African and European Descent, Ocular Blood Flow and Glaucoma Progression

非洲和欧洲血统、眼血流和青光眼进展

• 批准号: 8352455
• 负责人: ALON HARRIS
• 金额: $ 23.4万
• 依托单位: INDIANA UNIV-PURDUE UNIV AT INDIANAPOLIS
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-07-01 至 2014-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8352455
• 关键词: Affect; African; Applications Grants; Blood Circulation; Blood Flow Velocity; Blood Pressure; Blood Vessels; Blood capillaries; Blood flow; Body mass index; Cerebrum; Clinical; Clinical Markers; Color; Contrast Sensitivity; Cornea; Data; Data Analyses; Deterioration; Disease; Disease Progression; Enrollment; European; Evolution; Functional disorder; Glaucoma; Heart Rate; Height; High Prevalence; Image; Incidence; Individual; Inequality; Investigation; Ischemic Optic Neuropathy; Knowledge; Laser-Doppler Flowmetry; Literature; Measurement; Measures; Medical; Medical History; Microcirculation; Observational Study; Open-Angle Glaucoma; Optic Nerve; Optical Coherence Tomography; Patients; Perfusion; Perimetry; Persons; Physiologic Intraocular Pressure; Physiologic pulse; Play; Population; Prevalence; Questionnaires; Reporting; Retina; Retinal; Risk; Risk Factors; Role; Scanning; Structure; Testing; Thick; Time; Ultrasonics; United States; Vascular Diseases; Vision; Visit; Visual Acuity; Visual Fields; Weight; blood perfusion; capillary; ciliary artery; design; hemodynamics; indexing; insight; ophthalmic artery; patient population; population based; pressure; prospective; racial difference; tomography

DESCRIPTION (provided by applicant): The objective of this study is to investigate the role of the vascular risk factors in explaining why individuals of African descent (AD) are disproportionately affected by glaucoma compared to individuals of European descent (ED). Studies have suggested that ocular blood flow plays a significant role in the evolution of glaucomatous damage in some individuals. It is also well known that persons of AD have an increased prevalence of systemic and cerebral vascular diseases. Given these findings, this study is designed to investigate if abnormal ocular perfusion pressure and blood flow in persons of AD with glaucoma contribute to the differences observed in the prevalence and progression of glaucoma in the AD population. This investigation involves a carefully designed secondary analysis of the existing data from the Indianapolis Glaucoma Progression Study (IGPS). This study is unique in that it is the only long- term prospective observational study that investigates the relationship between ocular perfusion and blood flow and structural and functional glaucoma progression. The 113 open-angle glaucoma patients enrolled in the IGPS receive a comprehensive ocular blood flow and perfusion parameters assessment alongside comprehensive clinical markers of glaucoma progression. Extensive clinical and hemodynamic measures were identically assessed at two identical baseline visits one week apart followed by biannual visits over a 3 year period. At each visit, patients underwent comprehensive testing including: multiple measures of intraocular pressure (Goldmann and Psacal), visual acuity, contrast sensitivity, ultrasonic corneal pachymetry of central corneal thickness, height, weight, body mass index, blood pressure, heart rate, medical history, visual field testing (using standard automated perimetry), Fourier domain Doppler optical coherence tomography (FD-OCT) with total retinal blood flow assessment, Stratus optical coherence tomography (OCT) structural imaging, Heidelberg retina tomography III, color Doppler imaging of the retrobulbar blood vessels, confocal scanning laser Doppler flowmetry of retinal capillaries, ocular perfusion pressure calculations, refraction, Pascal applanation (ocular pulse amplitude) and medical questionnaires. The proposed secondary data analysis will analyze the relationship between structural and functional disease progression and ocular perfusion pressure and blood flow, and investigate the differences between AD and ED glaucoma populations. Identifying distinct differences in vascular parameters between individuals of AD and ED will provide valuable insight into determining the mechanisms of disparity in glaucoma prevalence and progression in persons of AD. PUBLIC HEALTH RELEVANCE: The objective of this study is to explore the role of vascular risk factors in explaining the mechanisms behind the disparity of glaucoma in persons of African descent compared to those of European descent. The known increased prevalence of systemic vascular disease in the African descent population suggests that deficiencies in ocular perfusion pressure and blood flow may have a significant role in explaining these inequalities. Our unique secondary analysis of the Indianapolis Glaucoma Progression Study data which includes comprehensive ocular perfusion pressure, blood flow, retinal and optic nerve structure, visual function and their relationship to disease progression has the potential to elucidate, for the firs time, the reason for the disparity in glaucomatous disease between those of African descent and European descent.

描述（由申请方提供）：本研究的目的是研究血管风险因素在解释为什么非洲裔（AD）个体与欧洲裔（艾德）个体相比不成比例地受青光眼影响方面的作用。研究表明，在某些个体中，眼血流在青光眼损伤的演变中起着重要作用。众所周知，AD患者全身和脑血管疾病的患病率增加。鉴于这些发现，本研究旨在研究AD伴青光眼患者的异常眼灌注压和血流量是否有助于观察到AD人群中青光眼患病率和进展的差异。这项研究涉及对印第安纳波利斯青光眼进展研究（IGPS）现有数据进行精心设计的二次分析。这项研究的独特之处在于它是唯一一项长期前瞻性观察性研究， 眼灌注和血流与结构性和功能性青光眼进展之间的关系。入组IGPS的113例开角型青光眼患者接受了全面的眼部血流和灌注参数评估以及青光眼进展的全面临床标志物。在间隔一周的两次相同基线访视时，对广泛的临床和血流动力学指标进行了相同的评估，随后在3年内进行了半年一次的访视。在每次访视时，患者接受全面检查，包括：多项眼压测量（Goldmann和Psacal）、视力、对比敏感度、中央角膜厚度的超声角膜厚度测量、身高、体重、体重指数、血压、心率、病史、视野检查（使用标准自动视野检查法）、具有总视网膜血流评估的傅立叶域多普勒光学相干断层扫描（FD-OCT）、Stratus光学相干断层扫描（OCT）结构成像，海德堡视网膜断层扫描III、球后血管的彩色多普勒成像、视网膜毛细血管的共焦扫描激光多普勒血流仪、眼灌注压计算、屈光、帕斯卡压平（眼脉冲幅度）和医学问卷。拟定的次要数据分析将分析结构性和功能性疾病进展与眼灌注压和血流量之间的关系，并研究AD和艾德青光眼人群之间的差异。识别AD和艾德个体之间血管参数的明显差异将为确定AD患者青光眼患病率和进展差异的机制提供有价值的见解。 公共卫生相关性：本研究的目的是探索血管危险因素在解释非洲裔与欧洲裔青光眼差异背后的机制中的作用。已知非裔人群中全身性血管疾病的患病率增加，这表明眼部灌注压和血流的不足可能在解释这些不平等方面发挥重要作用。我们对印第安纳波利斯青光眼进展研究数据进行了独特的二次分析，其中包括全面的眼部灌注压，血流量，视网膜和视神经结构，视觉功能及其与疾病进展的关系，这有可能首次阐明非洲裔和欧洲裔之间青光眼疾病差异的原因。