Diagnosis and Monitoring of Glaucoma with Optical Coherence Tomography Angiography

光学相干断层扫描血管造影对青光眼的诊断和监测

• 批准号: 9921397
• 负责人: ROBERT N WEINREB
• 金额: $ 50.37万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN DIEGO
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-05-01 至 2022-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9921397
• 关键词: 3-Dimensional; Age; Anatomy; Angiography; Area; Blindness; Blood Pressure; Blood Vessels; Bruch' s basal membrane structure; Cardiovascular Diseases; Cerebrovascular Disorders; Classification; Clinical; Complex; Data; Detection; Development; Diagnosis; Disease; Documentation; Early Diagnosis; Evaluation; Eye; Floor; Functional disorder; Ganglion Cell Layer; Glaucoma; Imaging technology; Individual; Laboratories; Lead; Longitudinal Studies; Measurable; Measurement; Measures; Methods; Monitor; Optic Disk; Optical Coherence Tomography; Participant; Pathogenesis; Patients; Perfusion; Peripheral; Primary Open Angle Glaucoma; Quality of life; Reporting; Research; Retina; Role; Science; Scotoma; Severity of illness; Structure; Suspect Glaucomas; Testing; Thick; Thinness; Thrombophilia; Time; Tissues; Vasospasm; Vision; Visual Fields; Width; advanced disease; central visual field; clinical care; clinical imaging; cohort; density; diagnostic accuracy; effective therapy; field study; follow-up; ganglion cell; high resolution imaging; imaging modality; improved; macula; novel; optical imaging; prevent; rate of change; retina blood vessel structure; retinal nerve fiber layer

Project Summary Optical coherence tomography angiography (OCTA) has been introduced recently as a non- invasive, 3-dimensional imaging method to visualize and quantify microvasculature throughout the retina. The proposed study evaluates the clinical utility of OCTA measurements compared to standard structural measurements of the optic nerve head (ONH), retinal nerve fiber layer (RNFL) and macula measured using the current clinical imaging standard, spectral domain optical coherence tomography (SDOCT). Our research, and that of others, has shown that superficial retinal vessel density (proportion of measured area composed of blood vessels) in the ONH region and macula is less dense in primary open angle glaucoma (POAG) eyes than in healthy eyes. Moreover, diagnostic accuracy is improved with increasing disease severity. Research from our laboratory suggests that the diagnostic accuracy of vessel density is similar to that of SDOCT-measured RNFL thickness, and that vessel density is reduced in retinal regions associated with localized visual field (VF) defects. These cross-sectional results strongly suggest that OCTA measurements reflect damage to tissues relevant to the pathophysiology of POAG. In a longitudinal study, moreover, the mean rate of change in macula vessel density is significantly faster in POAG eyes than in glaucoma suspect or healthy eyes. The current study provides a unique opportunity to extend for up to 8 years longitudinal OCTA data that has already been collected from 250 eyes over 2 years, and to investigate vessel density change over time in glaucoma suspect and POAG eyes, as well as to compare it to other imaging modalities and glaucoma-related visual field change. The aims of the study are 1) to assess the longitudinal temporal and topographic relationship in glaucoma between loss of superficial retinal vessel density, loss of RNFL thickness, loss of neuroretinal rim width, and loss of ganglion cell complex (GCC) thickness in glaucoma suspect and glaucoma eyes of varying disease severity, and 2) to assess the longitudinal temporal and topographic relationship between superficial loss of macula and ONH retinal vessel density, loss of RNFL thickness , loss of neuroretinal rim width, and loss GCC thickness with the development and progression of central and peripheral VF defects in glaucoma. Comparison of the time course of changes in vessel density relative to changes in RNFL thickness, neuroretinal rim width, ganglion cell layer thickness and visual function will provide information about the pathophysiology of glaucoma that can improve early detection and accurate monitoring of advanced disease compared to currently available and widely accepted methods. Enhanced diagnosis and detection of progression should lead to earlier and more effective treatment, thus reducing the rate of disease worsening and preventing loss of vision-related quality of life (including blindness).

项目摘要 光学相干断层扫描（OCTA）最近作为非 - 侵入性的三维成像方法，可视化和量化整个微脉管系统 视网膜。拟议的研究评估了八八章测量的临床实用性 视神经头（ONH），视网膜神经纤维层（RNFL）的标准结构测量值 和黄斑使用当前的临床成像标准，光谱域光学连贯性测量 断层扫描（SDOCT）。我们的研究以及其他的研究表明，表面视网膜血管 ONH区域和黄斑中的密度（由血管组成的测量区域的比例）为 一级敞开角度青光眼（POAG）眼睛比健康的眼睛较少。而且，诊断 随着疾病严重程度的增加，准确性提高了。我们实验室的研究表明 血管密度的诊断精度与SDOCT测量的RNFL厚度相似，并且 与局部视野（VF）缺陷相关的视网膜区域中，血管密度降低。这些 横截面结果强烈表明八八粒测量反映了对组织的损害 致POAG的病理生理学。此外，在一项纵向研究中，平均变化率 在POAG眼中，黄斑血管密度明显快于青光眼可疑或健康的眼睛。 当前的研究提供了一个独特的机会，可以扩展长达8年的纵向八章数据 在2年内，已经从250只眼睛收集了这一点，并调查了容器密度的变化 随着时间的流逝，在青光眼嫌疑人和Poag眼中，将其与其他成像方式进行比较 和与青光眼相关的视野变化。研究的目的是1）评估纵向 浅表视网膜血管密度丧失之间的青光眼中的时间和地形关系， RNFL厚度的丧失，神经视网膜缘宽度的丧失以及神经节细胞复合物（GCC）的损失 青光眼怀疑和青光眼的厚度有不同的疾病严重程度，以及2）评估 黄斑表面损失和ONH的纵向时间和地形关系 视网膜血管密度，RNFL厚度的损失，神经视网膜边缘宽度的丧失和损失GCC厚度 随着青光眼中央和周围VF缺陷的发展和发展。比较 相对于RNFL厚度的变化，神经网络变化的容器密度变化的时间过程 边缘宽度，神经节细胞层厚度和视觉功能将提供有关 青光眼的病理生理学可以改善早期检测并准确监测晚期 与当前可用的方法相比，疾病与广泛接受的方法相比。增强的诊断和 检测进展应导致更早，更有效的治疗，从而降低 疾病恶化并防止视力相关的生活质量（包括失明）。