Assessment of episcleral vasculature for glaucoma management

摘要 青光眼是全球不可逆性失明的主要原因之一，由视网膜神经节细胞引起 与眼压升高相关的死亡或丧失。目前的治疗策略围绕着 降低眼压，但受限于粘连性差和可能致盲的手术并发症。微创 青光眼手术(MIGS)提供了一个有希望的降低眼压的解决方案，然而结果是 不一致的部分原因是缺乏对房水外流的实时评估。这限制了 米格斯。我们的项目建议开发一种基于光学成像的解决方案来量化房水流出 和巩膜上静脉的血流，为眼科外科医生实时进行MIG提供了至关重要的洞察力。 支持最佳手术方法的时间到了。在第一阶段，我们将开发一个硬件-软件系统， 评估血流和房水流量，使用标准优化和表征其体外性能 成像目标和流动模体(目标1)，并随后在兔体内验证其性能 眼前段成像和青光眼模型(目标2)。如果成功，我们预计将进行第二阶段 包括临床研究的工作，以验证系统在MIG之前和之后的临床性能(目的 1)以及利用反馈的实时可用性对MiGs结果的改进进行演示 来自我们的技术(目标2)。因此，该项目旨在为以下方面的数据驱动方法奠定基础 米格，或智能米格。

ABSTRACT Glaucoma is one of the leading causes of irreversible blindness globally and is caused by retinal ganglion cell death or loss associated with elevated intra-ocular pressure (IOP). Current treatment strategies revolve around reduction of IOP, but are limited by poor adherence and potentially blinding surgical complications. Microinvasive glaucoma surgery (MIGS) has offered a promising solution to reduce IOP, however results have been inconsistent in part due to the lack of real-time assessment of aqueous outflow. This has limited the success of MIGS. Our project proposes to develop an optical imaging-based solution to quantify aqueous humor outflow and blood flow in the episcleral veins to provide crucial insight to ophthalmic surgeons performing MIGS in real- time to support optimal surgical approach. During Phase I, we will develop a hardware-software system for estimating flow of blood and aqueous humor, optimize and characterize its performance in vitro using standard imaging targets and flow phantoms (Aim 1), and subsequently validate its performance in vivo using rabbit models of anterior segment imaging and glaucoma (Aim 2). If successful, we anticipate undertaking a Phase II effort comprising clinical studies to validate the clinical performance of the system before and after MIGS (Aim 1) and the demonstration of improvement in outcomes of MIGS outcomes with real-time availability of feedback from our technology (Aim 2). This project, thereby, aims to the lay the foundation of a data-driven approach for MIGS, or smart MIGS.