Adaptive optics parallel confocal scanning ophthalmoscope (AO-PCSO)

自适应光学平行共焦扫描检眼镜 (AO-PCSO)

• 批准号: 8330770
• 负责人: Yuhua Liang Zhang
• 金额: $ 18.15万
• 依托单位: UNIVERSITY OF ALABAMA AT BIRMINGHAM
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-09-01 至 2014-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8330770
• 关键词: Accounting; Age related macular degeneration; Age-Years; Blindness; Bruch' s basal membrane structure; Cells; Cessation of life; Child; Clinical; Complex; Data Collection; Degenerative Disorder; Diagnosis; Disabled Persons; Disease; Disease Progression; Elderly; Eye; Eye Movements; Functional disorder; Fundus photography; Health; Human; Image; Knowledge; Lasers; Life; Morphologic artifacts; Ophthalmoscopes; Ophthalmoscopy; Optical Coherence Tomography; Participant; Pathologic Nystagmus; Persons; Photoreceptors; Principal Investigator; Research; Resolution; Retinal; Retinal Cone; Retinal Degeneration; Retinal Diseases; Sampling; Scanning; Secondary to; Speed; Staging; Structure; Structure of retinal pigment epithelium; Visual; adaptive optics; clinical practice; early onset; handicapping condition; imaging modality; improved; in vivo; instrument; patient oriented; photoreceptor degeneration; prevent; programs; retinal rods; sample fixation; success

DESCRIPTION (provided by applicant): Age-related macular degeneration (AMD) is the leading cause of blindness in people 50 years of age or older in the developed world. The most prominent clinical and histological damage involves retinal pigment epithelium (RPE), Bruch's membrane, and choriocapillaris; but it is the degeneration, dysfunction, and death of photoreceptors that accounts for the vision loss. Anatomical and functional studies have found that photoreceptor degeneration and loss occur before disease in the RPE/Bruch's membrane complex progresses to late AMD. Although the cone photoreceptor degeneration is secondary to rod death, it is the cone loss that causes major visual handicap. As such detecting early cone degeneration in a clinical setting is strategically critical to prevent vision loss. Cone inner segments become widened and misshapen during the degeneration; we hypothesize that enlargement and deformation of the parafoveal cones could be used as an early clinical sign for the diagnosis of AMD. Identifying these signs may be facilitated by high-resolution and high-fidelity retinal imaging. The cellular scale retinal image in the living human eye can only be achieved by adaptive optics (AO) assisted ophthalmoscopy. But current AO retinal imaging is hampered by insufficient image acquisition speed and inadequate image fidelity. In this application, we will develop a high- speed, high-resolution AO parallel confocal scanning ophthalmoscope (AO-PCSO) to facilitate diagnosis of AMD at an earlier stage. The instrument developed in this application is 'real-world' patient oriented. The AO-PCSO exceeds current AO retinal imaging modalities with significantly improved data collection efficiency and image fidelity. This application breaks the barrier to the study of AMD, seeking to shift current clinical practice paradigms from macro-scale to micro-scale by providing cellular diagnosis of retinal degenerative disease. The success of this research will significantly improve our ability to diagnose AMD at its onset and our knowledge of disease progression. High-speed image acquisition is a signature advance in confocal retinal imaging; it is not only important for imaging the elderly subjects but also equally important for studies involving children with early onset retinal disease.

描述（由申请人提供）：年龄相关性黄斑变性 (AMD) 是发达国家 50 岁或以上人群失明的主要原因。最突出的临床和组织学损伤涉及视网膜色素上皮 (RPE)、布鲁赫膜和脉络膜毛细血管；但正是光感受器的退化、功能障碍和死亡导致了视力丧失。解剖学和功能研究发现，在 RPE/Bruch 膜复合体疾病进展到晚期 AMD 之前，光感受器变性和丧失就发生了。尽管视锥细胞退化是继发于视杆细胞死亡的，但视锥细胞的损失却导致了主要的视觉障碍。因此，在临床环境中检测早期视锥细胞变性对于预防视力丧失具有重要的战略意义。锥体内节在退化过程中变宽并变形；我们假设中心凹旁视锥细胞的增大和变形可以作为诊断 AMD 的早期临床症状。高分辨率和高保真度的视网膜成像可能有助于识别这些迹象。 活体人眼中的细胞尺度视网膜图像只能通过自适应光学（AO）辅助检眼镜来实现。但目前的 AO 视网膜成像因图像采集速度不足和图像保真度不足而受到阻碍。在此应用中，我们将开发一种高速、高分辨率AO并行共焦扫描检眼镜（AO-PCSO），以促进AMD的早期诊断。 本应用中开发的仪器是面向“现实世界”患者的。 AO-PCSO 超越了当前的 AO 视网膜成像模式，显着提高了数据收集效率和图像保真度。该应用打破了AMD研究的障碍，试图通过提供视网膜退行性疾病的细胞诊断来将当前的临床实践范式从宏观尺度转向微观尺度。这项研究的成功将显着提高我们在 AMD 发病时诊断的能力以及我们对疾病进展的了解。高速图像采集是共焦视网膜成像的标志性进步；它不仅对于老年受试者的成像很重要，而且对于涉及早发性视网膜疾病的儿童的研究也同样重要。