Advanced imaging for diabetic retinopathy

糖尿病视网膜病变的先进成像

• 批准号: 8415887
• 负责人: Delia Cabrera DeBuc
• 金额: $ 52.49万
• 依托单位: UNIVERSITY OF MIAMI SCHOOL OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-02-01 至 2016-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8415887
• 关键词: Area Under Curve; Blindness; Blood Circulation; Blood Vessels; Blood flow; Caliber; Classification; Clinic; Clinical; Clinical Trials; Deterioration; Development; Diabetic Retinopathy; Diagnostic; Diagnostic Procedure; Discrimination; Disease Progression; Early Diagnosis; Early identification; Early treatment; Eye; Functional disorder; Fundus; Future; Goals; Health Personnel; Human; Image; Imaging Techniques; Individual; Intervention; Measurement; Measures; Methodology; Monitor; Morphology; Nerve Degeneration; Neural Retina; Optic Disk; Optical Coherence Tomography; Outcome; Pathogenesis; Pathology; Persons; Prevention; Public Health; Receiver Operating Characteristics; Retina; Retinal; Retinal Diseases; Risk; Role; Staging; Structure; System; Testing; Thick; Tissues; Venous; Vision; Visual; Visual Acuity; clinical practice; diabetic; diabetic patient; diagnosis evaluation; hemodynamics; improved; in vivo; novel; prevent; relating to nervous system; retina blood vessel structure; tool

DESCRIPTION (provided by applicant): Diabetic retinopathy (DR) is a major cause of visual loss in diabetic individuals that presents a significant diagnostic challenge. Advances in preventing vision loss in these individuals are hindered by limited understanding of mechanisms underlying DR and the altered relationships between the retinal neural tissue and retinal vasculature. Therefore, an objective test for the early diagnosis and evaluation of DR treatment is certainly needed in order to identify the individuals at great risk for vision-threatening problems. Our goal is to prevent visual loss in diabetic patients with an advanced imaging technique, Doppler Fourier Domain Optical Coherence Tomography (Doppler FD-OCT) that can facilitate a better understanding of the underlying sight- threatening complications of DR and the altered relationships between the neural retina and blood vessels. Our objective is to test the hypothesis that retinal structure alteration precedes disturbances in retinal hemodynamics and visual function deficit in DR. We will accomplish the following aims: Aim 1: Test the hypothesis the diagnostic power of the combination of advanced Doppler FD-OCT imaging and novel quantitative functional-anatomical measures can provide an objective methodology for non-invasive and in vivo quantification of retinal hemodynamics and structure morphology in normal healthy subjects and diabetic patients with and without DR. Aim 2: Test the hypothesis that retinal structure alteration precedes disturbances in retinal hemodynamics and visual function deficit in DR. Our hypothesis predicts that retinal structure alteration precedes disturbance of retinal hemodynamics, and at each stage of progressive DR the magnitude of structure deterioration will be larger than the magnitude of hemodynamic disturbance and visual function deficit. We will define the ratio of dysfunction to retinal structure alterations and hemodynamic disturbances at different stages of retinopathy by comparing anatomical variables, hemodynamic parameters and visual function measures. Our results will provide quantitative information about retinal blood flow in diabetic patients with and without retinopathy, and will improve the early diagnosis and treatment of DR. Our expected outcome will be to facilitate a ratio of visual dysfunction to retinal structure alterations and hemodynamic disturbances at different stages of retinopathy. We will characterize the retinal structure and hemodynamic parameters and relate the findings to systemic measures of control and complications in defined stratified groups of diabetic patients with varying levels of DR. Our impact will influence clinical practice by providing a means of identifying better clinical endpoints for DR clinical trials that are more sensitive to early disease progression than visual acuity and define the exact role of the blood circulation abnormalities in the DR progression.

描述（由申请人提供）：糖尿病视网膜病变（DR）是糖尿病患者视力丧失的主要原因，给诊断带来了重大挑战。由于对DR潜在机制的理解有限以及视网膜神经组织和视网膜血管系统之间关系的改变，阻碍了在这些个体中预防视力丧失的进展。因此，一个客观的测试，早期诊断和评估DR治疗是肯定需要的，以确定个人在很大的风险，视力威胁的问题。我们的目标是通过先进的成像技术，多普勒傅立叶域光学相干断层扫描（多普勒FD-OCT），预防糖尿病患者的视力丧失，该技术可以促进更好地了解DR的潜在视力威胁并发症以及神经视网膜和血管之间的关系改变。我们的目的是检验视网膜结构改变先于视网膜血流动力学紊乱和DR视功能缺陷的假设。我们将实现以下目标：目标1：检验先进多普勒FD-OCT成像和新型定量功能解剖测量组合的诊断能力可以为非超声心动图检查提供客观方法的假设。在正常健康受试者和有或没有DR的糖尿病患者中视网膜血流动力学和结构形态的侵入性和体内定量目的2：检验视网膜结构改变先于视网膜血流动力学紊乱和DR视功能缺陷的假设。视网膜结构的改变先于视网膜血流动力学的改变，在进行性DR的各个阶段，视网膜结构的改变程度均大于血流动力学的改变和视功能的损害程度。我们将通过比较解剖学变量、血流动力学参数和视觉功能指标，确定视网膜病变不同阶段功能障碍与视网膜结构改变和血流动力学紊乱的比例。我们的结果将提供有关伴和不伴视网膜病变的糖尿病患者视网膜血流的定量信息，并将改善DR的早期诊断和治疗。我们的预期结果将是促进不同阶段视觉功能障碍与视网膜结构改变和血流动力学障碍的比例视网膜病变。我们将描述视网膜结构和血流动力学参数，并将研究结果与具有不同DR水平的糖尿病患者的定义分层组中的控制和并发症的系统性措施相关联。我们的影响将通过为DR临床试验提供识别更好的临床终点的方法来影响临床实践，这些临床试验对早期疾病进展比视力更敏感，并定义血液的确切作用。DR进展中的循环异常。