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Scotoma Simulation in Healthy Subjects.

Sascha Klee, Dietmar Link1, Stefan Sinzinger2

  • 1Department of Optoelectrophysiological Engineering, Technische Universität Ilmenau, Ilmenau, Germany.

Optometry and Vision Science : Official Publication of the American Academy of Optometry
|November 20, 2018
PubMed
Summary

Researchers developed a new method to simulate age-related macular degeneration (AMD) central scotoma in healthy individuals using special contact lenses and a device. This technique allows for non-pharmacological control of scotoma size, aiding AMD research.

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Area of Science:

  • Ophthalmology
  • Visual Science
  • Medical Simulation

Background:

  • Age-related macular degeneration (AMD) is a leading cause of vision loss, characterized by central scotoma.
  • Simulating AMD scotoma in healthy subjects is crucial for understanding its effects and developing interventions.
  • Current simulation methods may have limitations in control and accessibility.

Purpose of the Study:

  • To design and validate a novel concept for simulating AMD-induced central scotoma in healthy individuals.
  • To utilize occlusive contact lenses and a miniaturized full-field adaptation device for scotoma induction.
  • To enable non-pharmacological adjustment of scotoma size by controlling pupil diameter.

Main Methods:

  • Developed an optical model to determine optimal contact lens parameters, considering pupil and opaque zone diameters.
  • Constructed a miniaturized full-field adaptation device for real-time scotoma size adjustment.
  • Validated the simulation using automated threshold perimetry for visual field measurements and a perception study with pictograms and letters.

Main Results:

  • Successfully induced absolute scotomas in all 10 volunteers, with contrast sensitivity loss ranging from 27 to 36 dB.
  • Localized scotomas accurately near the macula (mean variation < 5°).
  • Found that eccentric perception of magnified letters was most successful, while pictogram perception was significantly reduced and magnification-dependent.

Conclusions:

  • Demonstrated the feasibility of creating an absolute simulated AMD scotoma using occlusive contact lenses and a specialized adaptation device.
  • The developed method offers a controllable and non-pharmacological approach to scotoma simulation.
  • Findings suggest that magnified stimuli near the simulated scotoma improve perception, offering insights for visual rehabilitation strategies.