Clustered home assessment of visual fields in patients with glaucoma

青光眼患者视野的集群家庭评估

• 批准号: 10698909
• 负责人: BENJAMIN T BACKUS
• 金额: $ 83.89万
• 依托单位: VIVID VISION, INC.
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-30 至 2025-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10698909
• 关键词: 7 year old; Agreement; Algorithms; American; Binocular Vision; Blindness; Clinic; Clinical; Clinical Trials; Cognitive; Computer software; Data; Data Collection; Data Set; Devices; Diagnosis; Diagnostic; Disease Progression; Elderly; Equipment; Eye; Eye Movements; FDA Emergency Use Authorization; Fatigue; Feedback; Frequencies; Glaucoma; Health Insurance Portability and Accountability Act; Home; Insurance; Location; Marketing; Measurement; Measures; Medical; Medicare; Methods; Modeling; Modernization; Monitor; Names; Outcome; Patient Education; Patients; Pattern; Perimetry; Persons; Phase; Physicians; Play; Preparation; Procedures; Psychophysics; Sales; Sampling; San Francisco; Screening procedure; Severities; Site; Small Business Innovation Research Grant; Software Engineering; Source; Specialist; Stimulus; Structure; System; Telemedicine; Test Result; Testing; Therapeutic; Time; Training; Video Games; Vision; Visual Fields; aggressive therapy; blind; clinical efficacy; cognitive ability; cost; data exchange; design; effective therapy; field study; home test; improved; mathematical model; medical schools; novel; prevent; rapid detection; sample fixation; skills; standard of care; tool; usability; user-friendly; virtual reality game; virtual reality headset

Project summary/abstract Glaucoma is the second leading cause of irreversible vision loss in Americans. Effective treatment requires the patient to take visual field tests over time, to monitor for progression of visual field loss. In many patients there is no progression, but when it occurs it must be detected as quickly as possible in order to save vision by using a more aggressive treatment. Patients whose vision is actually stable don’t know it, so they worry unnecessarily. Conventional tests to measure visual fields are too difficult to take. They are fatiguing and the equipment they use is expensive and bulky A skilled perimetrist is still required to train the patient how to take the test and to monitor for eye movements and patient fatigue. As a result, glaucoma patients typically have a visual field test only one to three times a year. And unfortunately, the results of these tests have high variability due to the necessarily short duration of the test. Thus, there is large error when estimating the rate of disease progression from visual fields in a patient with glaucoma, and an urgent need to do additional testing at home to overcome the data limitation. We developed a test, called Vivid Vision Perimetry (VVP-10), that substantially increases the quantity of visual field data a patient can collect. Patients take VVP-10 at home on a low-cost virtual reality (VR) headset. We have made the test much more user-friendly, using a novel task. VVP-10 allows the patient to freely move their eyes and to know exactly when stimuli will appear. It gives feedback to the patient after every stimulus , and makes the test more like a video game. Patients have the option of guessing or not, because guessing does not affect the test outcome. During Phase I of this project, we demonstrated feasibility by showing that elderly glaucoma patients can perform the test at home without in-person training. The results agreed well with conventional tests, and our mathematical models suggest that taking a cluster of 10 tests four times a year could reduce by more than half the number of months needed to detect rapid progression. In this Direct to Phase II Project, we will make the test still easier to perform, optimize the quality of the data collected, and verify that VVP-10 can reduce by half the number of months needed to detect rapid progression. The new test is being developed by Vivid Vision, Inc., a seven-year-old company based in San Francisco, CA. The company sells a binocular vision treatment product used by 350 clinics worldwide. It has expertise in psychophysics, software engineering for VR games, HIPAA-compliant telemedicine, IP protection, marketing, and sales. Leading glaucoma specialists at the UCSF School of Medicine and the NYU School of Medicine have joined the team to carry out a one-year, multi-site study of VVP-10 in 65 patients with glaucoma.

项目摘要/摘要 青光眼是美国人视力丧失的第二大主要原因。有效的治疗需要 随着时间的推移，患者进行视野测试，以监视视野损失的进展。在许多患者中 没有进展，但是当它发生时，必须尽快检测到它以保存视力 通过使用更具侵略性的治疗。视力实际上稳定的患者不知道，所以他们担心 不必要。 进行测量视野的常规测试太难了。他们很疲劳，设备 他们使用昂贵且笨重 监控眼睛运动和患者疲劳。结果，青光眼患者通常具有视力 每年仅测试一到三次。不幸的是，由于 测试的持续时间必须短。那就估计疾病进展率时存在很大的错误 从青光眼患者的视野，迫切需要在家中进行其他测试以克服 数据限制。 我们开发了一种称为生动视力范围（VVP-10）的测试，该测试大大增加了数量 视野数据患者可以收集。患者在低成本虚拟现实（VR）耳机上在家中服用VVP-10。 我们使用新任务使测试更加用户友好。 VVP-10允许患者自由移动 他们的眼睛，确切地知道刺激何时会出现。每次刺激后，它都会向患者提供反馈 并使测试更像是电子游戏。病人可以选择是否猜测，因为猜测 不影响测试结果。在该项目的第一阶段，我们证明了可行性 老年青光眼患者可以在家中进行测试，而无需亲自培训。结果与 常规测试，我们的数学模型表明，每年四次参加10次测试 可以减少检测快速进展所需的月数的一半以上。在这个直接到 第二阶段项目，我们将使测试仍然更易于执行，优化收集的数据的质量，并且 验证VVP-10可以减少检测快速进展所需的月数的一半。 这项新测试是由一家位于旧金山的7年历史公司Vivid Vision，Inc。开发的， 大约该公司销售全球350个诊所使用的双眼视觉治疗产品。它具有专业知识 心理物理学，VR游戏的软件工程，HIPAA兼容远程医疗，IP保护，营销， 和销售。 UCSF医学院和纽约大学医学院领先的青光眼专家 已经加入了团队，对65例青光眼患者进行了一年的VVP-10多站点研究。