Novel Glaucoma Diagnostics for Structure and Function

新型青光眼结构和功能诊断

• 批准号: 9542334
• 负责人: Joel S Schuman
• 金额: $ 64.9万
• 依托单位: NEW YORK UNIVERSITY SCHOOL OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-09-10 至 2019-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9542334
• 关键词: Acute; Algorithms; Asses; Axon; Biomechanics; Birefringence; Blindness; Boston; Comorbidity; Computer software; Data; Detection; Development; Diagnosis; Diagnostic; Diagnostic Procedure; Differential Equation; Dimensions; Discrimination; Disease; Disease Progression; Enrollment; Evaluation; Exclusion Criteria; Eye; Functional disorder; Funding; Future; Generations; Glaucoma; Goals; Image; Image Analysis; Imagery; Imaging Device; Imaging technology; Individual; Intervention; Knowledge; Longitudinal cohort; Manufacturer Name; Measurement; Measures; Methods; Microtubules; Modeling; Morbidity - disease rate; Morphology; Optic Disk; Optical Coherence Tomography; Outcome; Outcomes Research; Patients; Performance; Prevention; Process; Property; Research Project Grants; Retina; Retinal; Risk; Sample Size; Scanning; Sclera; Signal Transduction; Software Tools; Source; Structure; Structure-Activity Relationship; Suspect Glaucomas; Synapses; System; Technology; Testing; Thick; Time; Tissues; Validity and Reliability; Visual; adaptive optics; analytical method; analytical tool; clinically relevant; cohort; design; follow-up; image reconstruction; imaging modality; improved; in vivo; innovation; innovative technologies; markov model; novel; novel diagnostics; ocular imaging; prevent; public health relevance; relating to nervous system; research clinical testing; response; retinal imaging; retinal nerve fiber layer; tool; translational impact; two-dimensional

DESCRIPTION (provided by applicant): Glaucoma is a leading cause of blindness and visual morbidity. Because the disease causes irreversible damage to neural tissue it is of upmost importance to identify glaucoma and its progression at the earliest possible stages. Through advancements in the use of optical coherence tomography (OCT) and other technologies, the long-term goal of this research project is to precisely and accurately detect ocular structural and functional changes associated with glaucoma and to identify eyes with glaucoma that are at risk for future disease progression. This is accomplished by consolidating our long-term data acquired from various generations of OCT technology over the last 19 years. By using innovative methods for image quality improvement along with signal morphing, it is now possible to reliably bridge data acquired by the different generations and manufacturers of OCT, creating the longest-term cohort of longitudinal OCT measurements of the retina and optic nerve head regions. Advanced retinal segmentation software will be applied enabling detailed discrimination of all retinal layers even in the presence of ocular co-morbidity coincident with glaucoma (a previous exclusion criteria), allowing maximal use of subject and patient data. Using this cohort, two methods will be uniquely applied for determining the long-term relationship between structure and function: Continuous-time hidden Markov model and Latent differential equation models. This would enhance understanding of the disease process and allow determination of the best methods to identify disease and its progression at various stages. We will utilize advanced innovative imaging technologies and methods to accurately and precisely detect evidence of early structural changes: Swept-source OCT, Adaptive-optics OCT and Polarization-sensitive OCT. These technologies will be used to image the retina, sclera and optic nerve head providing enhanced information of the lamina cribrosa and birefringence properties. Scans will be also acquired during and following provocative acute IOP elevation testing to asses the morphological and biomechanical responses as potential markers for current and future disease characterization. The outcomes of this research project will provide an innovative and enhanced evaluation of ocular structure and function in glaucoma that will expand our understanding of the disease pathophysiology, offer new diagnostic tools for early disease detection and disease progression and identify subjects at risk for rapid glaucoma progression.

描述（由申请人提供）：青光眼是失明和视觉发病率的主要原因。由于该疾病会对神经组织造成不可逆转的损害，因此最早识别青光眼及其进展至关重要。通过在使用光学相干断层扫描（OCT）和其他技术方面的进步，该研究项目的长期目标是精确，准确地检测眼睛结构和 与青光眼相关的功能变化，并确定有青光眼的眼睛，这是有未来疾病进展的风险。这是通过合并过去19年中从各个世代的OCT技术中获得的长期数据来完成的。通过使用创新的方法进行图像质量改进以及信号变形，现在可以可靠地可靠地由OCT的不同世代和制造商获得的桥梁数据，从而创建了视网膜和视神经头部区域的纵向OCT测量最长的同类。即使在眼科合并的存在与青光眼（以前的排除标准）的情况下，也将应用所有视网膜层的详细歧视，从而实现高级视网膜分割软件（以前的排除标准），从而最大程度地使用了受试者和患者数据，就可以应用所有视网膜层的详细歧视。使用此队列，将唯一应用两种方法来确定结构和功能之间的长期关系：连续时间隐藏的马尔可夫模型和潜在的微分方程模型。这将增强对疾病过程的理解，并允许确定在各个阶段鉴定疾病及其进展的最佳方法。 我们将利用先进的创新成像技术和方法来准确，精确地检测出早期结构变化的证据：扫描源OCT，自适应 - 启示OCT OCT和对极化敏感的OCT。这些技术将用于成像视网膜，巩膜和视神经头，从而提供了增强的lamina cribrosa和Birefringence特性的信息。扫描还将在挑衅性的急性IOP升高测试期间和之后进行，以评估形态和生物力学反应，作为当前和未来疾病表征的潜在标记。 该研究项目的结果将提供对青光眼中眼结构和功能的创新和增强的评估，这将扩大我们对疾病病理生理学的理解，为早期疾病检测和疾病进展提供新的诊断工具，并确定有快速青光瘤进展的风险的受试者。