Neonatal Optical Coherence Tomography Angiography to Assess the Effects of Postnatal Exposures on Retinal Development and Predict Neurodevelopmental Outcomes

新生儿光学相干断层扫描血管造影评估产后暴露对视网膜发育的影响并预测神经发育结果

• 批准号: 10588086
• 负责人: Alison Chu
• 金额: $ 40.68万
• 依托单位: UNIVERSITY OF CALIFORNIA LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-07-01 至 2027-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10588086
• 关键词: 3 year old; 5 year old; Adult; Affect; Age; Alzheimer' s Disease; Anesthesia procedures; Angiography; Biological Markers; Birth; Birth Weight; Blood Vessels; Brain; Cause of Death; Child; Choroid; Cognitive; Counseling; Cystoid Macular Edema; Data; Development; Devices; Diabetic Retinopathy; Disease Progression; Early Intervention; Epidemic; Evaluation; Exposure to; Eye; Eye Development; Future; Ganglion Cell Layer; Germany; Gestational Age; Goals; Head; Image; Impairment; Infant; Inpatients; Intensive Care; Language; Lasers; Life; Lung; Magnetic Resonance Imaging; Measurement; Measures; Microscopic; Motor; Neonatal; Neurodevelopmental Impairment; Neurologic; Newborn Infant; Operative Surgical Procedures; Optical Coherence Tomography; Outcome; Oxygen; Patient Care; Patient-Focused Outcomes; Phase; Population; Predictive Value; Premature Birth; Premature Infant; Reporting; Retina; Retinopathy of Prematurity; Risk; School-Age Population; Secondary to; Severities; Testing; Thick; Thinness; Treatment Factor; Vascular Endothelial Growth Factors; Vascular blood supply; Vision; Visual; Visual Acuity; Visual impairment; Vulnerable Populations; arm; blood vessel development; cohort; comorbidity; critical period; high risk; high risk infant; improved; indexing; individualized medicine; intravitreal injection; macula; neonatal period; neonate; nervous system disorder; neurodevelopment; neuroimaging; postnatal; postnatal period; premature; preterm newborn; response; retina blood vessel structure; retinal nerve fiber layer; supplemental oxygen; tomography; treatment effect; treatment risk; ultrasound

PROJECT SUMMARY/ABSTRACT Worldwide, more than 1 in 10 babies are born premature. Prematurity is not only the leading cause of death in children under 5 years of age, but also has serious long-term consequences for those preterm infants who survive. As such, there is a growing population of infants at risk for retinopathy of prematurity (ROP), visual impairment and neurodevelopmental impairment. Understanding how the eye is altered due to preterm birth, while accounting for postnatal factors such as oxygen use and anti-vascular endothelial growth factor (anti- VEGF) treatment, is key to determining those infants at highest risk for visual and neurodevelopmental impairment. Historically, this vulnerable population has been difficult to study, as invasive testing is both difficult to perform as well as potentially harmful. Our study will utilize non-invasive eye imaging, using ocular coherence tomography and angiography (OCT/OCTA), in preterm and term infants requiring intensive care. These images will be analyzed using established measures, to identify how eye development differs in newborn infants exposed to various systemic and local treatments such as oxygen and anti-VEGF intravitreal injections. Moreover, we will identify retinal biomarkers from OCT/OCTA imaging that predict a number of key visual and development outcomes, including treatment-requiring ROP shortly after birth and visual and neurodevelopmental impairment at 2-3 years of age. Results from these studies will broaden and deepen our understanding of retinal blood vessel development in preterm infants, the eye’s response to oxygen and anti-VEGF. In addition, developing non- invasive retinal biomarkers as predictors for visual and neurodevelopmental impairment will augment identification of at-risk infants early in the postnatal period will help to initiate individualized therapies during a period of critical neurodevelopment which will optimize their long-term outcomes.

项目摘要/摘要 在全球范围内，超过十分之一的婴儿出生于早产。早产不仅是死亡的主要原因 5岁以下的儿童，但对于那些早产儿就会产生严重的长期后果 存活。因此，越来越多的婴儿人数越来越高早产（ROP），视觉 损伤和神经发育障碍。了解因早产而改变眼睛的方式， 考虑到产后因素，例如使用氧气和抗血管内皮生长因子（抗 - VEGF）治疗是确定视觉和神经发育风险最高的婴儿的关键 损害。从历史上看，这个脆弱的人群很难研究，因为侵入性测试都很困难 执行和潜在有害。我们的研究将利用眼相干性利用非侵入性眼部成像 层析成像和血管造影（OCT/OCTA），在早产儿和需要重症监护的学期婴儿中。这些图像 将使用已建立的措施分析，以确定眼睛发育在暴露的新生婴儿中的不同 进行各种系统性和局部治疗，例如氧气和抗VEGF玻璃体内注射。而且，我们会的 从OCT/OCTA成像中识别视网膜生物标志物，以预测许多关键的视觉和发展 结果，包括出生后不久的治疗征用ROP以及视觉和神经发育障碍 2-3岁。这些研究的结果将扩大和加深我们对残留血管的理解 早产儿的发育，眼睛对氧气和抗VEGF的反应。此外，开发非 - 侵入性的视网膜生物标志物作为视觉和神经发育障碍的预测因子将增加 鉴定出生后早期的处于危险婴儿将有助于启动个性化疗法 关键神经发育的时期将优化其长期结局。