RISK FACTORS FOR PERSISTENT MACULAR EDEMA POST TREATMENT

描述：（申请人的摘要）糖尿病性黄斑水肿，或增厚的 视网膜是美国工作年龄段视力丧失的常见原因。的 糖尿病早期治疗视网膜病变研究（ETDRS）表明，视力可以 通过对增厚的区域迅速应用激光光凝来保存 视网膜。然而，尽管激光治疗临床上显著的黄斑病变， 水肿已被证明可以降低视力丧失的风险，但它不会 防止所有接受治疗的患者视力丧失。只有50%的风险降低， 在ETDRS中观察到由于快速光凝导致的视力丧失。的 国家眼科研究所（NEI），在其视觉研究：一个国家计划 1999-2003年，对糖尿病的发病机制有了明确的认识 视网膜病变与糖尿病治疗策略的发展 视网膜病变作为项目目标。利用我们独特的技术， NEI的支持，用于测量后部的视网膜厚度 客观而准确地，我们收集了个人的详细数据， 临床上显著的黄斑水肿。这些数据包括客观衡量的 激光治疗前后视网膜厚度图。另外我们 已收集数据以记录治疗点的位置，并已 立体眼底照片的视网膜病理学的详细分级。我们 建议扩大在前一份报告的支持下进行的分析， 授权并对这些数据进行图像处理， 激光治疗的位置、病理学和客观测量的视网膜 处理前后的厚度。描述区域的参数 视网膜显著增厚，治疗后视网膜厚度变化， 并且将导出距治疗点的距离和视网膜病变。 视网膜病变持续或恶化危险因素的统计分析 厚度将进行，使用的方法，考虑到空间 这些地图关联数据的相关性。这些分析将有助于确定 影响黄斑激光治疗良好结果的因素 水肿，并可能提出改变治疗策略的假设， 在未来的研究中测试。

DESCRIPTION: (Applicant's Abstract) Diabetic macular edema, or thickening of the retina, is a common cause of visual loss in working age Americans. The Early Treatment Diabetic. Retinopathy Study (ETDRS) showed that vision can be preserved by prompt application of laser photocoagulation to areas of thickened retina. However, although laser treatment for clinically significant macular edema has been demonstrated to reduce the risk of visual loss, it does not prevent visual loss in all treated patients. Only a 50% reduction in risk of visual loss as a result of prompt photocoagulation was seen in the ETDRS. The National Eye Institute (NEI), in its Vision Research: a National Plan 1999-2003, has identified the understanding of the pathogenesis of diabetic retinopathy and development of strategies for improved treatment of diabetic retinopathy as program objectives. Using our unique technology, developed under the auspices of the NEI, for measuring the retinal thickness at the posterior pole objectively and precisely, we collected detailed data on individuals with clinically significant macular edema. These data include objectively measured pre- and post-laser treatment maps of the retinal thickness. In addition, we have collected data to document the location of treatment spots and have detailed gradings of retinal pathology from stereo fundus photographs. We propose to extend the analysis performed under the support of the previous grant and subject these data to image processing to link the information on location of laser treatment, pathology, and objectively measured retinal thickness before and after treatment. Parameters to describe areas of significantly thickened retina, changes in retinal thickness after treatment, and distance from treatment spots and retinal pathology will be derived. Statistical analysis of risk factors for persistent or worsening of retinal thickness will be carried out, using methods to take into account the spatial correlation of these map-linked data. These analyses will help to identify factors contributing to favorable outcomes of laser treatment for macular edema, and may suggest hypotheses for altering treatment strategies that can be tested in future studies.