Virtual-Reality Assessment and Treatment of Binocular Vision Impairment in Traumatic Brain Injury

创伤性脑损伤双眼视觉障碍的虚拟现实评估和治疗

• 批准号: 10426240
• 负责人: MARK F. WALKER
• 金额: --
• 依托单位: LOUIS STOKES CLEVELAND VA MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-07-01 至 2023-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10426240
• 关键词: 3-Dimensional; Acute; Address; Adherence; Affect; Area; Assessment tool; Binocular Vision; Blunt Trauma; Clinical; Clinical Trials; Cognitive; Convergence Insufficiency; Custom; Data; Diagnosis; Diagnostic; Diplopia; Exercise; Eye; Eye Movements; Feedback; Functional disorder; Funding; Future; Goals; Image; Impairment; Improve Access; Individual; Injury; Left; Link; Measurement; Measures; Military Personnel; Monitor; Myopia; Neurologic; Optometrist; Participant; Patients; Performance; Performance at work; Pilot Projects; Play; Population; Post-Concussion Syndrome; Preparation; Protocols documentation; Reading; Recording of previous events; Reporting; Research; Resolution; Schools; Speed; Supervision; Symptoms; System; Technology; Testing; Therapeutic; Therapeutic Intervention; Training; Traumatic Brain Injury; Veterans; Vision; Vision Disorders; Vision Disparity; Visual; Visual Acuity; Visual impairment; accurate diagnosis; base; blast trauma; clinical diagnostics; compare effectiveness; compliance behavior; diagnostic criteria; diagnostic tool; experience; feasibility testing; functional improvement; gaze; improved; military veteran; nervous system disorder; novel; patient home care; portability; prototype; reading difficulties; success; tool; treatment response; virtual environment; virtual healthcare; virtual reality; virtual reality game; virtual reality headset; virtual reality system; visual control; visual tracking; visual-vestibular

Traumatic Brain Injury (TBI) is a common problem that affects both military and civilian populations. Although most individuals with TBI recover from the acute cognitive effects of the injury, persistent sensorimotor symptoms are not uncommon. One frequently occurring post- concussive symptom is impairment of near vision. This may manifest as overt diplopia or as new difficulties reading and maintaining focus on near objects. Such symptoms have been attributed to TBI-related convergence insufficiency, but this remains controversial given limited data and the lack of robust and reliable tools to measure vergence function in routine clinical settings. Even when accurately diagnosed, treatment options for convergence insufficiency are limited and generally require direct supervision of a trained optometrist or vision therapist. Moreover, current therapy is limited by the fact that exercises cannot be precisely matched to a particular patient's vergence deficit, there are few objective measures of functional improvement to judge progress and titrate therapy, and it is difficult to monitor whether a patient is following the therapy plan and performing the exercises correctly. This project will address diagnostic and treatment gaps for vergence impairment after TBI by developing a set of novel virtual-reality tools for the assessment of vergence and binocular visual function and for game-based therapy to improve vergence performance. There are two aims to this pilot study. The first aim will employ a virtual-reality headset with integrated eye tracking to test static and dynamic vergence and visual function in a group of veterans with historical TBI and persistent binocular symptoms, comparing the results to veterans with TBI and no visual symptoms and to participants with no history of TBI or binocular issues. In the second aim, a virtual-reality game will be developed and piloted to provide vision exercises to veterans with convergence impairment after TBI, primarily as a test of feasibility but also to acquire preliminary data for future larger scale clinical trials.

创伤性脑损伤（TBI）是一个常见的问题，会影响军事和平民 人群。尽管大多数具有TBI的人从 受伤，持续的感觉运动症状并不少见。一个经常发生的 脑震荡症状是近视的损害。这可能表现为公开的复视或新的 难以阅读和保持关注近对象。这种症状已归因于 对于与TBI相关的收敛性不足，但鉴于数据有限，这仍然是有争议的 缺乏可靠的可靠工具来测量常规临床环境中的Gergence功能。 即使准确诊断出，收敛性不足的治疗方案也有限，并且 通常需要直接监督训练有素的验光师或视力治疗师。而且，当前 治疗受到以下事实的限制：运动不能与特定患者的锻炼完全匹配 赤字赤字，几乎没有客观的功能改进来判断进度 和滴定疗法，很难监测患者是否遵循治疗计划和 正确执行练习。该项目将解决诊断和治疗差距 通过开发一组新颖的虚拟现实工具来评估，TBI之后发生了损害 Gergence和双眼视觉功能以及基于游戏的治疗以改善Gergence 表现。 这项试点研究有两个目标。第一个目的将使用带有虚拟现实耳机 集成的眼睛跟踪以测试一组静态和动态的静态和视觉功能 具有历史TBI和持续性双眼症状的退伍军人，将结果与退伍军人进行比较 没有TBI，没有视觉症状，没有TBI或双眼问题的参与者。在 第二个目的是，将开发和试点虚拟现实游戏，以提供视觉练习 TBI后有收敛损害的退伍军人，主要是作为可行性的测试 未来大规模临床试验的初步数据。