Ocular Blood Flow Imaging for Glaucoma Assessment

摘要 青光眼是全球成年人失明的主要原因之一。没有一种乐器可以 所有病例的青光眼诊断都需要多种方法的结合，包括标准的自动视野检查 评估周边视力，光学相干断层扫描(OCT)评估视网膜神经纤维层(RNFL) 测量眼压(IOP)和眼底照相以评估杯盘比。RNFL的变化是 高度近视患者和既往高度近视患者的评估具有挑战性 用激光打入眼睛进行治疗。眼球后段血流(OBF)信息，如通过 我们开发的名为XyCAM RI的FDA批准的仪器具有增加与青光眼相关的洞察力的潜力 与传统方法相辅相成的地位。我们的初步结果表明 青光眼受试者和健康对照组视盘和黄斑区OBF模式的差异。我们的 目前的第二阶段项目旨在验证XyCAM RI获得的OBF指标在 通过年龄匹配、种族匹配和性别匹配的严格临床研究来处理青光眼 对照，并特别证明了OBF衍生测量在青光眼评估中的有效性 在高度近视的患者身上。我们还寻求开发并向市场推出增强型多功能眼底 名为XyCAM FC的临床相机。XyCAM FC将允许从业者可视化眼底照片 在立体声模式下评估杯盘比以及包括最具诊断相关性的OBF信息 功能。作为一项前沿技术，它用OBF动态的视频数据来补充彩色眼底图像 高时间分辨率，XyCAM FC提供执行眼底可报销程序的能力 摄影，使眼科医生或验光师能够可视化青光眼的病理生理学，并进行 以OBF为基础的眼科和系统症状病理标记物的研究进展 眼睛的血管系统。

ABSTRACT Glaucoma is one of the leading causes of blindness in adults worldwide. There is no single instrument that can diagnose glaucoma in all cases requiring a combination of methods including standard automated perimetry to assess peripheral vision, optical coherence tomography (OCT) to assess retinal nerve fiber layer (RNFL) thinning, intraocular pressure (IOP), and fundus photography to assess the cup to disc ratio. RNFL changes are challenging to assess in individuals with a high degree of myopia as well as in patients that have previously been treated with laser in the eye. Ocular blood flow (OBF) information from posterior segment, as obtained by an FDA-cleared instrument called XyCAM RI developed by us, has the potential to add insights relevant to glaucoma status that are complementary to conventional methods. Our preliminary results have demonstrated significant differences in OBF patterns in the optic disc and macular regions in glaucoma subjects and healthy controls. Our present Phase II project seeks to validate the diagnostic potential of OBF metrics obtained by XyCAM RI in the management of glaucoma through a rigorous clinical study with age-matched, race-matched, and sex-matched controls, and specifically demonstrate the usefulness of OBF-derived measurements in assessment of glaucoma in highly myopic patients. We also seek to develop and bring to market an enhanced multi-function fundus camera called the XyCAM FC for clinical use. The XyCAM FC will permit practitioners to visualize fundus photos in stereo mode to assess cup-to-disc ratio and also OBF information including the most diagnostically relevant features. As a frontier technology that complements color fundus images with video data on OBF dynamics at a high temporal resolution, the XyCAM FC offers the ability to perform reimbursable procedures of fundus photography, enable an ophthalmologist or optometrist to visualize glaucoma pathophysiology, and conduct research on development of OBF-based biomarkers for ophthalmic and systemic pathology with symptoms in the ocular vasculature.