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.

项目概要/摘要 在世界范围内，超过十分之一的婴儿早产，这不仅是导致死亡的主要原因。 5 岁以下儿童，而且还会对那些早产儿产生严重的长期后果 因此，越来越多的婴儿面临早产儿视网膜病变 (ROP)、视力障碍的风险。 了解早产如何导致眼睛损伤和神经发育障碍， 同时考虑产后因素，例如氧气使用和抗血管内皮生长因子（抗血管内皮生长因子） VEGF）治疗是确定视觉和神经发育风险最高的婴儿的关键 从历史上看，这一弱势群体一直很难研究，因为侵入性检测都很困难。 我们的研究将利用眼相干性的非侵入性眼部成像来进行研究。 对需要重症监护的早产儿和足月儿进行断层扫描和血管造影 (OCT/OCTA) 这些图像。 将使用既定措施进行分析，以确定暴露的新生儿眼睛发育有何不同 此外，我们还会进行各种全身和局部治疗，例如吸氧和抗 VEGF 玻璃体内注射。 从 OCT/OCTA 成像中识别预测许多关键视觉和发育的视网膜生物标志物 结果，包括出生后不久需要治疗的 ROP 以及视力和神经发育障碍 这些研究的结果将拓宽和加深我们对 2-3 岁视网膜血管的了解。 早产儿的发育，眼睛对氧气和抗 VEGF 的反应，此外，还影响非生长发育。 作为视觉和神经发育障碍预测因子的侵入性视网膜生物标志物将增强 在产后早期识别高危婴儿将有助于在出生期间启动个体化治疗。 神经发育的关键时期，这将优化他们的长期结果。