Combined coaxial optical coherence tomography to identify and evaluate abnormal tissue deposits in retinal diseases

在发达国家，视网膜疾病是导致法定失明的最常见原因。鉴于正在进行和即将进行的治疗试验，需要经过验证的生物标志物。使用首个创新的联合同轴光学相干断层扫描（OCT）成像设备，提交的项目旨在评估临床研究的潜在新读数，促进鉴别诊断并提高对视网膜疾病致病途径的认识。联合同轴OCT使用不同波长的激光光源，以便在没有时间或空间分离的情况下实现视网膜内和视网膜下结构的最佳可视化。这是一个独特而有前途的特征，因为许多视网膜疾病都涉及视网膜和脉络膜作为辅助功能复合物。包括三个子项目。由于联合同轴OCT设备最近刚刚在Moorfields眼科医院建成并安装，第一个子项目的目的是通过调查健康的眼睛并提供规范的数据库来建立创新的设备。在第二个子项目中，将评估患有不同视网膜疾病的眼睛。与传统OCT设备相比，联合同轴OCT系统获得的视网膜和脉络膜的定性和定量检查以及第一个子项目收到的规范数据库是值得期待的。新的和已知的疾病相关的改变，特别是在视网膜和脉络膜之间的界面，将被调查。组织分子组成的变化导致不同的反射特性，这取决于联合同轴oct所显示的光波长。这些分子变化可能是可检测到的第一个疾病改变。因此，第三个子项目旨在通过数据后处理分析视网膜中异常沉积物在不同波长下的反射特性。组织反射特性的差异不仅可以作为创新的体内形态学替代标志物，而且还可以深入了解视网膜疾病的发病机制和更复杂的患者鉴别诊断。这可能进一步使针对视网膜疾病特定途径的视力障碍治疗和预防策略成功。提交项目所需的所有合作科学家和技术设备都是唯一可用的，并准备在穆尔菲尔德眼科医院和伦敦大学学院眼科研究所的Adnan Tufail教授研究小组中使用。

Retinal diseases are the most common cause of legal blindness in developed countries. In the view of ongoing and upcoming therapeutic trials, validated biomarkers are required. Using the first innovative combined coaxial optical coherence tomography (OCT) imaging device, the submitted project targets to evaluate potential new readouts for clinical studies, facilitate differential diagnosis and improve knowledge of pathogenic pathways of retinal diseases. The combined coaxial OCT uses different wavelengths of laser light sources in order to enable optimal visualisation of intraretinal as well as subretinal structures without temporal or spatial separation. This is a unique and promising feature as many retinal diseases involve both the retina and choroid as a coadjutant functional complex. Three subprojects are included. As the combined coaxial OCT device just recently has been built and installed at the Moorfields Eye Hospital, the aim of the first subproject is to establish the innovative device by investigating healthy eyes and providing a normative database. In the second subproject, eyes with different retinal diseases will be assessed. Qualitative and quantitative examination of retina and choroid obtained by the combined coaxial OCT system in comparison to a conventional OCT device as well as the normative database received by the first subproject is aspired. Novel and known disease-related alterations, particularly in the interface between retina and choroid, will be investigated. Changes in the molecular composition of tissue lead to different reflective properties dependent on the light wavelength visualized by the combined coaxial OCT. These molecular changes might be the first detectable disease alterations. The third subproject therefore aims to analyse the reflective properties of abnormal deposits in the retina under different wavelengths through post-processing of data. Differences in the reflective properties of tissue might not only serve as innovative morphologic in-vivo surrogate marker, but also enable an insight into the pathogenesis of retinal diseases and a more sophisticated differential diagnosis of patients. This could further enable successful visual impairment treatment and prevention strategies targeting specific pathways in retinal diseases. All collaborating scientists and technical devices required for the submitted project are uniquely available and ready for use in the Prof Adnan Tufail research group at the Moorfields Eye Hospital and the UCL Institute of Ophthalmology.