Retinal Therapy Guided by 3-D OCT Image Analysis

3-D OCT 图像分析引导的视网膜治疗

• 批准号: 8058743
• 负责人: Michael David Abramoff
• 金额: $ 52.69万
• 依托单位: UNIVERSITY OF IOWA
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-05-01 至 2015-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8058743
• 关键词: 3-Dimensional; Abbreviations; Address; Adopted; Adverse event; Affect; Aftercare; Age related macular degeneration; American; Back; Biological Preservation; Biometry; Blindness; Choroidal Neovascularization; Chronic; Clinical; Clinical assessments; Cyst Fluid; Data Analyses; Disease; Dose; Employment; Endophthalmitis; Exudate; Eye; Fluorescein Angiography; Goals; Human Characteristics; Image; Image Analysis; Imaging Device; Individual; Infection; Injection of therapeutic agent; Institutes; Interdisciplinary Study; Iowa; Light; Measures; Medical Imaging; Medicine; Methods; Modeling; Morphology; Optical Coherence Tomography; Outcome; Pathology; Patients; Performance; Phase; Photochemotherapy; Property; Protocols documentation; Public Health; Reaction Time; Reading; Recurrence; Reproducibility; Research; Research Infrastructure; Research Personnel; Resolution; Retina; Retinal; Retreatment; Risk; Scanning; Slice; Specialist; Structure; Structure of retinal pigment epithelium; Thick; Three-dimensional analysis; Time; Tissues; Translational Research; Treatment outcome; United States; Validation; Vascular Endothelial Growth Factors; Verteporfin; Vision; Visual Acuity; Wages; Work; base; bevacizumab; bioimaging; cost; cost effective; follow-up; improved; in vivo; indexing; legally blind; macula; novel; public health relevance; response; restoration; retinal nerve fiber layer; success; tool; treatment response; two-dimensional

DESCRIPTION (provided by applicant): Age related macular degeneration (AMD) is one of the primary causes of blindness in the U.S. A wealth of powerful new treatments, especially anti-VEGF agents, has recently become available to restore visual function in choroidal neovascularization (CNV), the most severe form of AMD. The risk of ocular adverse events increases with repeated intravitreal treatment injections. Ideally a patient-specific dosing strategy with the minimally necessary number of anti-VEGF injections would be employed. This study will address which patient-specific properties of the intra- and sub-retinal fluid, cysts, and retinal layers of the macula (obtained from 3D spectral domain optical coherence tomography or OCT) (i) are associated with individual response to anti-VGEF treatment, and (ii) can predict proper treatment timing and response. The main hypothesis motivating the proposed research is that a model of retinal response to initial anti-VEGF treatment for CNV, based on quantitative 3D OCT-derived measures, can predict the timing of retreatment.We have identified the following specific aims: Aim 1: Further refine and validate a comprehensive set of analysis methods and approaches for 3D spectral OCT image analysis in the presence of wet AMD pathology (Symptomatic Exudate Associated Derangements or SEADs) and assess its performance by comparison to expert analyses. Aim 2: Determine associations between standard 2D Spectralis OCT clinical readings from retinal specialists and quantitative SEAD- and layer-derived measures from 3D Cirrus OCT. Aim 3: Determine how well the quantitative SEAD- and layer-derived measures from 3D OCT predict the patient-specific outcome parameters in response to post-induction anti-VEGF treatment in patients with CNV, in order to predict the timing of retreatment. The work will be performed prospectively in in-vivo spectral-domain OCT images acquired during the course of CNV disease treatment. We will repeatedly image 200 patients with choroidal neovascularization before and during treatment and during the 1-year follow-up phase. PUBLIC HEALTH RELEVANCE: Three dimensional spectral OCT imaging provides a wealth of information about the morphology and tissue characteristics of human retinal. We propose to study structural and functional relationships of the macular intraretinal layers using this new 3-D OCT imaging device and relate the information about patient-specific retinal composition and structure with treatment outcome in age-related macular degeneration. This study has potentially important consequences for image guided treatment of this blindness-causing disease.

描述（由申请人提供）：年龄相关性黄斑变性（AMD）是美国致盲的主要原因之一。最近有大量有效的新治疗方法，特别是抗VEGF药物，可用于恢复脉络膜新生血管形成（CNV）（AMD的最严重形式）的视觉功能。眼部不良事件的风险随着重复玻璃体内治疗注射而增加。理想情况下，将采用具有最低必要数量的抗VEGF注射的患者特异性给药策略。本研究将解决黄斑的视网膜内和视网膜下液体、囊肿和视网膜层（从3D谱域光学相干断层扫描或OCT获得）的哪些患者特异性特性（i）与抗VGEF治疗的个体反应相关，以及（ii）可以预测适当的治疗时机和反应。本研究的主要假设是，基于定量3D OCT衍生测量的视网膜对CNV初始抗VEGF治疗的反应模型可以预测再治疗的时间。进一步完善和验证一套全面的分析方法和方法，用于湿性AMD病理情况下的3D光谱OCT图像分析（症状渗出物相关紊乱或SEAD），并通过与专家分析进行比较来评估其性能。目标二：确定视网膜专家的标准2D Spectralis OCT临床读数与3D Cirrus OCT的定量SEAD和层衍生测量之间的关联。 目标3：确定来自3D OCT的定量SEAD和层衍生测量在多大程度上预测CNV患者对诱导后抗VEGF治疗的反应的患者特异性结局参数，以预测再治疗的时间。这项工作将在CNV疾病治疗过程中采集的体内光谱域OCT图像中前瞻性地进行。我们将在治疗前、治疗期间和1年随访期间对200例脉络膜新生血管患者进行重复成像。 公共卫生相关性：三维光谱OCT成像提供了有关人类视网膜形态和组织特征的丰富信息。我们建议使用这种新的3-D OCT成像设备研究黄斑视网膜内层的结构和功能关系，并将有关患者特定视网膜组成和结构的信息与年龄相关性黄斑变性的治疗结果联系起来。这项研究对这种致盲疾病的图像引导治疗具有潜在的重要意义。