PERIMETRY AND CLINICAL PSYCHOPHYSICS IN GLAUCOMA

青光眼的视野检查和临床心理物理学

• 批准号: 2158798
• 负责人: CHRIS A JOHNSON
• 金额: $ 35.53万
• 依托单位: UNIVERSITY OF CALIFORNIA AT DAVIS
• 依托单位国家: 美国
• 财政年份: 1981
• 资助国家: 美国
• 起止时间: 1981-01-01 至 1996-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/2158798
• 关键词: biomedical automation; computer assisted diagnosis; computer simulation; diagnosis quality /standard; flicker fusion test; glaucoma; glaucoma test; human subject; hypertension; longitudinal human study; mass screening; optic nerve disorder; pathologic process; perimetry; psychophysics; visual fields; visual photosensitivity; visual threshold

Glaucoma affects more than 2 million people in the United States. It is usually characterized by damage to the optic nerve as a result of elevated intraocular pressure (IOP). A larger number of individuals, ocular hypertensives (OH), have elevated IOP and no clinical evidence of damage, but are at higher risk of developing glaucoma. Perimetry is an important clinical procedure for detecting, evaluating and monitoring glaucoma, although substantial optic nerve damage can occur prior to visual field loss. Thus, more sensitive clinical test procedures are needed. The goals of this project are: To evaluate psychophysical indicators of early glaucomatous damage to the optic nerve. * Short-wavelength-sensitive perimetry (SWSP) We have found that visual field deficits can be detected approximately two years earlier by SWSP than by standard automated perimetry (AP). However, this was m a small, selected group of patients. We now propose to determine, in a five-year follow-up study of a large sample of ocular hypertensive patients, the relative sensitivity, specificity and effectiveness of SWSP for early identification of the patients who will later develop AP visual field loss. * Temporal modulation perimetry (TMP) Sensitivity losses for high temporal flicker frequencies have also been proposed as an early indicator of glaucomatous damage. We have recently developed an automated TMP procedure that demonstrates abnormal results in some OH and most early glaucoma patients. A longitudinal study of TMP is needed to determine its efficacy for predicting AP visual field loss and progression in glaucoma. Longitudinal comparisons of TMP, SWSP and AP in the same patients will characterize the amount of early glaucomatous loss that is common to all tests (nonselective loss) and the amount of early loss attributable to individual tests (selective loss). We will examine selected groups of age-matched normal controls, OH patients and early glaucoma patients with TMP, SWSP and AP over a five year followup period. * Displacement threshold perimetry (DTP) Displacement thresholds appear to be disrupted in patients with ocular hypertension and early glaucoma. We propose to design a perimetric test based on displacement thresholds and assess its efficacy as a clinical test of early glaucomatous damage. To develop Integrated Modular Perimetry Strategies (IMPS) for automated perimetry (AP). Improvements m test strategies enhance the diagnostic utility of AP. We will use KRAKEN, our computer simulation model of perimetry, to construct rapid, heuristic test strategies (IMPS) for (1) optimal detection, (2) baseline evaluation and (3) followup of field loss and assess the robustness of these procedures to various visual field characteristics, patient errors and response fluctuations. The strategies employed in IMPS will be similar to those developed for RIOTS which have been successful in substantially reducing test time in AP without sacrificing accuracy.

青光眼在美国影响超过200万人。 这是 通常以对视神经的损害的特征 眼内压（IOP）升高。 更多的人， 眼高血压（OH），IOP升高，没有临床证据 损坏，但患有青光眼的风险更高。 外围是一个 检测，评估和监测的重要临床程序 青光眼，尽管可能发生实质性视神经损伤 视野损失。 因此，更敏感的临床测试程序是 需要。 该项目的目标是： 评估早期青光眼损害的心理物理指标 视神经。 *短波长敏感的周围（SWSP）我们发现 大约两年前可以检测到视野缺陷 SWSP比通过标准自动化图（AP）的SWSP。 但是，这是M a 小，选定的患者。 我们现在建议确定 大量眼部高血压样本的五年随访研究 患者，SWSP的相对灵敏度，特异性和有效性 为了早日识别患者，这些患者将随后发展AP Visual 现场损失。 *临时调制周围（TMP）敏感性损失 还提出了颞闪烁频率作为早期 青光眼损害的指标。 我们最近开发了 自动化的TMP程序证明异常结果在某些OH中，并且 大多数早期青光眼患者。 需要对TMP进行纵向研究 确定其预测AP视野损失和 青光眼进展。 TMP，SWSP和AP的纵向比较 同一患者将表征早期青光眼损失的量 所有测试（非选择性损失）和早期的数量都是常见的 损失归因于单个测试（选择性损失）。 我们将检查 选定的年龄匹配的正常对照组，OH患者和早期 在五年的随访期内，具有TMP，SWSP和AP的青光眼患者。 *位移阈值周围（DTP）位移阈值 眼高血压患者和早期患者似乎受到了破坏 青光眼。 我们建议设计基于位移的周长测试 阈值并评估其作为早期临床测试的功效 青光眼损害。 开发自动化的集成模块化策略（IMP） 围绕（AP）。 改进M测试策略增强了诊断 AP的实用程序。 我们将使用Kraken，我们的计算机模拟模型 构造（1）的周长，以构建快速的启发式测试策略（IMP） 最佳检测，（2）基线评估和（3）野外损失的随访 并评估这些过程到各种视野的鲁棒性 特征，患者错误和反应波动。 这 IMPS中采用的策略将与为暴动开发的策略相似 在大大减少了AP的测试时间方面已成功 没有牺牲准确性。