Amblyopia Clinical Trial
Official title:
Amblyopia and Neurovascular Coupling in the Retina of Humans
The visual disorder of amblyopia affects 2% to 3% of the population. Amblyopia is a
developmental condition that is characterized by reduced vision of the eye due to the
presence of a sensory impediment during visual development, such as strabismus (ocular
misalignment) or anisometropia (unequal refractive error), occurring early in life. Recent
studies in humans and animals point towards a cortical locus for the processing deficit in
amblyopia, revealing sensory deficits at the signal cell level that include reduced spatial
resolution, reduced contrast sensitivity, and a reduced number of binocular neural cells. In
the retina, however, no abnormalities have yet been reported.
Like in the brain blood flow in the retina is coupled to neuronal activity. This phenomenon
has been measured by different study groups with non invasive techniques in the brain and
retina. We therefore use a Zeiss fundus camera for the assessment of retinal vessel
diameters. This so called retinal vessel analyzer (RVA) is a combination of a fundus camera
connected to a high resolution video camera equipped with a software based analyzing system.
An unprecedented reproducibility and sensitivity of retinal vessel diameter measurements is
attained with this system. In addition this system allows real time analysis of retinal
vessels as well as off-line determinations from video tape. A special provocation test,
which minimizes risk and discomfort to the subject under study is applied through the
illumination pathway of the fundus camera: Diffuse luminance flicker is used as a stimulus
to augment intrinsic mechanisms by which the retina can vary the vascular supply, in
correspondence with local variations of functional activity. This system allows to study the
flicker response of retinal vessels, which is within a magnitude of 6 to 8%.
However, the exact mechanisms underlying this phenomenon are not fully understood.
Especially in the eye it is not clear whether it is an exclusive metabolic effect within the
retina and the surrounding blood vessels or dependent of central regulatory brain functions.
The purpose of the current study is to improve our understanding of the mechanisms
underlying flicker evoked responses of retinal blood vessels in humans. It is not clear
whether the retina of amblyopic eyes can regulate retinal blood flow in response to
increased metabolic demands as induced during flicking light stimulation. A detail
understanding of the metabolic and functional processes within the retina of patients with
amblyopia is a prerequisite for further research to prevent amblyopia.
n/a
Allocation: Non-Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Diagnostic
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