Adaptive Optics Imaging of Human Retinal Vascular Structure and Function

人视网膜血管结构和功能的自适应光学成像

• 批准号: 10534739
• 负责人: Stephen A Burns
• 金额: $ 46.17万
• 依托单位: TRUSTEES OF INDIANA UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-12-01 至 2024-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10534739
• 关键词: 3-Dimensional; Address; Adult; Age; Anatomy; Animal Model; Area; Biological; Biological Markers; Blindness; Blood; Blood Vessels; Blood capillaries; Blood flow; Cells; Choroid; Clinical; Clinical Pathology; Clinical Treatment; Cone; Consensus; Darkness; Data; Development; Diabetes Mellitus; Diabetic Retinopathy; Diameter; Disease; Dropout; Endothelial Cells; Endothelium; Erythrocytes; Evaluation; Failure; Future; Goals; Health; Human; Image; Imaging Techniques; Impairment; Individual; Link; Location; Maps; Measurement; Measures; Monitor; Nature; Optics; Patient imaging; Perfusion; Pericytes; Photic Stimulation; Photoreceptors; Play; Regulation; Reproducibility; Research; Resolution; Retina; Retinal Cone; Retinal Diseases; Risk; Role; Sampling Biases; Scanning; Speed; Structure; Techniques; Testing; Thick; Time; Vascular Diseases; Vascular remodeling; Visit; Visual; Work; adaptive optics; adaptive optics scanning laser ophthalmoscopy; arteriole; cellular imaging; clinically significant; diabetic; follow-up; high resolution imaging; human imaging; improved; indexing; individual patient; macular edema; neural; neurovascular coupling; novel strategies; optical imaging; response; retina blood vessel structure; retinal damage; retinal imaging; retinal ischemia; retinal neuron; routine imaging; temporal measurement; vascular abnormality; visual stimulus

Summary Diabetes and other retinal vascular diseases are a major cause of vision loss. This work builds on our measures of vascular remodeling in diabetes using adaptive optics (AO) retinal imaging. AO retinal imaging provides highly accurate and reproducible measures of both structural changes to the vascular walls of arterioles, and functional measures of blood flow and neurovascular coupling between visual stimulation and blood flow. By taking advantage of the precision of AO imaging we can make highly reproducible and accurate measurements of changes to retinal microvessels. In Aim 1 we will test the hypothesis that using a unique index of vascular wall damage which is insensitive to sampling biases can act as an index of diabetic damage. We will also generate a new measure of arteriole damage based on variability in the thickness of the vessel walls, presumably arising from endothelial and pericyte cell loss. We will then test whether these easily measured biomarkers are sensitive to local retinal ischemia, and can be used to measure progression of DR. Improving measurements in early DR is important as the clinical pathology is ultimately a consequence of these early changes. We will also test whether impaired neurovascular coupling is associated with these vascular changes. In Aim 2 we will measure early changes to the cone photoreceptors in diabetes, including both local areas of less reflective cones and regions of disordered cones and relate these changes to vascular changes. By also measuring visual sensitivity in areas with cone changes and those without we will test the hypothesis that imaging measurements can be used to understand the sensitivity changes occurring in DR. In Aim 3 we will for the first time, measure quantitative 3D flow maps of entire regions of the retinal vascular network. Flow maps include information as to where blood is flowing, velocity, size and in which direction allowing network quantification. Because the distribution of flow through a vascular network is sensitive to physical and biological constraints, flow maps will change markedly as capillary occlusion occur. By combining our state-of-the-art for retinal imaging of the vasculature with clinically available data we will continue to better understand the anatomical and functional basis for clinically observable damage. This work will advance our long term scientific goals of understanding the role that early vascular changes play in vision loss, our clinical goal of developing new approaches to identify those individuals most at risk for damage, as well as allow improved monitoring of future treatments on an individual basis.

摘要 糖尿病和其他视网膜血管疾病是导致视力丧失的主要原因。这项工作是建立在我们的 使用自适应光学(AO)视网膜成像测量糖尿病患者的血管重构。AO视网膜成像 提供对血管壁结构变化的高度准确和可重复性的测量 小动脉，以及视觉刺激和神经血管偶联之间的血流和神经血管耦合的功能测量 血液流动。通过利用声光成像的精确度，我们可以使高度的重复性和准确性 测量视网膜微血管的变化。 在目标1中，我们将检验这样一种假设，即使用唯一的血管壁损伤指数 抽样偏差可以作为糖尿病损害的一个指标。我们还将产生一种新的微动脉测量方法 根据血管壁厚度的变异性造成的损害，推测是由内皮细胞和 周细胞丢失。然后我们将测试这些容易测量的生物标志物是否对局部视网膜敏感 缺血，可以用来衡量DR的进展。改善早期DR的测量是重要的 因为临床病理最终是这些早期变化的结果。我们还将测试 神经血管偶联受损与这些血管改变有关。在目标2中，我们将提前进行测量 糖尿病患者视锥细胞光感受器的变化，包括局部锥体反射减弱区域和部分区域 并将这些变化与血管变化联系起来。通过还测量视觉敏感度 有锥体变化的区域和没有锥体变化的区域，我们将测试成像测量可以 用于了解在目标3中发生的敏感度变化，我们将首次测量 视网膜血管网络整个区域的定量3D血流图。流程图包括如下信息 血液流向、速度、大小和方向，从而实现网络量化。因为 血流通过血管网络的分布对物理和生物限制很敏感，流程图将 当发生毛细血管闭塞时发生明显变化。 通过将我们最先进的视网膜血管成像技术与临床可用的数据相结合，我们将 继续更好地了解临床可见损伤的解剖学和功能基础。这部作品 将推进我们的长期科学目标，即了解早期血管变化在视力中所起的作用 损失，我们的临床目标是开发新的方法来识别那些最有可能受到损害的人，因为 并允许在个人的基础上改进对未来治疗的监测。