Functional and Structural Optical Coherence Tomography for Glaucoma

青光眼的功能性和结构性光学相干断层扫描

• 批准号: 9130226
• 负责人: David Huang
• 金额: $ 74.83万
• 依托单位: OREGON HEALTH & SCIENCE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-09-30 至 2017-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9130226
• 关键词: 3-Dimensional; Algorithms; Anatomy; Angiography; Applications Grants; Arteries; Automation; Biomedical Engineering; Blindness; Blood Circulation; Blood Vessels; Blood flow; Clinical; Clinical Research; Collaborations; Complex; Computer software; Detection; Diagnosis; Diagnostic; Disease; Disease Progression; Dyes; Early Diagnosis; Evaluation; Eye; Fiber; Financial compensation; Functional Imaging; Functional disorder; Glaucoma; Goals; Health; Human; Image; Imaging technology; Injection of therapeutic agent; Institutes; Lasers; Massachusetts; Measurement; Measures; Medical; Methods; Microcirculation; Monitor; Motion; Nerve; Nerve Fibers; Observational Study; Operative Surgical Procedures; Ophthalmoscopy; Optic Disk; Optical Coherence Tomography; Outcome; Pathway interactions; Patients; Pattern; Perfusion; Pharmaceutical Preparations; Photography; Physiologic Intraocular Pressure; Play; Reproducibility; Research; Research Project Grants; Resolution; Retina; Retinal; Retinal Ganglion Cells; Risk; Role; Safety; Scanning; Source; Speed; Structure; Structure of central vein of the retina; Suspect Glaucomas; System; Techniques; Technology; Testing; Time; Trabeculectomy; Veins; Visual Fields; Work; base; blood flow measurement; central retinal artery; clinical practice; cost; diagnostic accuracy; field study; ganglion cell; high risk; imaging modality; improved; insight; instrument; macula; next generation; novel; optic nerve disorder; prognostic; prototype; quantitative imaging; relating to nervous system; screening; tool; vascular bed; vascular factor

DESCRIPTION (provided by applicant): Glaucoma is a leading cause of blindness. Early diagnosis and close monitoring of glaucoma are important because the onset is insidious and the damage is irreversible. Advanced imaging modalities such as optical coherence tomography (OCT) have been used in the past 2 decades to improve the objective evaluation of glaucoma. OCT has higher axial spatial resolution than other posterior eye imaging modalities, and it has relatively good diagnostic accuracy and reproducibility in the measurement of neural structures damaged by glaucoma. However, the measurement of structure alone, with any imaging modality, has limited sensitivity for detecting early glaucoma and only moderate correlation with visual field (VF) loss. Using high-speed OCT systems, we have developed new methods to image and measure optic nerve head (ONH) and retinal blood flow. Preliminary results showed that VF loss was more highly correlated with retinal blood flow as measured by OCT than any neural structure measured by OCT or other imaging modality. Accordingly, the goal of the proposed project is to improve the diagnostic and prognostic evaluation of glaucoma by further developing novel functional OCT measurements using ultrahigh-speed (70-100 kHz) OCT technology. The specific aims are: 1. Improve Doppler OCT measurement of retinal blood flow. Multi-circular scans of peripapillary retinal arteries and veins measure total retinal blood flow i 2 seconds. The use of faster OCT systems will allow automated measurement with improved reproducibility. 2. Develop quantitative OCT angiography of the ONH. Three dimensional (3D) OCT angiography has been made practical (3x3 mm scan in 3 seconds) by a novel split-spectrum amplitude-decorrelation algorithm. Preliminary results showed dramatic loss of ONH microcirculation in early glaucoma. Algorithmic improvement in angiography, segmentation, quantification, and automation are planned. 3. Measure nerve structure from the ONH to retinal ganglion cells. By registering several volumetric scans, we have demonstrated complete 3D characterization of the retinal fiber pathway from the ONH to the macula. Fully automated quantification of these structures will be developed. 4. Evaluate advanced OCT technologies in clinical studies. The utility of functional and structural OCT in glaucoma will be evaluated in a longitudinal observational study of 150 glaucoma and healthy subjects. The effect of IOP-lowering surgery on blood flow will be studied in 40 subjects. Retinal blood flow, ONH circulation, optic disc rim volume, peripapillary nerve fiber layer volume, and macular ganglion cell complex volume are all pieces of the same glaucoma puzzle. This project will develop novel imaging methods that allow us to look at the whole picture using one tool - ultrahigh-speed OCT.

描述（由申请人提供）：青光眼是导致失明的主要原因。青光眼的早期诊断和密切监测是重要的，因为发病是隐蔽的，损害是不可逆的。在过去的20年中，先进的成像方式，如光学相干断层扫描（OCT），已被用于改善青光眼的客观评价。OCT具有较高的轴向空间分辨率，在青光眼神经结构损伤的测量中具有较好的诊断准确性和可重复性。然而，单独的结构测量，与任何成像方式，检测早期青光眼的敏感性有限，只有中度相关性与视野（VF）的损失。使用高速OCT系统，我们已经开发出新的方法来成像和测量视神经乳头（ONH）和视网膜血流。初步结果表明，VF损失与OCT测量的视网膜血流的相关性比OCT或其他成像方式测量的任何神经结构更高。因此，拟议项目的目标是通过使用超高速（70-100 kHz）OCT技术进一步开发新的功能性OCT测量来改善青光眼的诊断和预后评估。具体目标是：1.改进多普勒OCT测量视网膜血流。视乳头周围视网膜动脉和静脉的多环形扫描测量2秒内的总视网膜血流量。使用更快的OCT系统将允许具有改进的再现性的自动测量。2.开发ONH的定量OCT血管造影。三维（3D）OCT血管造影术已通过一种新的分谱幅度去相关算法实现（3秒内扫描3x 3 mm）。初步结果显示，在早期青光眼中ONH微循环显著丧失。计划在血管造影、分割、量化和自动化方面进行系统改进。3.测量从ONH到视网膜神经节细胞的神经结构。通过注册几个体积扫描，我们已经证明了完整的三维表征的视网膜纤维通路从ONH的黄斑。将开发这些结构的全自动量化。4.在临床研究中评价先进的OCT技术。将在一项纳入150名青光眼和健康受试者的纵向观察性研究中评价功能性和结构性OCT在青光眼中的效用。将在40例受试者中研究降眼压手术对血流的影响。视网膜血流量、ONH循环、视盘边缘体积、视乳头周围神经纤维层体积和黄斑神经节细胞复合体体积都是同一个青光眼难题的组成部分。该项目将开发新的成像方法，使我们能够使用一种工具-超高速OCT来查看整个图像。