Functional Testing for Glaucoma

青光眼功能测试

基本信息

批准号：
9788453
负责人：
Stuart Gardiner
金额：
$ 42万
依托单位：
LEGACY EMANUEL HOSPITAL AND HEALTH CENTER
依托单位国家：
美国
项目类别：
财政年份：
2011
资助国家：
美国
起止时间：
2011-08-01 至 2022-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9788453
关键词：
Algorithms Anatomy Area Axon Blindness Characteristics Clinical Clinical Management Clinical Trials Cluster Analysis Data Data Collection Defect Detection Deterioration Disease Progression Eye Future Glaucoma Goals Individual Laboratories Light Location Longitudinal cohort Measurement Measures Monitor Neuroprotective Agents Pathway interactions Patients Perimetry Physiological Quality of life Reporting Research Research Personnel Retinal Ganglion Cells Scotoma Severity of illness Specificity Staging Stimulus Structure Techniques Test Result Testing Time Vision Visual Fields Work base clinical decision-making clinical practice cohort cost efficient design experience experimental study follow-up functional status glaucoma test improved indexing instrument neuromechanism next generation novel personalized management preservation primary endpoint rate of change treatment response trend analysis

项目摘要

Project Summary Glaucoma is a leading cause of blindness both in the US and worldwide. The long-term purpose of this project is to improve functional testing in glaucoma. Assessment and follow-up of patients currently relies on automated perimetry to provide functional testing of the visual field. However, the ability to assess progression and/or response to treatment using perimetry is hampered by high variability, especially in areas of moderate or severe glaucomatous damage. This proposal will build on previous work by our laboratory to reduce the variability, increase the dynamic range, and improve the analysis and interpretation, of these test results. Our experiments are explicitly designed so that their results and conclusions will be rapidly translatable to clinical practice. The project will improve the accuracy, efficiency and utility of functional testing, giving immediate impact in both research and clinical settings, and laying groundwork for the next generation of instruments and algorithms. The first Specific Aim is to use a novel stimulus to extend the effective dynamic range of perimetry and reduce its variability. Current clinical perimetry relies on the test subject pressing a button when they see a stimulus consisting of a small, stationary circle of brighter light on a white background. We propose to use a new stimulus, which we anticipate being easier to detect, allowing reliable measurements to be made in more damaged regions of the visual field than is currently possible, and reducing variability. The second Specific Aim is to better use data from current clinical perimetry. We anticipate being able to detect change sooner when looking for changes in anatomically-based clusters of test locations, rather than considering every location individually or considering all locations simultaneously. We will derive a measure of the rate of change based on this cluster analysis that corresponds with experienced clinicians’ opinions of the severity of disease progression, which would aid in the staging and monitoring of disease progression, and hence aid clinical decision making. The third Specific Aim is to perform high-accuracy testing of a subset of visual field locations. The current clinical standard is to instead perform low-accuracy testing of a wider selection of locations. We will compare the ability of these two approaches to detect functional change, and evaluate the effect on the strengths of the cross-sectional and longitudinal correlations with structural measures. The three aims are complementary. It is anticipated that these aims will improve data collection, analysis and interpretation when using perimetry. Such improvements in a test as commonly performed as perimetry will significantly impact future clinical practice.

项目概要青光眼是美国和世界范围内导致失明的主要原因该项目的长期目标。是为了改善目前依赖自动化的青光眼患者的功能测试。视野检查提供视野的功能测试但是，评估进展和/或的能力。使用视野检查对治疗的反应受到高变异性的阻碍，特别是在中度或重度区域该提案将建立在我们实验室之前的工作基础上，以减少变异性，增加我们的实验的动态范围，并改进这些测试结果的分析和解释。明确设计，以便其结果和结论能够快速转化为临床实践。项目将提高功能测试的准确性、效率和实用性，对这两个方面产生直接影响研究和临床环境，并为下一代仪器和算法奠定基础。第一个具体目标是使用一种新颖的刺激来扩展视野检查的有效动态范围并减少其当前的临床视野测量依赖于测试对象在看到刺激物时按下按钮。我们建议使用一种新的刺激，我们预计更容易检测到，从而可以在受损更严重的区域进行可靠的测量第二个具体目标是更好地利用视野。我们期望在寻找变化时能够更快地检测到变化。在基于解剖学的测试位置集群中，而不是单独考虑每个位置或考虑我们将根据此聚类分析得出变化率的度量：与经验丰富的参议员对疾病进展严重程度的看法相对应，这将有助于第三个具体目标是对疾病进展进行分期和监测，从而帮助临床决策。当前的临床标准是对视野位置的子集进行高精度测试。我们将比较这两个位置的能力。检测功能变化并评估对横截面和强度强度的影响的方法预计这三个目标是互补的。目的是在测试中使用视野检查时改进数据收集、分析和解释。与视野检查一样常见的操作将显着影响未来的临床实践。