Elucidating perifoveal vascular development in infants

阐明婴儿中心凹周围血管发育

• 批准号: 10696178
• 负责人: Xi Chen
• 金额: $ 39.89万
• 依托单位: DUKE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-30 至 2027-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10696178
• 关键词: 3-Dimensional; Adult; Age; Anastomosis - action; Angiography; Animal Model; Biomedical Engineering; Blindness; Blood Vessels; Blood capillaries; Child; Childhood; Complex; Cone; Data; Development; Devices; Disease; Early Diagnosis; Elderly; Etiology; Exhibits; Functional disorder; Fundus; Gestational Age; Goals; Human; Image; Imaging Techniques; Impairment; Individual; Infant; Infant Development; Knowledge; Location; Methods; Neurologic; Ophthalmologist; Optical Coherence Tomography; Pathology; Pattern; Photoreceptors; Pigmentation physiologic function; Pregnancy; Premature Birth; Premature Infant; Prevalence; Process; Recording of previous events; Research; Retina; Retinopathy of Prematurity; Sampling; Source; Speed; System; Three-dimensional analysis; Translations; Vascular Diseases; Vascularization; Vision; Visual; Visual Acuity; Visual impairment; Visualization; Work; density; disability; disorder of macula of retina; fovea centralis; imaging system; improved; in vivo; insight; longitudinal analysis; macular edema; multidisciplinary; premature

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.

项目摘要 每十个婴儿中就有一个早产。早产可导致早产儿视网膜病变（ROP）， 儿童失明的主要原因。即使没有ROP或神经系统残疾， 早产儿在视敏度和视功能方面表现出轻微的损害，尽管这种次优的病因学 早产儿的视力仍不清楚。中央凹（视网膜中央的凹痕）是最关键的 决定视敏度的区域。中央凹周围有三层毛细血管吻合， 中央凹无血管区。众所周知，有早产史的儿童和成人有一个小的 或缺乏中央凹无血管区、保留的中央凹视网膜内层和降低的感光器功能， 并且这些异常在有治疗过的ROP史的个体中更严重。的发展 然而，由于在最容易的情况下没有中心凹，因此难以研究人类中心凹周围脉管系统。 在妊娠后期，动物模型的可获得性和人类组织病理学样本的稀少性。 我们的多学科团队与互补的专业知识将共同努力，使用先进的床边手持 光学相干断层扫描（OCT）血管造影成像，以填补差距，在我们的知识中心凹周围 婴儿的血管发育。我们建议阐明人类视网膜中央凹周围血管的发展， 以下具体目标：1）优化床边手持婴儿OCT血管造影，以显示中心凹周围 血管发育; 2）确定与对照组相比，早产儿的中心凹周围血管发育是否延迟 对于足月婴儿，ROP进一步延迟，并且与外部视网膜成熟不良相关;以及3）确定 黄斑水肿与中心凹周围深血管复合体形成减少和外视网膜病变的关系 早产儿的成熟。这项研究将扩大我们对人类中央凹发育的了解， 告知黄斑和视网膜血管发育疾病的病理生理学。