Reading, Vision Function and Disease Progression in Early AMD

早期 AMD 的阅读、视觉功能和疾病进展

• 批准号: 9274972
• 负责人: LORI A LOTT
• 金额: $ 37.87万
• 依托单位: SMITH-KETTLEWELL EYE RESEARCH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-06-01 至 2019-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9274972
• 关键词: Activities of Daily Living; Adult; Adverse effects; Affect; Age; Age related macular degeneration; Appearance; Area; Blindness; Caring; Central Scotomas; Characteristics; Clinical; Clinical Protocols; Clinical Research; Clinical Trials; Clinical Trials Design; Cognitive; Control Groups; Degenerative Disorder; Diagnosis; Disease; Disease Progression; Drusen; Early treatment; Elderly; Emotional; Exhibits; Eye; Eye Movements; Fundus; Genetic; Goals; Health; Individual; Individual Differences; Length; Life Style; Longevity; Matched Group; Measures; Medical; Methods; Modeling; Monitor; Motor; Ophthalmic examination and evaluation; Outcome; Participant; Patients; Pattern; Performance; Pharmaceutical Preparations; Population; Preventive treatment; Quality of life; Reading; Rehabilitation therapy; Research; Retina; Retinal; Retinal Diseases; Risk; Risk Factors; Savings; Societies; Special Equipment; Specialist; Speed; Testing; Text; Time; Vision; Visual Acuity; Visual impairment; advanced disease; aged; bevacizumab; clinical practice; cognitive testing; cost; high standard; improved; neovascularization; predictive tools; prognostic; public health relevance; reading ability; reading difficulties; remediation; sample fixation; skills; success; tool; vision rehabilitation; visual motor

DESCRIPTION (provided by applicant): Project Summary Age-related macular degeneration (AMD) is the leading cause of vision loss among people aged 65 and older in the US. Since the advanced form of this disease affects central vision function, reading difficulties are one of the most common complaints of AMD patients. Most research on reading in AMD has focused on people with advanced disease, who already have significant central vision losses. However, research suggests that reading and other non-standard functional vision measures are afected earlier in the disease, prior to losses in standard visual acuity. This project aims to examine the contribution of visual, motor and cognitive factors to reading performance in elderly individuals with early AMD. This study also seeks to determine whether reading performance and other non-standard vision function measures can be used to predict which participants will go on to develop the advanced forms of the disease. Current clinical metrics (such as fundus appearance) provide little guidance on how much risk a given patient with early signs of AMD has of progressing to advanced disease and the accompanying central vision loss. Better, more accurate methods of identifying those at risk are needed. Our approach is to apply simple, inexpensive vision function tests, requiring minimal special equipment, and little time to administer, that can improve the ability to predict AMD progression. Previous research strongly suggests that some combination of such simple tests, in conjunction with existing clinical protocols identifying fundus risk factors, could boost the clinician's chances of prognostic success significantly. To examine these questions, individuals with early AMD will take part in test sessions consisting of vision, motor, and cognitive testing, along with an extensive reading assessment. These measures will also be compared in control groups with no retinal disease and with advanced AMD. Participants will also undergo a comprehensive eye exam by a retinal specialist. Study participants will be followed over time, and analyses will determine the best predictors of advanced disease progression. Understanding the causes of reading problems will allow us to identify the specific skills lacking in people with early AMD, which will aid in better understanding of the course of the disease, and suggest appropriate rehabilitative strategies. The significance of improving predictive ability is two-fold: As emerging AMD treatments that can be applied in the earliest stages of the disease become available, it will be absolutely vital to have appropriate and practical tools to identify which patients should receive them. This is key since all medications have costs and side effects. Second, availability of simple predictive tools will greatly simplify and streamline clinical trials of AMD treatments by reducing the number of subjects needed for statistical power and length of time over which the studies must be carried out.

描述（由申请人提供）： 项目摘要与年龄相关的黄斑变性（AMD）是美国65岁及以上人群视力丧失的主要原因。 由于该疾病的晚期形式会影响中央视力功能，因此阅读困难是AMD患者最常见的抱怨之一。 关于AMD阅读的大多数研究都集中在患有晚期疾病的人中，他们已经遭受了重大的中央视力损失。 然而，研究表明，在标准视力损失之前，疾病早期读取和其他非标准的功能视觉测量。 该项目旨在研究视觉，运动和认知因素对早期AMD老年人阅读表现的贡献。 这项研究还旨在确定阅读绩效和其他非标准视力功能度量是否可以用于预测哪些参与者将继续发展疾病的先进形式。 当前的临床指标（例如眼底外观）几乎没有关于AMD早期迹象的患者的风险几乎没有指导。 需要更好，更准确的方法来识别有风险的方法。 我们的方法是应用简单，廉价的视觉功能测试，需要最少的特殊设备以及几乎没有时间管理的时间，从而可以提高预测AMD进展的能力。 先前的研究强烈表明，这种简单测试的某种组合以及现有的临床方案鉴定了底眼风险因素，可以提高 临床医生获得预后成功的机会。 为了研究这些问题，早期AMD的人将参加包括视觉，运动和认知测试组成的测试课程，以及广泛的阅读评估。 这些措施也将在没有视网膜疾病和晚期AMD的对照组中进行比较。 参与者还将接受视网膜专家进行全面的眼科检查。 研究参与者将随着时间的流逝而进行，分析将确定晚期疾病进展的最佳预测指标。 了解阅读问题的原因将使我们能够确定早期AMD患者缺乏的特定技能，这将有助于更好地了解疾病的进程，并提出适当的康复策略。 提高预测能力的重要性是两倍：因为可以在疾病的最早阶段应用的新兴AMD治疗可用，因此拥有适当且实用的工具以识别哪些患者应该接受它们绝对至关重要。 这是关键，因为所有药物都有成本和副作用。 其次，简单预测工具的可用性将大大简化 并通过减少必须进行研究的统计能力和时间长度所需的受试者数量来简化AMD处理的临床试验。