Characterization of Exudative Macular Degeneration and Diabetic Retinopathy Using

使用渗出性黄斑变性和糖尿病视网膜病变的表征

• 批准号: 8002119
• 负责人: SCOTT E FRASER
• 金额: $ 15.39万
• 依托单位: VISDEX CORPORATION
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-09-30 至 2012-06-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8002119
• 关键词: Age related macular degeneration; Algorithms; Area; Automation; Blindness; Blood; Blood Vessels; Blood capillaries; Central Vein; Choroidal Neovascularization; Clinical; Computer software; Data; Data Analyses; Data Set; Detection; Development; Diabetic Retinopathy; Diagnosis; Diagnostic; Diagnostic Procedure; Diagnostic tests; Disease; Dyes; Early Diagnosis; Evaluation; Excision; Extravasation; Eye; Fluorescein; Fluorescein Angiography; Fluoresceins; Fluorescent Dyes; Fundus photography; Goals; Gold; Head; Histologic; Image; Image Analysis; Imagery; Imaging Techniques; Lead; Lesion; Macular degeneration; Maps; Marketing; Methods; Morphologic artifacts; Morphology; Motion; Newly Diagnosed; Noise; Ophthalmologist; Optical Coherence Tomography; Pathologic; Patients; Perfusion; Phase; Protocols documentation; Research; Resolution; Retina; Retinal; Retinal Vein Occlusion; Risk; Scanning; Screening procedure; Secondary to; Speed; Stream; Structure; System; Techniques; Three-Dimensional Imaging; Time; Variant; Vision; Work; base; capillary; capillary bed; data acquisition; dehydroretinal; design; disorder of macula of retina; imaging modality; improved; instrument; intravenous injection; processing speed; public health relevance; retina blood vessel structure; tool; vein occlusion

DESCRIPTION (provided by applicant): Since its first use in the retina in 1961, fluorescein angiography (FA) has been the gold standard for objective characterization of retinovascular disease (e.g. diabetic retinopathy, retinal vein occlusions, and choroidal neovascularization associated with age-related macular degeneration (AMD)). Despite its widespread use, FA is costly, invasive, and time consuming, limiting the usefulness as a screening tool. Optical coherence tomography (OCT) and its faster variation called spectral domain OCT (SDOCT) are interferometric imaging techniques which allow three-dimensional imaging of the retinal structure. This technique has enabled clinical imaging of retinal morphology and pathologic alteration with resolution nearly comparable to histologic sections. Because OCT is not capable of rendering most retinovascular abnormalities, it is frequently performed with FA to diagnose and manage patients with macular disease. As a potential alternative to FA in diagnosing retinovascular disease, we have developed an imaging method called phase contrast optical coherence tomography (PC-OCT) which uses specialized software analysis of data acquired from clinically available SDOCT imaging systems to provide the additional functionality of high resolution imaging of retinal vessels and choroidal neovascularization. To develop PC-OCT imaging as a non-invasive alternative for fluorescein angiography, we have the following goals: (1) improve the speed, accuracy and automation of PC-OCT imaging to allow for general clinical usage, and apply this developed technique towards disease targets of (2) retinal capillary non- perfusion in diabetic retinopathy and (3) choroidal neovascularization (CNV) in age-related macular degeneration (AMD). The visualization capabilities of PC-OCT imaging will be compared directly against fluorescein angiography images for subjects of the target diseases. Successful completion of the Phase I aims will lead to further development of PC-OCT imaging techniques and analysis for detection of vascular leakage and screening for sub-clinical CNV in asymptomatic fellow eyes. Developing motion contrast capabilities of PC-OCT to be used with clinically available SDOCT systems can establish a new non-invasive screening tool for retinovascular diagnosis. Earlier detection through non-invasive screening of AMD patients may enable earlier detection of subclinical CNV and initiation of therapy before central vision is lost. PUBLIC HEALTH RELEVANCE: This proposal describes a new software product that enhances the diagnostic capability of optical coherence tomography (OCT), the most commonly performed retinal diagnostic test used in the US for evaluation of macular degeneration and diabetic retinopathy. By non-invasively providing high resolution retinovascular imaging, the product, phase contrast OCT (PC-OCT), may potentially replace fluorescein angiography, the current invasive and costly gold standard for retinovascular imaging. The proposed research plan improves the capabilities of PC-OCT and then does a head-to-head comparison with fluorescein angiography in evaluation of patients with wet macular degeneration and diabetic retinopathy.

描述（由申请人提供）：自 1961 年首次在视网膜中使用以来，荧光素血管造影 (FA) 一直是客观表征视网膜血管疾病（例如糖尿病性视网膜病变、视网膜静脉阻塞以及与年龄相关的脉络膜新生血管）的金标准黄斑变性（AMD））。尽管 FA 被广泛使用，但其成本高昂、具有侵入性且耗时，限制了其作为筛查工具的实用性。光学相干断层扫描 (OCT) 及其称为谱域 OCT (SDOCT) 的更快变化是干涉成像技术，可以对视网膜结构进行三维成像。该技术使得视网膜形态和病理改变的临床成像成为可能，其分辨率几乎与组织学切片相当。由于 OCT 无法呈现大多数视网膜血管异常，因此经常与 FA 一起进行，以诊断和治疗黄斑疾病患者。作为诊断视网膜血管疾病 FA 的潜在替代方案，我们开发了一种称为相衬光学相干断层扫描 (PC-OCT) 的成像方法，该方法使用专门的软件分析从临床可用的 SDOCT 成像系统获取的数据，以提供高分辨率的附加功能视网膜血管和脉络膜新生血管成像。为了开发 PC-OCT 成像作为荧光素血管造影的非侵入性替代方案，我们有以下目标：(1) 提高 PC-OCT 成像的速度、准确性和自动化程度，以实现一般临床应用，并将这种开发的技术应用于(2)糖尿病视网膜病变中的视网膜毛细血管无灌注和(3)年龄相关性黄斑变性(AMD)中的脉络膜新生血管(CNV)的疾病目标。 PC-OCT 成像的可视化功能将直接与目标疾病受试者的荧光素血管造影图像进行比较。第一阶段目标的成功完成将导致 PC-OCT 成像技术和分析的进一步发展，用于检测血管渗漏和筛查无症状对眼中的亚临床 CNV。开发 PC-OCT 的运动对比功能，与临床上可用的 SDOCT 系统一起使用，可以为视网膜血管诊断建立一种新的非侵入性筛查工具。通过对 AMD 患者进行非侵入性筛查进行早期检测，可以更早地检测出亚临床 CNV，并在中心视力丧失之前开始治疗。 公共健康相关性：该提案描述了一种新的软件产品，可增强光学相干断层扫描 (OCT) 的诊断能力，OCT 是美国最常用的视网膜诊断测试，用于评估黄斑变性和糖尿病视网膜病变。通过非侵入性地提供高分辨率视网膜血管成像，相差 OCT (PC-OCT) 产品可能会取代荧光素血管造影术，后者是目前侵入性且昂贵的视网膜血管成像黄金标准。拟议的研究计划提高了 PC-OCT 的能力，然后与荧光素血管造影在评估湿性黄斑变性和糖尿病视网膜病变患者方面进行了头对头的比较。