Noninvasive ultrasound vibro-elastography for assessing ocular disorders

用于评估眼部疾病的无创超声振动弹性成像

• 批准号: 10436142
• 负责人: John Jing-Wei Chen
• 金额: $ 47.03万
• 依托单位: MAYO CLINIC ROCHESTER
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-07-01 至 2025-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10436142
• 关键词: Affect; Aftercare; Age; Back; Bilateral; Biomechanics; Blindness; Characteristics; Clinic; Clinical; Contralateral; Cornea; Data; Development; Diagnosis; Disease; Elasticity; Enrollment; Eye; Funding; Gender; Glaucoma; Grant; Individual; Intracranial Hypertension; Knowledge; Measurement; Measures; Mechanics; Medical; Methods; Modeling; Modification; Normal Range; Operative Surgical Procedures; Optic Disk; Optic Nerve; Outcome; Papilledema; Pathogenesis; Patients; Physiologic Intraocular Pressure; Pilot Projects; Property; Pseudotumor Cerebri; Research; Resolution; Risk; Risk Factors; Role; Sclera; Severities; Speed; Swelling; Techniques; Tissues; Viscosity; base; biomechanical test; clinical biomarkers; cohort; disorder risk; elastography; in vivo; new therapeutic target; novel; optic nerve disorder; pressure; recruit; risk stratification; ultrasound; viscoelasticity

PROJECT ABSTRACT Our understanding of the role of ocular biomechanical properties, such as elasticity and viscosity, is incomplete as there are no clinical methods for their in vivo clinical measurement. We propose to develop and refine a novel noninvasive ultrasound vibro-elastography (USVE) technique to measure viscoelastic properties of ocular tissues, and use the technique to assess two diseases, glaucoma and papilledema. We recently completed a R21 grant, evaluating USVE for assessing glaucoma. Glaucoma is the second leading cause of blindness in the US and worldwide, and the only available treatment is reduction of intraocular pressure (IOP). Our pilot study found significant differences in wave speed in the posterior sclera between glaucomatous and normal eyes. In another pilot project, we evaluated USVE in papilledema patients. Papilledema is optic nerve swelling, caused by increased intracranial pressure, and can cause significant vision loss. Papilledema from idiopathic intracranial hypertension (IIH) is typically bilateral and symmetric but can sometimes be asymmetric and even unilateral. We found that wave speeds in the posterior sclera of IIH patients were significantly higher than healthy subjects. In addition, wave speeds in patients with unilateral papilledema were significantly higher in affected eyes, compared with unaffected contralateral eyes. Both diseases depend on the biomechanics of ocular tissues including the posterior sclera surrounding the optic nerve head. However, they are on opposite ends of the spectrum where the deformation of the lamina cribrosa is back bowing in glaucoma and forward bowing in papilledema. Studying both diseases will help us to better understand the role of ocular tissue properties in disease risk and development, and the basic viscoelastic characteristics of the eye. In Aim 1, we will develop and refine USVE for measuring ocular viscoelastic properties. We will study various wave models in ocular tissues and develop advanced viscoelastic models to analyze ocular tissue’s elasticity and viscosity based on the wave speed dispersion measurements. In Aim 2, we will develop and refine USVE for assessing 50 patients with normal tension glaucoma (NTG) – glaucoma occurring at normal intraocular pressure – and 50 healthy control subjects. Since ocular biomechanical properties will be related to IOP, recruitment of NTG patients will allow comparison with IOP matched controls. In Aim 3, we will develop and refine USVE for assessing patients with papilledema. We will enroll a large cohort of 50 patients with papilledema from IIH and compare them with 50 age- and gender- matched healthy control subjects. We will study the changes of USVE measurements at baseline and after resolution of papilledema after treatment. Successful accomplishment of this project will provide fundamental knowledge about the role of ocular tissue biomechanical properties in glaucoma and papilledema. USVE may have the ability to stratify the risk of glaucomatous damage and the propensity toward the development of papilledema and vision loss, and identify novel targets for therapy.

项目摘要 我们对眼生物力学特性的作用的理解，如弹性和粘性，是不完整的 因为没有用于其体内临床测量的临床方法。我们建议制定和完善一个 一种新的非侵入性超声振动弹性成像（USVE）技术，用于测量 眼组织，并使用该技术来评估两种疾病，青光眼和视神经乳头水肿。我们最近 完成了R21赠款，评估USVE评估青光眼。青光眼是导致青光眼的第二大原因。 在美国和世界范围内，失明是唯一可用的治疗方法是降低眼内压（IOP）。 我们的初步研究发现，青光眼和青光眼后巩膜的波速度有显著差异。 正常的眼睛在另一个试点项目中，我们评估了视神经乳头水肿患者的USVE。视神经乳头水肿 肿胀，由颅内压增加引起，并可导致严重的视力丧失。乳头水肿， 特发性颅内高压（IIH）通常是双侧对称的，但有时也可能是不对称的 甚至是单方面的。我们发现IIH患者后巩膜的波速度明显高于 比健康的人。此外，单侧视神经乳头水肿患者的波速度明显高于 患眼与未受影响的对侧眼相比。这两种疾病都依赖于 包括围绕视神经乳头的后巩膜的眼组织。然而，他们在相反的 筛板的变形在青光眼中是向后弯曲，在青光眼中是向前弯曲， 视神经乳头水肿研究这两种疾病将有助于我们更好地了解眼组织的作用 在疾病风险和发展中的特性，以及眼睛的基本粘弹性特征。目标1： 将开发和完善USVE用于测量眼粘弹性。我们将研究各种波浪模型 并建立了先进的粘弹性模型来分析眼组织的弹性和粘性 基于波速分散测量。在目标2中，我们将开发和完善USVE，以评估 50例正常眼压性青光眼（NTG）患者-在正常眼内压下发生的青光眼-和50例 健康对照组。由于眼部生物力学特性将与IOP相关，因此NTG的募集 患者将允许与IOP匹配的对照进行比较。在目标3中，我们将开发和完善USVE， 评估视神经乳头水肿的患者。我们将从IIH招募50例视乳头水肿患者， 将他们与50名年龄和性别相匹配的健康对照组进行比较。我们将研究USVE的变化 基线时和治疗后视神经乳头水肿消退后的测量值。成功完成 该项目将提供有关眼组织生物力学特性在 青光眼和视神经乳头水肿。USVE可能有能力对昏迷性损伤的风险进行分层， 倾向于发展的视乳头水肿和视力丧失，并确定新的治疗目标。