Functional and Structural Optical Coherence Tomography for Glaucoma

青光眼的功能性和结构性光学相干断层扫描

• 批准号: 9130226
• 负责人: David Huang
• 金额: $ 74.83万
• 依托单位: OREGON HEALTH & SCIENCE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-09-30 至 2017-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9130226
• 关键词: 3-Dimensional; Algorithms; Anatomy; Angiography; Applications Grants; Arteries; Automation; Biomedical Engineering; Blindness; Blood Circulation; Blood Vessels; Blood flow; Clinical; Clinical Research; Collaborations; Complex; Computer software; Detection; Diagnosis; Diagnostic; Disease; Disease Progression; Dyes; Early Diagnosis; Evaluation; Eye; Fiber; Financial compensation; Functional Imaging; Functional disorder; Glaucoma; Goals; Health; Human; Image; Imaging technology; Injection of therapeutic agent; Institutes; Lasers; Massachusetts; Measurement; Measures; Medical; Methods; Microcirculation; Monitor; Motion; Nerve; Nerve Fibers; Observational Study; Operative Surgical Procedures; Ophthalmoscopy; Optic Disk; Optical Coherence Tomography; Outcome; Pathway interactions; Patients; Pattern; Perfusion; Pharmaceutical Preparations; Photography; Physiologic Intraocular Pressure; Play; Reproducibility; Research; Research Project Grants; Resolution; Retina; Retinal; Retinal Ganglion Cells; Risk; Role; Safety; Scanning; Source; Speed; Structure; Structure of central vein of the retina; Suspect Glaucomas; System; Techniques; Technology; Testing; Time; Trabeculectomy; Veins; Visual Fields; Work; base; blood flow measurement; central retinal artery; clinical practice; cost; diagnostic accuracy; field study; ganglion cell; high risk; imaging modality; improved; insight; instrument; macula; next generation; novel; optic nerve disorder; prognostic; prototype; quantitative imaging; relating to nervous system; screening; tool; vascular bed; vascular factor

DESCRIPTION (provided by applicant): Glaucoma is a leading cause of blindness. Early diagnosis and close monitoring of glaucoma are important because the onset is insidious and the damage is irreversible. Advanced imaging modalities such as optical coherence tomography (OCT) have been used in the past 2 decades to improve the objective evaluation of glaucoma. OCT has higher axial spatial resolution than other posterior eye imaging modalities, and it has relatively good diagnostic accuracy and reproducibility in the measurement of neural structures damaged by glaucoma. However, the measurement of structure alone, with any imaging modality, has limited sensitivity for detecting early glaucoma and only moderate correlation with visual field (VF) loss. Using high-speed OCT systems, we have developed new methods to image and measure optic nerve head (ONH) and retinal blood flow. Preliminary results showed that VF loss was more highly correlated with retinal blood flow as measured by OCT than any neural structure measured by OCT or other imaging modality. Accordingly, the goal of the proposed project is to improve the diagnostic and prognostic evaluation of glaucoma by further developing novel functional OCT measurements using ultrahigh-speed (70-100 kHz) OCT technology. The specific aims are: 1. Improve Doppler OCT measurement of retinal blood flow. Multi-circular scans of peripapillary retinal arteries and veins measure total retinal blood flow i 2 seconds. The use of faster OCT systems will allow automated measurement with improved reproducibility. 2. Develop quantitative OCT angiography of the ONH. Three dimensional (3D) OCT angiography has been made practical (3x3 mm scan in 3 seconds) by a novel split-spectrum amplitude-decorrelation algorithm. Preliminary results showed dramatic loss of ONH microcirculation in early glaucoma. Algorithmic improvement in angiography, segmentation, quantification, and automation are planned. 3. Measure nerve structure from the ONH to retinal ganglion cells. By registering several volumetric scans, we have demonstrated complete 3D characterization of the retinal fiber pathway from the ONH to the macula. Fully automated quantification of these structures will be developed. 4. Evaluate advanced OCT technologies in clinical studies. The utility of functional and structural OCT in glaucoma will be evaluated in a longitudinal observational study of 150 glaucoma and healthy subjects. The effect of IOP-lowering surgery on blood flow will be studied in 40 subjects. Retinal blood flow, ONH circulation, optic disc rim volume, peripapillary nerve fiber layer volume, and macular ganglion cell complex volume are all pieces of the same glaucoma puzzle. This project will develop novel imaging methods that allow us to look at the whole picture using one tool - ultrahigh-speed OCT.

描述（由申请人提供）：青光眼是失明的主要原因。青光眼的早期诊断和密切监测很重要，因为发作是阴险的，损害是不可逆的。在过去的20年中，已经使用了高级成像模态（例如光学相干断层扫描（OCT））来改善青光眼的客观评估。 OCT的轴向空间分辨率高于其他后眼成像方式，并且在测量青光眼受损的神经结构中，它具有相对较好的诊断准确性和可重复性。然而，单独的结构测量，具有任何成像方式，对检测早期青光眼的敏感性有限，并且仅与视野损失（VF）中等相关性。使用高速OCT系统，我们开发了新方法来图像和测量视神经头（ONH）和视网膜血流。初步结果表明，通过OCT测量的VF损失与视网膜血流高度高于OCT或其他成像方式测得的任何神经结构。因此，拟议项目的目的是通过进一步使用Ultrahigh-Speed（70-100 kHz）OCT技术开发新型的功能性OCT测量来改善青光眼的诊断和预后评估。具体目的是：1。改善视网膜血流的多普勒OCT测量。周围视网膜动脉和静脉的多圆形扫描测量了视网膜血流I 2秒。更快的OCT系统的使用将允许自动测量，并提高可重复性。 2。开发ONH的定量OCT血管造影。通过新型的偏谱振幅 - 与 - 授权算法，已经使三维（3D）OCT血管造影（在3秒内扫描3x3 mM扫描）。初步结果显示早期青光眼中ONH微循环的巨大丧失。计划了血管造影，分割，定量和自动化的算法改进。 3。测量从ONH到视网膜神经节细胞的神经结构。通过记录几次体积扫描，我们已经证明了从ONH到黄斑的视网膜纤维途径的完整3D表征。将开发这些结构的完全自动量化。 4。评估临床研究中的高级OCT技术。在150名青光眼和健康受试者的纵向观察研究中，将评估功能和结构OCT在青光眼中的实用性。将在40名受试者中研究降低IOP手术对血流的影响。视网膜血流，ONH循环，视盘边缘体积，围绕乳头神经纤维层的体积和黄斑神经节细胞复合体积都是相同的青光眼拼图的所有部分。该项目将开发新的成像方法，使我们可以使用一种工具 - 超高速度OCT来查看整个图片。