MRI of the Human Retina

人类视网膜 MRI

• 批准号: 8788528
• 负责人: Timothy Q. Duong
• 金额: $ 36.63万
• 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/8788528
• 关键词: Adult; Affect; Age; Anatomy; Angiotensin Receptor; Animal Model; Animals; Area; Background Diabetic Retinopathy; Behavioral; 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; Health; 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; Structural defect; 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; imaging biomarker; improved; innovation; insight; intravenous injection; luminance; macroalbuminuria; neovascularization; non-diabetic; non-invasive imaging; novel strategies; prevent; relating to nervous system; response; retinal damage; sample fixation; screening; tissue oxygenation; treatment response; visual stimulus

DESCRIPTION (provided by applicant): 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.

描述（由申请人提供）：糖尿病视网膜病变（DR）是糖尿病的一种并发症，也是工作年龄成年人失明的主要原因，是一种视网膜疾病，其长期病程通常在诊断前数年开始。目前，DR 是通过临床检查结果来诊断的；当这些变得可见时，大多数患者的视网膜已经发生了严重的不可逆转的损伤。与需要能量的光感受器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-利用不匹配最终会导致晚期新生血管形成和视力丧失。我们假设视网膜中氧气输送利用的不匹配导致了视力丧失前 DR 早期阶段的血流和组织氧合作用异常。目前，尚无现有的非侵入性成像技术可用于检测这些早期变化，而此时干预可能是最有效的。能够检测血流和氧合早期变化的成像技术可以加速 DR 的早期检测，对高危人群进行集中筛查，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缺乏深度分辨信息（用于解剖成像的光学相干断层扫描除外），并且依赖于光学透明度，而光学透明度经常受到介质不透明度（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分辨率的解剖、生理和功能数据。然而，它在薄视网膜上的应用一直具有挑战性。我们的团队开创了动物多参数、层特异性视网膜 MRI 技术，并展示了一些独特的优势。该提案旨在迈出第一步，将这种创新方法转化为研究人类视网膜。我们的中心假设是：i) 高分辨率 MRI 可以提供层状分辨率的人类视网膜的解剖、生理和功能图像，ii) DR 患者的功能和生理变化将在检测到结构异常之前发生。