MRI of the Human Retina

人类视网膜 MRI

• 批准号: 8631984
• 负责人: Timothy Q. Duong
• 金额: $ 29.9万
• 依托单位: UNIVERSITY OF TEXAS HLTH SCIENCE CENTER
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-01-01 至 2018-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8631984
• 关键词: Adult; Affect; Age; Anatomy; Angiotensin Receptor; Animal Model; Animals; Area; Background Diabetic Retinopathy; Behavioral; Biological Markers; Blindness; Blinking; Blood Vessels; Blood flow; Cataract; Clinical; Clinical Trials; Complications of Diabetes Mellitus; Contrast Media; Coupling; Cues; Data; Development; Diabetes Mellitus; Diabetic Retinopathy; Diagnosis; Disease; Early Diagnosis; Eye; Foundations; Functional Imaging; Functional Magnetic Resonance Imaging; Future; Gadopentetate Dimeglumine; Hour; Human; Hypoxia; Image; Imaging Techniques; Imaging technology; Individual; Intervention; Magnetic Resonance Imaging; Microalbuminuria; Monitor; Motion; Ophthalmic examination and evaluation; Optical Coherence Tomography; Optics; Outcome; Oxygen; Patients; Pharmacotherapy; Photoreceptors; Physiological; Physiology; Populations at Risk; Prevalence; Prevention; Protocols documentation; Quality of life; Regulation; Research; Resolution; Retina; Retinal; Retinal Diseases; Risk; Specificity; Staging; Stratification; Structure; Testing; Therapeutic Intervention; Time; Tissues; Translating; Treatment outcome; Vision; Vitreous Hemorrhage; Work; animal data; blood oxygen level dependent; blood oxygenation level dependent response; clinical Diagnosis; clinically significant; diabetic; diabetic patient; ganglion cell; glycemic control; hemodynamics; high risk; improved; innovation; insight; intravenous injection; luminance; macroalbuminuria; neovascularization; non-diabetic; non-invasive imaging; novel strategies; prevent; public health relevance; relating to nervous system; response; retinal damage; sample fixation; screening; tissue oxygenation; treatment response; visual stimulus

Diabetic retinopathy (DR), a complication of diabetes and the leading cause of blindness in working-age adults, is a retinal disease whose prolonged course typically begins years prior to diagnosis. DR is presently diagnosed by clinical findings on examination; by the time these are visible, significant irreversible damage to the retina has already occurred for most patients. Insufficient oxygen delivery and hypoxia associated with the energy-demanding photoreceptors has been implicated in the early stage of the disease. Such oxygen delivery-utilization mismatch ultimately precipitates late stage neovascularization and vision loss. We hypothesize that the mismatch in oxygen delivery-utilization in the retina results in abnormal blood flow and tissue oxygenation in the early stage of DR before vision loss. Currently, there are no existing non- invasive imaging technologies available to detect these early changes, when intervention could be most effective. Imaging technologies that can detect early changes in blood flow and oxygenation could accelerate early detection of DR, offer focused screening of population at risk, and enable longitudinal treatment monitoring. Early detection has the potential to prevent blindness and improve treatment outcomes, including quality of life. Most existing retinal imaging techniques lack depth-resolved information (except optical coherence tomography for anatomical imaging) and rely on optical transparency which is frequently hampered by media opacity (e.g., cataracts and vitreous hemorrhages). In contrast, MRI can provide anatomical, physiological, and functional data with lamina-specific depth resolution. Its application to the thin retina, however, has been challenging. Our group pioneered multi-parametric, layer-specific retinal MRI in animals and has demonstrated some unique advantages. This proposal aims to take the first step to translate this innovative approach to study the human retina. Our central hypothesis is that: i) high-resolution MRI can provide anatomical, physiological, and functional images of the human retina with laminar resolution, and ii) functional and physiological changes in DR patients will occur before structural abnormalities can be detected.

糖尿病性视网膜病（DR），糖尿病并发症和失明的主要原因 在工作年龄成年人中，是一种视网膜疾病 诊断。目前，通过检查的临床发现来诊断DR；到这些 可见，大多数患者已经对视网膜发生明显的不可逆损害。 氧递送不足和与能量启用感光体相关的缺氧 已经与疾病的早期有关。这样的氧递送不匹配 最终导致晚期新血管形成和视力丧失。我们假设 视网膜中氧递送的不匹配导致血流异常和组织 在视力丧失之前，DR的早期阶段充氧。目前，没有现有的非 当干预时，可检测这些早期变化的侵入性成像技术 最有效。成像技术可以检测到血流的早期变化和 氧合可以加速早期检测DR，提供集中筛查人口的筛查 风险，并实现纵向治疗监测。早期检测有可能预防 失明并改善治疗结果，包括生活质量。 大多数现有的视网膜成像技术都缺乏深度分辨信息（光学除外 解剖成像的相干断层扫描）和依靠光学透明度 经常受到媒体不透明度的阻碍（例如白内障和玻璃体出血）。相比之下， MRI可以提供具有椎板特异性深度的解剖学，生理和功能数据 解决。然而，它在稀薄的视网膜上的应用一直具有挑战性。我们的小组 先驱在动物中的多参数，层特异性视网膜MRI，并证明了一些 独特的优势。该建议旨在迈出第一步，以翻译这种创新性 研究人类视网膜的方法。我们的中心假设是：i）高分辨率MRI可以 用层流提供人类视网膜的解剖学，生理和功能图像 分辨率，以及ii）DR患者的功能和生理变化将发生 可以检测到结构异常。