Localization, safety, and efficacy of optic nerve injections

应用总结 这是一个K 08指导临床科学家研究职业发展奖的应用布莱斯蒋，医学博士。 完成眼科住院医师培训后，蒋医生将被聘为眼科助理教授， 斯坦福大学拜尔斯眼科研究所。此申请的目的是为蒋博士提供所需的培训，指导， 并支持成为一名具有眼部药物输送专门知识的研究者，特别是视神经乳头。临床 青光眼奖学金将在K 08奖的时间轴的25%临床时间内完成。蒋博士 组建了一个导师团队，由杰弗里·戈德堡博士组成，他是视神经神经保护和神经保护专家， 再生;和马克Prausntiz博士，在眼部药物输送专家。此外，他还确定了主要合作者， 包括眼部药物输送专家Uday Kompella博士、视神经疾病和动物疾病专家Joyce Liao博士、 模特; Jonathan Lin博士，眼科病理学家; Vinit Mahajan博士，玻璃体视网膜外科医生。 视神经病变是一类影响视神经的破坏性视力威胁疾病。没有方法可以 选择性地将治疗剂递送到视神经乳头，并且靶向递送可以改善由于生理性的 时空线索和/或损伤组织的选择性靶向。所提出的技术是通过以下方式进入视神经乳头： a脉络膜上至视神经（SCONE）注射。核心假设是SCONE注射技术可以 用于选择性靶向视神经乳头，并且用这种方法提供的治疗将更有效 与玻璃体内或眶内视神经注射相比。目标1的假设是SCONE注射可以 进一步优化，并且该技术不会在功能上或结构上影响视神经头组织。的假设 目的2的一个重要方面是SCONE注射将比玻璃体内或眶内视神经更局限于视神经乳头 注射剂目的3的假设是睫状神经营养因子（CNTF）传递到视神经乳头-无论是作为 游离蛋白，或在持续释放聚合物中，或用AAV转导局部细胞-将带来更大的神经保护， 再生比玻璃体内或眶内注射后视神经损伤。这项研究可能会导致改善交付 技术的视神经头，并将形成一个R 01应用程序的基础之前，K奖结束。

APPLICATION SUMMARY This is a K08 Mentored Clinician Scientist Research Career Development Award application for Bryce Chiang, MD PhD. Upon completion of ophthalmology residency, Dr. Chiang will be hired as an Assistant Professor of Ophthalmology at the Byers Eye Institute at Stanford. The purpose of this application is to provide Dr. Chiang with the needed training, mentorship, and support to become an investigator with expertise in ocular drug delivery, specifically to the optic nerve head. A clinical glaucoma fellowship will be completed during the 25% clinical time through the timeline of the K08 award. Dr. Chiang has assembled a mentorship team consisting of Dr. Jeffrey Goldberg, an expert on optic nerve neuro-protection and neuro- regeneration; and Dr. Mark Prausntiz, an expert in ocular drug delivery. In addition, he has identified key collaborators including Dr. Uday Kompella, an expert in ocular drug delivery; Dr. Joyce Liao, an expert in optic nerve diseases and animal models; Dr. Jonathan Lin, an ocular pathologist; Dr. Vinit Mahajan, a vitreoretinal surgeon. Optic neuropathy is a class of devastating vision threatening diseases that affect the optic nerve. There are no methods to selectively deliver therapeutics to the optic nerve head, and targeted delivery could improve outcomes due to physiologic spatiotemporal cues and/or selective targeting of injured tissue. The proposed technique is to access the optic nerve head by a SupraChoroidal-to-Optic-NErve (SCONE) injection. The central hypothesis is that the SCONE injection technique can be used to selectively target optic nerve head, and that therapies delivered with this method will be more efficacious compared with intravitreal or intraorbital optic nerve injections. The hypothesis of Aim 1 is that SCONE injection can be further optimized, and the technique will not impact the optic nerve head tissue functionally or structurally. The hypothesis of Aim 2 is that SCONE injection will be more localized to optic nerve head than intravitreal or intraorbital optic nerve injections. The hypothesis of Aim 3 is that Ciliary NeuroTrophic Factor (CNTF) delivered to the optic nerve head–either as free protein, or in a sustained release polymer, or transducing local cells with AAV–will bring greater neuroprotection and regeneration than intravitreal or intraorbital injections after optic nerve injury. The research may lead to improved delivery techniques to the optic nerve head, and will form the basis of an R01 application before the end of the K award.