NJIT
Physics Department Seminar
October 19th, Monday
The Underlying Mechanism
of Vision Therapy revealed using Functional Imaging
Prof. Tara Alvarez
Dept. of Biomedical
Engineering, NJIT
(Biophysics, Host:
Thomas/Dias)
Time: 11:45am-12:45pm with 11:30am tea time
Room: ECE 202
Abstract:
Convergence insufficiency (CI), a prevalent binocular vision
disorder in adults and children, is characterized by greater exophoria at near than at distance, reduced fusional convergence amplitude and
receded near point of convergence. CI is associated with symptoms including
double/blurred vision, eyestrain, and headaches when engaged in reading or
other near work. Dr. Alvarez and colleagues published the first data of
functional activity using functional MRI (fMRI) with convergence eye movements
correlated to vision function in CI patients before and after Office-Based Vergence and Accommodative Therapy with home reinforcement
(OBVAT). The recent NEI/NIH multi-center randomized clinical trial, the
Convergence Insufficiency Treatment Trial (CITT), demonstrated the
effectiveness of OBVAT for CI, reporting 73% of patients have sustained
improvements of vision function and symptoms. Our quantitative methods
integrated with established CITT standards address important questions about
the underlying neural substrates and changes in convergence presumed to be
evoked by OBVAT. We combine objective eye movement recordings and fMRI, to take
a first critical step to answer what neural substrates change within the visual
system as the near point of convergence and convergence amplitudes improve with
therapy. The relationship between convergence eye movements and fMRI will be
discussed. Measurements from the CI patients were obtained before and after 18
hours of vision therapy. Neural substrates were stimulated using an fMRI block
design composed of sustained fixation compared to vergence
eye movements. Individual subject reference vectors were computed using a
data-driven independent component analysis (ICA) of a group of time series.
After vision therapy, the blood oxygenation level dependent (BOLD) percent
signal change increased in the frontal eye fields (FEF), posterior parietal
cortex (PPC) and cerebellar vermis (CV). Second, the task induced functional
connectivity improved in the FEF, PPC, and CV. Last, the BOLD percent signal
change within FEF and CV significantly correlated to the clinically developed
symptom survey.
Biography:
Tara Alvarez is Professor of Biomedical Engineering at NJIT. After her Ph.D. (BME, Rutgers) and research
at Bell Labs, she helped found NJIT’s BME Department in 2001. Her laboratory seeks to understand
fundamental mechanisms of oculomotor learning.
She actively studies how clinical vision therapy leads to sustained
reduction in visual dysfunction. (5% of children and 40-50% of traumatic brain
injured patients suffer oculomotor dysfunction.) Dr. Alvarez is known for
demonstrating how vision therapy alters neural oculomotor control using
combined measurements of functional imaging (fMRI) and eye movements. This
knowledge improves therapeutic efficacy while decreasing cost – especially for
children and those with brain injury. Her work is funded by NIH, where her most
recent grant placed in the top 5%, NSF and Essilor
International. She has 125 peer reviewed publications and 4 patents. She has
been recognized by numerous awards: NSF CAREER (2005), Best Scientific
Achievement (NORA, 2008), Outstanding Woman of Science (NJABR, 2008), NJIT
Excellence in Education (2013), NJIT Excellence in Research (2015), Thomas
Edison Award (NJ R&D Council, 2015). She serves on the editorial board of Journal
of Eye Movement Research and actively reviews for 7 other journals.