Analyzing Retinal Microanatomy in Retinopathy of Prematurity to Improve Care

分析早产儿视网膜病变的视网膜显微解剖学以改善护理

• 批准号: 10596546
• 负责人: CYNTHIA ANN TOTH
• 金额: $ 59.89万
• 依托单位: DUKE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-03-10 至 2026-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10596546
• 关键词: Achievement; Address; Aftercare; Age; Angiography; Blindness; Blood Vessels; Brain; Caring; Child; Childhood Acute Lymphocytic Leukemia; Clinical; Clinical Trials; Communication; Computer software; Cornea; Darkness; Data; Data Pooling; Data Set; Databases; Development; Disease; Disease Pathway; Disease Progression; Documentation; Early Intervention; Ensure; Evaluation; Evolution; Eye; Feedback; Fostering; Friends; Fundus; Future; Goals; Grant; Health; Human; Image; Infant; Infant Care; Infant Health; Intensive Care; Investigation; Light; Methods; Microanatomy; Monitor; Morphology; Multivariate Analysis; Neural Retina; Neurologic; Nurses; Optical Coherence Tomography; Optical Methods; Outcome; Output; Pathologic; Perinatal; Photography; Physicians; Pigmentation physiologic function; Population Heterogeneity; Prediction of Response to Therapy; Premature Infant; Process; Recurrence; Recurrent disease; Reference Standards; Reproducibility; Research; Retina; Retinopathy of Prematurity; Retreatment; Risk; School-Age Population; Science; Scientist; Speed; Stress; Technology; Telemedicine; Test Result; Testing; Therapeutic; Time; Translating; Vision; Visual impairment; advanced analytics; clinical care; cohort; cost; design; extreme prematurity; high risk; imager; improved; information gathering; insight; interest; lens; neurodevelopment; neurovascular; next generation; ophthalmic examination; outcome prediction; preterm newborn; programs; screening; tool; treatment and outcome; treatment response; vascular abnormality; vision development

PROJECT SUMMARY As an increasing percentage of preterm infants survive worldwide, the number of infants at risk for retinopathy of prematurity (ROP) is increasing. These infants are also at high risk for future abnormal visual function and neurodevelopment. While current screening approaches address identifying eyes for treatment of severe ROP, there are no attempts to address the later subnormal vision of many preterm infants. In part, this is due to a lack of information about the retina beyond that of retinal vascular development. In addition, the most common method to screen for ROP remains indirect ophthalmoscopic examination by physicians with annotated drawings for documentation, a method proven to be poorly reproducible and stressful to the fragile infant. Bedside retinal photographs enable documentation and the possibility for telemedicine approaches, but lack information about retinal microanatomy, are poor quality in darkly pigmented eyes and also are stressful to the infant because of the required light exposure. We need an infant-friendly, more practical approach to evaluate ROP efficiently and additional information about ocular and neurovascular development that could lead to improved clinical care. This research builds on our group’s ability to reliably capture and process non-contact, infrared optical coherence tomography (OCT) and OCT-angiography of retinal microanatomy and microvasculature at high speed, across a wide field of view, and at the bedside in preterm infants. Our overall objectives are threefold: first, to evaluate infant microanatomy and microvascular flow findings relevant to vision and neurodevelopmental outcomes in children; second, to translate and test our imaging achievements for real-world use by nurses at the bedside and better clinical insight and feedback; and third, to gather additional data in eyes that progress to treatment and dive deeper into the insight that they provide into pathways of disease in ROP. The investigational OCT imaging will be used in this research to gather information that is otherwise not accessible to the physician. This research will lay the groundwork for future use of infant OCT markers to guide care.

项目摘要 随着早产儿的越来越多，在全球范围内生存，有视网膜病风险的婴儿人数 早产（ROP）正在增加。这些婴儿也有未来异常视觉功能的高风险和 神经发育。当前的筛查方法涉及识别眼睛以治疗严重ROP的眼睛，但 没有试图解决许多早产儿的后来的不正常视力。部分原因是由于缺乏 有关视网膜血管发育的信息的信息。另外，最常见的 筛选ROP的方法仍然是由带注释图的医生间接的眼镜检查 对于文档，一种被证明对脆弱的婴儿的可重复性和压力很大的方法。床头视网膜 照片可以使文档和远程医疗方法的可能性，但缺乏有关 视网膜微型解剖学，黑眼睛的质量较差，由于 所需的光曝光。我们需要一种对婴儿友好，更实用的方法来有效评估ROP， 有关眼和神经血管发育的其他信息，可能会改善临床护理。 这项研究基于我们小组可靠地捕获和处理非接触，红外光学连贯性的能力 在高速的视网膜微解剖学和微脉管系统的层析成像（OCT）和OCT血管造影 宽阔的视野，在早产儿的床边。我们的整体目标是三倍：首先，评估 婴儿微型解剖学和与视力和神经发育结果有关的微血管流动发现 孩子们;其次，要翻译和测试我们的成像成就，用于护士在床边的现实世界中使用 更好的临床见解和反馈；第三，在眼睛中收集其他数据，这些数据发展为治疗和 深入了解他们在ROP中提供的疾病途径的见解。研究八十片成像 这项研究将用于收集否则物理无法访问的信息。这项研究 将为未来使用婴儿OCT标记来指导护理奠定基础。