Objective Measures of Intraocular Inflammation in Pediatric Anterior Uveitis

项目总结 前葡萄膜炎是儿童眼内炎症最常见的形式。孩子们往往会有更多 慢性病程多于成人，因此需要更频繁的检查来筛查和监测 发炎。前房(AC)炎症的临床分级，包括细胞和红斑，目前正在进行。 在裂隙灯上使用被广泛接受的葡萄膜炎命名标准(SUN)工作组 标准。然而，由于该系统是非连续的、半定量的，因此具有局限性。一场快速的， 在儿童AS中，可重复性和定量评估炎症的技术是至关重要的 他们往往无法配合裂隙灯下长时间的检查。 这份K23指导的以患者为导向的职业发展奖提案旨在评估客观 提高儿童前葡萄膜炎诊断和监测的眼内炎症措施。 该奖项将为Stein Eye Institute的葡萄膜炎专家兼助理教授Edmund Tsui博士提供 在加州大学洛杉矶分校，有受保护的研究时间和正式的课程作业 临床研究理学硕士确立自己作为以患者为中心的研究人员的地位 葡萄膜炎。这个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 设计和实施临床试验。徐博士组建了一支杰出的多学科团队 导师要确保他会实现这些目标。他的导师团队由加里·N·霍兰德博士组成 (眼科学教授、儿科葡萄膜炎专家)，斯里尼瓦斯·R·萨达博士( 眼科和眼科图像处理和分析领域的世界领先者)和Deborah K. McCurdy(儿科风湿科儿科教授，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、可重复使用的技术，使用前路- 节段式光学相干断层扫描定量AC细胞；2)利用激光纵向评价AC耀斑 耀斑光度法，以及3)基于眼内客观测量创建预测性风险分层模型 发炎。长期目标是，这些结果将支持在日常工作中使用客观措施 作为临床实践和临床试验的终点。归根结底，更早地发现和改进对 儿童葡萄膜炎可以防止永久性视力丧失和残疾。这项研究将导致提交 在K23奖项结束前授予R01奖金，使徐医生能够成为一名独立的临床科学家。

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.