Retinal Neurovascular Patterning in Preterm Infants

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Candidate: I am currently a vitreoretinal fellow with the long-term career goal of becoming an independent clinician-scientist and a recognized leader in the field of retinal neurovascular development and pediatric retinal imaging. My research agenda is focused on investigating retinal neuronal and vascular development and disease using cutting-edge bedside noninvasive OCT imaging. I have a PhD in neuroscience and a longstanding interest in the development of neuronal and vascular systems. My immediate career goal in the current proposal is to perform simultaneous imaging of the retinal neuronal and vascular microstructures in the macula and retinal periphery in preterm infants, and correlate these changes in preterm infants with retinopathy of prematurity (ROP). With a K23 Mentored Patient-Oriented Research Career Development Award, I will acquire additional didactic training in clinical research and mentored research experience in pediatric retinal development, retinal imaging, photonics, clinical research and responsible conduct of research. Environment: The mentorship and expertise of the advisory committee, the extensive resources at Duke Eye Center and Department of Biomedical Engineering at Duke University, and the significant institutional commitment will provide me with the support needed to transition successfully into an independent research career. Research: The focus of this proposal is to test the hypothesis that retinal neuronal and vascular development are coordinated, and vascular pathology parallels defective neuronal development during ROP. We will assess simultaneously retinal neuronal and vascular development using advanced retinal optical coherence tomography (OCT) imaging technologies. In Specific Aim 1, we will implement a neonatal OCT research system to capture macular vascular development and analyze the correlation between neuronal and vascular development in preterm infants. Specifically, we will assess the size and vascular pattern of the foveal avascular zone and correlate with the foveal pit depth and retinal microstructures. In Specific Aim 2, we will investigate pathological neurovascular patterning in the retinal periphery in infants with ROP, and identify earlier subclinical features that may predict treatment-requiring disease. In Specific Aim 3, we will delineate factors and/or systemic diseases that affect retinal neurovascular development and patterning in preterm infants, such as stage of ROP, presence of plus disease, presence of macular edema of prematurity, presence of attenuated nerve fiber layers, ROP treatments (anti-VEGF or laser treatments) and systemic factors such as hypoxia. This body of work, which will constitute the basis of an R01 grant, will advance our understanding of retinal neurovascular patterning and pathogenesis of pediatric retinal vascular diseases such as ROP.