Spatial Extent of Retinal Damage

描述（由申请人提供）：视网膜和脉络膜损伤的空间范围将通过无创、定量的视觉功能和结构测绘来探测。我们将继续研究衰老变化和疾病过程之间的区别，特别是年龄相关性黄斑变性（AMD）。目的是确定患者失去视力的原因，并确定可以通过治疗来挽救视力的因素。长期目标涉及1999-2003年NEI国家计划的三个主要目标：提供早期诊断，探索AMD的病理生理异质性，并制定有效的眼病筛查策略。老龄化是一个重要的跨领域问题。这项研究包括随着年龄增长而增加的重要辅助因素：动脉粥样硬化性疾病、青光眼和II型糖尿病。此外，我们的纵向数据表明，被认为是视网膜内部异常的视网膜前膜是AMD患者的一个重要临床实体。为了达到这一目标，我们计划进行具有临床相关性的研究，包括正在进行的横断面研究和纵向研究。我们将采用独特、快速、抗杂散光的先进成像方法。为了研究人类的光感受器功能，我们将开发新的方法来测量患者或以前无法研究的视网膜区域的视锥细胞和视杆细胞内的光色素。为了研究光感受器下的支持细胞，视网膜色素上皮细胞的损伤，我们将主要使用近红外光技术，这是舒适的，几乎是不可见的。即使在中度白内障和出血时也能看到这些。我们将结合成像技术与图像处理的新方法。我们将在几个新的群体中研究视力丧失的机制，其中一些可能加剧视力丧失的重要因素，或改变疾病中的视网膜微环境。在我们的研究中，我们将纳入视力丧失高风险人群，以及在许多其他研究中被排除但代表临床管理问题的少数群体。具体来说，衰老的影响将与单独的年龄相关性黄斑变性以及在该年龄组中常见的疾病（动脉粥样硬化性心血管疾病、青光眼和ii型糖尿病）进行比较。心血管研究包括康复前后的测量。在这些组中，水肿、新血管膜、视网膜血管改变和未被发现的水肿的空间范围和分布是可用于评估可能的预防措施、确定局部治疗效果和估计预后的信息。

DESCRIPTION (provided by applicant): The spatial extent of retinal and choroidal damage will be probed with noninvasive, quantitative mapping of visual function and structure. We will continue to study the distinction between aging changes and disease processes, particularly for age-related macular degeneration (AMD). The goal is to determine why patients lose vision and to identify factors that are amenable to treatment to save vision. The long-term goals address three main thrusts of the NEI National Plan, 1999-2003: to provide early diagnosis, explore the pathophysiological heterogeneity of AMD, and develop effective strategies for screening for eye disease. Aging is an important cross-cutting issue. This study includes important co-factors that increase with age: atherosclerotic disease, glaucoma, and Type II diabetes. Further, our longitudinal data indicate that epiretinal membranes, considered an inner retinal abnormality, are an important clinical entity in our AMD patients. We plan studies with clinical relevance to reach this goal, including both on-going cross-sectional and longitudinal studies.We will use advanced imaging methods that are unique, rapid, and resistant to stray light. To investigate photoreceptor function in living humans, we will develop new methods that will measure the photopigment within cones and rods in patients or regions of the retina not amenable to study previously.To investigate the damage to support cells beneath the photoreceptors, the retinal pigment epithelial cells, we will use techniques primarily with near infrared light that is comfortable and virtually invisible. These are visible even through moderate cataract and hemorrhage. We will combine imaging techniques with novel methods of image processing. We will investigate the mechanisms of vision loss in several new groups, some of which exacerbate factors that may be important in vision loss, or change the retinal microenvironment in disease. We will include groups in our studies that are at high risk for vision loss, and minority groups, who have been excluded in many other studies but represent clinical management problems. Specifically, the effects of aging will be compared with age-related macular degeneration alone and in the presence of disease commonly found in this age group: atherosclerotic cardiovascular disease, glaucoma, and type Il diabetes. The cardiovascular study includes measuring before and after rehabilitation. The spatial extent and distribution of drusen, new vessel membranes, retinal vascular changes, and undetected edema in these groups is information that can used for evaluating possible preventative measures, determining the focal effects of treatment, estimating prognosis.