Binocular Summation in Strabismus

斜视的双眼求和

• 批准号: 8723221
• 负责人: Stacy Pineles
• 金额: $ 21.63万
• 依托单位: UNIVERSITY OF CALIFORNIA LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-09-01 至 2016-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8723221
• 关键词: Adult; Affect; Age; Age of Onset; Amblyopia; Award; Binocular Vision; Biometry; Blindness; Child; Childhood; Clinical; Clinical Research Curriculum Award; Clinical Trials; Clinical Trials Design; Contrast Sensitivity; Data; Depth Perception; Development; Development Plans; Diagnosis; Disease; Epidemiologic Studies; Epidemiology; Etiology; Eye diseases; Foundations; Future; Goals; Individual; Institution; K-Series Research Career Programs; Knowledge; Lead; Measurement; Measures; Mentors; Mentorship; Monocular Vision; Multi-Institutional Clinical Trial; Operative Surgical Procedures; Ophthalmologist; Outcome; Outcome Measure; Patient Care; Patient Self-Report; Patients; Population; Positioning Attribute; Principal Investigator; Proxy; Psychophysics; Quality of life; Questionnaires; Randomized Clinical Trials; Randomized Controlled Trials; Request for Applications; Research; Research Personnel; Series; Stimulus; Strabismus; Structure; Supervision; Surveys; Testing; Time; Training; Treatment outcome; Vision; Visual; Visual Acuity; Visual evoked cortical potential; Work; career; career development; design; early onset; evidence based guidelines; experience; functional outcomes; health related quality of life; improved; interest; monocular; novel; programs; randomized trial; responsible research conduct; skills; standard measure; success

DESCRIPTION (provided by applicant): This application requests a career development award for a dually trained pediatric and neuro- ophthalmologist with a scientific interest in developing large-scale randomized clinical trials evaluating strabismus surgery (the most commonly performed pediatric ophthalmic surgery) using a comprehensive battery of psychophysical and electrophysiological tests. This will allow the candidate to create an individual research program that evaluates binocular summation, a novel measure of binocular function not currently evaluated by strabismus researchers, using functional measures. Through the completion of this research, the candidate will establish preliminary data for further independent research, and she will also define novel objective measures by which to measure binocular function in larger clinical trials of strabismus treatments (surgical and non-surgical). In addition, by completing the proposed didactic program leading to a M.S. degree in Epidemiology and involvement in the multi-center Pediatric Eye Disease Investigators Group (PEDIG), the candidate will by the end of the award period, gain the valuable hands-on experience, knowledge, and mentorship required to design, propose and implement randomized clinical trials related to strabismus surgery. The candidate's long-term goal is to lead clinical trials that will improve evidence based recommendations for strabismus treatments. This project will be under the supervision of senior investigators who will jointly provide guidance in strabismus research, epidemiology, and psychophysics The candidate will have the following objectives during the award period: 1) Development of an individual research program in strabismus outcomes; 2) Completion of coursework in epidemiology, biostatistics, clinical trial design, and the responsible conduct of research through participation in an M.S. degree program in Epidemiology and the UCLA K30 program; 3) Develop expertise in psychophysics and the use of the sweep visual evoked responses; 4) Gain experience in multi-center clinical trial design and implementation with PEDIG. Presently, strabismus treatment outcomes are evaluated by subjective and insensitive tests, such as clinical examination and stereopsis that often do not adequately assess the binocular function. The development of objective outcome measures for strabismus surgery research is essential in order to provide meaningful evidence-based recommendations. The overall goal of the research component of this proposal is to evaluate binocular summation, which is defined as the improvement in binocular vision compared to monocular vision, in patients with strabismus using a comprehensive battery of functional psychophysical and electrophysiological tests. This goal will be accomplished with 3 specific aims: 1. Determine the effect of ocular misalignment on binocular summation. In a large population of strabismic individuals, we will test the hypothesis that ocular misalignment impairs binocular summation by comparing subjects with various forms of strabismus to control subjects. Our hypothesis is that binocular summation in strabismic subjects will be lower than non-strabismic controls, and that binocular summation scores can distinguish between these two populations. We will also test the effect of contrast level, strabismus sub-type, and onset age on binocular summation. 2. Determine the impact of surgical realignment on binocular summation. We will test the hypothesis that ocular realignment surgery improves binocular summation in most strabismic subjects. We will also evaluate the influence of age of strabismus onset, timing of ocular realignment, interocular differences in acuity, and strabismus type on improvement in binocular summation. 3. Evaluate binocular summation as a surrogate measure for other outcomes used in clinical trials, including ocular alignment before and after surgery, strabismus control, and quality of life. Together, this project will characterize a novel outcome that describes functional binocular visual status in strabismic subjects that can be used in future clinical trials. Beyond the development of this individual research program, the experienced gained by the candidate in the proposed interactions with expert mentors and collaborators will provide training in clinical trial design, psychophysical outcomes, and sweep visual evoked responses. The institution, mentors, and collaborators outlined in this proposal are dedicated to research and cultivating the careers of early investigators. This structured career development plan will to position the candidate for independent investigator status at the end of the award period.

描述（由申请人提供）：本申请要求为双重训练的儿科和神经眼科医生颁发职业发展奖，其科学兴趣在开发大规模的随机临床试验中评估斜视手术（最常见的儿科手术外科手术），该试验使用心理物理学和电学测试综合进行了综合的小病。这将使候选人能够创建一个评估双眼求和的个别研究计划，这是一种使用功能测量方法，是斜视研究人员目前未评估双眼功能的新型量度。通过完成这项研究，候选人将建立初步数据进行进一步的独立研究，她还将定义新的客观措施，通过这些措施在较大的斜视治疗（手术和非外科手术）的较大临床试验中测量双眼功能。此外，通过完成拟议的教学计划，导致了硕士学位。流行病学和参与多中心小儿眼病研究者小组（PEDIG）的学位，候选人将在奖励期结束前获得珍贵的动手经验，知识和指导，以设计，提出和实施与Strabismus手术相关的随机临床试验所需的宝贵实践经验，知识和指导。候选人的长期目标是领导临床试验，以改善基于证据的斜视治疗建议。该项目将在高级调查人员的监督下，他们将共同提供斜视研究，流行病学和心理物理学的指导，候选人将在奖励期内具有以下目标：1）开发斜视成果中的个别研究计划； 2）在流行病学，生物统计学，临床试验设计以及通过参与M.S.流行病学和UCLA K30计划的学位课程； 3）发展心理物理学方面的专业知识和扫描视觉诱发反应的使用； 4）通过PEDIG获得多中心临床试验设计和实施经验。 目前，通过主观和不敏感的测试（例如临床检查和立体观察）评估斜视治疗结果，这些测试通常无法充分评估双眼功能。为了提供有意义的基于证据的建议，必不可少的斜视外科手术研究的客观结果度量的发展至关重要。该提案的研究组成部分的总体目标是评估双眼求和，这定义为与单眼视力相比，使用全面的功能性心理生理和电生理学测试的斜视患者中，与单眼视力相比，双眼视力的改善。该目标将以3个特定的目的来实现：1。确定眼睛未对准对双眼求和的影响。在大量的斜视个体中，我们将检验以下假设：眼睛未对准会损害双眼求和，通过将各种形式的斜视的受试者与控制受试者进行比较。我们的假设是，斜率受试者中的双眼求和将低于非晶体震动对照，并且双眼求和分数可以区分这两个人群。我们还将测试对比度水平，斜视亚型和发作年龄对双眼求和的影响。 2。确定手术重组对双目求和的影响。我们将检验以下假设：眼部调整手术改善了大多数斜率受试者的双目求和。我们还将评估斜视起发作时代的影响，眼部调整的时机，敏锐度的眼内差异以及斜视类型对双眼求和的改善。 3。评估双眼总和作为临床试验中使用的其他结果的替代措施，包括手术前后的眼对准，斜视控制和生活质量。该项目将共同描述一个新的结果，该结果描述了斜率受试者的功能双眼视觉状态，可以在以后的临床试验中使用。除了开发该单独的研究计划外，候选人在与专家指导者和合作者的互动中获得的经验丰富的经验还将提供临床试验设计，心理物理结果和扫描视觉唤起的反应方面的培训。该提案中概述的机构，导师和合作者致力于研究和培养早期研究人员的职业。这项结构化的职业发展计划将在奖励期结束时定位独立调查员地位的候选人。