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

• 批准号: 8740482
• 负责人: David Huang
• 金额: $ 73.41万
• 依托单位: OREGON HEALTH & SCIENCE UNIVERSITY
• 依托单位国家: 美国
• 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/8740482
• 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

DESCRIPTION (provided by applicant): 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 i 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.

描述（由申请人提供）：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非常重要，因为其发病隐匿且损害不可逆转。过去 20 年来，光学相干断层扫描 (OCT) 等先进成像方式已被用于改善青光眼的客观评估。 OCT具有比其他眼后部成像方式更高的轴向空间分辨率，并且在测量青光眼损伤的神经结构方面具有相对较好的诊断准确性和重复性。然而，单独使用任何成像方式测量结构对于检测早期青光眼的敏感性有限，并且与视野 (VF) 损失仅具有中等相关性。使用高速 OCT 系统，我们开发了对视神经乳头 (ONH) 和视网膜血流进行成像和测量的新方法。初步结果表明，与通过 OCT 或其他成像方式测量的任何神经结构相比，通过 OCT 测量的 VF 损失与视网膜血流量的相关性更高。因此，该项目的目标是通过使用超高速（70-100 kHz）OCT 技术进一步开发新颖的功能性 OCT 测量来改善青光眼的诊断和预后评估。具体目标是： 1.改进视网膜血流的多普勒OCT测量。视乳头周围视网膜动脉和静脉的多循环扫描可测量 2 秒内的视网膜总血流量。使用更快的 OCT 系统将实现自动化测量并提高再现性。 2. 开发 ONH 的定量 OCT 血管造影。三维 (3D) OCT 血管造影已通过新颖的分谱幅度去相关算法变得实用（3 秒内扫描 3x3 毫米）。初步结果显示早期青光眼中 ONH 微循环急剧丧失。计划改进血管造影、分割、量化和自动化方面的算法。 3. 测量从 ONH 到视网膜神经节细胞的神经结构。通过记录多次体积扫描，我们展示了从 ONH 到黄斑的视网膜纤维通路的完整 3D 特征。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。功能性和结构性 OCT 在青光眼中的实用性将通过对 150 名青光眼和健康受试者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和黄斑神经节细胞复合物体积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。