Noninvasive ultrasound vibro-elastography for assessing ocular disorders

用于评估眼部疾病的无创超声振动弹性成像

• 批准号: 10625383
• 负责人: John Jing-Wei Chen
• 金额: $ 48.49万
• 依托单位: MAYO CLINIC ROCHESTER
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-07-01 至 2025-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10625383
• 关键词: Affect; Aftercare; Age; Back; Bilateral; Biomechanics; Blindness; Characteristics; Clinic; Clinical; Contralateral; Cornea; Data; Development; Diagnosis; Disease; Elastic Tissue; Elasticity; Enrollment; Eye; Eye diseases; Funding; Gender; Glaucoma; Grant; Individual; Intracranial Hypertension; Knowledge; Measurement; Measures; Mechanics; Medical; Methods; Modeling; Modification; Normal Range; Operative Surgical Procedures; Optic Disk; Optic Nerve; Outcome; Papilledema; Pathogenesis; Patients; Physiologic Intraocular Pressure; Pilot Projects; Property; Pseudotumor Cerebri; Research; Resolution; Risk; Risk Factors; Role; Sclera; Severities; Speed; Swelling; Techniques; Tissues; Viscosity; biomechanical test; clinical biomarkers; cohort; disorder risk; elastography; in vivo; new therapeutic target; novel; optic nerve disorder; pressure; recruit; risk stratification; ultrasound; viscoelasticity

PROJECT ABSTRACT Our understanding of the role of ocular biomechanical properties, such as elasticity and viscosity, is incomplete as there are no clinical methods for their in vivo clinical measurement. We propose to develop and refine a novel noninvasive ultrasound vibro-elastography (USVE) technique to measure viscoelastic properties of ocular tissues, and use the technique to assess two diseases, glaucoma and papilledema. We recently completed a R21 grant, evaluating USVE for assessing glaucoma. Glaucoma is the second leading cause of blindness in the US and worldwide, and the only available treatment is reduction of intraocular pressure (IOP). Our pilot study found significant differences in wave speed in the posterior sclera between glaucomatous and normal eyes. In another pilot project, we evaluated USVE in papilledema patients. Papilledema is optic nerve swelling, caused by increased intracranial pressure, and can cause significant vision loss. Papilledema from idiopathic intracranial hypertension (IIH) is typically bilateral and symmetric but can sometimes be asymmetric and even unilateral. We found that wave speeds in the posterior sclera of IIH patients were significantly higher than healthy subjects. In addition, wave speeds in patients with unilateral papilledema were significantly higher in affected eyes, compared with unaffected contralateral eyes. Both diseases depend on the biomechanics of ocular tissues including the posterior sclera surrounding the optic nerve head. However, they are on opposite ends of the spectrum where the deformation of the lamina cribrosa is back bowing in glaucoma and forward bowing in papilledema. Studying both diseases will help us to better understand the role of ocular tissue properties in disease risk and development, and the basic viscoelastic characteristics of the eye. In Aim 1, we will develop and refine USVE for measuring ocular viscoelastic properties. We will study various wave models in ocular tissues and develop advanced viscoelastic models to analyze ocular tissue’s elasticity and viscosity based on the wave speed dispersion measurements. In Aim 2, we will develop and refine USVE for assessing 50 patients with normal tension glaucoma (NTG) – glaucoma occurring at normal intraocular pressure – and 50 healthy control subjects. Since ocular biomechanical properties will be related to IOP, recruitment of NTG patients will allow comparison with IOP matched controls. In Aim 3, we will develop and refine USVE for assessing patients with papilledema. We will enroll a large cohort of 50 patients with papilledema from IIH and compare them with 50 age- and gender- matched healthy control subjects. We will study the changes of USVE measurements at baseline and after resolution of papilledema after treatment. Successful accomplishment of this project will provide fundamental knowledge about the role of ocular tissue biomechanical properties in glaucoma and papilledema. USVE may have the ability to stratify the risk of glaucomatous damage and the propensity toward the development of papilledema and vision loss, and identify novel targets for therapy.

项目摘要 我们对眼部生物力学特性（例如弹性和粘度）的作用的理解并不完整 因为没有临床方法对其进行体内临床测量。我们建议开发和完善一个 新型无创超声振动弹性成像 (USVE) 技术可测量粘弹性 眼组织，并使用该技术评估两种疾病：青光眼和视乳头水肿。我们最近 完成了 R21 资助，评估 USVE 评估青光眼的能力。青光眼是导致青光眼的第二大原因 在美国和世界范围内，这种疾病导致失明，唯一可用的治疗方法是降低眼压 (IOP)。 我们的初步研究发现，青光眼患者和青光眼患者后巩膜波速存在显着差异。 正常的眼睛。在另一个试点项目中，我们评估了视乳头水肿患者的 USVE。视乳头水肿是视神经 颅内压增高引起的肿胀，可导致严重的视力丧失。视乳头水肿来自 特发性颅内高压 (IIH) 通常是双侧对称的，但有时可能是不对称的 甚至是单方面的。我们发现 IIH 患者后巩膜的波速明显更高 比健康受试者。此外，单侧视乳头水肿患者的波速明显更高 与未受影响的对侧眼睛相比，受影响的眼睛。这两种疾病都取决于生物力学 眼组织，包括视神经乳头周围的后巩膜。然而他们却处于相反的位置 光谱的两端，其中筛板变形在青光眼中向后弯曲，而在青光眼中向前弯曲 视乳头水肿时鞠躬。研究这两种疾病将有助于我们更好地了解眼组织的作用 疾病风险和发展的特性，以及眼睛的基本粘弹性特征。在目标 1 中，我们 将开发和完善用于测量眼部粘弹性特性的 USVE。我们将研究各种波浪模型 眼组织并开发先进的粘弹性模型来分析眼组织的弹性和粘度 基于波速色散测量。在目标 2 中，我们将开发和完善 USVE 以进行评估 50 名正常眼压青光眼 (NTG) 患者（青光眼发生在正常眼压下）和 50 名患者 健康对照受试者。由于眼部生物力学特性与 IOP 相关，因此 NTG 的募集 患者将允许与 IOP 匹配的对照进行比较。在目标 3 中，我们将开发和完善 USVE 评估患有视乳头水肿的患者。我们将招募一个由 50 名来自 IIH 的视乳头水肿患者组成的大型队列， 将他们与 50 名年龄和性别匹配的健康对照受试者进行比较。我们将研究USVE的变化 基线时和治疗后视乳头水肿消退后的测量。成功完成 该项目将提供有关眼组织生物力学特性在 青光眼和视乳头水肿。 USVE 可能有能力对青光眼损伤的风险和 发生视乳头水肿和视力丧失的倾向，并确定新的治疗靶点。