Diagnostic Innovations in Glaucoma:Structural Assessment

青光眼诊断创新：结构评估

• 批准号: 7232301
• 负责人: LINDA M ZANGWILL
• 金额: $ 57.73万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN DIEGO
• 依托单位国家: 美国
• 财政年份: 1995
• 资助国家: 美国
• 起止时间: 1995-04-01 至 2011-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7232301
• 关键词: Address; African American; American; Characteristics; Clinical; Clinical Trials; Cohort Studies; Collaborations; Complex; Data; Data Set; Demographic Analyses; Detection; Development; Diagnosis; Diagnostic; Disease; Disease Progression; Documentation; End Point; Engineering; Eye; Funding; Germany; Glaucoma; Goals; Histopathology; Image; Imaging Techniques; Informatics; Lasers; Longitudinal Studies; Measurement; Measures; Medical; Methods; Monitor; National Eye Institute; Nerve Fibers; Ophthalmoscopy; Optic Disk; Optical Coherence Tomography; Participant; Patients; Pattern; Photography; Progress Reports; Protocols documentation; Publications; Race; Rate; Reproducibility; Research; Retina; Retinal; Scanning; Severities; Staging; Structure; Structure-Activity Relationship; Techniques; Testing; Time; Treatment Effectiveness; Vision; Visual Fields; base; diagnostic accuracy; follow-up; functional loss; improved; innovation; instrument; instrumentation; legally blind; novel; optic nerve disorder; optical imaging; polarimetry; prevent; programs; research study; retinal nerve fiber layer; stereophotography

DESCRIPTION: It is estimated that over 2.2 millions American have glaucoma and that over 130,000 are legally blind from the disease. Early, accurate diagnosis and treatment is important to prevent the progression of the disease, and loss of visual function. The National Eye Institute National Plan program objectives highlight the need to "develop improved diagnostic measures to detect optic nerve disease, progression and treatment effectiveness". The Diagnostic Innovation in Glaucoma Study (DIGS): Structural Assessment proposes to continue the longitudinal study initiated in 1995 to develop novel methods to diagnose and monitor glaucomatous changes of the optic disc and retinal nerve fiber layer (RNFL) with the most promising new optical imaging instruments: confocal scanning laser ophthalmoscopy (CSLO), scanning laser polarimetry (SLP) and optical coherence tomography (OCT). To date, this study has determined the reproducibility and diagnostic accuracy of these new techniques and has led to significant improvements in our ability to detect glaucoma. The objectives of the current proposal are to develop improved methods to 1) detect the progression of structural damage due to glaucoma, and 2) measure the rate of glaucomatous progression and its determinants, and 3) characterize the complex relationship between structural and functional change over time. Methods: This study will include at least 600 glaucoma patients and 250 healthy controls. At the end of the proposed study, over 300 patients will have >5 years of follow-up on each technique. Each subject will complete an ophthalmologic and visual field exam every 6 months. In addition, CSLO and OCT images will be obtained to measure the optic disc and, SLP and OCT images to measure the RNFL. Photographic documentation of optic disc and RNFL changes also will be evaluated and compared to the imaging techniques. This study will provide important longitudinal data to identify the most sensitive and specific methods for detecting glaucomatous changes over time. Significance: Study of this cohort will improve our ability to monitor glaucomatous change over time in clinical practice and enhance our ability to utilize structural changes of the optic disc and retinal nerve fiber layer as endpoints in clinical trials

描述：据估计，超过220万美国人患有青光眼，其中超过13万人因该疾病而法定失明。早期，准确的诊断和治疗对于预防疾病的进展和视觉功能的丧失至关重要。国家眼科研究所国家计划方案的目标强调需要“制定改进的诊断措施，以检测视神经疾病、进展和治疗效果”。青光眼的诊断创新研究（DIGS）：结构评估建议继续1995年开始的纵向研究，发展新的方法来诊断和监测视盘和视网膜神经纤维层（RNFL）的变化，使用最有前途的新型光学成像仪器：共聚焦扫描激光眼底镜（CSLO），扫描激光偏振仪（SLP）和光学相干断层扫描（OCT）。迄今为止，这项研究已经确定了这些新技术的可重复性和诊断准确性，并显著提高了我们检测青光眼的能力。本研究的目标是发展改进的方法，以1)检测青光眼结构损伤的进展，2)测量青光眼进展的速度及其决定因素，以及3)表征结构和功能变化之间的复杂关系。方法：本研究将包括至少600名青光眼患者和250名健康对照者。在研究结束时，300多名患者将对每种技术进行50 - 5年的随访。每位受试者每6个月完成一次眼科和视野检查。此外，将获得CSLO和OCT图像来测量视盘，SLP和OCT图像来测量RNFL。视盘和RNFL变化的摄影记录也将被评估并与成像技术进行比较。这项研究将提供重要的纵向数据，以确定最敏感和具体的方法来检测青光眼随时间的变化。意义：该队列的研究将提高我们在临床实践中监测青光眼随时间变化的能力，并增强我们在临床试验中利用视盘和视网膜神经纤维层结构变化作为终点的能力