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.

项目概要 年龄相关性黄斑变性 (AMD) 仍然是美国永久性视力丧失的最常见原因 和许多工业化国家，糖尿病性视网膜病变和糖尿病性黄斑水肿是糖尿病的主要原因。 工作年龄美国人的视力下降 视觉功能是几乎所有 1,861 名美国人的一个关键组成部分。 AMD 和 262 糖尿病视网膜病变和黄斑水肿的临床试验，包括结果测量。 视力，可以变得更加准确和具有成本效益，并减少重测变异性，然后 临床试验可以使用较小的样本量，从而节省将疗法推向市场的成本和时间。 构建新设备 Potential Vision Tester™ (PVT)，我们将通过最小化 同步视网膜成像将阐明注视点和注视的光学问题。 患者眼睛的稳定性将被测量为波前像差， 并且目标显示将通过价格适中的自适应光学器件进行校正，以克服视网膜抬高 渗出物和屈光不正的报告可区分神经元和波前误差。 适合视力测试的高分辨率显示器会将刺激投射到 麦克斯韦视图中的眼睛，以最大限度地减少老年眼睛的竞争设备中发现的瞳孔大小影响。 微视野测量缺乏视敏度所需的分辨率，我们将使用心理物理技术。 快速、准确并提供更好的可变性测量：在目标 1 中，我们将构建 4 个替代强制选择。 用于视网膜成像的自适应光学校正 PVT 视觉显示器和近红外照明。 舒适且昏暗，不会干扰视觉任务的专利近红外成像技术项目。 以光栅图案将一系列条纹投射到视网膜上，通过线扫描进行成像。 带有卷帘快门的 2D CMOS 探测器，行的串行读出与 这提供了计算机控制下的灵活的电子光圈。 共焦和多重散射光图像可显示玻璃疣和其他视网膜下增厚情况。 我们将优化 10 名具有不同屈光不正、眼部色素沉着和年龄的受试者的图像质量。 目标 2，我们将量化并验证 20 名患者的 PVT 的 Hartmann-Shack 波前测量 在目标 3 中，我们将确定患有视网膜疾病的 20 例与未患有视网膜疾病的 20 例对波前测量的影响。 使用目标 1 的数据优化潜在视力 (PVA) 有效测试和度量的算法 2、报告集中趋势（期望值）和变异性，包括光学误差和注视数据，以 在目标 4 中，针对 20 名渗出性 AMD 患者，确定了该患者可以达到的视力。 和 20 名患有糖尿病黄斑水肿的患者，我们将通过与标准比较来评估 PVA 的再现性和有效性 VA 和基线预测到治疗后实际测量的 VA 和 PVA 在随访中。