Novel Glaucoma Diagnostics for Structure and Function

描述（由申请人提供）：青光眼是导致失明和视觉疾病的主要原因。由于这种疾病会对神经组织造成不可逆的损伤，因此在尽可能早的阶段识别青光眼及其进展至关重要。通过使用光学相干断层扫描（OCT）和其他技术的进步，该研究项目的长期目标是精确和准确地检测眼部结构和 与青光眼相关的功能变化，并确定患有青光眼的眼睛是否有未来疾病进展的风险。这是通过整合我们在过去19年中从各代OCT技术中获得的长期数据来实现的。通过使用创新的图像质量改善方法沿着信号变形，现在可以可靠地桥接不同代和不同制造商的OCT采集的数据，创建视网膜和视神经乳头区域纵向OCT测量的最长期队列。将应用先进的视网膜分割软件，即使存在与青光眼同时发生的眼部共病（先前的排除标准），也能详细区分所有视网膜层，从而最大限度地利用受试者和患者数据。使用这个队列，两种方法将被独特地应用于确定结构和功能之间的长期关系：连续时间隐马尔可夫模型和潜微分方程模型。这将加强对疾病过程的理解，并确定疾病及其各个阶段进展的最佳方法。 我们将利用先进的创新成像技术和方法来准确和精确地检测早期结构变化的证据：扫频源OCT，自适应光学OCT和偏振敏感OCT。这些技术将用于视网膜，巩膜和视神经乳头成像，提供筛板和双折射特性的增强信息。还将在激发性急性IOP升高试验期间和之后进行扫描，以评估形态学和生物力学反应，作为当前和未来疾病表征的潜在标志物。 该研究项目的结果将提供一种创新的和增强的青光眼眼部结构和功能的评估，这将扩大我们对疾病病理生理学的理解，为早期疾病检测和疾病进展提供新的诊断工具，并确定具有快速青光眼进展风险的受试者。

DESCRIPTION (provided by applicant): Glaucoma is a leading cause of blindness and visual morbidity. Because the disease causes irreversible damage to neural tissue it is of upmost importance to identify glaucoma and its progression at the earliest possible stages. Through advancements in the use of optical coherence tomography (OCT) and other technologies, the long-term goal of this research project is to precisely and accurately detect ocular structural and functional changes associated with glaucoma and to identify eyes with glaucoma that are at risk for future disease progression. This is accomplished by consolidating our long-term data acquired from various generations of OCT technology over the last 19 years. By using innovative methods for image quality improvement along with signal morphing, it is now possible to reliably bridge data acquired by the different generations and manufacturers of OCT, creating the longest-term cohort of longitudinal OCT measurements of the retina and optic nerve head regions. Advanced retinal segmentation software will be applied enabling detailed discrimination of all retinal layers even in the presence of ocular co-morbidity coincident with glaucoma (a previous exclusion criteria), allowing maximal use of subject and patient data. Using this cohort, two methods will be uniquely applied for determining the long-term relationship between structure and function: Continuous-time hidden Markov model and Latent differential equation models. This would enhance understanding of the disease process and allow determination of the best methods to identify disease and its progression at various stages. We will utilize advanced innovative imaging technologies and methods to accurately and precisely detect evidence of early structural changes: Swept-source OCT, Adaptive-optics OCT and Polarization-sensitive OCT. These technologies will be used to image the retina, sclera and optic nerve head providing enhanced information of the lamina cribrosa and birefringence properties. Scans will be also acquired during and following provocative acute IOP elevation testing to asses the morphological and biomechanical responses as potential markers for current and future disease characterization. The outcomes of this research project will provide an innovative and enhanced evaluation of ocular structure and function in glaucoma that will expand our understanding of the disease pathophysiology, offer new diagnostic tools for early disease detection and disease progression and identify subjects at risk for rapid glaucoma progression.