Visual acuity and functional measurements in the aging eye

老化眼睛的视力和功能测量

• 批准号: 10478474
• 负责人: ANN E ELSNER
• 金额: $ 63.24万
• 依托单位: AEON IMAGING, LLC
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-01 至 2024-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10478474
• 关键词: Address; Adult; Affect; Aftercare; Age; Age related macular degeneration; Aging; Algorithms; American; Blindness; Burn injury; Cataract; Certification; Clinical; Clinical Trials; Computer software; Computers; Contrast Sensitivity; Data; Detection; Developed Countries; Devices; Diabetes Mellitus; Diabetic Retinopathy; Disease; Drusen; Epiretinal Membrane; Excision; Exudative age-related macular degeneration; Eye; Film; Future; Goals; Hyperopia; Image; Imaging technology; Indiana; Legal patent; Lesion; Light; Lighting; Liquid substance; Matched Group; Measurement; Measures; Methods; Miosis disorder; Modeling; Morphologic artifacts; Near-infrared optical imaging; Optics; Outcome; Outcome Measure; Patients; Pattern; Performance; Photoreceptors; Pigmentation physiologic function; Population; Price; Protocols documentation; Psychophysics; Pupil; Refractive Errors; Reporting; Reproducibility; Residual state; Resolution; Retina; Retinal Diseases; Sample Size; Savings; Scanning; Series; Speed; Stimulus; Testing; Time; Training; Universities; Vision; Visual; Visual Accommodation; Visual Acuity; adaptive optics; adaptive optics scanning laser ophthalmoscopy; algorithm development; base; cost; cost effective; design; detector; diabetic; feature detection; flexibility; follow-up; geographic atrophy; imager; improved; individual patient; light scattering; macular edema; medical schools; primary outcome; rapid technique; relating to nervous system; retina blood vessel structure; retinal imaging; sample fixation; tool; treatment trial; visual stimulus

Project Summary Age-related macular degeneration (AMD) remains the most common cause of permanent vision loss in the US and many industrialized countries. Diabetic retinopathy and diabetic macular edema are the leading cause of visual acuity loss in working age Americans. Visual function is a key component in almost all of the 1,861 US clinical trials for AMD and 262 for diabetic retinopathy and macular edema. If outcome measures, including visual acuity, could be made more accurate and cost-effective and with decreased test-retest variability, then clinical trials could use smaller sample sizes, giving savings in cost and time to bring therapies to market. By building a new device, the Potential Vision Tester™ (PVT), we will improve measurements by minimizing the issues from the optics of the aging eye. Simultaneous retinal imaging will clarify fixation locus and fixation stability of the patient’s eye. The optical errors of a patient’s eye will be measured as wavefront aberrations, and the target display will be corrected with moderately priced adaptive optics to overcome retinal elevation from exudation as well as refractive error. Reporting out of wavefront errors distinguishes between neural damage vs. optical issues. A high resolution display, suitable for visual acuity testing, will project stimuli onto the eye in Maxwellian view to minimize pupil size effects found in older eyes. Competing devices for microperimetry lack the resolution needed for visual acuity. We will use psychophysical techniques that are rapid, accurate, and provide better measures of variability: 4 alternative forced choice. In Aim 1, we will build an adaptive optics-corrected PVT visual display and NIR illumination for retinal imaging. The imaging light is comfortable and dim enough not to interfere with visual tasks. The patented NIR imaging technology projects a series of stripes onto the retina in a raster pattern, providing line scanning for imaging. The detection is via a 2D CMOS detector with a rolling shutter, with the serial read-out of the lines either synchronized with the illumination or offset in time. This provides a flexible electronic aperture under computer control. Both confocal and multiply scattered light images are available, revealing drusen and other subretinal thickening. We will optimize image quality in 10 subjects with a range of refractive error, ocular pigmentation, and age. In Aim 2, we will quantify and validate the Hartmann-Shack wavefront measurements of the PVT in 20 patients with retinal disease vs. 20 without to determine the effect on wavefront measurements. In Aim 3 we will optimize the algorithm for efficient testing and metric for Potential Visual Acuity (PVA), using data from Aims 1 and 2, reporting central tendency (expected value) and variability, including optical errors and fixation data, to address the acuity this patient could reach with retinal treatment. In Aim 4, for 20 patients with exudative AMD and 20 with diabetic macular edema, we will assess PVA reproducibility and validity by comparison to standard VA and the prediction at baseline to actual post-treatment measured VA and PVA at follow up.

项目摘要 与年龄有关的黄斑变性（AMD）仍然是美国永久视力丧失的最常见原因 以及许多工业化国家。糖尿病性视网膜病和糖尿病性黄斑水肿是 工作年龄的美国人视力丧失。视觉功能是几乎所有1,861个美国的关键组成部分 糖尿病性视网膜病和黄斑水肿的AMD临床试验和262次试验。如果结果措施，包括 视力可以使您更准确和更具成本效益，并且通过降低测试重度可变性，然后 临床试验可以使用较小的样本量，从而节省了将疗法推向市场的成本和时间。经过 构建一种新设备，即潜在的Vision Tester™（PVT），我们将通过最小化来改进测量 衰老眼镜的问题。同时进行视网膜成像将澄清固定基因座和固定 患者眼睛的稳定性。患者眼睛的光学错误将被测量为波前畸变， 并且目标显示将通过适度的自适应光学元件来纠正，以克服永久高程 来自渗出液以及折射率。从波前错误报告的中性区别 损坏与光学问题。适用于视力测试的高分辨率显示器会将刺激投影到 Maxwellian视图中的眼睛最大程度地减少了较老的眼睛中发现的瞳孔尺寸效果。竞争设备的 微量工缺乏视力所需的分辨率。我们将使用心理物理技术 快速，准确，并提供更好的可变性度量：4替代强制选择。在AIM 1中，我们将建立 自适应光学校正的PVT视觉显示和用于视网膜成像的NIR照明。成像光是 舒适且昏暗，不干扰视觉任务。获得专利的NIR成像技术项目 一系列的条纹以栅格模式在视网膜上，为成像提供线条扫描。检测是通过 2D CMOS检测器，带有滚动快门，线条的串行读数与该线路同步 照明或及时偏移。这在计算机控制下提供了灵活的电子光圈。两个都 提供共聚焦和乘散射的光图像，揭示了drusen和其他视网膜下增厚。 我们将优化10名受试者的图像质量，并具有一系列折射率，眼色素沉着和年龄。 AIM 2，我们将量化和验证20名患者的PVT的Hartmann-Shack波前测量 与残留疾病与20的无关，以确定对波前测量的影响。在目标3中，我们将 使用来自AIMS 1 2，报告中心趋势（期望值）和可变性，包括光错误和固定数据， 解决该患者可以通过残留治疗达到的敏锐度。在AIM 4中，有20例真实AMD的患者 20具有糖尿病性黄斑水肿，我们将与标准相比，评估PVA的可重复性和有效性 VA和实际处理后基线的预测在随访时测量了VA和PVA。