屈光参差患者双眼视损害的机制及可能恢复途径研究

Although the visual acuity of patients with anisometropia can reach the level of normal people, it is often found that their binocular vision function is still inferior to that of normal people, suggesting that patients with anisometropia may have some degree of binocular vision deficit. The neurological mechanism of this binocular vision deficit is still unclear, and the effect of various clinical treatment on binocular vision function is also unclear. In addition, corneal refractive surgery, cataract surgery and other operations may artificially cause binocular anisometropia, and then affect the binocular visual function of human eyes. Therefore, it is of great theoretical and clinical value to study the damage and recovery mechanism of binocular vision function in patients with anisometropia. We developed a multi-pathway contrast-gain control model (MCM), which could explain excellently the behavioral data measured in both binocular contrast perception and disparity threshold from normal people. The MCM has also been applied to the study of stereopsis in amblyopia. In this proposal, we systematically measure the disparity threshold under different contrast, spatial and temporal frequencies and extend the current MCM to account for the data of both normal and anisometropia people. With the extended MCM, we could quantitatively characterize the binocular deficits in anisometropia. Also several perceptual learning paradigms will be used to train the patients with anisometropia, and we will examine the outcomes as well as the system parameters before and after training. These data may be helpful for a deeper understanding of the mechanisms of binocular deficits in anisometropia and have potential value for the recovery of binocular vision in the patients with anisometropia.

屈光参差患者虽然视力可以达到正常人水平，但临床上经常发现其双眼视功能仍不及正常人，提示屈光参差患者可能存在一定程度的双眼视功能损害，这种双眼视认知损害的神经机制尚不清楚，临床上的多种矫正方案对于双眼视功能的影响也尚不清楚。此外，角膜屈光手术、白内障手术等术后可能会人为造成双眼屈光参差，进而对人眼的双眼视功能造成影响。因此对屈光参差患者双眼视功能损害机制和恢复途径的研究有着重大的理论和临床价值。本项目拟以申请团队在近期工作中提出的立体视对比度增益控制模型为切入点，系统深入地研究屈光参差患者立体视功能损害特性，并揭示其神经机制。同时通过横向比较几种双眼视恢复方法对成人屈光参差患者双眼视的改善程度，找到恢复成人屈光参差患者双眼视功能的最有效的方法。

屈光参差患者虽然视力可以达到正常人水平，但临床上经常发现其双眼视功能仍不及正常人，提示屈光参差患者可能存在一定程度的双眼视功能损害，这种双眼视认知损害的神经机制尚不清楚，临床上的多种矫正方案对于双眼视功能的影响也尚不清楚。本项目建立快速对比敏感度检测方法，获得峰值对比敏感度、最优空间频率、半高时带宽以及低频截止水平，并进而获得空间频率下的对比敏感度总和；建立双目相位组合任务获得双眼视知觉平衡参数。通过上述两种方法测量屈光参差患者双眼视功能，发现屈光参差患者双眼视功能尤其是对比敏感度功能等存在明显损害。通过框架眼镜和角膜接触镜矫正屈光参差患者发现光学成像矫正是影响双眼视功能的重要因素。良好的的光学矫正可在一定程度帮助屈光参差的患者维持双眼平衡和双眼视功能的恢复。这对屈光参差患者今后双眼视功能损害和治疗的研究有重要的示范意义。