Ocular Blood Flow Imaging for Glaucoma Assessment

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ABSTRACT Glaucoma is one of the leading causes of blindness in adults worldwide. There is no single instrument that can diagnose glaucoma in all cases requiring a combination of methods including standard automated perimetry to assess peripheral vision, optical coherence tomography (OCT) to assess retinal nerve fiber layer (RNFL) thinning, intraocular pressure (IOP), and fundus photography to assess the cup to disc ratio. RNFL changes are challenging to assess in individuals with a high degree of myopia as well as in patients that have previously been treated with laser in the eye. Ocular blood flow (OBF) information from posterior segment, as obtained by an FDA-cleared instrument called XyCAM RI developed by us, has the potential to add insights relevant to glaucoma status that are complementary to conventional methods. Our preliminary results have demonstrated significant differences in OBF patterns in the optic disc and macular regions in glaucoma subjects and healthy controls. Our present Phase II project seeks to validate the diagnostic potential of OBF metrics obtained by XyCAM RI in the management of glaucoma through a rigorous clinical study with age-matched, race-matched, and sex-matched controls, and specifically demonstrate the usefulness of OBF-derived measurements in assessment of glaucoma in highly myopic patients. We also seek to develop and bring to market an enhanced multi-function fundus camera called the XyCAM FC for clinical use. The XyCAM FC will permit practitioners to visualize fundus photos in stereo mode to assess cup-to-disc ratio and also OBF information including the most diagnostically relevant features. As a frontier technology that complements color fundus images with video data on OBF dynamics at a high temporal resolution, the XyCAM FC offers the ability to perform reimbursable procedures of fundus photography, enable an ophthalmologist or optometrist to visualize glaucoma pathophysiology, and conduct research on development of OBF-based biomarkers for ophthalmic and systemic pathology with symptoms in the ocular vasculature.