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）一直是视网膜疾病的客观表征的黄金标准（例如，糖尿病性视网膜病变，视网膜静脉闭塞和与年龄相关的宏观宏观分离型黄斑变性（AMD）相关）。尽管它广泛使用，但FA还是昂贵，侵入性和耗时的，限制了用作筛查工具的用途。光学相干断层扫描（OCT）及其更快的变化称为光谱结构域OCT（SDOCT）是干涉成像技术，可以对视网膜结构进行三维成像。该技术使视网膜形态和病理改变的临床成像，分辨率几乎与组织学部分相当。由于OCT无法呈现大多数视网膜血管异常，因此经常使用FA进行诊断和管理黄斑病患者。作为诊断视网膜疾病的FA的潜在替代方法，我们开发了一种名为“相对比光学相干断层扫描（PC-OCT）”的成像方法，该方法使用了从临床上可用的SDOCT成像系统中获取的数据的专业软件分析，以提供视网膜血管和脉络膜新血管生长的高分辨率成像的附加功能。要开发PC-OCT成像作为荧光素血管造影的非侵入性替代方法，我们具有以下目标：（1）提高PC-OCT成像的速度，准确性和自动化以允许一般使用，并将这种已发达的技术应用于（2）视网膜毛细管（2）糖尿病性视网膜疗法（3）CHORICATIAN CHORICATIAN CHORICATIAN CHORICATIAL CHOROITAL CHOROITAL CHOROITAL CHOROITIAN（3）CHOROITIAL CHOROITIAL（3）CHOROITAL INSN NEAVESIN NEAVEAD NEAVESIN NEAVES VORIDES VAST型（3）疾病。变性（AMD）。 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。成功完成I期目标将导致PC-OCT成像技术的进一步开发，并分析用于检测无症状眼睛中临床CNV的血管泄漏和筛查。与临床上可用的SDOCT系统一起使用的PC-OCT的运动对比度可以建立一种新的非侵入性筛查工具，用于视网膜诊断。通过非侵入性筛查AMD患者的早期检测可能会在丢失中央视力之前早期检测到亚临床CNV和开始治疗。 公共卫生相关性：该提案描述了一种新的软件产品，该产品增强了光学相干断层扫描（OCT）的诊断能力，这是美国最常见的视网膜诊断测试，用于评估黄斑变性和糖尿病性视网膜病。通过非侵入性提供高分辨率的视网膜成像，产物，相比OCT（PC-OCT）可能会替代荧光素血管造影，这是视网膜成像的当前侵入性且昂贵的金标准。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进行正面比较，以评估湿黄斑变性和糖尿病性视网膜病的患者。