Blood flow and hemodynamics in glaucoma

青光眼的血流和血流动力学

• 批准号: 10701693
• 负责人: Stuart Gardiner
• 金额: $ 52.67万
• 依托单位: LEGACY EMANUEL HOSPITAL AND HEALTH CENTER
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-30 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10701693
• 关键词: Age; Angiography; Area; Axon; Blindness; Blood Pressure Monitors; Blood Vessels; Blood capillaries; Blood flow; Cell Death; Cells; Characteristics; Chronic; Clinical; Clinical Management; Diagnostic tests; Disease; Disease Progression; Eye; Eye Manifestations; Fingers; Functional disorder; Future; Glaucoma; Goals; Impairment; Individual; Lasers; Measurement; Measures; Mechanics; Metabolic; Methods; Nerve Degeneration; Optic Disk; Optical Coherence Tomography; Papillary; Pathogenesis; Patients; Perfusion; Physiologic Intraocular Pressure; Physiologic pulse; Predisposition; Primary Open Angle Glaucoma; Process; Regimen; Research; Resolution; Retina; Retinal Ganglion Cells; Risk Factors; Role; Shapes; Stress; Suspect Glaucomas; Testing; Tissues; Vasodilation; Work; blood perfusion; cell injury; cohort; density; diagnostic tool; functional loss; hemodynamics; human subject; new technology; novel diagnostics; optic nerve disorder; response; temporal measurement; theories

Project Summary / Abstract Glaucoma is a leading cause of blindness both in the US and worldwide, and is characterized by damage to and loss of retinal ganglion cells. It is known that blood flow within the optic nerve head and retina are altered in glaucomatous eyes. Flow may initially increase, but is eventually decreased in eyes with more severe glaucomatous damage. The capillary density gradually decreases as the disease progresses. There is also evidence of altered hemodynamics, in that the shape of the pulse waveform measured within the optic nerve head differs between glaucomatous and healthy eyes. However, it is not yet known whether these changes occur because axon loss has reduced the metabolic demand; or whether the changes contribute towards retinal ganglion cell damage and death; or both. This proposal will examine in detail the changes in blood flow and hemodynamics that occur at different stages of glaucoma. We will leverage new technologies to measure different aspect of the vasculature, and relate them to disease status and progression, both individually and in combination. In Aim 1, we will measure blood flow within the optic nerve head and as it passes through the peripapillary retina, both to quantify the amount of flow and to measure and quantify the pulse waveform. This will allow us to test whether the observed differences in flow in eyes that are considered glaucoma suspects are an early part of the disease process that could be measured diagnostically, and/or reflect longstanding differences that could be used to predict susceptibility to glaucoma. In Aim 2, we will also measure the systemic pulse waveform in the same individuals. This will allow us to determine whether differences in hemodynamics that could be measured diagnostically are localized to the eye due to pathophysiologic processes; and/or represent a systemic risk factor for glaucoma. In Aim 3, we will measure the area of perfused blood vessels, both in the optic nerve head and the peripapillary retina. This will allow us to determine whether flow is altered within the remaining vessels after some of the capillaries have been pruned, potentially causing further damage. Together, these aims will reveal multiple facets of the relation between vascular changes and glaucoma, and answer major questions that have remained unresolved. Overall, the project will provide substantial advances in both diagnostic tools and mechanistic understanding of glaucoma.

项目概要/摘要 青光眼是美国和世界范围内导致失明的主要原因，其特点是损伤和 视网膜神经节细胞损失。众所周知，视神经乳头和视网膜内的血流在 青光眼的眼睛。流量最初可能会增加，但在病情更严重的眼睛中最终会减少 青光眼损伤。随着疾病的进展，毛细血管密度逐渐降低。还有 血流动力学改变的证据，即视神经内测量的脉冲波形的形状 青光眼和健康眼睛之间的头部不同。但目前尚不清楚这些变化是否会发生 因为轴突损失减少了代谢需求；或者这些变化是否有助于视网膜 神经节细胞损伤和死亡；或两者兼而有之。该提案将详细检查血流量的变化和 青光眼不同阶段发生的血流动力学。我们将利用新技术来衡量 脉管系统的不同方面，并将它们与个体和个体的疾病状态和进展联系起来 组合。在目标 1 中，我们将测量视神经乳头内的血流量以及流经视神经乳头时的血流量。 视乳头周围视网膜，既可以量化流量，也可以测量和量化脉搏波形。这 将使我们能够测试被认为患有青光眼的眼睛中观察到的血流差异是否是 疾病过程的早期部分，可以进行诊断测量，和/或反映长期存在的情况 可用于预测青光眼易感性的差异。在目标 2 中，我们还将衡量系统性 同一个人的脉搏波形。这将使我们能够确定血流动力学是否存在差异 由于病理生理过程，可以诊断性测量的信息仅限于眼睛；和/或 代表青光眼的系统性危险因素。在目标 3 中，我们将测量灌注血管的面积， 在视神经乳头和视乳头周围视网膜。这将使我们能够确定流量是否在 一些毛细血管被修剪后剩余的血管，可能会造成进一步的损害。 总之，这些目标将揭示血管变化与青光眼之间关系的多个方面，以及 回答尚未解决的重大问题。总体而言，该项目将在以下方面取得重大进展： 青光眼的诊断工具和机制理解。