Analyzing Retinal Microanatomy in Retinopathy of Prematurity to Improve Care

分析早产儿视网膜病变的视网膜显微解剖学以改善护理

• 批准号: 10210847
• 负责人: CYNTHIA ANN TOTH
• 金额: $ 62.22万
• 依托单位: DUKE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-03-10 至 2026-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10210847
• 关键词: Achievement; Address; Aftercare; Age; Angiography; Blindness; Blood Vessels; Brain; Caring; Child; Childhood Acute Lymphocytic Leukemia; Clinical; Clinical Trials; Computer software; Cornea; Data; Data Set; Databases; Development; Disease; Disease Pathway; Disease Progression; Documentation; Early Intervention; Ensure; Evaluation; Evolution; Eye; Feedback; Fostering; Fundus; Future; Goals; Grant; Health; Human; Image; Infant; Infant Care; Infant Health; Intensive Care; Investigation; Lead; Light; Methods; Microanatomy; Monitor; Morphology; Multivariate Analysis; Neural Retina; Neurologic; Nurseries; Nurses; Ophthalmic examination and evaluation; Ophthalmoscopes; Optical Coherence Tomography; Optical Methods; Outcome; Output; Pathologic; Perinatal; Physicians; Pigmentation physiologic function; Pigments; Population Heterogeneity; Premature Infant; Process; Recurrence; Reference Standards; Reproducibility; Research; Retina; Retinopathy of Prematurity; Retreatment; Risk; School-Age Population; Science; Scientist; Speed; Stress; Technology; Telemedicine; Test Result; Testing; Therapeutic; Time; Translating; Treatment outcome; Vision; Visual impairment; advanced analytics; clinical care; cohort; cost; design; high risk; imager; improved; insight; interest; lens; neurodevelopment; neurovascular; next generation; outcome prediction; preterm newborn; programs; response; screening; tool; treatment response; vascular abnormality; vision development

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.

项目摘要 随着全世界早产儿存活率的增加， 早产率（ROP）正在上升。这些婴儿也有很高的风险，为未来异常的视觉功能， 神经发育虽然目前的筛查方法致力于识别用于治疗严重ROP的眼睛， 没有人试图解决许多早产儿后期视力低于正常的问题。部分原因是缺乏 视网膜血管发育之外的视网膜信息。此外，最常见的 一种筛查ROP的方法仍然是由医生用注释图纸进行间接检眼镜检查 对于文件，一种方法被证明是可重复性差，并对脆弱的婴儿造成压力。床旁视网膜 照片使文件和远程医疗方法的可能性，但缺乏信息， 视网膜显微解剖结构，在深色眼睛中质量差，并且由于 所需的曝光量。我们需要一种对婴儿友好的、更实用的方法来有效地评估ROP， 关于眼部和神经血管发育的额外信息，可能导致改善临床护理。 这项研究建立在我们小组可靠地捕获和处理非接触式红外光学相干的能力之上 视网膜显微解剖结构和微血管系统的高速断层扫描（OCT）和OCT血管造影， 视野开阔，早产儿的床边。我们的总体目标有三个方面：第一，评估 与视力和神经发育结果相关的婴儿显微解剖学和微血管血流发现 第二，翻译和测试我们的成像成果，供护士在床边实际使用， 更好的临床洞察力和反馈;第三，收集进展到治疗的眼睛的额外数据， 深入了解他们提供的ROP疾病途径。研究用OCT成像 将在本研究中用于收集医生无法获得的信息。本研究 将为未来使用婴儿OCT标记物指导护理奠定基础。