Age-related Changes in Human Retinal Microvasculature

工程 摘要 /摘要 与年龄相关的视网膜血管变性是衰老过程中最普遍的发展之一。 眼睛，导致对威胁视力的眼部疾病的易感性增加。许多人的糖尿病视网膜病变 方式表现为加速衰老。尽管进行了广泛的研究，但描述动态的定量数据 在人类视网膜血管系统正常老化过程中发生的变化是有限的。对个人的欣赏 健康衰老对照组人群中的变异性对于准确解释临床结果和规划至关重要 研究新的治疗策略。因此，迫切需要量化的规范数据。 描述老龄化人口中视网膜血管的变化。这些数据将提供与年龄匹配的参考 视网膜血管测量值。我们的中心假设是，这些标准化数据对于 了解年龄相关变化对视网膜血管疾病进展的影响，以便 成功识别出更敏感和更具预测性的生物标志物。目前可用的最先进的 无创成像技术、自适应光学扫描检眼镜和光学相干 断层血管造影术将用于研究人类视网膜微血管系统的结构和功能 衰老对照组和糖尿病视网膜病变的受试者。我们将评估三个相互关联的假说 支持我们的中心假设的能力，(1)推进我们目前的活体成像技术，这使得 前所未有的成像和监控血管细胞的能力，一直延伸到毛细血管水平，可以用于 记录老化和病变视网膜的结构和功能特征的精确量化，(2) 在健康老化的视网膜中是否发生了微血管变化，需要加以识别和解释？ 在任何视网膜血管病变的评估中，以及(3)糖尿病患者的亚临床视网膜改变 使用这些成像技术可以检测到，这些成像技术可以帮助区分病理和区分 与正常衰老特征不同的变化。我们希望这些知识能够 拟议的项目将提供有意义的微血管指标和解释，以便转化为临床 关心。

PROJECT SUMMARY /ABSTRACT Age-related degeneration of the retinal vasculature is one of the most pervasive developments in the aging eye, resulting in increased susceptibility to vision threatening ocular diseases. Diabetic retinopathy in many ways manifests as accelerated aging. Despite extensive research, quantitative data describing the dynamic changes that occur during normal aging of the human retinal vasculature are limited. Appreciation of individual variability in groups of healthy aging controls is critical for accurate interpretation of clinical results and planning research into new treatment strategies. Thus, there is a desperate need for quantitative normative data describing retinal vascular changes in the aging population. Such data will provide age-matched reference values for retinal vasculature measurements. Our central hypothesis is that this normative data is essential for understanding the impact of age-related changes on the progression of retinal vascular diseases, in order to successfully identify more sensitive and predictive biomarkers. The most advanced currently available noninvasive imaging techniques, adaptive optics scanning light ophthalmoscopy and optical coherence tomography angiography, will be used to study structure and function of the human retinal microvasculature in aging controls, and subjects with diabetic retinopathy. Three linking hypotheses will be evaluated for their ability to support our central hypothesis, (1) advancing our current in vivo imaging techniques, which allow the unprecedented ability to image and monitor the vascular cells down to the capillary level, can be used to document precise quantification of structural and functional features of aging and diseased retinas, (2) there are microvascular changes occurring in the healthy aging retina which need to be identified and accounted for in any evaluation of retinal vascular pathology, and (3) subclinical retinal changes in diabetic patients detectable using these imaging techniques that can be used to help differentiate pathology and distinguish changes from those which characterize normal aging. It is hoped that the knowledge generated by the proposed project will provide meaningful microvascular metrics and interpretations for translation to clinical care.