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 新生血管性年龄相关性黄斑变性 (AMD)，以脉络膜新生血管 (CNV) 的存在为特征，占 AMD 相关视力丧失的大部分。光学相干断层扫描（OCT）已成为AMD评估最常用的测试；然而，最初的 CNV 诊断需要荧光素血管造影 (FA)，需要侵入性静脉注射染料。使用高速 OCT 系统，我们开发了一种称为“分裂频谱幅度去相关血管造影”(SSADA) 的算法，可对视网膜和脉络膜血流进行无创成像和测量。初步结果表明OCT血管造影成功对CNV组织进行成像。该项目的目标是改进 OCT 血管造影技术并确定其在 AMD 评估和管理中的作用。 1. 通过 OCT 血管造影改善脉络膜新生血管 (CNV) 的成像。计划对血管造影、分割、配准和自动化方面的算法进行改进。 2. 使用 OCT 血管造影术量化新生血管性 AMD 的视网膜内层、视网膜外层 (CNV) 和脉络膜血流。 OCT 血管造影将通过物理血流模型进行校准。将开发不同血管床内血流的全自动量化，包括新型 CNV 面积和流量指数产品。将开发自动化软件来量化视网膜内液量、视网膜下液量和中央视网膜厚度，所有这些都来自单次 OCT 血管造影扫描。 3. 进行横断面研究，利用OCT血管造影初步评估CNV。 OCT 血管造影检测 CNV 的特异性和敏感性将在 60 名新生血管性 AMD 和 60 名年龄匹配的正常对照受试者中进行确定。 4. 对接受治疗的新生血管性 AMD 受试者进行 OCT 血管造影的纵向研究。将在一年内对 25 名新生血管性 AMD 受试者进行 OCT 血管造影在治疗期间评估 CNV 活性的效用。 5. 对 OCT 血管造影进行纵向研究，以确定脉络膜血流减少是否是 CNV 发展的危险因素。 OCT 血管造影在识别脉络膜血流减少作为 CNV 发展的潜在危险因素方面的效用以及 OCT 血管造影在检测临床前 CNV 方面的可能性将在三年内以 6 个月的间隔对 60 只高危眼进行评估。我们希望我们的结果将表明 OCT 血管造影可以提供临床相关信息，协助 CNV 诊断、评估治疗期间的 CNV 活动，并帮助监测有 CNV 风险的干性 AMD 眼睛。 OCT 血管造影有可能减少（如果不是取代）对 FA 的需求。