Visual Field Expansion Through Innovative Multi-periscopic Prism Design

通过创新的多潜望棱镜设计扩展视野

• 批准号: 10334699
• 负责人: ELI PELI
• 金额: $ 8.3万
• 依托单位: SCHEPENS EYE RESEARCH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-09-30 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10334699
• 关键词: 3D Print; Area; Automobile Driving; Brain Injuries; Choroideremia; Clinic; Clinical Trials; Color; Computers; Detection; Devices; Eye; Eyeglasses; Glaucoma; Homonymous Hemianopia; Image; Individual; Island; Judgment; Lateral; Measures; Multi-Institutional Clinical Trial; Optics; Outcome Measure; Patient Preferences; Patients; Pentas; Performance; Peripheral; Positioning Attribute; Quality of life; Randomized; Reaction Time; Reporting; Residual state; Retinal Diseases; Retinitis Pigmentosa; Risk; Scanning; Side; Stroke; System; Techniques; Testing; Time; Trauma; Visual; Visual Aid; Visual Fields; Walking; base; blind; clinical research site; cost effective; design; detection test; effectiveness testing; efficacy study; expectation; falls; feasibility testing; hazard; improved; innovation; novel; parent grant; preference; primary outcome; prototype; secondary outcome; success; tumor; virtual reality

Parent Grant Abstract Individuals with visual field loss report collisions with other pedestrians or objects, tripping over obstacles, and are commonly not permitted to drive. All of these factors severely restrict their independence and quality of life. Visual field loss is common following brain injuries such as stroke, trauma, or tumors (hemianopic field loss, HFL) or it may be due to retinal diseases such as retinitis pigmentosa, choroideremia, and advanced glaucoma (peripheral field loss, PFL). Most visual aids developed for field expansion have had limited success. Prisms designed to shift portions of a scene from the blind field to the residual seeing field are the simplest, lightest, and most cost-effective devices for visual field loss patients. These prism devices create artificial visual islands that can help PFL and HFL patients detect and avoid collision risks. A pedestrian on a collision course will stay at a fixed position in the visual field of the patient. Our recent analysis found that the risk of a collision with other pedestrians is highest when the oncoming pedestrian approaches from an angle of 45. Conventional prism devices can shift images up to 30° but do not reach this area of peak collision risk. Further, the shifted images are distorted spatially (minified) and in color and have low contrast. When patients scan (look) toward the blind side the effective expansion benefit is limited to only 5° by current prism designs. Thus, the actual field expansion benefit of current devices falls below the best possible theoretical expectation. To overcome these limitations, we invented a new optical device, the “multi-periscopic prism (MPP)”, which uses cascaded half-penta prisms (typically used in binoculars). Whereas conventional prisms use refraction, the MPP uses two reflections, resulting in a 45° image shift (improvement of 50% over current prisms) without the refraction effects of minification, color distortion, or contrast reduction. The MPP covers the peak collision risk eccentricity and permits 15° of effective eye scanning into the blind side (3 times wider than current prisms). We developed prototypes and preliminary configurations of this novel device to enable field expansion in HFL and PFL patients. This field expansion is intended to facilitate detection of pedestrian collisions when walking, or hazards at intersections when driving (HFL). We have proposed configurations of the device for PFL patients to allow for downward eye scanning and detection of tripping hazards. Here we propose to iteratively implement additional refinements, fine-tune, and test the effectiveness of the MPP as an aid for patients with HFL or PFL. This will begin with feasibility tests in the lab and culminate in a randomized controlled multicenter clinical trial. We will compare patients’ pedestrian collision detection performance with the novel MPP devices and current prism devices and evaluate their device preferences. In the multicenter clinical trial, we will use an innovative virtual reality pedestrian collision detection test system that can be easily implemented at clinics using standard computers and large screen TVs. We will also conduct a lab test during the multi-center clinical trial to further study the efficacy of the MPP in HFL driving.

父授予摘要 视野损失报告与其他行人或物体相撞的人，绊倒障碍，以及 通常不允许开车。所有这些因素都严重限制了它们的独立性和生活质量。 脑损伤（例如中风，创伤或肿瘤）（止血场丧失，脑损伤），视野损失是常见的 HFL）或可能是由于视网膜疾病（例如视网膜炎，绒毛膜血症和晚期青光眼）引起的 （外围场损失，PFL）。为现场扩展而开发的大多数视觉辅助工具取得了有限的成功。棱镜 旨在将场景的某些部分从盲区转移到残留的视野是最简单，最轻巧的 视野损失患者的最具成本效益的设备。这些棱镜设备创建了人造视觉岛屿 可以帮助PFL和HFL患者发现并避免碰撞风险。碰撞课程中的行人将留在 在患者的视野中固定位置。我们最近的分析发现，与其他碰撞的风险 当迎面而来的行人从45个角度接近时，行人最高。传统的棱镜 设备可以将图像移至30°，但不会达到峰值碰撞风险的区域。此外，移动的图像 在空间上被扭曲（缩小）和颜色，并且对比度较低。当患者扫描（看）盲目 当前的棱镜设计仅限5°，有效的扩展优势仅限于5°。那是实际的现场扩展 当前设备的益处低于最佳的理论期望。为了克服这些限制， 我们发明了一种新的光学设备，即“多层棱镜（MPP）”，该设备使用级联的半尖锐棱镜 （通常用于双筒望远镜）。传统的棱镜使用折射，而MPP使用两种反射， 导致45°图像转移（比目前的棱镜提高了50％），而没有折射影响 最小化，颜色失真或对比度还原。 MPP涵盖了峰值碰撞风险偏心率和 允许15°有效的眼睛扫描到盲侧（比目前的棱镜宽3倍）。我们开发了 这种新型设备的原型和初步构型可在HFL和PFL患者中进行现场扩张。 该田野扩展旨在促进行走时的行人碰撞检测，或 驾驶时的交叉点（HFL）。我们已经提出了该设备配置，以供PFL患者使用 向下眼睛扫描和检测绊倒危险。在这里，我们建议迭代实施其他 改进，微调和测试MPP作为HFL或PFL患者的有助于。这会 从实验室中的可行性测试开始，然后在一项随机对照多中心临床试验中达到高潮。我们将 比较患者的行人碰撞检测性能与新型MPP设备和当前的棱镜 设备并评估其设备偏好。在多中心临床试验中，我们将使用创新的虚拟 现实的行人碰撞检测测试系统，可以在诊所使用标准轻松实施 计算机和大型屏幕电视。我们还将在多中心临床试验期间进行实验室测试以进一步 研究MPP在HFL驾驶中的效率。