# Visual acuity and functional measurements in the aging eye

> **NIH NIH R44** · AEON IMAGING, LLC · 2022 · $632,430

## Abstract

Project Summary
Age-related macular degeneration (AMD) remains the most common cause of permanent vision loss in the US
and many industrialized countries. Diabetic retinopathy and diabetic macular edema are the leading cause of
visual acuity loss in working age Americans. Visual function is a key component in almost all of the 1,861 US
clinical trials for AMD and 262 for diabetic retinopathy and macular edema. If outcome measures, including
visual acuity, could be made more accurate and cost-effective and with decreased test-retest variability, then
clinical trials could use smaller sample sizes, giving savings in cost and time to bring therapies to market. By
building a new device, the Potential Vision Tester™ (PVT), we will improve measurements by minimizing the
issues from the optics of the aging eye. Simultaneous retinal imaging will clarify fixation locus and fixation
stability of the patient’s eye. The optical errors of a patient’s eye will be measured as wavefront aberrations,
and the target display will be corrected with moderately priced adaptive optics to overcome retinal elevation
from exudation as well as refractive error. Reporting out of wavefront errors distinguishes between neural
damage vs. optical issues. A high resolution display, suitable for visual acuity testing, will project stimuli onto
the eye in Maxwellian view to minimize pupil size effects found in older eyes. Competing devices for
microperimetry lack the resolution needed for visual acuity. We will use psychophysical techniques that are
rapid, accurate, and provide better measures of variability: 4 alternative forced choice. In Aim 1, we will build
an adaptive optics-corrected PVT visual display and NIR illumination for retinal imaging. The imaging light is
comfortable and dim enough not to interfere with visual tasks. The patented NIR imaging technology projects
a series of stripes onto the retina in a raster pattern, providing line scanning for imaging. The detection is via a
2D CMOS detector with a rolling shutter, with the serial read-out of the lines either synchronized with the
illumination or offset in time. This provides a flexible electronic aperture under computer control. Both
confocal and multiply scattered light images are available, revealing drusen and other subretinal thickening.
We will optimize image quality in 10 subjects with a range of refractive error, ocular pigmentation, and age. In
Aim 2, we will quantify and validate the Hartmann-Shack wavefront measurements of the PVT in 20 patients
with retinal disease vs. 20 without to determine the effect on wavefront measurements. In Aim 3 we will
optimize the algorithm for efficient testing and metric for Potential Visual Acuity (PVA), using data from Aims 1
and 2, reporting central tendency (expected value) and variability, including optical errors and fixation data, to
address the acuity this patient could reach with retinal treatment. In Aim 4, for 20 patients with exudative AMD
and 20 with diabetic ...

## Key facts

- **NIH application ID:** 10478474
- **Project number:** 2R44EY030829-02
- **Recipient organization:** AEON IMAGING, LLC
- **Principal Investigator:** ANN E ELSNER
- **Activity code:** R44 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $632,430
- **Award type:** 2
- **Project period:** 2019-09-01 → 2024-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10478474

## Citation

> US National Institutes of Health, RePORTER application 10478474, Visual acuity and functional measurements in the aging eye (2R44EY030829-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10478474. Licensed CC0.

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