Objective Measures of Intraocular Inflammation in Pediatric Anterior Uveitis

项目摘要 前葡萄膜炎是儿童眼内炎症最常见的形式。孩子们往往有更多的 慢性病程，因此需要更频繁的检查，以筛查和监测 炎症目前，对前房（AC）炎症（细胞和耀斑）进行临床分级 在裂隙灯下使用广泛接受的葡萄膜炎命名标准化（SUN）工作组 的搜索.然而，该系统具有局限性，因为它是不连续的和半定量的。一个快速， 评价炎症的可重复和定量技术在儿童中至关重要， 他们经常不能配合裂隙灯下的长时间检查。 这个K23指导的以患者为导向的职业发展奖提案旨在评估目标 眼内炎症的措施，以提高儿童前葡萄膜炎的诊断和监测。 这个奖项将提供博士埃德蒙徐，葡萄膜炎专家和助理教授在斯坦眼科研究所 在加州大学，洛杉矶，与保护的研究时间和正式的课程，以实现一个 临床研究理学硕士，以确立自己在以患者为导向的研究中的研究者地位。 葡萄膜炎该奖项将为徐博士提供支持，以实现以下目标：1）学习生物统计学 和流行病学，2）熟练掌握图像采集，处理和分析，3）了解 临床试验的设计和实施。徐博士组建了一支优秀的跨专业团队， 导师，以确保他将实现这些目标。他的导师团队由加里N.荷兰 （眼科教授和儿科葡萄膜炎专家），博士Srinivas R。Sadda（Professor of 眼科和世界领先的眼科图像处理和分析），和博士黛博拉K。 McCurdy（儿科教授，儿科风湿病学分部和儿科关节炎专家）。 我们将追求以下具体目标：1）开发一种标准化的，可重复的技术，使用前- 分段光学相干断层扫描以量化AC细胞，2）使用激光纵向评估AC耀斑 闪光光度法，和3）创建一个预测性的风险分层模型的基础上，客观措施的眼内 炎症长期目标是这些结果将支持在日常工作中使用客观措施 临床实践和临床试验中的终点。最后，早期发现和改善监测 儿童葡萄膜炎可预防永久性视力丧失和残疾。这项研究将导致提交 在K23奖项结束前获得R 01资助，使徐博士能够成为独立的临床科学家。

PROJECT SUMMARY Anterior uveitis is the most common form of intraocular inflammation in children. Children tend to have more chronic courses than adults and thus require more frequent examinations for screening and monitoring of inflammation. Clinical grading of anterior chamber (AC) inflammation, both cell and flare, is currently performed at the slit lamp utilizing the widely accepted Standardization of Uveitis Nomenclature (SUN) Working Group criteria. However, this system has limitations since it is non-continuous and semi-quantitative. A rapid, reproducible, and quantitative technique to evaluate inflammation is of paramount importance in children as they are often unable to cooperate with prolonged examination at the slit lamp. This K23 Mentored Patient-Oriented Career Development Award proposal seeks to evaluate objective measures of intraocular inflammation to improve the diagnosis and monitoring of anterior uveitis in children. This award will provide Dr. Edmund Tsui, a uveitis specialist and Assistant Professor at the Stein Eye Institute at the University of California, Los Angeles, with the protected research time and formal coursework towards a Master’s of Science in Clinical Research to establish himself as an investigator in patient-oriented research in uveitis. This award will provide Dr. Tsui with the support to achieve the following goals: 1) to learn biostatistics and epidemiology, 2) to become skilled at image acquisition, processing and analysis, 3) to learn about the design and implementation of clinical trials. Dr. Tsui has assembled an outstanding multi-disciplinary team of mentors to ensure that he will achieve these goals. His mentorship team consists of Dr. Gary N. Holland (Professor of Ophthalmology and an expert in pediatric uveitis), Dr. Srinivas R. Sadda (Professor of Ophthalmology and a world-leader in ophthalmic image processing and analysis), and Dr. Deborah K. McCurdy (Professor of Pediatrics, Division of Pediatric Rheumatology and an expert in pediatric arthritis). We will pursue the following specific aims: 1) develop a standardized, reproducible technique using anterior- segment optical coherence tomography to quantify AC cells, 2) longitudinally evaluate AC flare using laser flare photometry, and 3) create a predictive risk stratification model based on objective measures of intraocular inflammation. The long-term goal is that these results would support the use of objective measures in routine clinical practice and as endpoints in clinical trials. Ultimately, earlier detection and improved monitoring of uveitis in children can prevent permanent vision loss and disability. This research will lead to the submission of an R01 grant prior to the end of the K23 award to enable Dr. Tsui to become an independent clinician-scientist.