Mechanistic-Based Non-Invasive Assessment of Retinal Damage in HAART Era

描述（由申请人提供）：hiv患者继续接受高活性抗逆转录病毒治疗（HAART）。然而，我们的研究小组和其他人已经表明，尽管CD4细胞计数升高，视力下降和神经功能丧失仍会继续发生。我们之前已经证明，我们能够在活动期后16年看到与愈合的棉絮斑（CWS）相关的细微视网膜变化。在这项拨款中，我们计划研究一组继续表现出神经变化和视网膜损伤的受试者。我们的假设是视网膜损伤与神经系统变化有关。我们的第一个具体目标是通过高分辨率自适应光学校正oct来量化视网膜损伤。我们的第二个具体目标是开发一种计算机算法来绘制与愈合CWS相关的缺陷。我们的结果表明，愈合的CWS表现出视网膜层的特征性重组。这种重组可以映射到三维OCT图像中。第三个具体目标是将结构性视网膜缺陷与我们在加州大学圣地亚哥分校艾滋病毒神经行为研究中心的合作者收集的神经标志物联系起来。通过使用视网膜结构标记作为神经损伤的指标，一种可能的相关性可能会对我们有所帮助。我们的合作团队包括视网膜成像、计算机处理和神经行为研究方面的专家。

DESCRIPTION (provided by applicant): Patients with HIV-disease continue to be treated with highly activated antiretroviral therapy (HAART). However, our research group and others have shown that vision loss and neurological loss continues to occur despite elevated CD4 counts. We have previously shown that we are able to visualize subtle retinal changes associated with healed cotton-wool spots (CWS) up to 16 years after the active phase. In this grant we plan to study the group of subjects that continue to exhibit neurological changes and retinal damage. Our hypothesis is that retinal damage is associated with neurological changes. Our first specific aim is to quantify retinal damage by high-resolution adaptive- optical corrected OCT. Our second specific aim is to develop a computer algorithm to map the defects associated with healed CWS. Our results have indicated that healed CWS demonstrate a characteristic restructuring of the retinal layers. This restructuring can be mapped in 3-D OCT images. The third specific aim is to correlate structural retinal defects with neurological markers collected by our collaborators at the UCSD's HIV Neurobehavioral Research Center. A possible correlation might help us by using retinal structural markers as indicators for neurological damage. Our team of collaborators includes experts on retinal imaging, computer processing, and neurobehavioral research. PUBLIC HEALTH RELEVANCE: This grant will create a method of automatically mapping the presence of retinal damage associated with HIV infection. A high-resolution eye camera will be used to systematically image the back of the eye. The study will compare structural information to functional information to find a possible correlation.