Online Program

Neural Pathways and Optic Nerve: Dementia, Glaucoma and Injury

Monday, November 2, 2015

Denise Valenti, OD, Aging/VIsion Rehabilitation, MCPHS University School of Optometry, Quincy, MA
Amy Falk, OD, School of Optometry, MCPHS University, Worcester, MA
Background     As much as 20 percent of the brain is related to direct sight tasks and 50 percent is involved in vision-related neuroprocessing. The retina is a direct extension of the brain. Neurodegenerative diseases and injury to the brain impact the retina and age-related diseases originating in the eye result in measureable structural losses of brain structure.  With newer imaging technologies we are gaining a greater knowledge of the structural functional relationships in the visual system.  With this understanding we will be better able to guide treatment and rehabilitation as well as prevention.

Methods     While the emphasis will be on glaucoma, other neurodegenerative processes impacting vision  will be discussed such as injury and Alzheimer’s disease.  The dynamics of brain structure, cerebral spinal fluid changes with injury or disease and implications for the eye will be reviewed.  Even in the absence of reduced acuities or field loss, patients experiencing injury can have substantial visual dysfunction.  This is particularly compelling with the head injuries experienced by first responders or military or risks for falls after injury or stroke.  

Outcomes    The literature reports very early detriments to visual pathways with disease; even in the absence of cell death when using more dynamic imaging technologies such as Diffuse Tensor Imaging and retinal imaging technologies.

Conclusions    Tasks such as safe mobility and reading are often demonstrating deficits with disease or injury.  A knowledge of where the structural damage within the brain has occurred will enable more focused therapies and a better understanding of prognosis. 

Learning Areas:

Chronic disease management and prevention
Clinical medicine applied in public health

Learning Objectives:
Describe the imaging that demonstrates functional processing of vision within the brain. Discuss how age related neurodegenerative processes related to Alzheimer's disease have been shown to impact the functional vision pathways within the brain. Discuss how functional imaging demonstrates early losses in the brain related to glaucoma. Explain the implications of comorbid neurodegenerative disease process and visual function and its impact on the quality of life.

Keyword(s): Aging, Quality of Life

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Dr. Denise A. Valenti is an optometrist with expertise in the field of age-related neurodegenerative diseases. Dr. Valenti was a Functional MRI Fellow at the Martinos Center for Biomedical Imaging. Her research includes imaging of retinal neural tissue and functional assessment of neural processing in the visual system in Alzheimer’s, injury, Parkinson’s and glaucoma. Dr. Valenti currently teaches Low Vision and Geriatrics at the MCPHS University School of Optometry and Gerontology at Quincy College.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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