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

项目摘要/摘要 在世界范围内，超过十分之一的婴儿是早产的。早产不仅是#年导致死亡的主要原因 5岁以下的儿童，但也会对那些早产儿产生严重的长期后果 活下去。因此，有越来越多的婴儿面临早产儿视网膜病变(ROP)的风险。 损害和神经发育障碍。了解早产是如何改变眼睛的， 同时考虑了出生后的因素，如氧气使用和抗血管内皮生长因子(抗血管内皮生长因子) 血管内皮生长因子)治疗，是确定那些视觉和神经发育风险最高的婴儿的关键 减损。从历史上看，这一弱势群体很难研究，因为侵入性检测既困难 既有潜在的危害，也有良好的表现。我们的研究将利用非侵入性的眼睛成像，使用眼部相干 需要重症监护的早产儿和足月儿的断层扫描和血管造影术(OCT/OCTA)。这些图像 将使用既定的测量方法进行分析，以确定接触辐射的新生儿的眼睛发育有何不同 用于各种全身和局部治疗，如氧气和抗血管内皮生长因子玻璃体内注射。此外，我们还将 从OCT/OCTA成像中识别预测一系列关键视力和发育的视网膜生物标志物 结果，包括出生后不久需要治疗的ROP以及视觉和神经发育障碍 2-3岁。这些研究的结果将拓宽和加深我们对视网膜血管的理解 早产儿的发育，眼睛对氧气和抗血管内皮生长因子的反应。此外，发展非 作为视力和神经发育障碍预测指标的侵袭性视网膜生物标志物将增加 在出生后早期识别高危婴儿将有助于在 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.