Noninvasive assessment of the cornea by diffusion OCT

通过扩散 OCT 对角膜进行无创评估

• 批准号: 10171859
• 负责人: William Joseph Dupps
• 金额: $ 38.15万
• 依托单位: CASE WESTERN RESERVE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-07-01 至 2023-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10171859
• 关键词: Achievement; Address; Affect; Algorithmic Analysis; Algorithms; Animals; Anterior; Automobile Driving; Biomechanics; Clinical; Clinical Research; Complication; Computational Technique; Computer Models; Cornea; Corneal Diseases; Custom; Data; Degenerative Disorder; Detection; Development; Diagnostic; Diffusion; Disease; Doctor of Philosophy; Early Diagnosis; Ensure; Exhibits; Eye; Family suidae; Feedback; Future; Human; Hydration status; Image; Keratoconus; Keratoplasty; Laser In Situ Keratomileusis; Lead; Life; Machine Learning; Maps; Measurement; Measures; Methods; Operative Surgical Procedures; Optical Coherence Tomography; Optics; Outcome; Pathological Dilatation; Patients; Pattern; Performance; Phase; Physiologic Intraocular Pressure; Physiological; Plant Roots; Play; Procedures; Property; Proxy; Quality of life; Risk; Role; Scanning; Shapes; Speed; Structure; Surgical Flaps; Surgical incisions; System; Techniques; Technology; Temperature; Testing; Time; Torsion; United States; Validation; Vision; Visual impairment; base; clinical practice; cohesion; computerized data processing; crosslink; data acquisition; data integration; design; detection sensitivity; experimental study; first-in-human; human study; imaging modality; interest; mechanical properties; nanoscale; novel; outcome prediction; research clinical testing; screening; simulation; success; tool; treatment effect

Keratoconus is a degenerative disease of the cornea that is a major cause of reduced vision-related quality of life in the United States, often leading to corneal transplantation. Ectasia after refractive surgery is a vision-threatening complication that can occur in apparently low-risk patients despite current screening technology. The biomechanical properties of the cornea play a central role in these diseases, but diagnostics are still rooted in shape measures because doctors lack direct measures of biomechanical change. While several methods have shown early promise for addressing this gap, most require contact with or perturbation of the cornea, cannot spatially resolve biomechanical properties, or involve expensive optical systems. To address the need for direct biomechanical measurement of the cornea and the limitations of other approaches, we introduce phase-decorrelation OCT (phd-OCT). Phd-OCT makes use optical coherence tomography (OCT) to quantify random nanoscale mobility that is related to the strength and cohesion of the cornea. Preliminary results strongly support the rationale, feasibility and potential advantages of the approach. Our objectives are: (1) to refine our method to optimize detection sensitivity and speed, and (2) to determine if the technique is clinically useful. We will achieve these objectives through the following aims: 1. To develop and validate mobility-sensitive phd-OCT for corneal imaging. Spectral-domain OCT will be used for anterior segment phase-decorrelation imaging and the analysis algorithm will be optimized. The system will be validated using phantoms and torsional rheometry. 2. To investigate the potential influence of physiological factors (intraocular pressure (IOP), hydration, and temperature). Factorial design experiments in porcine and human donor globes will establish the sensitivity of phd-OCT measurements to potential confounders. 3. To develop and validate data acquisition and processing methods to enable clinical testing. GPU processing and machine learning will be configured to minimize processing time. Scan patterns will be optimized to minimize scan time and return clinically useful data. 4. To assess feasibility and preliminary diagnostic performance of clinical mobility-sensitive OCT imaging of the cornea. A first-in-human study will characterize repeatability and test the hypotheses that phd-OCT mobility measurements are increased in the region of a LASIK flap and decreased in CXL. Expected Outcomes: The proposed studies will establish a new, non-contact method for imaging corneal biomechanical properties with the potential to address many shortcomings of current and emerging methods. Success could lead to earlier detection of of ectasia risk and allow more appropriate timing and customization of corneal treatments. Future integration of data into computational models has the potential to greatly impact the field by driving a shift from empirical planning and risk analysis to patient-specific strategies.

圆锥角膜是一种角膜退行性疾病，是导致视力下降的主要原因 在美国，生活质量的下降常常导致角膜移植。屈光手术后的扩张是 尽管目前进行了筛查，但明显低风险患者仍可能出现威胁视力的并发症 技术。角膜的生物力学特性在这些疾病中起着核心作用，但诊断 仍然植根于形状测量，因为医生缺乏生物力学变化的直接测量。尽管 几种方法已显示出解决这一差距的早期前景，大多数方法需要接触或扰动 角膜的结构，无法在空间上解析生物力学特性，或涉及昂贵的光学系统。 解决角膜直接生物力学测量的需求以及其他方法的局限性 方法中，我们引入了相位去相关 OCT (phd-OCT)。 Phd-OCT 利用光学相干性 断层扫描（OCT）来量化与强度和内聚力相关的随机纳米级迁移率 角膜。初步结果有力地支持了该方法的基本原理、可行性和潜在优势。 我们的目标是：(1) 改进我们的方法以优化检测灵敏度和速度，以及 (2) 确定该技术在临床上是否有用。我们将通过以下目标来实现这些目标： 1. 开发并验证用于角膜成像的移动敏感 phd-OCT。谱域 OCT 将是 用于眼前节相位去相关成像，并对分析算法进行优化。这 系统将使用模型和扭转流变测量法进行验证。 2. 探讨生理因素（眼压（IOP）、水合作用和 温度）。猪和人类供体眼球的析因设计实验将确定以下因素的敏感性： phd-OCT 测量潜在的混杂因素。 3. 开发和验证数据采集和处理方法以实现临床测试。图形处理器 处理和机器学习将被配置为最小化处理时间。扫描模式将是 经过优化，可最大程度地减少扫描时间并返回临床有用的数据。 4. 评估临床移动敏感OCT成像的可行性和初步诊断性能 角膜的。一项首次人体研究将描述重复性并测试 phd-OCT 的假设 LASIK 皮瓣区域的活动度测量值增加，而 CXL 区域的活动度测量值减少。 预期结果：拟议的研究将建立一种新的非接触式角膜成像方法 生物力学特性有可能解决当前和新兴方法的许多缺点。 成功可能会导致更早发现扩张风险，并允许更合适的时机和定制 的角膜治疗。未来将数据集成到计算模型中可能会产生巨大影响 通过推动从经验规划和风险分析向针对患者的特定策略的转变来推动该领域的发展。