Perimetry and Psychophysics in Glaucoma

青光眼的视野测量和心理物理学

• 批准号: 6477969
• 负责人: CHRIS A JOHNSON
• 金额: $ 37万
• 依托单位: LEGACY EMANUEL HOSPITAL AND HEALTH CENTER
• 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 2007-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6477969
• 关键词: biomedical automation; cell death; clinical research; diagnosis design /evaluation; diagnosis quality /standard; evoked potentials; flicker fusion test; glaucoma; glaucoma test; human subject; lateral geniculate body; mass screening; nerve injury; noninvasive diagnosis; optic nerve disorder; pathologic process; perimetry; psychophysics; retinal ganglion; vision tests; visual fields; visual threshold; biomedical automation; cell death; clinical research; diagnosis design /evaluation; diagnosis quality /standard; evoked potentials; flicker fusion test; glaucoma; glaucoma test; human subject; lateral geniculate body; mass screening; nerve injury; noninvasive diagnosis; optic nerve disorder; pathologic process; perimetry; psychophysics; retinal ganglion; vision tests; visual fields; visual threshold

DESCRIPTION (Provided by applicant): Glaucoma is a disease characterized by optic nerve damage (retinal ganglion cell loss), and is one of the leading causes of blindness. It is estimated that 2 million people in the United States have been diagnosed with glaucoma, 1 million others have undiagnosed glaucoma, and up to 6 million (including 4-8 percent of people over 40) are at risk of developing glaucoma. Our current understanding of early damage in glaucoma, however, remains limited. Histopathologic studies in humans and experimental primate glaucoma models suggest that there can be substantial loss of retinal ganglion cells before reliable changes in visual function can be measured. This project will investigate a new method of noninvasively monitoring retinal ganglion cell loss, and potential functional and structural predictors of this loss. Our first aim determines the effect of glaucomatous retinal ganglion cell loss on cortical responses. Most new visual function tests for glaucoma have attempted to isolate and measure response properties of retinal ganglion cell subpopulations. We will use a noninvasive electrophysiology procedure, the multifocal Visual Evoked Potential (mfVEP), to measure cortical responses and the consequences of retinal ganglion cell loss on these responses. Because cortical responses are dependent on summed ganglion cell input, we propose that the mfVEP may be a more sensitive indicator of visual function loss, and may correlate more strongly with early structural optic nerve damage than other visual function measures. However, it is possible that retinal ganglion cell malfunction (sick cells) precedes the ganglion cell dropout (dead cells) investigated as part of our first aim. Our second aim therefore examines a method of functionally distinguishing sick from dead ganglion cells. We hypothesize that sick ganglion cells will show normal flicker sensitivity at lower adaptation levels, but will show deficits when challenged with higher adaptation levels. We will test the hypothesis that flicker adaptation dysfunction will predict future visual field deficits produced by retinal ganglion cell loss. In addition to these functional predictors of ganglion cell loss, our third aim evaluates the importance of structural damage to the optic nerve head (using stereo optic disc photographs and measurements with Heidelberg Retinal Tomography images) for predicting the location of future visual function deficits indicative of ganglion cell loss. Together, these objectives will provide a better understanding of the underlying basis of early glaucomatous damage.

描述（由申请人提供）：青光眼是一种疾病，其特征是 视神经损伤（视网膜神经节细胞损失），是领先的 失明的原因。据估计，美国有200万人 已被诊断出患有青光眼，100万人未诊断过青光眼， 多达600万（包括40岁以上的4-8％）有可能 发展青光眼。我们目前对青光眼早期损害的理解， 但是，仍然有限。人类的组织病理学研究和实验性研究 灵长类动物青光眼模型表明，视网膜可能会大大损失 在可靠的视觉功能变化之前，可以测量神经节细胞。这 项目将研究一种非侵入性监测视网膜的新方法 神经节细胞的损失以及潜在的功能和结构预测指标 损失。我们的第一个目标决定了青光眼视网膜神经节细胞的影响 皮质反应的损失。青光眼的大多数新的视觉功能测试具有 试图隔离和测量视网膜神经节细胞的响应特性 亚群。我们将使用无创的电生理程序， 多灶性视觉诱发电位（MFVEP），以测量皮质反应和 视网膜神经节细胞损失对这些反应的后果。因为 皮质反应取决于求和神经节细胞的输入，我们建议 MFVEP可能是视觉功能丧失的更敏感的指标，可以 与其他结构性视神经损伤更加与早期结构的关联 视觉功能度量。但是，视网膜神经节细胞可能 出现在神经节细胞辍学（死细胞）之前的故障（病细胞） 作为我们第一个目标的一部分进行了调查。因此，我们的第二个目标研究了 在功能上将病人与死神细胞区分开的方法。我们 假设生病的神经节细胞会在 降低适应水平，但在挑战较高时会显示出赤字 适应水平。我们将测试闪烁适应的假设 功能障碍将预测视网膜产生的未来视野缺陷 神经节细胞损失。除了这些神经节细胞的功能预测因子 损失，我们的第三个目标评估了结构性损害对光学的重要性 神经头（使用立体声光盘照片和测量 海德堡视网膜层析成像图像）用于预测未来的位置 视觉功能缺陷指示神经节细胞损失。在一起，这些 目标将更好地理解早期的基础 青光眼损害。