Structural and Functional Progression of Glaucomatous Damage to the Macula

青光眼黄斑损伤的结构和功能进展

• 批准号: 9265095
• 负责人: Carlos Gustavo De Moraes
• 金额: $ 40万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-05-01 至 2019-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9265095
• 关键词: Affect; Agreement; Area; Bayesian Analysis; Bayesian Modeling; Biometry; Clinical; Clinical Trials; Collaborations; Computer software; Data; Data Set; Databases; Decision Making; Disease; Doctor of Medicine; Doctor of Philosophy; Glaucoma; Goals; Institution; Joints; Knowledge; Length; Literature; Measures; Methods; Modeling; Monitor; Nature; Noise; Optical Coherence Tomography; Paper; Patient Recruitments; Patients; Performance; Perimetry; Peripheral; Process; Prospective Studies; Publishing; Recruitment Activity; Research; Resolution; Retinal; Retinal Ganglion Cells; Scanning; Sensitivity and Specificity; Source; Specialist; Statistical Methods; Structure; Techniques; Technology; Testing; Time; Training; Translating; Universities; Vision; Visual Cortex; Visual Fields; Work; area striata; clinical practice; clinically significant; density; experience; field study; follow-up; health related quality of life; improved; indexing; innovation; longitudinal database; longitudinal dataset; macula; patient population; prospective; public health relevance; rate of change; tool; trend analysis

 DESCRIPTION (provided by applicant): There is compelling evidence that glaucomatous damage to the macula occurs even in early stages of the disease. The macula comprises about 30% of all retinal ganglion cells and its information corresponds to over 50% of the visual cortex. However, glaucomatous damage to the macula is often missed in clinical practice. Some of the reasons are: 1) traditional glaucoma knowledge supports that glaucoma is fundamentally a peripheral disease; 2) inherent limitations of conventional clinical tests to detect damage to the macula; and 3) the paucity of large, prospective studies that describe the nature of glaucomatous damage to the macula. Our group has published numerous papers in the past two years showing that macular damage is prevalent among patients with early glaucoma if one employs the appropriate tools to assess it, namely 10-2 visual fields and high-resolution optical coherence tomography (OCT). This information comes from a unique prospective cross- sectional database and techniques we developed to produce objective metrics of structure and function. Now that we understand the cross-sectional nature of macular damage, this proposal aims to: 1) develop a longitudinal database including patients with early glaucoma and healthy controls, 2) to test models that explain progression of macular damage, and 3) to apply new statistical methods combining structural and functional tests which could improve the accuracy to detect progression and shorten the length of clinical trials. Our main hypothesis is that incorporating 10-2 visual field testing and high-resolution OCT scans of the macula to the conventional repertoire of technologies used in clinical practice, in addition to translating recently described statistical methods into softwares that can be used in daily practice, enhances the performance and confidence to detect glaucoma progression. In Aim 1 we plan to follow healthy subjects and glaucoma patients at regular intervals with 10-2, 24-2 visual fields, and swept source (ss) OCT tests and define metrics of short- and long-term test variability that are needed to differentiate true progression from 'noise'. To date, there is no such database combining these technologies. In Aim 2 we plan to combine metrics of structure and function from this longitudinal database using two methods: a spatial approach, which will ultimately produce a joint structure-function index using 10-2 and ssOCT data; and a temporal approach, which will employ Bayesian statistics to measure rates of progression using trend analysis. By the end of the study, our contributions to the field should be: 1) to make available a unique and pristine longitudinal database that could be used for other hypotheses testing, 2) to translate techniques recently described in the literature into objective tools to be readily useful in clinicl practice, and 3) to mitigate the burdens of progressive loss of central vision in glaucoma.



项目成果

The 24-2 Visual Field Guided Progression Analysis Can Miss the Progression of Glaucomatous Damage of the Macula Seen Using OCT.

• DOI: 10.1016/j.ogla.2022.03.007
• 发表时间: 2022-11
• 期刊: OPHTHALMOLOGY GLAUCOMA
• 影响因子: 2.9
• 作者: Hood, Donald C.;La Bruna, Sol;Tsamis, Emmanouil;Leshno, Ari;Melchior, Bruna;Grossman, Jennifer;Liebmann, Jeffrey M.;De Moraes, Carlos Gustavo
• 通讯作者: De Moraes, Carlos Gustavo

Rationale and Development of an OCT-Based Method for Detection of Glaucomatous Optic Neuropathy.

• DOI: 10.1097/ijg.0000000000002005
• 发表时间: 2022-06-01
• 期刊: Journal of glaucoma
• 影响因子: 2

Effects of the relative positioning between the disc-fovea angle and localized optic disc defects on the 10-2 visual field results in glaucoma.

视盘-中央凹角度和局部视盘缺损之间的相对定位对 10-2 视野的影响导致青光眼。

• DOI: 10.1016/j.ogla.2018.10.006
• 发表时间: 2018
• 期刊: Ophthalmology. Glaucoma
• 作者: Matos,AlexisG;DeMoraes,CarlosG;Pinto,TomasT;Silva,MarceloJL;Paula,JayterS
• 通讯作者: Paula,JayterS

The Role of Intraocular Pressure and Systemic Hypertension in the Progression of Glaucomatous Damage to the Macula.

• DOI: 10.1097/ijg.0000000000002018
• 发表时间: 2022-05-01
• 期刊: Journal of glaucoma
• 影响因子: 2

The ICD-10 Glaucoma Severity Score Underestimates the Extent of Glaucomatous Optic Nerve Damage.

ICD-10 青光眼严重程度评分低估了青光眼视神经损伤的程度。

• DOI: 10.1016/j.ajo.2022.08.009
• 发表时间: 2022
• 期刊: American journal of ophthalmology
• 影响因子: 4.2
• 作者: Leshno,Ari;Tsamis,Emmanouil;Harizman,Noga;Cioffi,GeorgeA;Wang,Qing;LaBruna,Sol;Rai,Anvit;DeMoraes,CarlosGustavo;Liebmann,JeffreyM;Hood,DonaldC
• 通讯作者: Hood,DonaldC