Elucidating perifoveal vascular development in infants

项目总结 每十个婴儿中就有一个是早产的。早产会导致早产儿视网膜病变(ROP)， 儿童失明的主要原因。即使在没有ROP或神经残疾的情况下，出生的儿童 早产儿在视觉敏锐度和视觉功能方面表现出轻微的损害，尽管这种情况的病因不佳 早产儿的视力仍不清楚。中央视网膜的凹陷是最关键的。 决定视力的区域。中心凹周围有三层毛细血管吻合，形成 中心凹无血管区。众所周知，有早产史的儿童和成年人有少量的 或无中心凹无血管区，保留中心凹内视网膜层，光感受器功能下降， 这些异常在有ROP治疗史的个体中更为严重。的发展。 然而，人的中央凹周围的血管系统很难研究，因为最容易的是没有中心凹。 可获得的动物模型和妊娠晚期人类组织病理标本的稀缺性。 我们的多学科团队将相互补充专业知识，共同使用先进的床边手持设备 光学相干断层扫描(OCT)血管成像填补了我们对黄斑周围血管知识的空白 婴儿的血管发育。我们建议通过以下途径来阐明人类前庭周围血管的发育 具体目标如下：1)优化床边手持婴儿OCT血管成像以可视化乳房周围 血管发育；2)比较早产儿的穹窿周围血管发育是否延迟 对于足月婴儿，ROP进一步延迟，并与视网膜外部成熟度差相关；以及3)确定 黄斑水肿与黄斑周围深血管复合体形成减少和外视网膜的关系 早产儿的成熟。这项研究将扩大我们对人类中心凹发育的了解 告知黄斑和视网膜血管发育疾病的病理生理学。

PROJECT SUMMARY One out of every ten infants is born preterm. Preterm birth can cause retinopathy of prematurity (ROP), a leading cause of childhood blindness. Even in the absence of ROP or neurological disability, children born preterm exhibit subtle impairments in visual acuity and visual function, though the etiology of this suboptimal vision in preterm infants remains unclear. The fovea, an indentation in the central retina, is the most critical region determining visual acuity. The fovea is surrounded by anastomosis of three layers of capillaries, forming the foveal avascular zone. It is well-established that children and adults with history of prematurity have a small or absent foveal avascular zone, retained foveal inner retinal layers, and decreased photoreceptor function, and that these abnormalities are more severe in individuals with history of treated ROP. The development of human perifoveal vasculature, however, is difficult to study due to the absence of fovea in most easily accessible animal models and the rarity of human histopathological samples during late gestation. Our multidisciplinary team with complementary expertise will work together to use advanced bedside handheld optical coherence tomography (OCT) angiography imaging to fill the gap in our knowledge of perifoveal vascular development in infants. We propose to elucidate the human perifoveal vascular development through the following specific aims: 1) optimize bedside handheld infant OCT angiography to visualize perifoveal vascular development; 2) determine if perifoveal vascular development is delayed in preterm infants compared to term infants, further delayed in ROP, and associates with poor outer retinal maturation; and 3) determine the association of macular edema and decreased perifoveal deep vascular complex formation and outer retinal maturation in preterm infants. This research will expand our knowledge of human foveal development and inform the pathophysiology of diseases of macular and retinal vascular development.