Psychophysical Correlates of Neurodegeneration in Glaucoma

青光眼神经变性的心理物理相关性

基本信息

批准号：
7731888
负责人：
Peter John Bex
金额：
$ 48.96万
依托单位：
SCHEPENS EYE RESEARCH INSTITUTE
依托单位国家：
美国
项目类别：
财政年份：
2009
资助国家：
美国
起止时间：
2009-09-01 至 2013-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7731888
关键词：
Adopted Age Apoptosis Area Behavior Behavioral Binocular Vision Blindness Cell Death Cell physiology Clear Cell Clinic Clinical Clinical Management Detection Deterioration Diagnostic Disease Early treatment Effectiveness Environment Eye Eye Movements Financial compensation Functional disorder Glaucoma Home environment Impairment Incidence Intervention Lead Masks Measures Modeling Motion Movement Nature Nerve Degeneration Noise Optical Coherence Tomography Patients Perimetry Peripheral Population Process Psychophysiology Research Retinal Ganglion Cells Risk Sampling Scotoma Screening procedure Source Staging Suspect Glaucomas Techniques Testing Vision Visual Visual Fields Visual impairment design monocular motion sensitivity novel diagnostics prevent programs public health relevance relating to nervous system self diagnosis

Adopted Age Apoptosis Area Behavior Behavioral Binocular Vision Blindness Cell Death Cell physiology Clear Cell Clinic Clinical Clinical Management Detection Deterioration Diagnostic Disease Early treatment Effectiveness Environment Eye Eye Movements Financial compensation Functional disorder Glaucoma Home environment Impairment Incidence Intervention Lead Masks Measures Modeling Motion Movement Nature Nerve Degeneration Noise Optical Coherence Tomography Patients Perimetry Peripheral Population Process Psychophysiology Research Retinal Ganglion Cells Risk Sampling Scotoma Screening procedure Source Staging Suspect Glaucomas Techniques Testing Vision Visual Visual Fields Visual impairment design monocular motion sensitivity novel diagnostics prevent programs public health relevance relating to nervous system self diagnosis

展开

项目摘要

DESCRIPTION (provided by applicant): Glaucoma is the second leading cause of blindness in the developed world and causes progressive loss of the peripheral visual field. While visual loss caused by glaucoma is currently irreversible, clinical intervention is most effective if the disease is caught at an early stage, when catastrophic field loss can be averted. Unfortunately existing screening techniques can only detect glaucoma once significant visual impairment has occurred. Although visual deficits in glaucoma are thought to be attributable to programmed cell death (apoptosis) of retinal ganglion cells (RGCs) it is now clear that cell-death is the endpoint of a gradual deterioration in RGC-function. Effective diagnostics cannot wait for cell death, but must measure a behavioral impact of RGC dysfunction. When screening fails, the clinician is particularly reliant on the patients self-diagnosing. Unfortunately more than 50% of people who have diagnosable glaucoma are unaware of it. This, along with poor screening sensitivity has long-term implications for the effective management of an increasingly prevalent disease. This proposal assesses a more efficient and more sensitive motion screening technique that may help detect RGC dysfunction earlier, facilitating prompt clinical intervention to slow the progression of glaucoma. We examine binocular vision, filling-in and compensatory eye movements that may obscure detection of progressive visual impairment and prevent patients from self-diagnosing at an earlier stage of the disease. The overall aim of this proposal is to identify signs of glaucoma that may help bring patients to clinic before catastrophic glaucomatous visual field loss has occurred. Such early intervention allows clinical management of glaucoma to be most effective and so relieves the burden of visual impairment. PUBLIC HEALTH RELEVANCE: Glaucoma is the second leading cause of blindness in the developed world and its incidence is set to rise as the population ages. While visual loss caused by glaucoma is currently irreversible, clinical intervention is most effective if the disease is detected and treated at an early stage, when catastrophic field loss can be averted. The proposed program of research develops new diagnostics that are sensitive to the early stages of neuro-degeneration in glaucoma.

描述（由申请人提供）：青光眼是发达世界失明的第二大主要原因，并导致外围视野的逐渐丧失。虽然目前由青光眼引起的视觉丧失是不可逆的，但如果在灾难性的田间损失可以避免时，临床干预是最有效的。不幸的是，现有的筛查技术只有一旦发生了重大视觉障碍，才能检测到青光眼。尽管青光眼中的视觉缺陷被认为归因于视网膜神经节细胞（RGC）的程序性细胞死亡（凋亡），但现在很明显，细胞死亡是RGC功能逐渐降低的终点。有效的诊断不能等待细胞死亡，但必须测量RGC功能障碍的行为影响。当筛查失败时，临床医生特别依赖患者的自我诊断。不幸的是，超过50％的具有可诊断青光眼的人没有意识到这一点。这与筛查敏感性不佳有关，对日益普遍疾病的有效管理具有长期影响。该提案评估了一种更有效，更敏感的运动筛选技术，该技术可能有助于早期检测RGC功能障碍，从而促进迅速的临床干预，以减慢青光眼的发展。我们检查了双眼视力，填充和补偿性眼动运动，这些视力可能掩盖了进行性视觉障碍的检测，并阻止患者在疾病的早期阶段进行自我诊断。该提案的总体目的是确定青光眼的迹象，这些迹象可能有助于在发生灾难性的青光眼视野丧失之前将患者带到诊所。这种早期干预使青光眼的临床管理最有效，因此减轻了视觉障碍的负担。公共卫生相关性：青光眼是发达国家失明的第二大主要原因，随着人口年龄的增长，其发病率将上升。尽管目前由青光眼引起的视觉丧失目前是不可逆的，但如果在灾难性的田间损失可以避免时，临床干预是最有效的，则最有效。拟议的研究计划开发了对青光眼神经脱位早期敏感的新诊断。