OCT Angiography for Neovascular Age-related Macular Degeneration

OCT 血管造影治疗新生血管性年龄相关性黄斑变性

• 批准号: 8750633
• 负责人: Steven T Bailey
• 金额: $ 38.01万
• 依托单位: OREGON HEALTH & SCIENCE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-09-01 至 2018-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8750633
• 关键词: Accounting; Adverse effects; Age related macular degeneration; Algorithms; Anaphylaxis; Angiography; Area; Automation; Blindness; Blood Vessels; Blood flow; Choroidal Neovascularization; Clinical Management; Code; Color; Computer software; Cross-Sectional Studies; Detection; Development; Diagnosis; Diagnostic tests; Dyes; Evaluation; Excision; Exudative age-related macular degeneration; Eye; Fluorescein; Fluorescein Angiography; Fluorescence; Goals; Gold; Hemorrhage; Image; Imagery; Imaging technology; Injection of therapeutic agent; Intravenous; Liquid substance; Location; Longitudinal Studies; Manuals; Maps; Measurement; Measures; Morphologic artifacts; Nature; Nausea; Optical Coherence Tomography; Performance; Recruitment Activity; Research; Retina; Retinal; Retreatment; Risk; Risk Factors; Role; Scanning; Sensitivity and Specificity; Speed; Structure of retinal pigment epithelium; System; Technology; Testing; Thick; Tissues; United States; Vascular Endothelial Growth Factors; Vision; base; choroidal circulation; clinical application; clinical practice; clinically relevant; density; high risk; hypoperfusion; imaging modality; improved; indexing; instrument; intravenous injection; macula; next generation; normal aging; novel; optic nerve disorder; pre-clinical; prevent; public health relevance; response; retina blood vessel structure; software development; treatment trial; two-dimensional; vascular bed

DESCRIPTION (provided by applicant): PROJECT SUMMARY Neovascular age-related macular degeneration (AMD), characterized by the presence of choroidal neovascularization (CNV), accounts for the majority of AMD-related vision loss. Optical coherence tomography (OCT) has become the most frequently used test for AMD evaluation; however, fluorescein angiography (FA), which requires an invasive intravenous dye injection, is needed for initial CNV diagnosis. Using a high-speed OCT system, we have developed an algorithm called "split-spectrum amplitude decorrelation angiography" (SSADA) to non-invasively image and measure both retinal and choroidal blood flow. Preliminary results showed that OCT angiography successfully imaged CNV tissue. The goal of the proposed project is to improve OCT angiography technology and determine its role in AMD evaluation and management. 1. Improve imaging of choroidal neovascularization (CNV) with OCT angiography. Algorithmic improvements in angiography, segmentation, registration, and automation are planned. 2. Quantify inner retinal, outer retinal (CNV), and choroidal flow using OCT angiography for neovascular AMD. OCT angiogram will be calibrated by physical flow phantoms. Fully automated quantification of the blood flow within different vascular beds will be developed including a novel CNV area and flow index product. Automated software will be developed to quantify intraretinal fluid volume, subretinal fluid volume, and central retinal thickness, all from a single OCT angiography scan. 3. Conduct a cross-sectional study to use OCT angiography in the initial evaluation of CNV. The specificity and sensitivity of OCT angiography to detect CNV will be determined in 60 neovascular AMD and 60 normal age-matched control subjects. 4. Conduct a longitudinal study of OCT angiography in the evaluation of neovascular AMD subjects undergoing treatment. The utility of OCT angiography for assessing CNV activity while undergoing treatment will be evaluated in 25 neovascular AMD subjects over the course of one year. 5. Conduct a longitudinal study of OCT angiography to determine if reduced choroidal flow is a risk factor for CNV development. The utility of OCT angiography for identifying reduced choroidal flow as a potential risk factor for CNV development and the possibility of OCT angiography in detecting pre-clinical CNV will be evaluated with 60 high-risk eyes at 6-month intervals for three years. We expect that our results will show OCT angiography can provide clinically relevant information assisting with CNV diagnosis, assessing CNV activity while undergoing treatment, and aid with surveillance for dry AMD eyes at risk for CNV. OCT angiography has the potential to reduce (if not replace) the need for FA.

描述（由申请人提供）： 项目摘要新血管与年龄相关的黄斑变性（AMD），其特征在于存在脉络膜新生血管形成（CNV），占AMD与AMD相关的视力丧失的大部分。光学相干断层扫描（OCT）已成为最常用的AMD评估测试。然而，需要进行最初的CNV诊断需要荧光素血管造影（FA），需要进行浸润性静脉注射染料。使用高速OCT系统，我们开发了一种称为“分裂谱振幅去相关血管造影”（SSADA）的算法，以非侵入性图像并测量视网膜和脉络膜血流。初步结果表明，OCT血管造影成功成像CNV组织。拟议项目的目标是改善OCT血管造影技术并确定其在AMD评估和管理中的作用。 1。用OCT血管造影改善脉络膜新生血管化（CNV）的成像。计划了血管造影，细分，注册和自动化的算法改进。 2。使用OCT血管造影进行新的视网膜，视网膜（CNV）和脉络膜流动，用于新血管造影。 OCT血管造影将通过物理流幻象校准。将开发出不同血管床内血流的全自动定量，包括新型的CNV区域和流量指数产品。将开发自动化软件以量化视网膜内流体体积，视网膜下流体体积和中央视网膜厚度，全部从单个OCT血管造影扫描中进行。 3。进行横截面研究以在CNV的初始评估中使用OCT血管造影。 OCT血管造影检测CNV的特异性和敏感性将在60个新血管AMD和60个正常年龄匹配的对照受试者中确定。 4.在评估接受治疗的新血管AMD受试者的纵向研究中。在一年的时间内，将在25名新血管AMD受试者中评估OCT血管造影评估CNV活性的效用。 5。进行OCT血管造影的纵向研究，以确定脉络膜流量减少是否是CNV发育的危险因素。 OCT血管造影的实用性以鉴定脉络膜发育的潜在危险因素以及OCT血管造影在检测临床前CNV时的潜在危险因素的实用性将以60个高风险的眼睛的6个月间隔评估三年。我们预计我们的结果将表明OCT血管造影可以提供临床相关的信息，以帮助CNV诊断，评估CNV活动，同时接受治疗，并帮助监视干燥的AMD眼睛的CNV风险。 OCT血管造影有可能减少（如果不取代）FA的需求。