Advanced imaging for diabetic retinopathy

糖尿病视网膜病变的先进成像

• 批准号: 8415887
• 负责人: Delia Cabrera DeBuc
• 金额: $ 52.49万
• 依托单位: UNIVERSITY OF MIAMI SCHOOL OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-02-01 至 2016-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8415887
• 关键词: Area Under Curve; Blindness; Blood Circulation; Blood Vessels; Blood flow; Caliber; Classification; Clinic; Clinical; Clinical Trials; Deterioration; Development; Diabetic Retinopathy; Diagnostic; Diagnostic Procedure; Discrimination; Disease Progression; Early Diagnosis; Early identification; Early treatment; Eye; Functional disorder; Fundus; Future; Goals; Health Personnel; Human; Image; Imaging Techniques; Individual; Intervention; Measurement; Measures; Methodology; Monitor; Morphology; Nerve Degeneration; Neural Retina; Optic Disk; Optical Coherence Tomography; Outcome; Pathogenesis; Pathology; Persons; Prevention; Public Health; Receiver Operating Characteristics; Retina; Retinal; Retinal Diseases; Risk; Role; Staging; Structure; System; Testing; Thick; Tissues; Venous; Vision; Visual; Visual Acuity; clinical practice; diabetic; diabetic patient; diagnosis evaluation; hemodynamics; improved; in vivo; novel; prevent; relating to nervous system; retina blood vessel structure; tool

DESCRIPTION (provided by applicant): Diabetic retinopathy (DR) is a major cause of visual loss in diabetic individuals that presents a significant diagnostic challenge. Advances in preventing vision loss in these individuals are hindered by limited understanding of mechanisms underlying DR and the altered relationships between the retinal neural tissue and retinal vasculature. Therefore, an objective test for the early diagnosis and evaluation of DR treatment is certainly needed in order to identify the individuals at great risk for vision-threatening problems. Our goal is to prevent visual loss in diabetic patients with an advanced imaging technique, Doppler Fourier Domain Optical Coherence Tomography (Doppler FD-OCT) that can facilitate a better understanding of the underlying sight- threatening complications of DR and the altered relationships between the neural retina and blood vessels. Our objective is to test the hypothesis that retinal structure alteration precedes disturbances in retinal hemodynamics and visual function deficit in DR. We will accomplish the following aims: Aim 1: Test the hypothesis the diagnostic power of the combination of advanced Doppler FD-OCT imaging and novel quantitative functional-anatomical measures can provide an objective methodology for non-invasive and in vivo quantification of retinal hemodynamics and structure morphology in normal healthy subjects and diabetic patients with and without DR. Aim 2: Test the hypothesis that retinal structure alteration precedes disturbances in retinal hemodynamics and visual function deficit in DR. Our hypothesis predicts that retinal structure alteration precedes disturbance of retinal hemodynamics, and at each stage of progressive DR the magnitude of structure deterioration will be larger than the magnitude of hemodynamic disturbance and visual function deficit. We will define the ratio of dysfunction to retinal structure alterations and hemodynamic disturbances at different stages of retinopathy by comparing anatomical variables, hemodynamic parameters and visual function measures. Our results will provide quantitative information about retinal blood flow in diabetic patients with and without retinopathy, and will improve the early diagnosis and treatment of DR. Our expected outcome will be to facilitate a ratio of visual dysfunction to retinal structure alterations and hemodynamic disturbances at different stages of retinopathy. We will characterize the retinal structure and hemodynamic parameters and relate the findings to systemic measures of control and complications in defined stratified groups of diabetic patients with varying levels of DR. Our impact will influence clinical practice by providing a means of identifying better clinical endpoints for DR clinical trials that are more sensitive to early disease progression than visual acuity and define the exact role of the blood circulation abnormalities in the DR progression.

描述（由申请人提供）：糖尿病性视网膜病（DR）是糖尿病患者视觉丧失的主要原因，这引起了重大的诊断挑战。由于对DR的基础机制以及视网膜神经组织与视网膜脉管系统之间的关系的改变而阻碍了预防这些个体视力丧失的进步。因此，当然需要对DR治疗的早期诊断和评估进行客观测试，以确定有危及视力问题的个人。我们的目标是防止具有高级成像技术，多普勒傅立叶域光学相干断层扫描（多普勒FD-OCT）的糖尿病患者的视觉丧失，这可以促进对DR的潜在观察并发症的理解以及神经视网膜和血管之间的改变。我们的目的是检验以下假设：视网膜结构改变先于视网膜血流动力学和DR中视觉功能不足的干扰。我们将完成以下目标：目标1：测试假设的假设是高级多普勒FD-OCT成像和新型定量功能 - 功能 - 解剖学测量的诊断能力，可以为非侵入性和体内量化视网膜血液动力学和在正常健康的患者和糖尿病患者中和无dr dr dr dr dr dr dr dr dr dr and and vivo量化。 AIM 2：检验假说，即视网膜结构改变在DR中的视网膜血流动力学和视觉功能不足的干扰之前。我们的假设预测，视网膜结构的改变先于视网膜血流动力学的干扰，在进行性DR的每个阶段，结构恶化的幅度将大于血液动力学干扰和视觉功能不足的大小。我们将通过比较解剖变量，血液动力学参数和视觉功能测量方法来定义视网膜病变不同阶段的视网膜结构改变和血液动力学障碍的比率。我们的结果将提供有关患有和没有视网膜病的糖尿病患者视网膜血流的定量信息，并将改善DR的早期诊断和治疗。我们的预期结果是促进视觉功能障碍与视网膜结构改变和视网膜病变阶段的血液动力学障碍之比。我们将表征视网膜结构和血液动力学参数，并将发现与糖尿病患者定义的分层组的系统性测量和并发症相关联，DR的水平变化。我们的影响将通过提供与视力相比对早期疾病进展更敏感的DR临床终点的方法来影响临床实践，并确定血液循环异常在DR进展中的确切作用。