Point-of-care ophthalmic diagnostic imaging of retinopathy of prematurity
早产儿视网膜病变的护理点眼科诊断成像
基本信息
- 批准号:10587600
- 负责人:
- 金额:$ 58.3万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2023
- 资助国家:美国
- 起止时间:2023-03-01 至 2027-01-31
- 项目状态:未结题
- 来源:
- 关键词:3-DimensionalAdultAffectAlgorithmsAngiographyAreaBlindnessBlood VesselsChildhoodClinicalClinical ResearchComputer softwareCoupledCustomDataData SetDevelopmentDevicesDiagnosisDiagnosticDiagnostic ImagingDilatation - actionEnsureEyeEye diseasesFluoresceinImageImage AnalysisImage EnhancementIncidenceInfantInterventionManualsMeasuresMorphologic artifactsMotionOperative Surgical ProceduresOphthalmologyOphthalmoscopyOptical Coherence TomographyOpticsOutcomePatientsPerformancePeripheralPremature InfantProtocols documentationQuality ControlReproducibilityResearchResolutionRetinaRetinal DetachmentRetinopathy of PrematuritySamplingSignal TransductionSourceSpeedStagingSystemTechnologyTimeTranslatingTranslationsVascular DiseasesVascularizationVertebral columnVisionVisualVisualizationWeightanalysis pipelineanterior chamberawakeclinical diagnosticsclinical examinationclinically relevantdesigndetection limitdetection sensitivitydiagnostic biomarkerergonomicsfeature extractionimage processingimage registrationimaging platformimaging systemimprovedin vivo imaginginsightinterestkinematicsmultimodalityneovascularizationnovelpharmacologicpoint of careprognosticprogramsprototypequantitative imagingretinal imagingsample fixationserial imagingstandard of carestructural imagingtomographytractographyvascular abnormality
项目摘要
Retinopathy of prematurity (ROP) is a proliferative retinal vascular disease that affects preterm infants and a
major cause of childhood blindness. ROP is diagnosed and staged under indirect ophthalmoscopy at the junction
between the vascularized and avascular retina (i.e., periphery) using features such as retinal detachment (RD)
and increased vascular dilatation and tortuosity. While surgical and pharmacologic therapies exist, poor
structural and visual outcomes (<20/200 vision or blindness) occur in >50% of severe cases because RD, schisis,
and vascular abnormalities are often missed on clinical examination. Conventional ophthalmoscopic examination
in infants is performed using fundoscopy. However, retinal microvasculature is poorly visualized even when
combined with exogenous fluorescein contrast. Optical coherence tomography (OCT) is currently the gold-
standard for ophthalmic diagnostic imaging in adults and developments in OCT angiography (OCT-A) have
enabled in vivo imaging of retinal vasculature without the need for exogenous contrast. While several research
groups have developed handheld OCT/OCTA imaging systems and demonstrated imaging in ROP patients,
longitudinal quantitative imaging of retinal vasculature to track ROP progression remains limited by several key
challenges: 1) infants cannot fixate, making repeated imaging of regions-of-interest (ROIs) impossible; 2)
handheld imaging coupled with infant motion results in significant artifacts and poor OCTA contrast; 3)
OCT/OCTA quality is severely degraded by vitreous/anterior chamber haze, which is common in ROP; 4)
peripheral retinal vascular changes are important for ROP staging but aiming of OCT/OCTA at these ROIs is
difficult; 5) vascular volumes provide clinically relevant features such as dilatation and tortuosity, but OCTA is
conventionally assessed using only en face projections. To overcome these limitations, we have developed a
combination of hardware and image-processing technologies for handheld OCT/OCTA built around a multimodal
spectrally encoded coherence tomography and reflectometry (SECTR) ophthalmic imaging platform. SECTR
simultaneously acquires orthogonal en face reflectance and cross-sectional OCT images that uniquely benefits
volumetric registration for motion-correction and multi-volumetric mosaicking. We hypothesize that the
translation of these technologies into a point-of-care ophthalmic imaging system will allow for robust,
reproducible, and quantitative longitudinal tracking of retinal vascular changes, which will improve the diagnostic
and staging accuracy of ROP in preterm infants. We aim to develop custom hardware (AIM 1) and image analysis
pipelines (AIM 2) optimized for handheld SECTR imaging in infant eyes. These technologies will be validated in
longitudinal imaging of structural and functional changes in ROP (AIM 3) and provide quantitative insight on the
viability of SECTR imaging to benefit treatment decisions. The proposed device and quantitative analysis pipeline
are not limited to ROP cases and can be broadly applied in any area of ophthalmology where a robust point-of-
care OCT/OCTA may improve current clinical standard-of-care.
早产儿视网膜病变(ROP)是一种增生性视网膜血管疾病,影响早产儿和
儿童失明的主要原因。在交界处的间接眼底镜下诊断和分期ROP
利用视网膜脱离(RD)等特征,在有血管的视网膜和无血管的视网膜(即,外围)之间
血管扩张和弯曲度增加。虽然有手术和药物治疗,但很差
结构和视觉结果(20/200视力或失明)发生在50%的严重病例中,因为RD,裂伤,
而血管异常在临床检查中往往被遗漏。常规检眼镜检查
在婴儿中使用眼底镜进行检查。然而,视网膜微血管的可视化很差,即使当
结合外源性荧光素对比剂。光学相干层析成像(OCT)是目前的黄金技术--
成人眼科诊断成像标准和OCT血管造影术(OCT-A)的进展
实现了视网膜血管系统的活体成像,而不需要外部对比。虽然有几项研究
研究小组开发了手持OCT/OCTA成像系统,并在ROP患者中演示了成像,
追踪ROP进展的视网膜血管的纵向定量成像仍然受到几个关键因素的限制
挑战:1)婴儿不能注视,使感兴趣区域(ROI)无法重复成像;2)
手持成像结合婴儿运动导致明显的伪影和较差的OCTA对比度;3)
OCT/OCTA质量因玻璃体/前房混浊而严重退化,这在ROP中很常见;4)
周边视网膜血管改变对ROP分期很重要,但OCT/OCTA针对这些ROI
困难;5)血管体积提供临床相关特征,如扩张和弯曲,但OCTA
传统上仅使用面部投影进行评估。为了克服这些限制,我们开发了一种
硬件和图像处理技术相结合的手持OCT/OCTA围绕多模式构建
光谱编码相干层析成像和反射仪(SECTR)眼科成像平台。SECTR
同时获得正交的面部反射率和横截面OCT图像,这对
用于运动校正和多体积拼接的体积配准。我们假设
将这些技术转化为护理点眼成像系统将允许强大的、
可重复性的,定量的视网膜血管变化的纵向跟踪,这将提高诊断
早产儿ROP分期的准确性。我们的目标是开发定制硬件(AIM 1)和图像分析
针对婴儿眼部手持SECTR成像进行优化的管道(AIM 2)。这些技术将在
ROP结构和功能变化的纵向成像(AIM 3),并提供对ROP的定量洞察
SECTR成像的可行性有利于治疗决策。所提出的装置和定量分析流水线
不仅限于ROP病例,还可以广泛应用于任何眼科领域,在这些领域中,
CARE OCT/OCTA可能会改善当前的临床护理标准。
项目成果
期刊论文数量(0)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
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Ipek Oguz其他文献
Ipek Oguz的其他文献
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{{ truncateString('Ipek Oguz', 18)}}的其他基金
A placenta-based strategy for improved clinical prediction of fetal growth trajectory using automated image analysis of placental morphology and vascularity
基于胎盘的策略,使用胎盘形态和血管分布的自动图像分析来改进胎儿生长轨迹的临床预测
- 批准号:
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9174773 - 财政年份:2016
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