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Theses

Impact de l’atteinte visuelle sur la cognition : application des connaissances théoriques pour le développement d’outils numériques adaptés aux patients glaucomateux

Abstract : Glaucoma is a complex visual disorder clinically defined by the optic nerve degeneration and progressive loss of peripheral to central vision. Brain imaging studies have shownthat damage to the optic nerve not only alters the sensory functions of patients, but also has consequences for neuroanatomical structures at the central nervous system level. The impact of these neurophysiological changes on the cognitive abilities of patients remains poorly documented.Two lines of research with glaucoma patients were conducted during this Ph.D. work.First, the theoretical framework aimed to understand the impact of visual impairment on cognition : through visual-cognitive tasks, monitored by electroencephalography or eyetracking.Secondly, the applied research explored the impact of glaucoma on computer useand assessed specific adaptations of the graphical interface to this form of visual impairment.To measure subjective preferences and objective performances of patients towards graphical enhancement, two experiments monitored by eye-tracking were conducted usingecological computer scenes.The global overview of our results showed that glaucoma patients display different braindynamics and top-down compensation mechanisms compared to controls. At a neurophysiologicallevel, the perceptual deficit induces a delay in the early stages of visual information processing but seems to be compensated by later mechanisms involved in the cognitive task. At a behavioral level, our theoretical and applied experiments highlighteds lower and fewer oculomotor activities in the healthy central visual field of patients. These oculomotor modifications appear to alter the visual performance of patients in theoretical experimental settings, and conversely maintain similar performance to controls in more ecological situations. Experiments dedicated to the difficulties encountered during computer use emphasized a major effect of normal aging of the visual system. However, the enhancement of graphical properties seemed to benefit a part of the glaucomatous population tested, exhibiting severe glaucoma with central vision impairment and contrast sensitivity deficit. This research contributes to the understanding of the impact of glaucoma on cognition andopen new research perspectives on the neurophysiological and oculomotor compensations of patients. Further adaptations of computer graphical interface remain to be explored to propose a digital solution to a larger number of glaucoma patients.
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https://tel.archives-ouvertes.fr/tel-03528467
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Submitted on : Monday, January 17, 2022 - 11:42:23 AM
Last modification on : Wednesday, March 23, 2022 - 3:51:30 PM
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Clémentine Garric. Impact de l’atteinte visuelle sur la cognition : application des connaissances théoriques pour le développement d’outils numériques adaptés aux patients glaucomateux. Médecine humaine et pathologie. Université de Lille, 2021. Français. ⟨NNT : 2021LILUS029⟩. ⟨tel-03528467⟩

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