Visual functional analysis in medical imaging

Aims of study: 1) Describe the importance of human visual system on lesion detection in medical imaging perception research; 2) Discuss the relevance of research in medical imaging addressing visual function analysis; 3) Identify visual function tests which could be conducted on observers prior to participation in medical imaging perception research.

Influência da experiência profissional e da função visual do operador no processamento semiautomático da cintigrafia de perfusão do miocárdio: variabilidade intra e interoperador na determinação dos parâmetros quantitativos

Introdução – A cintigrafia de perfusão do miocárdio (CPM) desempenha um importante papel no diagnóstico, avaliação e seguimento de pacientes com doença arterial coronária, sendo o seu processamento realizado maioritariamente de forma semiautomática. Uma vez que o desempenho dos técnicos de medicina nuclear (TMN) pode ser afetado por fatores individuais e ambientais, diferentes profissionais que processem os mesmos dados poderão obter diferentes estimativas dos parâmetros quantitativos (PQ). Objetivo – Avaliar a influência da experiência profissional e da função visual no processamento semiautomático da CPM. Analisar a variabilidade intra e interoperador na determinação dos PQ funcionais e de perfusão. Metodologia – Selecionou-se uma amostra de 20 TMN divididos em dois grupos, de acordo com a sua experiência no software Quantitative Gated SPECTTM: Grupo A (GA) – TMN ≥600h de experiência e Grupo B (GB) – TMN sem experiência. Submeteram-se os TMN a uma avaliação ortóptica e ao processamento de 21 CPM, cinco vezes, não consecutivas. Considerou-se uma visão alterada quando pelo menos um parâmetro da função visual se encontrava anormal. Para avaliar a repetibilidade e a reprodutibilidade recorreu-se à determinação dos coeficientes de variação, %. Na comparação dos PQ entre operadores, e para a análise do desempenho entre o GA e GB, aplicou-se o Teste de Friedman e de Wilcoxon, respetivamente, considerando o processamento das mesmas CPM. Para a comparação de TMN com visão normal e alterada na determinação dos PQ utilizou-se o Teste Mann-Whitney e para avaliar a influência da visão para cada PQ recorreu-se ao coeficiente de associação ETA. Diferenças estatisticamente significativas foram assumidas ao nível de significância de 5%. Resultados e Discussão – Verificou-se uma reduzida variabilidade intra (<6,59%) e inter (<5,07%) operador. O GB demonstrou ser o mais discrepante na determinação dos PQ, sendo a parede septal (PS) o único PQ que apresentou diferenças estatisticamente significativas (zw=-2,051, p=0,040), em detrimento do GA. No que se refere à influência da função visual foram detetadas diferenças estatisticamente significativas apenas na fração de ejeção do ventrículo esquerdo (FEVE) (U=11,5, p=0,012) entre TMN com visão normal e alterada, contribuindo a visão em 33,99% para a sua variação. Denotaram-se mais diferenças nos PQ obtidos em TMN que apresentam uma maior incidência de sintomatologia ocular e uma visão binocular diminuída. A FEVE demonstrou ser o parâmetro mais consistente entre operadores (1,86%). Conclusão – A CPM apresenta-se como uma técnica repetível e reprodutível, independente do operador. Verificou-se influência da experiência profissional e da função visual no processamento semiautomático da CPM, nos PQ PS e FEVE, respetivamente.

Função visual e desempenho na leitura em crianças do 1º ciclo do ensino básico do concelho de Lisboa

RESUMO - Esta tese pretende ser um contributo para o estudo das anomalias da função visual e da sua influência no desempenho da leitura. Apresentava como objetivos: (1) Identificar a prevalência de anomalias da função visual, (2) Caracterizar o desempenho da leitura em crianças com e sem anomalias da função visual, (3) Identificar de que modo as anomalias da função visual influenciam o desempenho da leitura e (4) Identificar o impacto das variáveis que determinam o desempenho da leitura. Foi recolhida uma amostra de conveniência com 672 crianças do 1º ciclo do ensino básico de 11 Escolas do Concelho de Lisboa com idades compreendidas entre os 6 e os 11 anos (7,69±1,19), 670 encarregados de educação e 34 Professores. Para recolha de dados, foram utilizados três instrumentos: 2 questionários de perguntas fechadas, avaliação da função visual e prova de avaliação da leitura com 34 palavras. Após observadas, as crianças foram classificadas em dois grupos: função visual normal (FVN=562) e função visual alterada (FVA=110). Identificou-se uma prevalência de 16,4% de crianças com FVA. No teste de leitura, estas crianças apresentaram um menor número de palavras lidas corretamente (FVA=31,00; FVN=33,00; p<0,001) e menor precisão (FVA=91,18%; FVN=97,06%; p<0,001). Esta tendência também foi observada na comparação entre os 4 anos de escolaridade. As crianças com função visual alterada mostraram uma tendência para a omissão de letras e a confusão de grafema. Quanto à fluência (FVA=24,71; FVN=27,39; p=0,007) esta foi inferior nas crianças com FVA para todos os anos de escolaridade, exceto o 3º ano. As crianças com hipermetropia (p=0,003) e astigmatismo (p=0,019) não corrigido leram menos palavras corretamente (30,00; 31,00) e com menor precisão (88,24%; 91,18%) que as crianças sem erro refrativo significativo (32,00; 94,12%). A performance escolar classificada pelos professores foi inferior nas crianças com FVA e mais de ¼ necessitavam de medidas de apoio especial na escola. Não se verificaram diferenças significativas na performance da leitura das crianças com FVA por grupos de habilitações dos encarregados de educação. Verificou-se que o risco de ter um desempenho na leitura alterado é superior [OR=4,29; I.C.95%(2,49;7,38)] nas crianças que apresentam FVA. Relativamente ao 1º ano de escolaridade, o 2º, 3º e 4º anos apresentam um menor risco de ter um desempenho na leitura alterado. As variáveis método de ensino, habilitações dos encarregados de educação, tipo de escola (pública/privada), idade do Professor e número de anos de experiência do Professor, não foram fatores estatisticamente significativos para explicar a alteração do desempenho na leitura, quando o efeito da função visual se encontra contemplado no modelo. Um mau desempenho na leitura foi considerado nas crianças que apresentaram uma precisão inferior a 90%. Este indicador pode ser utilizado para identificar crianças em risco, que necessitam de uma observação Ortóptica/Oftalmológica para confirmação ou exclusão da existência de alterações da função visual. Este trabalho constitui um contributo para a identificação de crianças em desvantagem educacional devido a anomalias da função visual tratáveis, propondo um modelo que pretende orientar os professores na identificação de crianças que apresentem um baixo desempenho na leitura.

Traitement chirurgical de la diplopie secondaire à l'orbitopathie dysthyroïdienne [Surgical treatment of diplopia in Graves' orbitopathy]

BACKGROUND: The correction of oculomotor disorder in Grave's disease is applied on pathological extraocular muscles. Based on the global muscular restriction (bilateral forced duction test) and angular measurements, we have used a non-adjustable technique. PATIENTS AND METHODS: We performed a retrospective analysis of 21 patients (23 operations) with thyroid-associated orbitopathy operated for persisting diplopia. The angles of deviation in the 9 diagnostic directions of gaze and the field of binocular vision were measured with the Harm's tangent scale before and after surgery. Sixteen patients were operated only on vertical muscles. The mean follow-up was 45 months. RESULTS: 76 % of the patients (95 % confidence interval [CI], 58-94 %) obtained a large and centred field of binocular vision without prisms. 14 % (95 % CI, 0-29 %) had binocular vision with the use of prisms. Diplopia persisted in one patient despite 3 operations. Taking into consideration the interventions done before the patient was referred to us, the reintervention rate was 13 % (95 % CI, 0-28 %). CONCLUSIONS: A binocular field of vision can be successfully restored in the majority of patients with Graves' orbitopathy, using a non-adjustable surgical technique.

Étude électrophysiologique de la suppression interoculaire : implication pour l'amblyopie

L’amblyopie est un trouble développemental de la vision binoculaire. Elle est typiquement caractérisée par des atteintes de l’acuité visuelle et de la stéréoscopie. Toutefois, de plus en plus d’études indiquent la présence d’atteintes plus étendues telles que les difficultés d’attention visuelle ou de lecture. L’amblyopie est généralement expliquée par une suppression interoculaire au niveau cortical, considérée comme chronique ou permanente à l’extérieur de la période développementale. Or, un nombre croissant d’études suggèrent que des interactions binoculaires normales seraient présentes chez les amblyopes adultes. Dans une première étude, nous avons tenté d’identifier un marqueur électrophysiologique de la vision binoculaire. Nous avons enregistré des potentiels évoqués visuels chez des observateurs normaux à qui l’on a induit une dysfonction binoculaire. Les interactions binoculaires étaient caractérisées à l’aide de patrons (facilitation, moyennage et suppression) en comparant les réponses monoculaires et binoculaires. De plus, ces interactions étaient quantifiées à partir d’index d’intégration continus en soustrayant la somme des réponses monoculaires de la réponse binoculaire. Les résultats indiquaient que les patrons d’interaction n’étaient pas optimaux pour estimer les performances stéréoscopiques. Ces dernières étaient, en revanche, mieux expliquées par notre index d’intégration binoculaire. Ainsi, cette étude suggère que l’électrophysiologie est un bon prédicteur de la vision binoculaire. Dans une deuxième étude, nous avons examiné les corrélats neuronaux et comportementaux de la suppression interoculaire chez des amblyopes adultes et des observateurs normaux. Des potentiels évoqués visuels stationnaires ont été enregistrés en utilisant un paradigme de suppression par flash. La suppression était modulée par un changement de contraste du stimulus flash (10, 20, 30, ou 100%), ou le suppresseur, qui était présenté soit dans l’œil dominant ou non-dominant (ou amblyope). Sur le plan comportemental, la suppression interoculaire était observée indépendamment de l’œil stimulé par le flash chez les contrôles. Au contraire, chez les amblyopes, la suppression était asymétrique (c’est-à-dire supérieure lorsqu’elle provenait de l’œil dominant), ce qui suggérait une suppression chronique. De manière intéressante, l’œil amblyope a supprimé l’œil dominant à haut niveau de contraste. Sur le plan électrophysiologique, l’effet de suppression interoculaire observé à la région occipitale était équivalent dans chaque groupe. Toutefois, les réponses électrophysiologiques à la région frontale chez les amblyopes n’étaient pas modulées comme celles des contrôles; la suppression de l’œil amblyope était manifeste même à bas contraste. Nous résultats supportent ainsi l’existence d’interaction binoculaire fonctionnelle chez les amblyopes adultes ainsi que l’implication d’un réseau cortical étendu dans la suppression interoculaire. En somme, l’amblyopie est une condition complexe dont les atteintes corticales et les déficits fonctionnels semblent globaux. L’amblyopie ne doit plus être considérée comme limitée à une dysfonction de l’aire visuelle primaire. La suppression interoculaire semble un point central de cette problématique, mais encore beaucoup d’études seront nécessaires afin de déterminer l’ensemble des mécanismes impliqués dans celle-ci.

Receding and disparity cues aid relaxation of accommodation

Purpose. Accommodation can mask hyperopia and reduce the accuracy of non-cycloplegic refraction. It is, therefore, important to minimize accommodation to obtain a measure of hyperopia as accurate as possible. To characterize the parameters required to measure the maximally hyperopic error using photorefraction, we used different target types and distances to determine which target was most likely to maximally relax accommodation and thus more accurately detect hyperopia in an individual. Methods. A PlusoptiX SO4 infra-red photorefractor was mounted in a remote haploscope which presented the targets. All participants were tested with targets at four fixation distances between 0.3 and 2 m containing all combinations of blur, disparity, and proximity/looming cues. Thirty-eight infants (6 to 44 weeks) were studied longitudinally, and 104 children [4 to 15 years (mean 6.4)] and 85 adults, with a range of refractive errors and binocular vision status, were tested once. Cycloplegic refraction data were available for a sub-set of 59 participants spread across the age range. Results. The maximally hyperopic refraction (MHR) found at any time in the session was most frequently found when fixating the most distant targets and those containing disparity and dynamic proximity/looming cues. Presence or absence of blur was less significant, and targets in which only single cues to depth were present were also less likely to produce MHR. MHR correlated closely with cycloplegic refraction (r = 0.93, mean difference 0.07 D, p = n.s., 95% confidence interval +/-<0.25 D) after correction by a calibration factor. Conclusions. Maximum relaxation of accommodation occurred for binocular targets receding into the distance. Proximal and disparity cues aid relaxation of accommodation to a greater extent than blur, and thus non-cycloplegic refraction targets should incorporate these cues. This is especially important in screening contexts with a brief opportunity to test for significant hyperopia. MHR in our laboratory was found to be a reliable estimation of cycloplegic refraction. (Optom Vis Sci 2009;86:1276-1286)

Humans ignore motion and stereo cues in favor of a fictional stable world

As we move through the world, our eyes acquire a sequence of images. The information from this sequence is sufficient to determine the structure of a three-dimensional scene, up to a scale factor determined by the distance that the eyes have moved [1, 2]. Previous evidence shows that the human visual system accounts for the distance the observer has walked [3,4] and the separation of the eyes [5-8] when judging the scale, shape, and distance of objects. However, in an immersive virtual-reality environment, observers failed to notice when a scene expanded or contracted, despite having consistent information about scale from both distance walked and binocular vision. This failure led to large errors in judging the size of objects. The pattern of errors cannot be explained by assuming a visual reconstruction of the scene with an incorrect estimate of interocular separation or distance walked. Instead, it is consistent with a Bayesian model of cue integration in which the efficacy of motion and disparity cues is greater at near viewing distances. Our results imply that observers are more willing to adjust their estimate of interocular separation or distance walked than to accept that the scene has changed in size.

Accommodation and vergence response gains to different near cues characterize specific esotropias

Aim. To describe preliminary findings of how the profile of the use of blur, disparity and proximal cues varies between non-strabismic groups and those with different types of esotropia. Design. Case control study Methodology. A remote haploscopic photorefractor measured simultaneous convergence and accommodation to a range of targets containing all combinations of binocular disparity, blur and proximal (looming) cues. 13 constant esotropes, 16 fully accommodative esotropes, and 8 convergence excess esotropes were compared with age and refractive error matched controls, and 27 young adult emmetropic controls. All wore full refractive correction if not emmetropic. Response AC/A and CA/C ratios were also assessed. Results. Cue use differed between the groups. Even esotropes with constant suppression and no binocular vision (BV) responded to disparity in cues. The constant esotropes with weak BV showed trends for more stable responses and better vergence and accommodation than those without any BV. The accommodative esotropes made less use of disparity cues to drive accommodation (p=0.04) and more use of blur to drive vergence (p=0.008) than controls. All esotropic groups failed to show the strong bias for better responses to disparity cues found in the controls, with convergence excess esotropes favoring blur cues. AC/A and CA/C ratios existed in an inverse relationship in the different groups. Accommodative lag of >1.0D at 33cm was common (46%) in the pooled esotropia groups compared with 11% in typical children (p=0.05). Conclusion. Esotropic children use near cues differently from matched non-esotropic children in ways characteristic to their deviations. Relatively higher weighting for blur cues was found in accommodative esotropia compared to matched controls.

Convergence accommodation trumps accommodative convergence

Purpose. This symposium contribution presents research that shows that disparity cues within a near stimulus drive not only vergence but also most of the accommodation. Be-cause blur is a weaker cue, accommodative convergence is therefore only of minor significance for most individuals. Methods. The Infant Vision Laboratory at the University of Reading uses a Power Ref II photorefractor to collect simultaneous accommodation and convergence data from participants fixating targets moving in depth. By manipulating target characteristics, we have been able to test how blur, disparity and proximal cues each contribute to driving responses. Results. Results from a series of studies over the past 12 years have contributed to a coherent body of evidence suggesting that disparity cues override blur and proximity cues in most individuals. Some strabismic patients do use blur as a more strongly weighted cue, and this strategy could contribute to their symptoms, clinical characteristics and response to treatment. Conclusion. Although convergence accommodation is extremely difficult to measure clinically, clinicians should be aware of its importance in binocular vision and strabismus. Although CA/C relationships typically seem more important than AC/A, bo th only partly explain the interplay between convergence and accommodation.

Effects of age and optical blur on real depth stereoacuity

Stereoscopic depth perception utilizes the disparity cues between the images that fall on the retinae of the two eyes. The purpose of this study was to determine what role aging and optical blur play in stereoscopic disparity sensitivity for real depth stimuli. Forty-six volunteers were tested ranging in age from 15 to 60 years. Crossed and uncrossed disparity thresholds were measured using white light under conditions of best optical correction. The uncrossed disparity thresholds were also measured with optical blur (from +1.0D to +5.0D added to the best correction). Stereothresholds were measured using the Frisby Stereo Test, which utilizes a four-alternative forced-choice staircase procedure. The threshold disparities measured for young adults were frequently lower than 10 arcsec, a value considerably lower than the clinical estimates commonly obtained using Random Dot Stereograms (20 arcsec) or Titmus Fly Test (40 arcsec) tests. Contrary to previous reports, disparity thresholds increased between the ages of 31 and 45 years. This finding should be taken into account in clinical evaluation of visual function of older patients. Optical blur degrades visual acuity and stereoacuity similarly under white-light conditions, indicating that both functions are affected proportionally by optical defocus.

Stereoscope

Wheatstone’s stereoscope placed two mirrors on either side that were mounted at a right angle in order to view the two dissimilar drawings presented (Hankins 148). There are two identical monocular tubes that allow each eye to view the images (Hankins 148). Each eye views the image it was intended to see. The two eyes see slightly different images through this binocular vision (Hankins 148). The combination of the two images creates this illusion of depth and solidarity through their superimposition (Hankins 154). In order to view these images, the eyes were covered from all external light (Clay 152). The stereoscope was first seen as a philosophical toy along with other inventions such as the zoetrope, providing entertainment as well as scientific insight (Hankins 148). The stereoscope above is more similar to the “Holmes Stereoscope”, which transformed Wheatstone’s stereoscope into a handheld version that could be put on a stand (Hawkins 155). He replaced the retina of the eye with a sensitive plate; therefore, the lenses acted as the eyes (Silverman 738). In the video, an embellishment adorns the bottom of the stand that holds up the binocular lens and the images. The lenses are in a wooden frame that has an attached stand that holds the slides of images. There also is a knob on the side of the device that can adjust the lens on the two monocular tubes (Bokander 485).

Minimally invasive strabismus surgery (MISS) for inferior obliquus recession

PURPOSE: To present a novel, minimally invasive strabismus surgery (MISS) technique for inferior obliquus recessions. METHODS: Graded MISS inferior obliquus recessions were performed in 20 eyes of 15 patients by applying two small conjunctival cuts, one at the insertion of inferior obliquus and another where the scleral anchoring of the muscle occurred. RESULTS: The amount of recession was 12.2 +/- 2.3 mm (range 6 to 14 mm). The vertical deviation, which was measured in 25 degrees of adduction, decreased from preoperatively 12.8 degrees +/- 5.6 degrees to 2.7 degrees +/- 2.2 degrees (p < 0.0001) at 6 months. LogMAR visual acuity was preoperatively -0.10 +/- 0.17 and at 6 months -0.14 +/- 0.22 (p > 0.1). In one eye (2.5%) the two cuts had to be joined because of excessive bleeding. Binocular vision improved in eight patients, remained unchanged in six patients, and decreased from 30 to 60 arcsec in one patient (p > 0.1). Conjunctival and lid swelling were hardly visible on the first postoperative day in primary gaze position in 10/20 (50%) of eyes. Five of the eyes (25%) had mild and five (25%) moderate visibility of surgery. One patient out of 15 (7%) needed repeat surgery because of insufficient reduction of the sursoadduction within the first 6 months. The dose-effect relationship 6 months postoperatively for an accommodative near target at 25 degrees adduction was 0.83 degrees +/- 0.43 degrees per mm of recession. CONCLUSIONS: This study demonstrates that small-incision, minimal dissection inferior obliquus graded recessions are feasible and effective to improve ocular alignment in patients with strabismus sursoadductorius.

Stereocopic Photography Encounters the Staircase

The staircase is presented as the architectural component that most potently embodies thresholds, boundaries and passages due to its diagonal orientation and essence as an intermediary zone. Connections then are made between the kinesthetic requirements of traversing a staircase and viewing a stereoscopic photograph. From this foundation, the haptic essence of stereoscopic photography is proposed as uniquely qualified medium through which to view a staircase and therefore thresholds, boundaries, and passages within architecture. Analyses of stereoviews of staircases in the Palais de Justice in Brussels, the Library of Congress in Washington, and the Palais Garnier (Opéra) in Paris close the essay.

Diseño y test VHDL de un cambiador de formato para ver TV3D en un televisor convencional

La difusión de TV3D actual utiliza formatos como el Side-by-Side o Top-and-Bottom, en los que cada par de imágenes, correspondiente a las vistas de los ojos derecho e izquierdo, se encapsula con la mitad de la resolución espacial en una sola imagen. Estas imágenes se muestran de manera casi simultánea de forma que el ojo humano compone una imagen con profundidad que se asemeja a la visión binocular natural. Desde hace un par de años las principales plataformas de televisión han empezado a crear canales con contenido 3D. La televisión 3D (TV3D) se ha introducido en los hogares gracias a los televisores estereoscópicos. Estos televisores, que son compatibles con los formatos antes mencionados, extraen de cada imagen sus dos vistas, recuperan la resolución original y presentan cada vista alternativamente en la pantalla, generando al mismo tiempo una señal de sincronismo para las gafas activas, creando de esta forma la sensación tridimensional de las imágenes. En este PFC se pretende realizar el diseño VHDL de un cambiador de formato que genere en tiempo real la secuencia de imágenes correspondiente a los ojos derecho e izquierdo, con resolución completa, a partir de una secuencia codificada en formato tipo Top-and-Bottom y el banco de test para su prueba. Este circuito se implementará como un periférico del procesador NIOS II de Altera. El diseño podría utilizarse como parte de un sistema que permita la visualización de las actuales emisiones de televisión 3D en un televisor convencional. La tecnología de referencia que se utilizará serán las FPGAs, más concretamente la tarjeta Cyclone III FPGA Starter Kit (EP3C25 FPGA) de Altera, junto a una tarjeta de ampliación de Microtronix con entrada y salida HDMI para video y audio. Además se pretende crear la documentación necesaria para el desarrollo de futuros trabajos relacionados con la televisión 3D. ABSTRACT Current TV3D broadcasting uses formats as Side-by-Side or Top-and-Bottom, where every single pair of images, corresponding to left and right eyes views, are encapsulated with half spatial resolution in one single image. These images are almost simultaneously displayed so that the human eye forms an image with depth resembling naturally binocular vision. From a couple of years the major TV platforms have begun to create 3D content channels. 3D Television (3DTV) has been introduced in homes through stereoscopic televisions. These televisions, which are compatible with the above formats, each image is extracted from the two views, and recover the original resolution and displays alternately each view in screen, while generating a synchronization signal for active glasses, thereby creating the three-dimensional sensation of the images. The main objective in this PFC is to make the design of an exchanger VHDL format in real time to generate the image sequence corresponding to the right and left eyes, with full resolution from an encoded sequence type format Top-and-Bottom and test bench for testing. This circuit is implemented as a Altera NIOS II processor peripheral.The design could be used as part of a system enabling the display of current television broadcasts 3D on a conventional television. The reference technology that will be use are FPGAs, more specifically Cyclone III FPGA Starter Card Kit (EP3C25 FPGA) Altera, along with an expansion card Microtronix with HDMI input and output video and audio. It also aims to create documentation for the development of future works related to 3D TV.

Desarrollo de tecnologías de telemanipulación con alto grado de escalado orientadas a la interacción hombre-robot en entornos nucleares

Esta tesis se centra en desarrollo de tecnologías para la interacción hombre-robot en entornos nucleares de fusión. La problemática principal del sector de fusión nuclear radica en las condiciones ambientales tan extremas que hay en el interior del reactor, y la necesidad de que los equipos cumplan requisitos muy restrictivos para poder aguantar esos niveles de radiación, magnetismo, ultravacío, temperatura... Como no es viable la ejecución de tareas directamente por parte de humanos, habrá que utilizar dispositivos de manipulación remota para llevar a cabo los procesos de operación y mantenimiento. En las instalaciones de ITER es obligatorio tener un entorno controlado de extrema seguridad, que necesita de estándares validados. La definición y uso de protocolos es indispensable para regir su buen funcionamiento. Si nos centramos en la telemanipulación con algo grado de escalado, surge la necesidad de definir protocolos para sistemas abiertos que permitan la interacción entre equipos y dispositivos de diversa índole. En este contexto se plantea la definición del Protocolo de Teleoperación que permita la interconexión entre dispositivos maestros y esclavos de distinta tipología, pudiéndose comunicar bilateralmente entre sí y utilizar distintos algoritmos de control según la tarea a desempeñar. Este protocolo y su interconectividad se han puesto a prueba en la Plataforma Abierta de Teleoperación (P.A.T.) que se ha desarrollado e integrado en la ETSII UPM como una herramienta que permita probar, validar y realizar experimentos de telerrobótica. Actualmente, este Protocolo de Teleoperación se ha propuesto a través de AENOR al grupo ISO de Telerobotics como una solución válida al problema existente y se encuentra bajo revisión. Con el diseño de dicho protocolo se ha conseguido enlazar maestro y esclavo, sin embargo con los niveles de radiación tan altos que hay en ITER la electrónica del controlador no puede entrar dentro del tokamak. Por ello se propone que a través de una mínima electrónica convenientemente protegida se puedan multiplexar las señales de control que van a través del cableado umbilical desde el controlador hasta la base del robot. En este ejercicio teórico se demuestra la utilidad y viabilidad de utilizar este tipo de solución para reducir el volumen y peso del cableado umbilical en cifras aproximadas de un 90%, para ello hay que desarrollar una electrónica específica y con certificación RadHard para soportar los enormes niveles de radiación de ITER. Para este manipulador de tipo genérico y con ayuda de la Plataforma Abierta de Teleoperación, se ha desarrollado un algoritmo que mediante un sensor de fuerza/par y una IMU colocados en la muñeca del robot, y convenientemente protegidos ante la radiación, permiten calcular las fuerzas e inercias que produce la carga, esto es necesario para poder transmitirle al operador unas fuerzas escaladas, y que pueda sentir la carga que manipula, y no otras fuerzas que puedan influir en el esclavo remoto, como ocurre con otras técnicas de estimación de fuerzas. Como el blindaje de los sensores no debe ser grande ni pesado, habrá que destinar este tipo de tecnología a las tareas de mantenimiento de las paradas programadas de ITER, que es cuando los niveles de radiación están en sus valores mínimos. Por otro lado para que el operador sienta lo más fielmente posible la fuerza de carga se ha desarrollado una electrónica que mediante el control en corriente de los motores permita realizar un control en fuerza a partir de la caracterización de los motores del maestro. Además para aumentar la percepción del operador se han realizado unos experimentos que demuestran que al aplicar estímulos multimodales (visuales, auditivos y hápticos) aumenta su inmersión y el rendimiento en la consecución de la tarea puesto que influyen directamente en su capacidad de respuesta. Finalmente, y en referencia a la realimentación visual del operador, en ITER se trabaja con cámaras situadas en localizaciones estratégicas, si bien el humano cuando manipula objetos hace uso de su visión binocular cambiando constantemente el punto de vista adecuándose a las necesidades visuales de cada momento durante el desarrollo de la tarea. Por ello, se ha realizado una reconstrucción tridimensional del espacio de la tarea a partir de una cámara-sensor RGB-D, lo cual nos permite obtener un punto de vista binocular virtual móvil a partir de una cámara situada en un punto fijo que se puede proyectar en un dispositivo de visualización 3D para que el operador pueda variar el punto de vista estereoscópico según sus preferencias. La correcta integración de estas tecnologías para la interacción hombre-robot en la P.A.T. ha permitido validar mediante pruebas y experimentos para verificar su utilidad en la aplicación práctica de la telemanipulación con alto grado de escalado en entornos nucleares de fusión. Abstract This thesis focuses on developing technologies for human-robot interaction in nuclear fusion environments. The main problem of nuclear fusion sector resides in such extreme environmental conditions existing in the hot-cell, leading to very restrictive requirements for equipment in order to deal with these high levels of radiation, magnetism, ultravacuum, temperature... Since it is not feasible to carry out tasks directly by humans, we must use remote handling devices for accomplishing operation and maintenance processes. In ITER facilities it is mandatory to have a controlled environment of extreme safety and security with validated standards. The definition and use of protocols is essential to govern its operation. Focusing on Remote Handling with some degree of escalation, protocols must be defined for open systems to allow interaction among different kind of equipment and several multifunctional devices. In this context, a Teleoperation Protocol definition enables interconnection between master and slave devices from different typologies, being able to communicate bilaterally one each other and using different control algorithms depending on the task to perform. This protocol and its interconnectivity have been tested in the Teleoperation Open Platform (T.O.P.) that has been developed and integrated in the ETSII UPM as a tool to test, validate and conduct experiments in Telerobotics. Currently, this protocol has been proposed for Teleoperation through AENOR to the ISO Telerobotics group as a valid solution to the existing problem, and it is under review. Master and slave connection has been achieved with this protocol design, however with such high radiation levels in ITER, the controller electronics cannot enter inside the tokamak. Therefore it is proposed a multiplexed electronic board, that through suitable and RadHard protection processes, to transmit control signals through an umbilical cable from the controller to the robot base. In this theoretical exercise the utility and feasibility of using this type of solution reduce the volume and weight of the umbilical wiring approximate 90% less, although it is necessary to develop specific electronic hardware and validate in RadHard qualifications in order to handle huge levels of ITER radiation. Using generic manipulators does not allow to implement regular sensors for force feedback in ITER conditions. In this line of research, an algorithm to calculate the forces and inertia produced by the load has been developed using a force/torque sensor and IMU, both conveniently protected against radiation and placed on the robot wrist. Scaled forces should be transmitted to the operator, feeling load forces but not other undesirable forces in slave system as those resulting from other force estimation techniques. Since shielding of the sensors should not be large and heavy, it will be necessary to allocate this type of technology for programmed maintenance periods of ITER, when radiation levels are at their lowest levels. Moreover, the operator perception needs to feel load forces as accurate as possible, so some current control electronics were developed to perform a force control of master joint motors going through a correct motor characterization. In addition to increase the perception of the operator, some experiments were conducted to demonstrate applying multimodal stimuli (visual, auditory and haptic) increases immersion and performance in achieving the task since it is directly correlated with response time. Finally, referring to the visual feedback to the operator in ITER, it is usual to work with 2D cameras in strategic locations, while humans use binocular vision in direct object manipulation, constantly changing the point of view adapting it to the visual needs for performing manipulation during task procedures. In this line a three-dimensional reconstruction of non-structured scenarios has been developed using RGB-D sensor instead of cameras in the remote environment. Thus a mobile virtual binocular point of view could be generated from a camera at a fixed point, projecting stereoscopic images in 3D display device according to operator preferences. The successful integration of these technologies for human-robot interaction in the T.O.P., and validating them through tests and experiments, verify its usefulness in practical application of high scaling remote handling at nuclear fusion environments.