Visible-light OCT angiography, velocimetry, and oximetry for characterizing retinal vascular alterations in glaucoma

可见光 OCT 血管造影、测速和血氧测定法用于表征青光眼视网膜血管改变

• 批准号: 10470130
• 负责人: Yali Jia
• 金额: $ 50.07万
• 依托单位: OREGON HEALTH & SCIENCE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-01 至 2024-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10470130
• 关键词: 3-Dimensional; Abbreviations; Acute; Address; Affect; Angiography; Architecture; Arteries; Attention; Axon; Blindness; Blood Circulation; Blood Vessels; Blood capillaries; Blood flow; Computer software; Defect; Detection; Development; Diagnosis; Early identification; Event; Eye; Glaucoma; Glossary; Goals; Homeostasis; Impairment; Injury; Intraocular pressure test; Lasers; Lateral; Lead; Lighting; Machine Learning; Measurement; Measures; Methods; Modeling; Noise; Optic Nerve; Optic Nerve Injuries; Optic Nerve Transections; Optical Coherence Tomography; Oxygen; Oxygen saturation measurement; Patients; Performance; Physiologic Intraocular Pressure; Predisposition; Process; Progressive Disease; Rattus; Resolution; Retina; Retinal Ganglion Cells; Rodent Model; Role; Scanning; Signal Transduction; Speed; Structure; Structure of central vein of the retina; System; Technology; Testing; Time; Tissues; Vascular Diseases; Veins; Velocimetries; Visible Radiation; Vision; Visual impairment; attenuation; automated segmentation; central retinal artery; data acquisition; deep learning; density; image processing; improved; in vivo; innovation; insight; metabolic rate; new technology; novel strategies; preservation; pressure; prototype; response; retina blood vessel structure; retina circulation; retinal imaging; retinal ischemia; traditional therapy; vascular factor

Project Summary Glaucoma damage to the optic nerve and impairment of vision are progressive and irreversible. Understanding mechanisms of glaucomatous injury will help to develop new approaches for treatments that can be used along with traditional therapies that lower intraocular pressure (IOP). Recent developments in optical coherence tomography (OCT) angiography have brought increased attention to the role of the inner retinal circulation in glaucoma. To improve our understanding of retinal vascular alterations in glaucoma, we can take advantage of recent developments in visible-light OCT (vis-OCT) to characterize simultaneously tissue structure, vessel density, blood flow and oxygenation. The goal of this project is to further advance vis-OCT by attaining capillary-level measurements, test the value of measuring their local alterations as early indicators of glaucoma and glaucomatous progression and use this to evaluate impaired retinal autoregulation from retinal ganglion cell (RGC) loss as a potential cause of increased susceptibility in advanced glaucoma. In Specific Aim 1 we will develop high-speed, high-sensitivity, high-resolution vis-OCT. The speed will be double that of the current system. A more stable supercontinuum laser will be used to improve system sensitivity, and a tighter focus will be used to improve lateral resolution. This will enable complete detection of capillaries that may be vulnerable to vascular dysfunction. Specific Aim 2 will develop quantitative OCT angiography, velocimetry and oximetry in capillaries as well as arteries and veins. Building on the high-resolution, high-contrast scans acquired in Aim 1, we will use machine learning to segment capillary plexuses, and advanced image processing to extract capillary architecture. Aided by this capillary architecture, we will automatically measure blood flow and oxygenation in capillary segments and incorporate them into a real-time platform. Specific Aim 3 will use this system to demonstrate that acute loss of RGCs, produced by optic nerve transection, alters retinal capillary plexus density, oximetry and velocimetry over time and that these changes precede altered oximetry and flow in larger retinal vessels. We will also show that loss of RGCs impairs the autoregulatory response to acute IOP challenge. In Specific Aim 4, we will demonstrate that optic nerve injury in a model of controlled, elevated IOP produces early alterations in capillary velocimetry, oximetry and autoregulation, show that they are more persistent with advanced injury, and demonstrate the pathophysiologic consequences of these observations. Successful development of this new technology will improve methods of early glaucoma diagnosis and detection of progression. Better understanding of retinal vascular factors that lead to increased susceptibility in advanced glaucoma will lead to improved treatments for these highly vulnerable patients.

项目摘要 对视神经和视力损害的青光眼损害是进行性和不可逆的。理解 青光眼损伤机制将有助于开发可用于沿途使用的新方法 传统的疗法降低了眼内压（IOP）。光学连贯性的最新发展 层析成像（OCT）血管造影引起了人们对内部视网膜循环作用的关注 青光眼。为了提高我们对青光眼视网膜血管改变的理解，我们可以利用 可见光的OCT（Vis-OCT）的最新发展，以同时表征组织结构，血管 密度，血流和氧合。该项目的目的是通过达到进一步的促进 毛细管水平的测量，测试其局部变化作为青光眼的早期指标的价值 和青光眼进展，并使用它来评估视网膜神经节的视网膜自动调节受损 细胞（RGC）丢失是高级青光眼易感性增加的潜在原因。 在特定目标1中，我们将开发高速，高敏性，高分辨率相关。速度将是 当前系统的两倍。将使用更稳定的超局部激光器来改善系统 灵敏度和更紧密的焦点将用于改善横向分辨率。这将使能够完全检测 可能容易受到血管功能障碍的毛细血管。 特定的目标2将在毛细血管以及 动脉和静脉。在AIM 1中获得的高分辨率，高对比度扫描的基础上，我们将使用机器 学会分割毛细管丛和高级图像处理以提取毛细管体系结构。帮助 通过这种毛细管体系结构，我们将自动测量毛细血管段中的血流和氧合 并将它们纳入实时平台。 特定目标3将使用该系统来证明由视神经产生的RGC的急性损失 横向，变化视网膜毛细血丛密度，血氧仪和速度法随着时间的流逝而变化 在较大的视网膜血管中改变了血氧饱和度和流动。我们还将证明RGC的损失会损害 对急性IOP挑战的自动调节反应。 在特定的目标4中，我们将证明在受控的，升高的IOP产生的模型中，视神经损伤 毛细管速度法，血氧仪和自动调节的早期改变表明，它们更持久 晚期损伤，并证明了这些观察结果的病理生理后果。 这项新技术的成功开发将改善早期青光眼诊断方法和 检测进展。更好地了解视网膜血管因素，从而提高了易感性 晚期青光眼将为这些高度脆弱的患者提供改进的治疗方法。