Characterization of Exudative Macular Degeneration and Diabetic Retinopathy Using

使用渗出性黄斑变性和糖尿病视网膜病变的表征

• 批准号: 8002119
• 负责人: SCOTT E FRASER
• 金额: $ 15.39万
• 依托单位: VISDEX CORPORATION
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-09-30 至 2012-06-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8002119
• 关键词: Age related macular degeneration; Algorithms; Area; Automation; Blindness; Blood; Blood Vessels; Blood capillaries; Central Vein; Choroidal Neovascularization; Clinical; Computer software; Data; Data Analyses; Data Set; Detection; Development; Diabetic Retinopathy; Diagnosis; Diagnostic; Diagnostic Procedure; Diagnostic tests; Disease; Dyes; Early Diagnosis; Evaluation; Excision; Extravasation; Eye; Fluorescein; Fluorescein Angiography; Fluoresceins; Fluorescent Dyes; Fundus photography; Goals; Gold; Head; Histologic; Image; Image Analysis; Imagery; Imaging Techniques; Lead; Lesion; Macular degeneration; Maps; Marketing; Methods; Morphologic artifacts; Morphology; Motion; Newly Diagnosed; Noise; Ophthalmologist; Optical Coherence Tomography; Pathologic; Patients; Perfusion; Phase; Protocols documentation; Research; Resolution; Retina; Retinal; Retinal Vein Occlusion; Risk; Scanning; Screening procedure; Secondary to; Speed; Stream; Structure; System; Techniques; Three-Dimensional Imaging; Time; Variant; Vision; Work; base; capillary; capillary bed; data acquisition; dehydroretinal; design; disorder of macula of retina; imaging modality; improved; instrument; intravenous injection; processing speed; public health relevance; retina blood vessel structure; tool; vein occlusion

DESCRIPTION (provided by applicant): Since its first use in the retina in 1961, fluorescein angiography (FA) has been the gold standard for objective characterization of retinovascular disease (e.g. diabetic retinopathy, retinal vein occlusions, and choroidal neovascularization associated with age-related macular degeneration (AMD)). Despite its widespread use, FA is costly, invasive, and time consuming, limiting the usefulness as a screening tool. Optical coherence tomography (OCT) and its faster variation called spectral domain OCT (SDOCT) are interferometric imaging techniques which allow three-dimensional imaging of the retinal structure. This technique has enabled clinical imaging of retinal morphology and pathologic alteration with resolution nearly comparable to histologic sections. Because OCT is not capable of rendering most retinovascular abnormalities, it is frequently performed with FA to diagnose and manage patients with macular disease. As a potential alternative to FA in diagnosing retinovascular disease, we have developed an imaging method called phase contrast optical coherence tomography (PC-OCT) which uses specialized software analysis of data acquired from clinically available SDOCT imaging systems to provide the additional functionality of high resolution imaging of retinal vessels and choroidal neovascularization. To develop PC-OCT imaging as a non-invasive alternative for fluorescein angiography, we have the following goals: (1) improve the speed, accuracy and automation of PC-OCT imaging to allow for general clinical usage, and apply this developed technique towards disease targets of (2) retinal capillary non- perfusion in diabetic retinopathy and (3) choroidal neovascularization (CNV) in age-related macular degeneration (AMD). The visualization capabilities of PC-OCT imaging will be compared directly against fluorescein angiography images for subjects of the target diseases. Successful completion of the Phase I aims will lead to further development of PC-OCT imaging techniques and analysis for detection of vascular leakage and screening for sub-clinical CNV in asymptomatic fellow eyes. Developing motion contrast capabilities of PC-OCT to be used with clinically available SDOCT systems can establish a new non-invasive screening tool for retinovascular diagnosis. Earlier detection through non-invasive screening of AMD patients may enable earlier detection of subclinical CNV and initiation of therapy before central vision is lost. PUBLIC HEALTH RELEVANCE: This proposal describes a new software product that enhances the diagnostic capability of optical coherence tomography (OCT), the most commonly performed retinal diagnostic test used in the US for evaluation of macular degeneration and diabetic retinopathy. By non-invasively providing high resolution retinovascular imaging, the product, phase contrast OCT (PC-OCT), may potentially replace fluorescein angiography, the current invasive and costly gold standard for retinovascular imaging. The proposed research plan improves the capabilities of PC-OCT and then does a head-to-head comparison with fluorescein angiography in evaluation of patients with wet macular degeneration and diabetic retinopathy.

描述（由申请人提供）：自1961年首次用于视网膜以来，荧光素血管造影术（FA）一直是客观表征视网膜血管疾病（例如糖尿病视网膜病变、视网膜静脉阻塞和与年龄相关性黄斑变性（AMD）相关的脉络膜新生血管形成）的金标准。尽管其广泛使用，FA是昂贵的，侵入性的，耗时的，限制了作为筛查工具的有用性。光学相干断层扫描（OCT）及其更快的变化称为光谱域OCT（SDOCT）是干涉成像技术，允许三维成像的视网膜结构。该技术使得视网膜形态学和病理改变的临床成像具有与组织切片几乎相当的分辨率。由于OCT不能显示大多数视网膜血管异常，因此经常与FA一起进行，以诊断和管理黄斑疾病患者。作为FA在诊断视网膜血管疾病中的潜在替代方案，我们开发了一种称为相位对比光学相干断层扫描（PC-OCT）的成像方法，该方法使用专门的软件分析从临床可用的SDOCT成像系统获得的数据，以提供视网膜血管和脉络膜新生血管的高分辨率成像的附加功能。为了开发PC-OCT成像作为荧光素血管造影的非侵入性替代方案，我们有以下目标：（1）提高PC-OCT成像的速度、准确性和自动化以允许一般临床使用，并将这种开发的技术应用于以下疾病目标：（2）糖尿病视网膜病变中的视网膜毛细血管无灌注和（3）年龄相关性黄斑变性（AMD）中的脉络膜新生血管（CNV）。针对靶疾病的受试者，将直接将PC-OCT成像的可视化能力与荧光素血管造影图像进行比较。I期目标的成功完成将导致进一步开发PC-OCT成像技术和分析，用于检测血管渗漏和筛查无症状对侧眼的亚临床CNV。开发PC-OCT的运动对比度功能，与临床可用的SDOCT系统一起使用，可以建立一种新的非侵入性视网膜血管诊断筛查工具。通过AMD患者的非侵入性筛查的早期检测可以使亚临床CNV的早期检测和在中心视力丧失之前开始治疗成为可能。 公共卫生关系：该提案描述了一种新的软件产品，可增强光学相干断层扫描（OCT）的诊断能力，OCT是美国用于评估黄斑变性和糖尿病视网膜病变的最常用的视网膜诊断测试。通过非侵入性地提供高分辨率视网膜血管成像，该产品，相位对比OCT（PC-OCT），可能会取代荧光素血管造影，目前的视网膜血管成像的侵入性和昂贵的金标准。提出的研究计划提高了PC-OCT的能力，然后在评估湿性黄斑变性和糖尿病视网膜病变患者时与荧光素血管造影进行了头对头比较。