Assessment of episcleral vasculature for glaucoma management

青光眼治疗中巩膜外层血管系统的评估

• 批准号: 10324938
• 负责人: Abhishek Rege
• 金额: $ 25.66万
• 依托单位: VASOPTIC MEDICAL, INC.
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-01 至 2023-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10324938
• 关键词: Adherence; Animals; Anterior; Aqueous Humor; Blindness; Blood; Blood Flow Velocity; Blood flow; Cell Death; Clinical; Clinical Research; Clinical assessments; Data; Data Set; Devices; Effectiveness; Endothelin-1; Equation; Erythrocytes; Eye; Feedback; Foundations; Future; Glaucoma; Image; In Vitro; Indocyanine Green; Infusion procedures; Injections; Intervention; Label; Laser Speckle Imaging; Lasers; Lighting; Measures; Methodology; Methods; Microfluidics; Microinvasive; Modeling; Monitor; Non-linear Models; Operative Surgical Procedures; Oryctolagus cuniculus; Outcome; Pathway interactions; Performance; Pharmaceutical Preparations; Phase; Physiologic Intraocular Pressure; Physiological; Primary Open Angle Glaucoma; Public Health; Pump; Reporting; Retinal Ganglion Cells; Rhodamine; Saline; Surgeon; Surgical complication; Surgical incisions; System; Techniques; Technology; Test Result; Testing; Time; Training; Validation; Vasoconstrictor Agents; Veins; Visual impairment; Withdrawal; aqueous; base; blind; clinical translation; commercialization; fluorescence imaging; glaucoma surgery; improved; in vivo; innovation; insight; intravenous injection; multimodality; non-invasive imaging; novel; optical imaging; prognostic; software systems; success; surgery outcome; targeted imaging; tool; treatment strategy

ABSTRACT Glaucoma is one of the leading causes of irreversible blindness globally and is caused by retinal ganglion cell death or loss associated with elevated intra-ocular pressure (IOP). Current treatment strategies revolve around reduction of IOP, but are limited by poor adherence and potentially blinding surgical complications. Microinvasive glaucoma surgery (MIGS) has offered a promising solution to reduce IOP, however results have been inconsistent in part due to the lack of real-time assessment of aqueous outflow. This has limited the success of MIGS. Our project proposes to develop an optical imaging-based solution to quantify aqueous humor outflow and blood flow in the episcleral veins to provide crucial insight to ophthalmic surgeons performing MIGS in real- time to support optimal surgical approach. During Phase I, we will develop a hardware-software system for estimating flow of blood and aqueous humor, optimize and characterize its performance in vitro using standard imaging targets and flow phantoms (Aim 1), and subsequently validate its performance in vivo using rabbit models of anterior segment imaging and glaucoma (Aim 2). If successful, we anticipate undertaking a Phase II effort comprising clinical studies to validate the clinical performance of the system before and after MIGS (Aim 1) and the demonstration of improvement in outcomes of MIGS outcomes with real-time availability of feedback from our technology (Aim 2). This project, thereby, aims to the lay the foundation of a data-driven approach for MIGS, or smart MIGS.

抽象的 青光眼是全球不可逆失明的主要原因之一，是由视网膜神经节细胞引起的 与眼内压（IOP）升高有关的死亡或损失。当前的治疗策略围绕 IOP的减少，但受到依从性差和潜在盲目手术并发症的限制。微侵染 青光眼手术（MIGS）提供了一种有希望的解决方案来减少IOP，但是结果是 不一致的部分原因是缺乏对水溶液的实时评估。这限制了成功的成功 migs。我们的项目建议开发一种基于光学成像的解决方案，以量化幽默流出 和血管中的血液流动，为在现实中进行MIGS的眼科医生提供关键的见解 是时候支持最佳手术方法了。在第一阶段，我们将开发一个硬件软件系统 估计血液和水性幽默的流量，使用标准在体外进行优化和表征其表现 成像目标和流幻象（AIM 1），然后使用兔子在体内验证其性能 前节成像和青光眼的模型（AIM 2）。如果成功，我们预计将进行II阶段 包括临床研究的努力，以验证MIG前后系统的临床性能（AIM 1）并证明了MIG结果的改善以及反馈的实时可用性 来自我们的技术（AIM 2）。因此，该项目的目的是为数据驱动方法的基础 MIGS或智能MIGS。