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.

糖尿病视网膜病变（DR）是糖尿病的并发症，也是导致失明的主要原因 在工作年龄的成年人中，是一种视网膜疾病，其长期病程通常开始于几年前 来诊断。目前，DR 是通过临床检查结果来诊断的；到了这些时候 可见，大多数患者的视网膜已经发生了严重的不可逆转的损伤。 与能量需求感光细胞相关的供氧不足和缺氧 与疾病的早期阶段有关。这种氧气输送与利用不匹配 最终导致晚期新生血管形成和视力丧失。我们假设 视网膜中氧输送与利用的不匹配导致血流和组织异常 DR 早期视力丧失前的氧合。目前，不存在现有的非 当干预可以时，侵入性成像技术可用于检测这些早期变化 是最有效的。可以检测血流早期变化的成像技术 氧合可以加速 DR 的早期检测，对人群进行集中筛查 风险，并实现纵向治疗监测。早期发现有可能预防 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缺乏深度分辨信息（光学成像除外） 用于解剖成像的相干断层扫描）并依赖于光学透明度 经常受到介质混浊（例如白内障和玻璃体出血）的阻碍。相比之下， MRI 可以提供具有特定椎板深度的解剖学、生理学和功能数据 解决。然而，它在薄视网膜上的应用一直具有挑战性。我们组 率先在动物身上进行多参数、层特异性视网膜 MRI，并证明了一些 独特的优势。该提案旨在迈出转化这一创新成果的第一步 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 通过层流提供人类视网膜的解剖学、生理学和功能图像 解决，并且 ii) DR 患者的功能和生理变化将在 可以检测到结构异常。