Functional and Structural Optical Coherence Tomography for Glaucoma

青光眼的功能性和结构性光学相干断层扫描

基本信息

批准号：
8479117
负责人：
David Huang
金额：
$ 75.01万
依托单位：
OREGON HEALTH & SCIENCE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2013
资助国家：
美国
起止时间：
2013-09-30 至 2017-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8479117
关键词：
3-Dimensional Abbreviations Algorithms Anatomy Angiography Applications Grants Arteries Automation Biomedical Engineering Blindness Blood Blood Circulation Blood Vessels Blood flow Clinical Clinical Research Collaborations Complex Computer software Detection Diagnosis Diagnostic Disease Disease Progression Dyes Early Diagnosis Evaluation Eye Fiber Financial compensation Functional Imaging Functional disorder Glaucoma Glossary Goals Human Image Imaging technology Injection of therapeutic agent Institutes Lasers Massachusetts Measurement Measures Medical Methods Microcirculation Monitor Motion Nerve Nerve Fibers Observational Study Operative Surgical Procedures Ophthalmoscopy Optic Disk Optical Coherence Tomography Outcome Pathway interactions Patients Pattern Perfusion Pharmaceutical Preparations Photography Physiologic Intraocular Pressure Play Reproducibility Research Research Project Grants Resolution Retina Retinal Retinal Ganglion Cells Risk Role Safety Scanning Source Speed Structure Structure of central vein of the retina Suspect Glaucomas System Techniques Technology Testing Time Trabeculectomy Veins Visual Fields Work base blood flow measurement central retinal artery clinical practice cost diagnostic accuracy ganglion cell high risk imaging modality improved insight instrument macula next generation novel optic nerve disorder prognostic prototype public health relevance relating to nervous system screening tool vascular bed vascular factor

项目摘要

PROJECT SUMMARY Glaucoma is a leading cause of blindness. Early diagnosis and close monitoring of glaucoma are important because the onset is insidious and the damage is irreversible. Advanced imaging modalities such as optical coherence tomography (OCT) have been used in the past 2 decades to improve the objective evaluation of glaucoma. OCT has higher axial spatial resolution than other posterior eye imaging modalities, and it has relatively good diagnostic accuracy and reproducibility in the measurement of neural structures damaged by glaucoma. However, the measurement of structure alone, with any imaging modality, has limited sensitivity for detecting early glaucoma and only moderate correlation with visual field (VF) loss. Using high-speed OCT systems, we have developed new methods to image and measure optic nerve head (ONH) and retinal blood flow. Preliminary results showed that VF loss was more highly correlated with retinal blood flow as measured by OCT than any neural structure measured by OCT or other imaging modality. Accordingly, the goal of the proposed project is to improve the diagnostic and prognostic evaluation of glaucoma by further developing novel functional OCT measurements using ultrahigh-speed (70-100 kHz) OCT technology. The specific aims are: 1. Improve Doppler OCT measurement of retinal blood flow. Multi-circular scans of peripapillary retinal arteries and veins measure total retinal blood flow in 2 seconds. The use of faster OCT systems will allow automated measurement with improved reproducibility. 2. Develop quantitative OCT angiography of the ONH. Three dimensional (3D) OCT angiography has been made practical (3x3 mm scan in 3 seconds) by a novel split-spectrum amplitude-decorrelation algorithm. Preliminary results showed dramatic loss of ONH microcirculation in early glaucoma. Algorithmic improvement in angiography, segmentation, quantification, and automation are planned. 3. Measure nerve structure from the ONH to retinal ganglion cells. By registering several volumetric scans, we have demonstrated complete 3D characterization of the retinal fiber pathway from the ONH to the macula. Fully automated quantification of these structures will be developed. 4. Evaluate advanced OCT technologies in clinical studies. The utility of functional and structural OCT in glaucoma will be evaluated in a longitudinal observational study of 150 glaucoma and healthy subjects. The effect of IOP-lowering surgery on blood flow will be studied in 40 subjects. Retinal blood flow, ONH circulation, optic disc rim volume, peripapillary nerve fiber layer volume, and macular ganglion cell complex volume are all pieces of the same glaucoma puzzle. This project will develop novel imaging methods that allow us to look at the whole picture using one tool - ultrahigh-speed OCT.

项目概要青光眼是导致失明的主要原因。青光眼的早期诊断和密切监测很重要因为它的发作是隐秘的，而且损害是不可逆转的。先进的成像方式，例如光学相干断层扫描 (OCT) 在过去 20 年中被用来改善对疾病的客观评估青光眼。 OCT 比其他眼后部成像方式具有更高的轴向空间分辨率，并且在测量神经结构损伤方面具有相对较好的诊断准确性和可重复性青光眼。然而，单独使用任何成像方式测量结构的灵敏度有限检测早期青光眼，与视野 (VF) 损失仅中度相关。使用高速 OCT 系统，我们开发了成像和测量视神经乳头 (ONH) 和视网膜血液的新方法流动。初步结果表明，测得的 VF 损失与视网膜血流量的相关性更高 OCT 测量的神经结构优于 OCT 或其他成像方式测量的任何神经结构。因此，该项目的目标是拟议项目是通过进一步开发青光眼的诊断和预后评估使用超高速 (70-100 kHz) OCT 技术进行新颖的功能性 OCT 测量。具体目标是： 1.改进多普勒OCT测量视网膜血流。视乳头周围视网膜多圈扫描动脉和静脉在 2 秒内测量视网膜总血流量。使用更快的 OCT 系统将允许自动化测量，提高了再现性。 2. 开发 ONH 的定量 OCT 血管造影。三维 (3D) OCT 血管造影具有通过新颖的分谱幅度去相关技术已变得实用（3 秒内扫描 3x3 毫米）算法。初步结果显示早期青光眼中 ONH 微循环急剧丧失。算法计划改进血管造影、分割、量化和自动化。 3. 测量从 ONH 到视网膜神经节细胞的神经结构。通过注册几个体积通过扫描，我们展示了从 ONH 到黄斑。将开发这些结构的全自动量化。 4. 评估临床研究中先进的OCT技术。功能和结构 OCT 在中的应用青光眼将通过一项对 150 名青光眼和健康受试者进行的纵向观察研究进行评估。降低眼压手术对血流的影响将在 40 名受试者中进行研究。视网膜血流量、ONH 循环、视盘边缘体积、视乳头周围神经纤维层体积，以及黄斑神经节细胞复合体都是同一个青光眼拼图的各个部分。该项目将开发新颖的成像方法使我们能够使用一种工具——超高速 OCT 来观察整个图像。