Visual & Memory Stimulating (VMS) Grid Self-Monitoring Tests

视觉的

• 批准号: 7481990
• 负责人: Mark C Roser
• 金额: $ 11.92万
• 依托单位: RESULTS GROUP
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-07-01 至 2009-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7481990
• 关键词: Address; Affect; Age; Age related macular degeneration; Age-Years; Amsler Grid Test; Anxiety; Area; Attention; Baltimore; Blindness; Brain; Caring; Central Scotomas; Clinical; Color; Commit; Communication; Communities; Comparative Study; Connecticut; Consult; Custom; Data; Databases; Decision Trees; Detection; Development; Diagnostic; Early Diagnosis; Effectiveness; Elderly; Electronics; Elements; Enrollment; Environment; Epidemic; Eye; Feedback; Focus Groups; Fright; Future; Hand; Home environment; Human; Image; Incidence; Individual Adjustment; Informed Consent; Institutes; Instruction; Internet; Lead; Legal Blindness; Legal patent; Lighting; Location; Logic; Mails; Measurement; Measures; Memory; Memory Loss; Methodology; Methods; Modeling; Monitor; Office Visits; Online Systems; Panthera leo; Paper; Patients; Pattern; Performance; Periodicity; Peripheral; Phase; Phase I Clinical Trials; Preparation; Printing; Process; Provider; Psyche structure; Public Health; Questionnaires; Reading; Recruitment Activity; Regression Analysis; Reporting; Retina; Retinal; Retinal blind spot; Retirement; Risk; Scanning; Scotoma; Shapes; Solutions; Specialist; Spottings; Standards of Weights and Measures; Stimulus; Supervision; System; Technology; Test Result; Testing; Time; Today; Training; Uncertainty; Universities; Validation; Vision; Visual; Visual Fields; Visual impairment; Week; Western World; Work; Writing; age related; cohort; comparative; compliance behavior; design; extrastriate visual cortex; gaze; human subject; improved; macula; novel; programs; prototype; research and development; research study; sample fixation; size; success; tool; visual information; visual memory; visual tracking

DESCRIPTION (provided by applicant): Age-related macular degeneration (AMD) continues to be the leading cause of central vision loss in the US today for those over fifty years of age and will likely become epidemic as Baby Boomers reach retirement age. Over the last 15 years treatments have become available to treat advanced AMD (1) but effectiveness of these advances is challenged by patients' lack of ability to recognize the need for urgent care between regular office visits. The Amsler and Yanuzzi tests, the only widely used self-tests for AMD, have proven largely ineffective at enabling patients to recognize the signs that they should consult their retina specialist for treatment. For optimal benefit, patients should be able to observe changes in their vision over time. The principal shortcomings of the Amsler grid include periodicity of the test pattern and lack of individual adjustment. For the current study, we have developed several versions of improved grids, both on paper and on the Internet. These patent-pending Visual and Mental Stimulation (VMS) grids are hypothesized to facilitate a substantial degree of recall of prior measurements, necessary for monitoring vision over time. Adjustment features have also been incorporated to allow patients to customize their grid to their particular visual field. In preliminary studies, positive feedback was obtained on initial prototypes from AMD patients and retina specialists. The result will lead to more rapid identification of problems, earlier diagnosis and treatment that will result in fewer people losing their vision. This project will pursue three areas of study: 1 Preparation of paper & electronic prototypes suitable for testing We will continue development of prototypes towards a reliable test tool, formalizing static testing elements and developing dynamic adjustment tools supported by a web-based work-flow logic approach and database. 2 - Comparative study of novel solutions with current prevailing test At the Wilmer Eye Institute of Johns Hopkins University, we will recruit 25 patients (Group 1) with recent onset of unilateral AMD under current care of a retina specialist. The study will compare the results of the novel self-diagnostic VMS tools with current self-monitoring tools (specifically the Amsler grid) over a 6 week period. Current clinical tools (FA, OCT & ICG) will be used to determine a reference baseline. 3 Study to gain feedback of patients' use of tests outside a clinical environment We will recruit two cohorts of 50 patients with recent onset of unilateral AMD under current care of a retina specialist (Group 2, Connecticut cohort) or at risk of AMD (Group 3, Baltimore cohort), and measure their ability to access and utilize the VMS tools without 3rd party support. Patients' success in using the system and their confidence level in results will be ascertained through a questionnaire. PUBLIC HEALTH RELEVANCE: Age-related macular degeneration (AMD) is the major cause of irreversible legal blindness in the western world. Current self-monitoring tools in patients with AMD fail to adequately indicate pathological vision changes that require immediate attention thus resulting in delayed treatment starts and higher incidences of severe vision loss. Through the application of a novel Visual and Memory Stimulating tool (VMS) this project will improve patients' ability to accurately and confidently self-monitor their AMD between office visits resulting in fewer people losing their vision.

描述（由申请人提供）：年龄相关性黄斑变性 (AMD) 仍然是当今美国 50 岁以上人群中央视力丧失的主要原因，并且随着婴儿潮一代达到退休年龄，这种疾病很可能成为流行病。在过去 15 年里，治疗晚期 AMD 的方法已经出现 (1)，但这些进展的有效性受到患者缺乏认识到定期就诊之间需要紧急护理的能力的挑战。 Amsler 和 Yanuzzi 测试是唯一广泛使用的 AMD 自我测试，已被证明在帮助患者识别应咨询视网膜专家进行治疗的迹象方面基本上无效。 为了获得最佳益处，患者应该能够观察视力随时间的变化。阿姆斯勒网格的主要缺点包括测试模式的周期性和缺乏个体调整。对于当前的研究，我们在纸上和互联网上开发了多个版本的改进网格。这些正在申请专利的视觉和心理刺激（VMS）网格被假设可以促进对先前测量结果的很大程度上回忆，这对于随着时间的推移监测视力是必要的。还结合了调整功能，允许患者根据自己的特定视野定制网格。在初步研究中，AMD 患者和视网膜专家对最初的原型获得了积极的反馈。结果将导致更快地发现问题、更早地诊断和治疗，从而减少失明的人数。该项目将进行三个研究领域： 1 准备适合测试的纸质和电子原型 我们将继续开发可靠的测试工具原型，形式化静态测试元素并开发由基于网络的工作流程逻辑支持的动态调整工具方法和数据库。 2 - 新解决方案与当前流行测试的比较研究 在约翰·霍普金斯大学 Wilmer 眼科研究所，我们将招募 25 名近期出现单侧 AMD 且目前由视网膜专家护理的患者（第 1 组）。该研究将在 6 周内将新型自我诊断 VMS 工具与当前自我监控工具（特别是阿姆斯勒网格）的结果进行比较。当前的临床工具（FA、OCT 和 ICG）将用于确定参考基线。 3 研究获取患者在临床环境之外使用测试的反馈 我们将招募两组患者，每组 50 名近期出现单侧 AMD 的患者，目前正在视网膜专家的护理下（第 2 组，康涅狄格州队列）或有 AMD 风险（第 2 组，康涅狄格州队列） 3、巴尔的摩队列），并衡量他们在没有第三方支持的情况下访问和使用 VMS 工具的能力。患者使用该系统的成功程度及其对结果的置信度将通过调查问卷来确定。公共卫生相关性：年龄相关性黄斑变性 (AMD) 是西方世界不可逆转的法定失明的主要原因。目前 AMD 患者的自我监测工具无法充分指示需要立即关注的病理性视力变化，从而导致治疗开始延迟和严重视力丧失的发生率更高。通过应用新型视觉和记忆刺激工具 (VMS)，该项目将提高患者在就诊期间准确、自信地自我监测 AMD 的能力，从而减少失明的人数。