VISUAL FIELD EXPANSION THROUGH INNOVATIVE MULTIPLEXING PRISM DESIGN

通过创新的多路复用棱镜设计扩展视野

• 批准号: 9136153
• 负责人: ELI PELI
• 金额: $ 49.25万
• 依托单位: SCHEPENS 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: 2013-09-30 至 2018-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9136153
• 关键词: Area; Automobile Driving; Bilateral; Caliber; Clinical Trials; Confusion; Crossover Design; Crowding; Detection; Development; Devices; Disease; Effectiveness; Electronics; Elements; Environment; Evaluation; Eyeglasses; Glaucoma; Head; Head Movements; Health; Homonymous Hemianopia; Impairment; Island; Laboratories; Laboratory Study; Lateral; Lead; Licensing; Maintenance; Marketing; Measures; Motion; Multi-Institutional Clinical Trial; Optics; Patients; Performance; Perimetry; Peripheral; Posture; Process; Quality of life; Randomized; Randomized Controlled Clinical Trials; Reporting; Residual state; Retinitis Pigmentosa; Scanning; System; Testing; Visual; Visual Aid; Visual Fields; Walking; central visual field; design; improved; improved mobility; innovation; lens; monocular; novel; tool; trial comparing; virtual

DESCRIPTION (provided by applicant): Severe peripheral field loss (PFL) sometimes called tunnel vision is a result of retinitis pigmentosa and related diseases as well as glaucoma. Currently there are no effective visual aids for these patients whose mobility is seriously affecte by this impairment. The novel concept of vision multiplexing as a design principle for low vision devices has provided guidance for the development of numerous devices for visual field losses. Spatial multiplexing by shifting, combined with biocular multiplexing, has been a proven effective aid for homonymous hemianopia. This approach, known as EP Prisms, uses unilateral prisms, and is applied to the peripheral field where double vision is well tolerated, and has evolved into a successful optical treatment. In numerous studies half or more of patients fitted with the EP prisms continue to wear and use the device over a long term and reported improved mobility. For PFL, Trifield prism spectacles, a biocular multiplexing device that applied central visual confusion to patients with tunnel vision (e. g., due to RP) has proven much more difficult. Despite there being no alternative aids available, and despite it being effective for 25% of patients, it has not made inroads in the marketplace. It is very complicated to construct and most patient find the central double vision it imposes disturbing. In considering the successful and limiting aspects of both approaches, the main requirements of patients with severe PFL, and the dynamic of a walking situation, we have designed a new visual aid, Quadrafield lens (creating artificial peripheral visual islands). This is achieved by applying near peripheral fiel expansion while avoiding the central confusion and fields tradeoffs of prior designs. We also invented a new optical element, a "multiplexing prism" that can be applied to this and other devices. Multiplexing prisms provide simultaneous (monocularly) superimposed views of the shifted and direct see-through fields of view. The maintenance of the see through view permits treatment of monocular patients. It also permits fitting the prisms closer to the central field, a even with occasional encroachment, due to head movements, foveal vision is not completely blocked. In addition we have found a way to convert the regular vertical head bobbing motion into a lateral scanning through the prisms, implementing temporal multiplexing. Here we propose to implement, tune, and test the effectiveness of the multiplexing prisms as an aid for PFL, when used in the Quadrafield lens in laboratory studies and culminating in a multicenter randomized control clinical trial.

描述（由申请人提供）：严重的周边视野丧失（PFL）有时称为管状视力，是色素性视网膜炎和相关疾病以及青光眼的结果。 目前，对于这些因这种障碍而严重影响行动能力的患者，尚无有效的视觉辅助工具。 视觉复用的新颖概念作为低视力设备的设计原理，为众多视野损失设备的开发提供了指导。 通过移位进行空间复用与生物复用相结合已被证明是治疗同向偏盲的有效方法。 这种方法被称为EP棱镜，使用单边棱镜，应用于复视耐受性良好的周边视野，并已发展成为一种成功的光学治疗方法。 在大量研究中，一半或更多装有 EP 棱镜的患者继续长期佩戴和使用该设备，并报告活动能力有所改善。 对于 PFL 而言，Trifield 棱镜眼镜是一种双目复用设备，可对隧道视力（例如由于 RP）患者施加中心视觉混乱，事实证明要困难得多。 尽管没有可用的替代辅助工具，尽管它对 25% 的患者有效，但它尚未进入市场。 它的构造非常复杂，并且大多数患者发现它造成的中央复视令人不安。 考虑到这两种方法的成功和局限性、严重 PFL 患者的主要要求以及步行情况的动态，我们设计了一种新的视觉辅助工具，Quadrafield 镜片（创建人工周边视觉岛）。 这是通过应用近外围场扩展来实现的，同时避免了现有设计的中心混乱和场权衡。 我们还发明了一种新的光学元件，即“多路复用棱镜”，可以应用于该设备和其他设备。 多路复用棱镜提供移动和直接透视视野的同时（单眼）叠加视图。 保持透视视野可以治疗单眼患者。 它还允许将棱镜安装得更靠近中心视野，即使由于头部运动而偶尔侵入，中心凹视力也不会完全被阻挡。 此外，我们还找到了一种方法，将常规的垂直头部摆动运动转换为通过棱镜的横向扫描，实现时间复用。 在这里，我们建议在实验室研究中使用四视场透镜并最终进行多中心随机对照临床试验时，实施、调整和测试多路复用棱镜作为 PFL 辅助手段的有效性。