Imaging of Retinal Oxygen Metabolism in Diabetic Retinopathy

糖尿病视网膜病变的视网膜氧代谢成像

• 批准号: 9886053
• 负责人: Mahnaz Shahidi
• 金额: $ 42.53万
• 依托单位: UNIVERSITY OF SOUTHERN CALIFORNIA
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-01-01 至 2024-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9886053
• 关键词: Adult; Aftercare; Age; Anatomy; Biological Markers; Blindness; Blood Vessels; Blood capillaries; Blood flow; Caliber; Caring; Cell Survival; Cells; Classification; Clinical; Clinical assessments; Complications of Diabetes Mellitus; Data; Defect; Developed Countries; Diabetic Retinopathy; Diagnosis; Diagnostic; Early Diagnosis; Equilibrium; Evaluation; Functional disorder; Glycosylated Hemoglobin; Growth; Health Care Costs; Healthcare; Hemoglobin concentration result; Hypoxia; Image; Impairment; Individual; Knowledge; Light; Maintenance; Measurement; Measures; Metabolic; Metabolism; Methods; Monitor; Morphology; Multimodal Imaging; Optical Coherence Tomography; Oxygen; Oxygen saturation measurement; Pathology; Physiological; Population; Prevention; Preventive Intervention; Production; Public Health; Quality of life; Research Project Grants; Research Proposals; Retina; Schedule; Staging; Subgroup; Therapeutic Intervention; Thick; Time; Tissues; Treatment outcome; Vascular Endothelial Growth Factors; Vision; Visit; Visual Acuity; Visual impairment; Work; base; bevacizumab; care costs; density; diabetic; glycemic control; imaging approach; improved; indexing; innovation; macular edema; neovascularization; non-diabetic; prognostic; prospective; research study; response; retinal imaging; study population; vision development; visual processing

Abstract Diabetic retinopathy (DR) is currently the leading cause of vision loss in working age adults. With the anticipated growth of the diabetic population, the number of visually impaired diabetic people who cannot work or care for themselves will continue to be a major public health concern. Vision loss prevention due to DR requires early diagnosis, regular monitoring, and timely therapeutic intervention. Currently, the unmet clinical needs are the ability to prospectively identify which diabetic individuals will develop DR, progress to vision- threatening stages, or respond favorably to therapy. A generally recognized factor that contributes to the development of vision-threatening pathologies due to DR is retinal hypoxia, which can subsequently impair oxygen metabolism. Maintenance of oxygen metabolism is essential for energy production that is vital for cells to survive and perform visual processing. Inner retinal oxygen metabolism is maintained by the balance of inner retinal oxygen delivery and oxygen extraction fraction. Although the retinal tissue and microvasculature have been extensively studied from an anatomical perspective, there is limited information about alterations in retinal oxygen metabolic function and energy production due to DR. The research proposal will overcome this limitation by an innovative, quantitative, and comprehensive multimodal imaging approach to elucidate alterations in oxygen metabolism and defects in regulatory mechanisms that occur at progressive stages of DR, with application of treatment, and in relation to retinal capillary plexus morphology. The specific aims are to: 1) identify inner retina oxygen-metabolic metrics that are associated with stages of DR and indicative of past glycemic control; 2) determine pre-treatment inner retina oxygen-metabolic metrics that are predictive of treatment outcome; 3) elucidate associations among inner retina oxygen-metabolic metrics, capillary plexus morphology and cell layer thickness at stages of DR. The findings will broaden knowledge of DR pathophysiology, improve diagnostic and prognostic evaluation, and propel search for new preventative and therapeutic interventions. The research study can potentially transform clinical assessment of DR, thereby significantly impacting the quality of life of diabetic people and the cost of caring for visually impaired individuals.

抽象的 糖尿病视网膜病变（DR）目前是工作年龄成年人视力丧失的主要原因。随着 糖尿病人口的预期增长、无法工作的视障糖尿病患者数量 或照顾自己将继续成为主要的公共卫生问题。预防 DR 引起的视力丧失 需要早期诊断、定期监测、及时治疗干预。目前临床上尚未满足 需求是前瞻性地识别哪些糖尿病患者会出现 DR、视力进展的能力- 威胁阶段，或对治疗有良好反应。一个公认的促成因素 DR 引起的威胁视力的病变是视网膜缺氧，随后会损害视力 氧代谢。维持氧代谢对于能量产生至关重要，而能量产生对细胞至关重要 生存并进行视觉处理。视网膜内氧代谢是通过以下物质的平衡来维持的 视网膜内氧输送和氧提取分数。虽然视网膜组织和微血管系统 已经从解剖学的角度进行了广泛的研究，但有关改变的信息有限 DR 导致的视网膜氧代谢功能和能量产生。研究计划将克服这个问题 创新、定量和全面的多模态成像方法的局限性来阐明 氧代谢的改变和调节机制的缺陷发生在进展阶段 DR，与治疗的应用，以及与视网膜毛细血管丛形态的关系。具体目标是 目的：1) 确定与 DR 阶段相关的视网膜内氧代谢指标，并指示 过去的血糖控制情况； 2) 确定治疗前视网膜内氧代谢指标，以预测 治疗结果； 3）阐明视网膜内氧代谢指标、毛细血管丛之间的关联 DR 阶段的形态和细胞层厚度。研究结果将拓宽灾难恢复的知识 病理生理学，改善诊断和预后评估，并推动寻找新的预防和治疗方法 治疗干预。该研究可能会改变 DR 的临床评估，从而 显着影响糖尿病患者的生活质量和视力障碍患者的护理成本 个人。