Dr. Alberti is a new investigator seeking to establish herself as an independent researcher in vision rehabilitation. She has considerable experience in low vision clinical settings and in research methods and is a strong candidate to conduct the research described in the application. The project that is subject of the application will be critial for innovation and importance in the field of vision rehabilitation for Age-related Macular Degeneration (AMD). AMD causes vision loss in the central retinal area used for high-resolution vision with relative sparing of peripheral vision. People with central field loss may develop the ability to compensate for the deficit by using a peripheral portion of their retina for vision: the Preferred Retinal Locus (PRL). The selection of the PRL location depends on the size and location of the scotoma (blind spot caused by the disease), which is not the same size and shape in the right and left eyes. This project aims at evaluating visual function when patients use both eyes and investigating how the binocular PRL is derived from the locations of the monocular scotomas, and finally, measuring how the functionality of the chosen PRL changes with different tasks and conditions. The development of a functional PRL is the main objective of rehabilitation practices for AMD but the efficacy of rehabilitation training is not proven because of the lack of technologies and knowledge about how PRLs work. We propose to study binocular PRL selection by first simulating central field loss in normally sighted people (k99 phase). After underpinning the factors affecting PRL selection, we will recruit a clinical group with AMD to test our hypothesis from the simulation experiments. In addition, in this new phase (R00 phase) we will test binocular vision in everyday activities such as reaching for an object (reach and grasp). In order to measure binocular PRL location a new PRL mapping method will be developed and integrated in our testing protocol. The development of appropriate clinical and rehabilitation practices for elderly people with AMD is the main objective of this project in line with NIA mission. Thanks to this award, I will have the opportunity to study the PRL selection under the supervision of one outstanding mentor, Dr. Peter Bex who is currently leading the Translational Vision Group at the College of Science. My long-term goal is obtaining a research appointment and starting an independent lab with clear translational impact on important aging-related vision problems. An independent lab will require the acquisition of new technical skills and the instauration of clinical collaborations to recruit low vision subjects. The software development will be conducted with the help of Dr. Bex. The collaboration with Dr. Lashkari (eye doctor at a local retina clinic) will create a low vision subjects database for easy recruitment. I will also benefit from my integration in the large community at Northeastern University for subjects recruitment and for the available learning resources.
Rehabilitation strategies for Age-related Macular Degeneration involve training a Preferred Retinal Locus (PRL) in the periphery for vision. Most of our current understanding on how the selection process of a PRL occurs is based on studies that employed monocular micro-perimetric methods that do not evaluate visual function when patients use both eyes. Our project aims at improving rehabilitation strategies and outcomes by relating the selection of the binocular PRL to binocular visual performance and for this purpose we will use new technologies currently under development in our lab.