Evaluation of Visual and Task Performance

Better understand the impact of visual impairment on daily task performance in patients with eye diseases of the visual pathways, such as glaucoma and age-related macular degeneration (AMD). Longitudinal study, with biannual visits, including patients with: glaucoma, suspected of having glaucoma, non-glaucomatous optic neuropathies, AMD, retinal degenerations, other diseases involving the visual pathways, besides healthy controls. Subjects will perform standard ophthalmological exams, and the following research tests: psychophysical, eye tracking, electroencephalogram, driving simulator, virtual reality, balance assessment, and questionnaires. This proposal also includes an investigation of the ability of longitudinal brain-computer interface (BCI) multifocal steady-state visual-evoked potentials (mfSSVEP) parameters in detecting glaucoma progression. We hypothesize that BCI mfSSVEP data will be able to successfully detect progression and measure rates of change, as compared to functional assessment by standard automated perimetry (SAP) and structural assessment by optical coherence tomography.

Glaucoma, Macular Degeneration, Glaucoma Suspect, Optic Neuropathy, Retinal Degeneration, Visual Pathway Disorder

virtual reality, glaucoma, age related macular degeneration, quality of life, visual field, optical coherence tomography, brain-computer interface

Patients with suspicious of having glaucoma based on intra-ocular pressure or optic nerve photographs with glaucoma appearance

Patients labeled as healthy controls for not having any other eye diseases that would be included on the other groups

The overall goal of this proposal is to improve our understanding of functional disability in glaucoma by using virtual reality tests to investigate objective performance during simulated daily life activities.

The brain-computer interface (BCI) device consists of a modified virtual reality goggle integrated with wireless no-prep electroencephalogram (EEG). The portable BCI is able to objectively measure multifocal steadystate visual evoked potentials in response to brain stimulation through presentation of visual stimuli in the goggle.

The study team will evaluate visual impairment through the following scores obtained from the following composite tests: ophthalmological evaluation, questionnaires, psychophysics tests, eye tracking devices, electroencephalogram exams, driving simulator, virtual reality tests, and balance assessment.

The proportion of eyes showing progression will be compared between the home-based Brain-computer interface testing and standard clinical testing (standard automated perimetry), matched by specificity.

The time to detect progression will be compared between the home-based Brain-computer interface testing and standard clinical testing (standard automated perimetry).

The ability of home-based BCI testing to predict future progression on standard automated perimetry will be assessed by the c-index.

The ability of home-based BCI testing to predict changes in patient-reported quality of life data as assessed by the National Eye Institute Visual Function Questionnaire (NEI VFQ-25) will be assessed by the c-index.

Inclusion Criteria: Subjects must be between the ages of 18 and 90 years old; Both males and females will be included. Be able and willing to provide signed informed consent and follow study instructions Exclusion Criteria: Subjects will be excluded if they present with any systemic conditions that in the opinion of the Principal Investigator may prevent them from completing the tests.