Adaptive Optics Imaging of Human Retinal Vascular Structure and Function

人视网膜血管结构和功能的自适应光学成像

• 批准号: 9887532
• 负责人: Stephen A Burns
• 金额: $ 48.87万
• 依托单位: TRUSTEES OF INDIANA UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-12-01 至 2024-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9887532
• 关键词: 3-Dimensional; Address; Adult; Age; Anatomy; Animal Model; Area; Biological; Biological Markers; Blindness; Blood; Blood Vessels; Blood capillaries; Blood flow; Caliber; Cells; Choroid; Clinical; Clinical Pathology; Clinical Treatment; Cone; Consensus; Data; Development; Diabetes Mellitus; Diabetic Retinopathy; Disease; Dropout; Endothelial Cells; Endothelium; Erythrocytes; Evaluation; Failure; Future; Goals; Health; Human; Image; Imaging Techniques; Impairment; Individual; Lasers; Link; Location; Maps; Measurement; Measures; Monitor; Nature; Ophthalmoscopes; Optics; Patient imaging; Perfusion; Pericytes; Photic Stimulation; Photoreceptors; Play; Regulation; Reproducibility; Research; Resolution; Retina; Retinal Cone; Retinal Diseases; Risk; Role; Sampling Biases; Scanning; Speed; Structure; Techniques; Testing; Thick; Time; Vascular Diseases; Vascular remodeling; Visit; Visual; Work; adaptive optics; adaptive optics scanning laser ophthalmoscopy; arteriole; base; cellular imaging; clinically significant; diabetic; follow-up; high resolution imaging; human imaging; improved; indexing; individual patient; macular edema; neurovascular coupling; novel strategies; optical imaging; relating to nervous system; response; retina blood vessel structure; retinal damage; retinal imaging; retinal ischemia; retinal neuron; routine imaging; temporal measurement; vascular abnormality; visual stimulus

Summary Diabetes and other retinal vascular diseases are a major cause of vision loss. This work builds on our measures of vascular remodeling in diabetes using adaptive optics (AO) retinal imaging. AO retinal imaging provides highly accurate and reproducible measures of both structural changes to the vascular walls of arterioles, and functional measures of blood flow and neurovascular coupling between visual stimulation and blood flow. By taking advantage of the precision of AO imaging we can make highly reproducible and accurate measurements of changes to retinal microvessels. In Aim 1 we will test the hypothesis that using a unique index of vascular wall damage which is insensitive to sampling biases can act as an index of diabetic damage. We will also generate a new measure of arteriole damage based on variability in the thickness of the vessel walls, presumably arising from endothelial and pericyte cell loss. We will then test whether these easily measured biomarkers are sensitive to local retinal ischemia, and can be used to measure progression of DR. Improving measurements in early DR is important as the clinical pathology is ultimately a consequence of these early changes. We will also test whether impaired neurovascular coupling is associated with these vascular changes. In Aim 2 we will measure early changes to the cone photoreceptors in diabetes, including both local areas of less reflective cones and regions of disordered cones and relate these changes to vascular changes. By also measuring visual sensitivity in areas with cone changes and those without we will test the hypothesis that imaging measurements can be used to understand the sensitivity changes occurring in DR. In Aim 3 we will for the first time, measure quantitative 3D flow maps of entire regions of the retinal vascular network. Flow maps include information as to where blood is flowing, velocity, size and in which direction allowing network quantification. Because the distribution of flow through a vascular network is sensitive to physical and biological constraints, flow maps will change markedly as capillary occlusion occur. By combining our state-of-the-art for retinal imaging of the vasculature with clinically available data we will continue to better understand the anatomical and functional basis for clinically observable damage. This work will advance our long term scientific goals of understanding the role that early vascular changes play in vision loss, our clinical goal of developing new approaches to identify those individuals most at risk for damage, as well as allow improved monitoring of future treatments on an individual basis.

概括 糖尿病和其他视网膜血管疾病是视力丧失的主要原因。这项工作建立在我们的 使用自适应光学（AO）视网膜成像测量糖尿病血管重塑。 AO视网膜成像 提供血管壁结构变化的高度准确和可重复的测量 小动脉，以及视觉刺激和视觉刺激之间的血流和神经血管耦合的功能测量 血流（量。通过利用 AO 成像的精度，我们可以实现高度可重复且准确的 测量视网膜微血管的变化。 在目标 1 中，我们将测试以下假设：使用对血管壁损伤不敏感的独特指数 抽样偏差可以作为糖尿病损害的指标。我们还将生成新的小动脉测量值 基于血管壁厚度变化的损伤，可能是由内皮细胞和 周细胞损失。然后我们将测试这些易于测量的生物标志物是否对局部视网膜敏感 缺血，可用于测量 DR 的进展。改进早期 DR 的测量非常重要 因为临床病理最终是这些早期变化的结果。我们还将测试是否 神经血管耦合受损与这些血管变化有关。在目标 2 中，我们将尽早测量 糖尿病患者视锥细胞的变化，包括反射性较低的视锥细胞的局部区域和区域 紊乱的视锥细胞并将这些变化与血管变化联系起来。通过测量视觉敏感度 有锥体变化的区域和没有锥体变化的区域我们将检验成像测量可以是的假设 用于了解 DR 中发生的敏感性变化。在目标 3 中，我们将首次测量 视网膜血管网络整个区域的定量 3D 血流图。流程图包括以下信息 血液流动的位置、速度、大小以及方向，允许网络量化。因为 通过血管网络的流量分布对物理和生物约束很敏感，流量图将 当毛细血管闭塞发生时，其变化显着。 通过将我们最先进的脉管系统视网膜成像与临床可用数据相结合，我们将 继续更好地了解临床可观察到的损伤的解剖学和功能基础。这部作品 将推进我们了解早期血管变化在视力中所起的作用的长期科学目标 损失，我们的临床目标是开发新方法来识别那些最有可能遭受损害的人，例如 并允许改进对个人未来治疗的监测。