Objective Methods to Test Visual Dysfunction in the Presence of Cognitive Impairment.

摘要

Purpose: to develop and validate objective tests to diagnose vision deficits in patients with cognitive impairment and ensure effective monitoring of their treatment. Scope: objective methods to monitor visual function include 1) the pupil light reflex (PLR), 2) light evoked potentials (VEP) from the brain and from the eye and 3) purposeful eye movements to track moving targets that are resolved. Major Findings (year 3): i) development of an objective test protocol and data analysis routines to derive metrics that correlate with clinical diagnoses of afferent and efferent pathway pathologies based on the PLR. This protocol is less than 22 seconds in duration. The Pearson correlation coefficient between the derived continuous RAPD metric and clinical RAPD measurements is 0.86; ii) implementation and testing of a user interface to quickly and efficiently detect and remove artifacts from PLR data; iii) comparison of the design matrix method for VEP stimuli with the maximum length sequences (msequences) method based on simulations and various statistical metrics. Significance: objective tests of vision will greatly improve eye care by providing faster, lower cost testing that can be performed in remote settings and will provide a new tool for assessing innovative treatments being developed to save or restore vision.