Mechanistic-Based Non-Invasive Assessment of Retinal Damage in HAART Era

描述(申请人提供)：艾滋病患者对高度激活的抗逆转录病毒疗法(HAART)反应良好。然而，我们的研究小组和其他研究人员已经表明，尽管CD4计数上升，视力损失仍在继续发生。在这笔赠款中，我们计划借助两种非侵入性成像技术-扫描激光偏振(SLP)和光学相干断层扫描(OCT)-评估和量化视网膜神经纤维层(RNFL)和正常视网膜组织的视网膜损伤。我们将测试两种可能解释视力丧失的不同假说--一种是细胞因子介导的视神经病变，另一种是视网膜微血管缺血。我们研究的第一个具体目标是在横断面和纵向研究中通过SLP、常规OCT和高分辨率(HR)OCT对RNFL缺陷进行量化。RNFL缺陷是沿着视神经头周围的圆周测量的，方法类似于青光眼研究中的研究。第二个具体目标是在横断面和纵向研究中，通过HR-OCT对整个后极部的视网膜缺陷进行量化。这些视网膜缺陷可以发生在整个视网膜上，并将通过3D图像进行成像。第三个具体目标是将两种成像仪器检测到的RNFL和视网膜缺陷与标准视野功能测试、短波自动视野检查和其他结构和功能数据相关联。我们的研究团队由一群具有各种专业知识的高素质人员组成。我们的团队包括视网膜成像专家、艾滋病毒相关眼部并发症研究专家、神经行为研究专家和高分辨率光学相干断层扫描专家。

DESCRIPTION (provided by applicant): Patients with HIV-disease have responded well to the highly activated antiretroviral therapy (HAART). However, our research group and others have shown that vision loss continues to occur despite elevated CD4 counts. In this grant we plan to assess and quantify retinal damage to the retinal nerve fiber layer (RNFL) and normal retinal tissue with the help of two non-invasive imaging techniques - scanning laser polarimetry (SLP) and optical coherence tomography (OCT). We will test two different hypotheses that might explain the vision loss - one is cytokine mediated optic neuropathy and the other is microvascular ischemia in the retina. The first specific aim of our study is to quantify RNFL defects by SLP, conventional OCT and high-resolution (HR) OCT in a cross-sectional and longitudinal study. RNFL defects are measured along a circumference around the optic nerve head in a manner analogous to studies in glaucoma research. The second specific aim is to quantify retinal defects throughout the posterior pole by HR-OCT in a cross-sectional and longitudinal study, as well. These retinal defects can occur throughout the retina and will be imaged by 3-D images. The third specific aim is correlate the RNFL and retinal defects detected with both imaging instruments with standard visual field function testing, short-wavelength automated perimetry and other structural and function data. Our research team encompasses a group of highly-qualified individuals with various expertise. Our team includes experts on retinal imaging, an expert in the study of HIV-related ocular complications, an expert in neurobehavioral research, and an expert on high-resolution optical coherence tomography.