神经损失将是 基于模糊刺激下的视力测量而确定的。提高阅读能力 速度将根据PRL的神经损失和/或PRL的稳定性进行评估，在 利用我们的自适应光学系统补偿光学损耗。调查结果将提供 对PRL功能和稳定性的了解，有助于改善可用结果 视力康复方法，训练患者更好地使用他们的PRL。此外，还可以定制 可以纠正眼睛的光学缺陷以有效地改善视觉性能 作为患者更好的视力康复的一种方法而开发。优化视觉 我们退伍军人的康复将使他们能够保持功能和生产力。

Project Summary / Abstract Vision loss has become a major public health problem due to the growth and aging of the population. Age-related macular degeneration (AMD) is the most common cause of vision loss in people over 50 years of age. In the United States, over 10 million people have AMD and over 1.6 million people age 50 and older have late-stage advanced AMD. It is well established that AMD patients with central vision loss use preferred retinal loci (PRL) which are peripheral retinal areas adjacent to the fovea for performing daily activities, such as reading. However, even in healthy eyes, peripheral vision is limited due to reduced neural sampling density compared to the fovea. Additionally, the function of the peripheral retina can be further reduced in patients, owing to degenerative disease processes. These neural substrate losses are coupled with losses in the quality of the optical image on the retina. Optical imperfections increase with age and off-axis viewing, compared to viewing along the optical axis of the eye. The combination of these factors plays a significant role in reducing visual performance of patients with eccentric fixation. The long term goal of the project is to improve the visual performance of veterans with central vision loss by development of innovative approaches that will optimize the benefit of vision rehabilitation techniques. In the current proposal, optical and neural losses will be assessed in AMD patients with central vision loss using novel techniques. Increased optical losses due to age and viewing off the optical axis of the eye will be established with wavefront analysis technology. Increased neural losses due to retinal dysfunction at PRL will be determined based on measurement of visual acuity with blurred stimuli. Improvement in reading speed will be evaluated, conditional on neural losses at PRL and/or the stability of PRL, after compensating for optical losses with our adaptive optics system. The findings will provide knowledge of PRL function and stability that is beneficial for improving the outcome of available vision rehabilitation methods that train patients to better use their PRLs. Also, customized correction of optical imperfections of the eye for effectively improving visual performance can be developed as an approach for better vision rehabilitation of patients. Optimizing vision rehabilitation of our veterans will allow them to maintain function and productivity.