Analyzing Retinal Microanatomy in Retinopathy of Prematurity to Improve Care

项目总结 随着全球早产儿存活率的增加，视网膜病变风险婴儿的数量 早产儿的风险(ROP)正在增加。这些婴儿未来视觉功能异常的风险也很高 神经发育。虽然目前的筛查方法针对用于治疗严重ROP的辨认眼睛， 没有人试图解决许多早产儿后来视力不正常的问题。在一定程度上，这是由于缺乏 关于视网膜的信息，而不是视网膜血管发育的信息。此外，最常见的 医生附图间接眼底镜检查筛查ROP残留物的方法 对于文件，这种方法被证明重复性差，对脆弱的婴儿有压力。床边视网膜 照片使记录和远程医疗方法成为可能，但缺乏关于 视网膜显微解剖，在深色眼睛中质量较差，也会给婴儿带来压力，因为 所需的光曝光量。我们需要一种更适合婴儿的、更实用的方法来有效地评估ROP，并 关于眼睛和神经血管发育的更多信息，可能会导致改善临床护理。 这项研究建立在我们团队可靠地捕获和处理非接触式红外光学相干的能力基础上 视网膜微解剖和微血管的高速断层扫描(OCT)和OCT血管成像 视野开阔，早产儿躺在床边。我们的总体目标有三个方面：一是评估 婴儿显微解剖和微血管血流表现与视力和神经发育结局的关系 第二，翻译和测试我们的成像成果，供床边的护士和 更好的临床洞察力和反馈；第三，收集进展到治疗和治疗的眼睛的额外数据 深入了解它们为ROP的疾病途径提供的洞察力。探索性OCT成像 将在这项研究中用于收集医生无法获取的信息。这项研究 将为未来使用OCT标记指导护理奠定基础。

PROJECT SUMMARY As an increasing percentage of preterm infants survive worldwide, the number of infants at risk for retinopathy of prematurity (ROP) is increasing. These infants are also at high risk for future abnormal visual function and neurodevelopment. While current screening approaches address identifying eyes for treatment of severe ROP, there are no attempts to address the later subnormal vision of many preterm infants. In part, this is due to a lack of information about the retina beyond that of retinal vascular development. In addition, the most common method to screen for ROP remains indirect ophthalmoscopic examination by physicians with annotated drawings for documentation, a method proven to be poorly reproducible and stressful to the fragile infant. Bedside retinal photographs enable documentation and the possibility for telemedicine approaches, but lack information about retinal microanatomy, are poor quality in darkly pigmented eyes and also are stressful to the infant because of the required light exposure. We need an infant-friendly, more practical approach to evaluate ROP efficiently and additional information about ocular and neurovascular development that could lead to improved clinical care. This research builds on our group’s ability to reliably capture and process non-contact, infrared optical coherence tomography (OCT) and OCT-angiography of retinal microanatomy and microvasculature at high speed, across a wide field of view, and at the bedside in preterm infants. Our overall objectives are threefold: first, to evaluate infant microanatomy and microvascular flow findings relevant to vision and neurodevelopmental outcomes in children; second, to translate and test our imaging achievements for real-world use by nurses at the bedside and better clinical insight and feedback; and third, to gather additional data in eyes that progress to treatment and dive deeper into the insight that they provide into pathways of disease in ROP. The investigational OCT imaging will be used in this research to gather information that is otherwise not accessible to the physician. This research will lay the groundwork for future use of infant OCT markers to guide care.