PERIMETRY AND CLINICAL PSYCHOPHYSICS IN GLAUCOMA

青光眼的视野检查和临床心理物理学

• 批准号: 2019440
• 负责人: CHRIS A JOHNSON
• 金额: $ 22.33万
• 依托单位: UNIVERSITY OF CALIFORNIA AT DAVIS
• 依托单位国家: 美国
• 财政年份: 1981
• 资助国家: 美国
• 起止时间: 1981-01-01 至 1997-09-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/2019440
• 关键词: biomedical automation; diagnosis quality /standard; flicker fusion test; glaucoma; glaucoma test; human subject; hypertension; lateral geniculate body; mass screening; optic nerve disorder; pathologic process; perimetry; psychophysics; visual fields; visual threshold

DESCRIPTION (from abstract): Glaucoma is one of the leading causes of blindness. Approximately 2 million people in the United States have glaucoma, and another 3 to 6 million people, including 4-8 percent of the population over age 40, are at risk of developing glaucoma because of elevated intraocular pressure. The ability to detect the earliest signs of glaucomatous damage to the optic nerve is important for effective clinical decision-making concerning treatment intervention. In order to improve early detection, an understanding of the nature of early glaucomatous damage to the optic nerve is essential. This project tests three competing hypotheses concerning the basis of early glaucomatous damage: (1) that there is a selective loss of large diameter optic nerve fibers; (2) that the earliest glaucomatous damage is specific to a group of nerve fibers that terminate in the magnocellular layers of the lateral geniculate nucleus (M-cells); or (3) that nerve fiber losses in glaucoma are not specific to particular fiber pathways or sizes, but are most readily noticed for visual functions that are subserved by nerve fibers that have minimal redundancy or receptive field coverage. The three hypotheses will be tested by longitudinally evaluating a variety of visual functions throughout the visual field of moderate and high risk ocular hypertensives and patients with early glaucomatous visual field loss. The visual functions will include conventional automated perimetry, short wavelength automated perimetry (SWAP), resolution perimetry, high frequency flicker perimetry, and frequency doubling perimetry. These functions are thought to be mediated by ganglion cells with different functional properties, fiber sizes and amounts of coverage or redundancy. By examining the extent of neural damage and changes over time in the various visual functions, it will be possible to determine the validity of the three hypotheses. The outcome of this work will provide both a theoretical and an empirical basis for the development of new screening procedures for glaucoma. This project will also assess the relation between early losses of visual function in glaucoma and structural changes to the optic nerve head. Quantitative measures of optic disc topography will be obtained, using infrared raster stereography with the Glaucoma-Scope and confocal scanning laser ophthalmoscopy with the Heidelberg Retina Tomograph. Together with evaluations of visual function, these optic disc topography measures will permit the relationship between structural and functional losses to be determined for early glaucomatous damage.

描述（摘要）：青光眼是主要原因之一 失明。 美国约有200万人 青光眼和另外3至600万人，包括4-8％ 40岁以上的人口有患青光眼的风险 眼内压力升高。 检测最早迹象的能力 对视神经的青光眼损害对于有效的临床很重要 有关治疗干预的决策。 为了改善 早期发现，了解早期青光眼损伤的性质 对视神经至关重要。 该项目测试三个竞争 关于早期青光眼损害基础的假设：（1） 大直径纤维纤维的选择性损失； （2）那个 最早的青光眼损伤是特定于一组神经纤维的 终止于侧元核的巨细胞层 （M细胞）;或（3）青光眼中的神经纤维损失不是特定的 特定的纤维途径或尺寸，但最容易注意到视觉 由具有最小冗余或的神经纤维提供的功能 接受场覆盖范围。 这三个假设将通过 纵向评估整个整个整个视觉功能 中等和高风险眼高血压和患者的视野 与早期的青光眼视野损失。 视觉功能将 包括常规自动化的周围，短波长自动化 周期（交换），分辨率周围，高频闪烁，跨越范围， 和频率加倍的周围。 这些功能被认为是 由具有不同功能特性的神经节细胞介导的纤维大小 和覆盖范围或冗余量。 通过检查神经的程度 在各种视觉功能中随着时间的流逝而变化，它将是 可能确定三个假设的有效性。 结果 这项工作将为理论和经验基础提供 开发青光眼的新筛选程序。 这个项目将 还评估青光眼的早期视觉功能丧失之间的关系 和视神经头的结构变化。 定量度量 使用红外栅格立体摄影将获得视盘地形 与青光眼镜和共聚焦扫描激光眼镜检查一起 海德堡视网膜断层片。 以及评估视觉功能， 这些视盘地形措施将允许 早期青光眼确定的结构和功能损失 损害。