Diagnosis and Monitoring of Glaucoma with Optical Coherence Tomography Angiography

光学相干断层扫描血管造影对青光眼的诊断和监测

• 批准号: 10615796
• 负责人: ROBERT N WEINREB
• 金额: $ 69.17万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN DIEGO
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-05-01 至 2025-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10615796
• 关键词: 3-Dimensional; Age; Angiography; Area; Artificial Intelligence; Award; Blindness; Blood Vessels; Blood capillaries; Caring; Classification; Clinical; Clinical Trials; Complex; Data; Data Set; Detection; Development; Diagnosis; Disease; Disease Progression; Dropout; Evaluation; Eye; Eye diseases; Functional disorder; Funding; Glaucoma; Global Change; Image; Individual; Institutional Review Boards; Knowledge; Laboratories; Longitudinal Studies; Machine Learning; Measurable; Measurement; Measures; Monitor; Multimodal Imaging; Open-Angle Glaucoma; Optic Disk; Optical Coherence Tomography; Patients; Productivity; Publications; Quality of life; Research; Retina; Risk; Risk Estimate; Risk Reduction; Science; Scotoma; Severity of illness; Specificity; Suspect Glaucomas; Testing; Thick; Time; Tissues; Vision; Visual Fields; Visual impairment; Visualization; age related; clinical care; clinical imaging; cohort; cost; deep learning; density; diagnostic accuracy; effective therapy; ganglion cell; imaging modality; improved; instrument; macula; multimodality; novel; novel therapeutics; predictive modeling; prevent; racial diversity; rate of change; retina blood vessel structure; retinal nerve fiber layer; statistical learning

Project Summary Optical coherence tomography angiography (OCTA) is a non-invasive, 3-dimensional imaging method to visualize and quantify microvasculature throughout the retina. The proposed study evaluates the clinical utility of OCTA measurements compared to standard structural measurements of the optic nerve head (ONH), retinal nerve fiber layer (RNFL) and macula measured using the current clinical imaging standard, spectral domain optical coherence tomography (OCT) to predict and detect progression of disease in glaucoma suspects and glaucoma patients. Our research, and that of others, has shown that superficial retinal vessel density (proportion of measured area composed of blood vessels) in the ONH region and macula is less dense in open angle glaucoma (OAG) eyes than in healthy eyes. Moreover, diagnostic accuracy is improved with increasing disease severity. Research from our laboratory suggests that the diagnostic accuracy of vessel density is similar to that of OCT-measured RNFL thickness, and that vessel density is reduced in retinal regions associated with localized visual field (VF) defects. These cross-sectional results strongly suggest that OCTA measurements reflect damage to tissues relevant to the pathophysiology of OAG. In a longitudinal study, the mean rate of change in macula vessel density was shown to be significantly faster in OAG eyes than in glaucoma suspect or healthy eyes. Finally, recent results indicate that shallow machine learning analyses of combinations of OCTA measurements can improve classification of healthy and glaucoma eyes compared to standard instrument measurements as can deep learning analyses of OCTA enface images. The current study provides a unique opportunity to extend the longitudinal OCTA data that has already been collected from 480 eyes racially diverse individuals for up to 10 years to investigate vessel density change over time in healthy, glaucoma suspect and OAG eyes, and to compare it to other imaging modalities. The aims of this study are 1) to improve our understandingof the relative change over time of OCTA and OCT measurements in healthy and diseased eyes to identify true disease-related change more accurately and 2) to improve our understanding of the risk of developing glaucomatous progression using statistical and deep learning-based analyses of multi- modal OCTA and OCT measurements. The proposed studies will enhance our understanding of age and glaucoma-related change in vessel density and retinal tissue thickness allowing us to predict and detect change more accurately, thus possibly slowing the rate of progression and consequently reducing the risk of reduction of vision related quality of life, including blindness.

项目摘要 光学相干断层造影术（八八）是一种非侵入性的3维成像方法 在整个视网膜中可视化和量化微脉管系统。拟议的研究评估了临床实用性 与视神经头（ONH）的标准结构测量相比，八八颗测量值 使用当前临床成像标准，光谱结构域测量的神经纤维层（RNFL）和黄斑 光学相干断层扫描（OCT），以预测和检测青光眼嫌疑犯和 青光眼患者。我们的研究以及其他的研究表明，表面视网膜血管密度 （由血管组成的测量区域的比例）在ONH区域和黄斑中的密度较小 角度青光眼（OAG）的眼睛比健康的眼睛中的眼睛。此外，随着增加的诊断精度而提高 疾病的严重程度。我们实验室的研究表明，血管密度的诊断准确性为 类似于OCT测量的RNFL厚度，并且在视网膜区域降低了该血管密度 与局部视野（VF）缺陷相关联。这些横截面结果强烈表明八 测量反映了与OAG病理生理学相关的组织的损害。在一项纵向研究中 在OAG眼中，黄斑血管密度的平均变化速率明显快于 青光眼可疑或健康的眼睛。最后，最近的结果表明，机器学习分析 与八八颗测量的组合可以改善健康和青光眼眼睛的分类 标准仪器测量以及对八角图图像的深度学习分析。当前的研究 提供了一个独特的机会，可以扩展从480的纵向八个数据 眼睛种族多样化的个人长达10年，以调查健康的船只密度随着时间的流逝而变化。 青光眼可疑和OAG眼睛，并将其与其他成像方式进行比较。这项研究的目的是1） 为了提高我们在健康和OCT的相对变化的理解和健康和OCT测量中的相对变化 患病的眼睛以更准确地识别与疾病相关的真正变化，2）提高我们对 使用统计和深度学习的多数分析来发展青光眼进展的风险 模态八八和OCT测量。拟议的研究将增强我们对年龄和年龄的理解 血管密度和视网膜组织厚度与青光眼相关的变化，使我们能够预测和检测 更准确地更改，因此可能会降低进展速度，从而降低 降低视力相关的生活质量，包括失明。

项目成果

Temporal Optic Disc Microvasculature Dropout in Glaucoma.

• DOI: 10.1167/iovs.64.11.6
• 发表时间: 2023-08-01
• 期刊: Investigative ophthalmology & visual science
• 影响因子: 4.4

Referenced scans improve the repeatability of optical coherence tomography angiography measurements in normal and glaucoma eyes.

• DOI: 10.1136/bjophthalmol-2020-316480
• 发表时间: 2021-11
• 期刊: BRITISH JOURNAL OF OPHTHALMOLOGY
• 影响因子: 4.1
• 作者: Rao, Harsha Laxmana;Dasari, Srilakshmi;Riyazuddin, Mohammed;Lavanya, Raghavan;Narenda, K. P.;Pradhan, Zia Sultan;Moghimi, Sasan;Mansouri, Kaweh;Webers, Carroll A. B.;Weinreb, Robert N.
• 通讯作者: Weinreb, Robert N.

Optical Microangiography and Progressive Retinal Nerve Fiber Layer Loss in Primary Open Angle Glaucoma.

• DOI: 10.1016/j.ajo.2021.07.023
• 发表时间: 2022-01
• 期刊: American journal of ophthalmology
• 影响因子: 4.2
• 作者: Rao HL;Dasari S;Puttaiah NK;Pradhan ZS;Moghimi S;Mansouri K;Webers CAB;Weinreb RN
• 通讯作者: Weinreb RN

Lamina Cribrosa and Choroid Features and Their Relationship to Stage of Pseudoexfoliation Glaucoma.

• DOI: 10.1167/iovs.18-25035
• 发表时间: 2018-11-01
• 期刊: Investigative ophthalmology & visual science
• 影响因子: 4.4
• 作者: Moghimi S;Nekoozadeh S;Motamed-Gorji N;Chen R;Fard MA;Mohammadi M;Weinreb RN
• 通讯作者: Weinreb RN

Optic nerve head vessel density in different stages of pseudoexfoliation disease.

假性剥脱性疾病不同阶段的视神经乳头血管密度。

• DOI: 10.1136/bjophthalmol-2020-317605
• 发表时间: 2022
• 期刊: The British journal of ophthalmology
• 作者: Safizadeh,Mona;Shaabani,Amirreza;Kamalipour,Alireza;Fard,MasoudAghsaei;Yeh,Kaileen;Yaseri,Mehdi;Hamzeh,Nikoo;Khatibi,Nassim;Rao,HarshaLaxmana;Weinreb,Robert;Moghimi,Sasan
• 通讯作者: Moghimi,Sasan