Retinal imaging tests for microvascular functions

微血管功能的视网膜成像测试

• 批准号: 6576258
• 负责人: GEORGE L KING
• 金额: $ 16.44万
• 依托单位: JOSLIN DIABETES CENTER
• 依托单位国家: 美国
• 财政年份: 2002
• 资助国家: 美国
• 起止时间: 2002-09-30 至 2004-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6576258
• 关键词: adolescence (12-20); blood vessel disorder; clinical research; diabetic angiopathy; diabetic neuropathy; diabetic retinopathy; diagnosis design /evaluation; electroretinography; fluorescein angiography; human subject; hyperglycemia; insulin dependent diabetes mellitus; medical complication; microcirculation; oximetry; patient oriented research; retina circulation disorder; skin circulation; ultrasound blood flow measurement; young adult human (21-34)

DESCRIPTION (provided by applicant): Microvascular abnormalities and pathologies occur in all the tissues and organs of diabetic patients. Cellular abnormalities in the microvessels extend to both vascular cells and innervation surrounding the microvasculature. We suggest that microvascular diseases in the retina and those in the skin or peripheral tissues may share many common characteristics in early stages of diabetes. Thus, imaging techniques to assess both vascular and neurological functions via the retina may be helpful to diagnose and quantitate microvascular and neurological damage in the periphery. This postulate is based on the fact that clinically, diabetic retinopathy and sensory polyneuropathy (DPN), occurs frequently together. Functional studies have shown that blood flow is decreased in the retina and peripheral nerve early in the course of diabetes. Common pathologies for both tissues include pericyte loss, basal membrane thickening, capillary dropouts and microaneurysms. Thus, imaging tests that could directly assess retinal microvascular dysfunction and sensory abnormalities in diabetic patients may also detect peripheral microvascularopathy and sensory neuropathy at earlier time since it is much easier to visualize retinal microvasculature and potentially neurological functions than the microvessels of the skin or nerves. In collaboration with Dr. Veves and Dr. Bursell, we have developed a series of retinal and systemic microvascular function tests to evaluate their possible use for the diagnosis of microvascular disease in diabetic patients. The retinal function tests are: digitalized retinal video fluorescein angiogram (VFA) for quantitating microvascular flow; retinal oximetry (RO) for measuring oxygen saturation; and electroretinogram (ERG) for measuring neural-retina functions. The results from these retinal functions will be correlated to peripheral microvascular and sensory function tests which will include neuropathy sensory score (NSS), neuropathy disability score (NDS) and quantitative sensory testing (QST) and nerve axonal reflex (NAR) for measuring sensory fiber abnormalities and skin blood flow by laser Doppler flowmetry. The specific aims for this grant are: 1) to determine in control and non-diabetic subjects from 18-35 years of age, the normal range for changes in VFA, RO and ERG and several neural vascular function tests such as NSS, NDS, QST, nerve axonal reflex and skin blood flow by laser Doppler both breathing room air and 12 percent and 100 percent oxygen (O2) in the breathing air; 2) to assess correlation between retinal, neural and microvascular changes by ERG, VFA and RO and peripheral microvascular and sensory functions as described in specific aim 1 in Type 1 diabetic patients with no or minimal retinopathy, moderate and severe non-proliferative diabetic retinopathy. These studies should provide us with information on whether retinal neural and vascular imaging function tests can be related to peripheral neural and microvascular dysfunctions and pathologies in diabetic patients.

描述（由申请人提供）：糖尿病患者的所有组织和器官都会发生微血管异常和病理。微血管中的细胞异常延伸至微脉管系统周围的血管细胞和神经。我们建议，视网膜和皮肤或周围组织中的微血管疾病可能在糖尿病的早期阶段具有许多常见特征。因此，通过视网膜评估血管和神经功能的成像技术可能有助于诊断和定量周围的微血管和神经系统损害。这一假设是基于以下事实：临床，糖尿病性视网膜病和感觉多神经病（DPN）经常一起发生。功能研究表明，在糖尿病过程中，视网膜和周围神经的血流减少。两种组织的常见病理包括周细胞损失，基底膜增厚，毛细血管辍学和微型干扰瘤。因此，糖尿病患者中可以直接评估视网膜微血管功能障碍和感觉异常的成像测试也可能在早期检测到周围的微血管病和感觉神经病，因为比起皮肤或皮肤的微量蛋白质，可视化视网膜微血管和潜在的神经功能要容易得多。与Veves博士和Bursell博士合作，我们开发了一系列视网膜和系统的微血管功能测试，以评估它们在糖尿病患者中可能使用的微血管疾病。视网膜功能测试是：数字化视网膜视频荧光素血管造影（VFA），用于定量微血管流动；用于测量氧饱和度的视网膜血清法（RO）；和电子图（ERG），用于测量神经疗法功能。 The results from these retinal functions will be correlated to peripheral microvascular and sensory function tests which will include neuropathy sensory score (NSS), neuropathy disability score (NDS) and quantitative sensory testing (QST) and nerve axonal reflex (NAR) for measuring sensory fiber abnormalities and skin blood flow by laser Doppler flowmetry.该赠款的具体目的是：1）确定从18-35岁的对照和非糖尿病受试者确定，VFA，RO和ERG的变化的正常范围以及几种神经血管功能测试，NSS，NDS，NDS，QST，QST，神经轴突反射和皮肤血液流动均由激光多普勒的呼吸室和12％的OXY（OOX）（OY2％）（OE 100％）（OO2）（OO2）。 2）评估ERG，VFA和RO的视网膜，神经和微血管变化之间的相关性，以及外周的微血管和感觉功能，如1型1型糖尿病患者中所述，无视网膜病，中度和严重的非增生性非增生性糖尿病性糖尿病性视网膜病。这些研究应为我们提供有关视网膜神经和血管成像功能测试是否与糖尿病患者的周围神经和微血管功能障碍和病理学相关的信息。