Spatial Extent of Retinal Damage

描述(申请人提供)：视网膜和脉络膜损伤的空间范围将通过非侵入性的、定量的视觉功能和结构映射来探测。我们将继续研究衰老变化和疾病过程之间的区别，特别是年龄相关性黄斑变性(AMD)。目标是确定患者丧失视力的原因，并确定可以接受治疗以挽救视力的因素。长期目标涉及1999-2003年NEI国家计划的三个主要目标：提供早期诊断，探索AMD的病理生理异质性，并制定有效的眼病筛查策略。老龄化是一个重要的跨领域问题。这项研究包括随着年龄增长的重要辅助因素：动脉粥样硬化性疾病、青光眼和II型糖尿病。此外，我们的纵向数据表明，被认为是视网膜内异常的视网膜前膜是我们AMD患者的重要临床实体。我们计划进行与临床相关的研究以实现这一目标，包括正在进行的横断面和纵向研究。我们将使用独特、快速和抗杂散光的先进成像方法。为了研究活人的光感受器功能，我们将开发新的方法来测量以前无法研究的患者或视网膜区域的视锥和视杆内的光色素。为了研究光感受器下的支持细胞-视网膜色素上皮细胞的损害，我们将主要使用舒适且几乎不可见的近红外光技术。即使在中度白内障和出血的情况下，也能看到这些。我们将把成像技术与新的图像处理方法结合起来。我们将在几个新的组中研究视力丧失的机制，其中一些会加剧可能在视力丧失中起重要作用的因素，或改变疾病中的视网膜微环境。我们将在我们的研究中包括视力丧失的高风险群体，以及少数群体，他们在许多其他研究中被排除在外，但代表着临床管理问题。具体地说，衰老的影响将与单独的年龄相关性黄斑变性以及在这个年龄段常见的疾病：动脉粥样硬化性心血管疾病、青光眼和Il型糖尿病的存在进行比较。心血管研究包括康复前后的测量。这些组中玻璃体、新生血管膜、视网膜血管改变和未发现的水肿的空间范围和分布是可以用于评估可能的预防措施、确定治疗的局部效果和估计预后的信息。

DESCRIPTION (provided by applicant): The spatial extent of retinal and choroidal damage will be probed with noninvasive, quantitative mapping of visual function and structure. We will continue to study the distinction between aging changes and disease processes, particularly for age-related macular degeneration (AMD). The goal is to determine why patients lose vision and to identify factors that are amenable to treatment to save vision. The long-term goals address three main thrusts of the NEI National Plan, 1999-2003: to provide early diagnosis, explore the pathophysiological heterogeneity of AMD, and develop effective strategies for screening for eye disease. Aging is an important cross-cutting issue. This study includes important co-factors that increase with age: atherosclerotic disease, glaucoma, and Type II diabetes. Further, our longitudinal data indicate that epiretinal membranes, considered an inner retinal abnormality, are an important clinical entity in our AMD patients. We plan studies with clinical relevance to reach this goal, including both on-going cross-sectional and longitudinal studies.We will use advanced imaging methods that are unique, rapid, and resistant to stray light. To investigate photoreceptor function in living humans, we will develop new methods that will measure the photopigment within cones and rods in patients or regions of the retina not amenable to study previously.To investigate the damage to support cells beneath the photoreceptors, the retinal pigment epithelial cells, we will use techniques primarily with near infrared light that is comfortable and virtually invisible. These are visible even through moderate cataract and hemorrhage. We will combine imaging techniques with novel methods of image processing. We will investigate the mechanisms of vision loss in several new groups, some of which exacerbate factors that may be important in vision loss, or change the retinal microenvironment in disease. We will include groups in our studies that are at high risk for vision loss, and minority groups, who have been excluded in many other studies but represent clinical management problems. Specifically, the effects of aging will be compared with age-related macular degeneration alone and in the presence of disease commonly found in this age group: atherosclerotic cardiovascular disease, glaucoma, and type Il diabetes. The cardiovascular study includes measuring before and after rehabilitation. The spatial extent and distribution of drusen, new vessel membranes, retinal vascular changes, and undetected edema in these groups is information that can used for evaluating possible preventative measures, determining the focal effects of treatment, estimating prognosis.