Coordination of Eye and Head Movements in Central Field Loss

中心场丢失时眼睛和头部运动的协调

基本信息

批准号：
9360137
负责人：
Natela M. Shanidze
金额：
$ 9.31万
依托单位：
SMITH-KETTLEWELL EYE RESEARCH INSTITUTE
依托单位国家：
美国
项目类别：
财政年份：
2016
资助国家：
美国
起止时间：
2016-09-30 至 2018-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9360137
关键词：
Accidents Address Affect Age Age related macular degeneration Animals Behavior Blindness Calibration Categories Central Scotomas Crowding Dangerousness Darkness Dependence Diagnostic Procedure Dizziness Elderly Environment Evolution Eye Eye Movements Functional disorder Future Head Head Movements Image Impairment Incidence Individual Injury Lead Life Style Mechanics Mentors Motion Motion Perception Movement Ocular orbit Outcome Participant Pathway interactions Patient-Focused Outcomes Patients Performance Phase Planet Earth Population Positioning Attribute Ramp Reflex action Research Retina Retinal Rotation Short Interspersed Nucleotide Elements Smooth Pursuit Source Spottings Stimulus Sum System Testing Therapeutic Training Translating Translations Vision Visual Visual Acuity Visual Fields Visual impairment Visual system structure Volition Work central visual field disability falls fovea centralis gaze improved interest meter oculomotor oculomotor behavior patient population public health relevance rehabilitation strategy research clinical testing response sample fixation senescence vestibulo-ocular reflex visual feedback visual information visual stimulus visual-vestibular

项目摘要

ABSTRACT Age-related macular degeneration is the most common cause of vision loss in the central visual field, making central field loss (CFL) a major problem in the world today. Two-thirds of patients with CFL complain of vestibular problems, such as dizziness and instability, leading to a high incidence of potentially fatal accidents and falls. The problem is exacerbated by the patient population's advanced age, due to the documented decline in vestibular function in senescence. Vestibular deficits in CFL patients are likely due to miscalibrated or non-optimal stabilizing eye movements - many essential oculomotor behaviors are highly reliant on retinal input. Individuals with compromised vestibular responses have difficulties with visual field stability, navigation, and self- and external motion perception. These limitations are particularly true for CFL patients, whose visual acuity is already compromised and for whom the vestibular system becomes the predominant source of motion information. Furthermore, vestibular deficits likely affect patients' use of head movements to compensate for oculomotor limitations due to eccentric viewing and a patchy visual field. Despite the day-to-day importance of visual and vestibular interaction, these behaviors have not been comprehensively studied in CFL. This proposal seeks to address this gap. The first aim examines the contribution of head movements to smooth pursuit in CFL patients. This aim extends previous work quantifying smooth pursuit deficits in CFL to a more natural, head-unrestrained condition to determine if head movements are helpful or detrimental in CFL. Understanding the contribution of head movements can guide future rehabilitation strategies and clinical testing in this population. The second aim examines the effect of CFL on the angular vestibuloocular reflex (VOR). The reflex has little foveal dependence and is thus likely to be unaffected in CFL. However, foveal vision is known to contribute to both the calibration of this reflex and to its suppression when the head movement follows target motion. A deficit in any aspect of angular VOR will have consequences on the visual instability and vestibular discomfort of the affected individuals. Understanding these problems would inform necessary treatments in this population. The final aim examines the effects of CFL on translational VOR, a behavior that is completely fovea-dependent and is essential when body movement is present. Determining the degree of its impairment and exact influences of CFL is key to understanding vestibular dysfunction due to this visual deficit. VOR responses will be studied during passive and volitional, active motion. Previous research suggests fundamental differences in the processing of these two types of behavior, which indicates that they might be affected differently by central vision loss. If present, this dichotomy could have implications on how patients are advised and trained to interact with their environment while maintaining an active and productive lifestyle. Active behaviors (including head-free smooth pursuit) will be examined during the mentored portion of this project, while passive vestibular studies make up the bulk of the independent research.

抽象的年龄相关性黄斑变性是中央视野视力丧失的最常见原因，使得中心场损耗（CFL）是当今世界的一个主要问题。三分之二的 CFL 患者抱怨前庭问题，例如头晕和不稳定，导致潜在致命事故的发生率很高并跌倒。由于患者群体的高龄化，这个问题变得更加严重，因为有记录的衰老时前庭功能下降。 CFL 患者的前庭缺陷可能是由于校准错误造成的或非最佳稳定眼球运动 - 许多基本的动眼神经行为高度依赖于视网膜输入。前庭反应受损的个体在视野稳定性、导航、以及自我和外部运动感知。这些限制对于 CFL 患者尤其如此，他们的视力敏锐度已经受到损害，前庭系统成为主要的运动来源信息。此外，前庭缺陷可能会影响患者使用头部运动来补偿由于偏心观察和视野不均匀导致动眼神经受限。尽管日常的重要性视觉和前庭相互作用，这些行为尚未在 CFL 中得到全面研究。该提案旨在解决这一差距。第一个目标检查头部运动对平滑的贡献 CFL 患者的追求。这一目标将之前量化 CFL 平滑追踪缺陷的工作扩展到更广泛的领域。自然、头部不受约束的条件，以确定头部运动对于 CFL 是否有益或有害。了解头部运动的贡献可以指导未来的康复策略和临床在这个人群中进行测试。第二个目标是检查 CFL 对前庭眼角反射的影响（甚远信标）。该反射几乎不依赖中心凹，因此在 CFL 中可能不受影响。然而，中心凹众所周知，视觉有助于这种反射的校准和头部反射的抑制。运动跟随目标运动。角度 VOR 任何方面的缺陷都会对视觉产生影响受影响个体的不稳定和前庭不适。了解这些问题将有助于对该人群进行必要的治疗。最终目标是检验 CFL 对平移 VOR 的影响，完全依赖于中央凹的行为，并且在存在身体运动时至关重要。确定其损伤程度和 CFL 的确切影响是理解前庭功能障碍的关键视力缺陷。将研究被动和自主、主动运动期间的 VOR 响应。先前的研究表明这两种行为的处理存在根本差异，这表明它们中心视力丧失可能会受到不同的影响。如果存在，这种二分法可能会影响如何建议并培训患者与环境互动，同时保持积极和富有成效的态度生活方式。主动行为（包括无头平稳追踪）将在指导部分进行检查这个项目，而被动前庭研究构成了独立研究的大部分。