Neonatal Optical Coherence Tomography Angiography to Assess the Effects of Postnatal Exposures on Retinal Development and Predict Neurodevelopmental Outcomes

项目概要/摘要 在世界范围内，每10个婴儿中就有1个是早产儿。早产不仅是导致死亡的主要原因， 对5岁以下的儿童也有严重的长期后果， 生存因此，有越来越多的婴儿处于早产儿视网膜病变（ROP）、视觉性视网膜病变（视觉性视网膜病变）的风险中。 损伤和神经发育损伤。了解早产如何改变眼睛， 虽然考虑到出生后的因素，如氧气的使用和抗血管内皮生长因子（抗- VEGF）治疗，是确定那些视力和神经发育风险最高的婴儿的关键 损伤从历史上看，这一弱势群体一直很难研究，因为侵入性检测既困难， 也有潜在的危害我们的研究将利用非侵入性的眼睛成像，使用眼睛相干性， 在需要重症监护的早产儿和足月儿中进行断层扫描和血管造影（OCT/OCTA）。这些图像 将使用已建立的措施进行分析，以确定暴露于 各种全身和局部治疗，如氧气和抗VEGF玻璃体内注射。而且还要 从OCT/OCTA成像中识别视网膜生物标志物，预测许多关键的视觉和发育 结局，包括出生后不久需要治疗的ROP以及视觉和神经发育障碍 在2-3岁的时候。这些研究结果将拓宽和加深我们对视网膜血管的认识 早产儿的发育，眼睛对氧气和抗VEGF的反应。此外，发展非 作为视觉和神经发育障碍的预测因子的侵入性视网膜生物标志物将增加 在出生后早期识别有风险的婴儿将有助于在婴儿出生后早期开始个性化治疗。 关键的神经发育期，这将优化他们的长期结果。

PROJECT SUMMARY/ABSTRACT Worldwide, more than 1 in 10 babies are born premature. Prematurity is not only the leading cause of death in children under 5 years of age, but also has serious long-term consequences for those preterm infants who survive. As such, there is a growing population of infants at risk for retinopathy of prematurity (ROP), visual impairment and neurodevelopmental impairment. Understanding how the eye is altered due to preterm birth, while accounting for postnatal factors such as oxygen use and anti-vascular endothelial growth factor (anti- VEGF) treatment, is key to determining those infants at highest risk for visual and neurodevelopmental impairment. Historically, this vulnerable population has been difficult to study, as invasive testing is both difficult to perform as well as potentially harmful. Our study will utilize non-invasive eye imaging, using ocular coherence tomography and angiography (OCT/OCTA), in preterm and term infants requiring intensive care. These images will be analyzed using established measures, to identify how eye development differs in newborn infants exposed to various systemic and local treatments such as oxygen and anti-VEGF intravitreal injections. Moreover, we will identify retinal biomarkers from OCT/OCTA imaging that predict a number of key visual and development outcomes, including treatment-requiring ROP shortly after birth and visual and neurodevelopmental impairment at 2-3 years of age. Results from these studies will broaden and deepen our understanding of retinal blood vessel development in preterm infants, the eye’s response to oxygen and anti-VEGF. In addition, developing non- invasive retinal biomarkers as predictors for visual and neurodevelopmental impairment will augment identification of at-risk infants early in the postnatal period will help to initiate individualized therapies during a period of critical neurodevelopment which will optimize their long-term outcomes.