Functional Optical Coherence Tomography-derived Biomarkers for Diabetic Retinopathy

功能性光学相干断层扫描衍生的糖尿病视网膜病变生物标志物

• 批准号: 8832474
• 负责人: Yali Jia
• 金额: $ 103.67万
• 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: 2014-09-30 至 2017-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8832474
• 关键词: Adverse effects; Affect; Age; Algorithms; Anaphylaxis; Anatomy; Angiography; Applications Grants; Area; Arteriosclerosis; Biological Markers; Blindness; Blood Circulation; Blood Vessels; Blood capillaries; Blood flow; Clinical; Clinical Research; Clinical Trials; Clinical assessments; Computer software; Control Groups; Cyst; Detection; Diabetes Mellitus; Diabetic Retinopathy; Diagnosis; Disease; Dropout; Dyes; Early Diagnosis; Enrollment; Evaluation; Extravasation; Fluorescein; Fluorescein Angiography; Fundus photography; Generations; Glaucoma; Goals; Gold; Image; Injection of therapeutic agent; Intravenous; Life; Liquid substance; Manuals; Maps; Measurement; Measures; Methods; Microcirculation; Monitor; Motion; Nausea; Optical Coherence Tomography; Participant; Patients; Pattern; Perfusion; Reading; Research; Research Project Grants; Resistance; Retina; Retinal; Retinal Diseases; Retinal Edemas; Retinal Neovascularization; Role; Sampling; Scanning; Sensitivity and Specificity; Severities; Speed; Staging; Structure; System; Techniques; Technology; Testing; United States; Visit; Visual Acuity; capillary; clinical practice; diabetic; diabetic patient; follow-up; image processing; imaging modality; improved; indexing; instrument; intravenous injection; macular edema; neovascularization; non-diabetic; novel; optic nerve disorder; prototype; public health relevance; screening; tool

 DESCRIPTION (provided by applicant): Diabetic retinopathy (DR), associated with long-term diabetes mellitus, is a leading cause of blindness in the US. Structural optical coherence tomography (OCT) has become the standard method for evaluating diabetic macular edema; however, fluorescein angiography (FA), which requires an invasive intravenous dye injection, is still needed to assess capillary dropout and confirm neovascularization. Recently, we have used a high- speed OCT system to make non-invasive functional measurements such as angiography, total retinal blood flow, and retinal arterial pulsatility. The goal of the proposed project is to improve these functional OCT-derived biomarkers and determine their roles in the early detection and management of DR. 1. Develop quantitative OCT angiography of capillary dropout and retinal neovascularization (RNV). Three dimensional (3D) OCT angiography has been made practical (6x6 mm scan in 3 seconds) by a novel split-spectrum amplitude-decorrelation algorithm. The algorithm will be improved and OCT angiograms will be calibrated by physical flow phantoms. Automated software will be developed to quantify the following angiographic biomarkers: non-perfusion area, RNV area and flow index, and parafoveal and perifoveal flow indexes. 2. Improve Doppler OCT measurement of total retinal blood flow (TRBF) and retinal arterial pulsatility. A 3-second 3D Doppler OCT scan will be used to measure TRBF using an en face summation algorithm. A 4-second cylindrical Doppler OCT scan will be used to measure retinal arterial pulsatility. Automated measurement algorithms will be developed for these novel biomarkers. 3. Improve structural OCT measurement of macular edema. By registering several volumetric scans, we have demonstrated detailed mapping and quantification of retinal thickening and fluid spaces (cysts). Fully automated quantification of these structural biomarkers will be developed. 4. Evaluate functional and structural OCT-derived biomarkers in clinical studies. The specificity and sensitivity of OCT angiography for detection of capillary dropout and RNV will be determined in 50 severe non-proliferative (NPDR) and proliferative (PDR) subjects (Group A) and 30 age-matched non-diabetic controls (Group C). The utility of OCT-derived biomarkers for early detecting retinal abnormalities will be evaluated in 80 subjects with or without mild to moderate NPDR (Group B). The capability of biomarkers for assessing the disease change will be evaluated with Groups A and B over a 12-month interval. The proposed functional OCT-derived biomarkers will be more sensitive to early vascular change compared to standard fundus photography and are likely to provide more reliable endpoints for diabetic clinical trials. Unlike FA, functional OCT is non-invasive and coul be used in routine clinical screening and monitoring of DR.

 描述（由适用提供）：与长期糖尿病有关的糖尿病性视网膜病（DR）是美国失明的主要原因。结构光学相干断层扫描（OCT）已成为评估糖尿病黄斑水肿的标准方法。但是，需要进行浸润性静脉注射染料注射的荧光素血管造影（FA）仍需要评估毛细血管辍学并确认新血管形成。最近，我们使用了高速OCT系统来进行非侵入性功能测量，例如血管造影，总残留血流和残留动脉脉冲性。拟议项目的目的是改善这些功能性的OCT衍生的生物标志物，并确定它们在DR的早期检测和管理中的作用。 1。发展毛细血管辍学和残留新血管形成（RNV）的定量OCT血管造影。新型的偏谱放大器 - 与 - 与 - 与算法算法已经使三维（3D）OCT血管造影（在3秒内进行6x6 mM扫描）。该算法将得到改善，OCT血管造影将通过物理流幻象校准。将开发自动化软件以量化以下血管造影生物标志物：非灌注区域，RNV区域和流量指数，以及parafoveal和Perifoveal流量指数。 2。改进总计3秒3D多普勒OCT扫描的多普勒OCT测量将使用eN face Humpation算法测量TRBF。四秒钟的圆柱多普勒OCT扫描将用于测量残留的动脉搏动性。这些新型生物标志物将开发自动测量算法。 3。改善黄斑水肿的结构OCT测量。通过记录几次体积扫描，我们已经证明了视网膜增厚和流体空间（囊肿）的详细映射和定量。将开发这些结构生物标志物的完全自动定量。 4。在临床研究中评估功能和结构OCT衍生的生物标志物。 OCT血管造影检测毛细血管辍学和RNV的特异性和灵敏度将在50个严重的非增殖（NPDR）中确定，并增殖（PDR）受试者（A组）和30个年龄匹配的非糖尿病对照（C组）。在有或没有轻度至中度NPDR的80名受试者中，将评估OCT衍生的生物标志物用于早期检测视网膜异常的效用（B组）。生物标志物评估疾病变化的能力将在12个月的时间内通过A组和B组进行评估。与标准的眼底摄影相比，拟议的功能性OCT生物标志物将对早期的血管变化更加敏感，并且可能为糖尿病临床试验提供更可靠的终点。与FA不同，功能性OCT是无创的，并且在常规的临床筛查和DR监测中使用问题。

项目成果

Three-dimensional structural and angiographic evaluation of foveal ischemia in diabetic retinopathy: method and validation.

• DOI: 10.1364/boe.10.003522
• 发表时间: 2019-06
• 期刊: Biomedical optics express
• 影响因子: 3.4
• 作者: Bingjie Wang;Acner Camino;Shaohua Pi;Yukun Guo;Jie Wang;David Huang;T. Hwang;Yali Jia