Spatial Extent of Retinal Damage

描述（由申请人提供）：将通过视觉功能和结构的非侵入性定量映射来探测视网膜和脉络膜损伤的空间范围。我们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）。其目标是确定患者丧失视力的原因，然后确定适合治疗以挽救视力的因素。长期目标针对NEI国家眼科和视力研究计划的3个重点：1）开发和应用非侵入性技术，以更好地了解视网膜功能和疾病状态的变化; 2）改善AMD的早期诊断; 3）探索AMD的病理生理异质性，以加速开发改善诊断，预防和治疗所需的工具。该项目是为数不多的包括测量活体人类（包括患者）视觉周期的项目之一。我们研究了AMD患者及其家庭成员，老年对照组和年轻受试者，作为患者家庭成员的对照，并寻求眼病的早期变化。 我们将使用先进的成像方法，独特，快速，抗杂散光。我们探测内部和外部视网膜的变化，以了解光感受器的环境。这包括视网膜色素上皮和视网膜血管的变化。为了研究光感受器的功能，我们将继续开发新的方法来测量患者或视网膜区域的视锥细胞和视杆细胞内的色素沉着，这些色素沉着以前不适合研究。在我们现有的方法中，我们正在增加新的偏振技术，包括多波长扫描激光偏振仪。一个不寻常的方面是使用多重散射光来提供视网膜内和视网膜下的病理信息，否则会被反射的视网膜表面所掩盖。我们的许多方法使用近红外光，这提高了患者的舒适度，并通过适度的透镜变化和视网膜中的液体提供视网膜的视图。

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 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 then identify factors that are amenable to treatment to save vision. The long-term goals address 3 thrusts of the NEI National Plan for Eye and Vision Research: 1) develop and apply noninvasive technologies to better understand retinal function and changes in disease states; 2) improve early diagnosis of AMD; and 3) explore the pathophysiological heterogeneity of AMD to hasten development of the tools needed for improved diagnosis, prevention, and therapy. This project is one of the few that includes measurements of the visual cycle in living humans, including patients. We study patients with AMD and their family members, older control subjects, and young subjects, both as controls for family members of patients and to seek the very early changes in eye disease. We will use advanced imaging methods that are unique, rapid, and resistant to stray light. We probe both inner and outer retinal changes, to understand the environment of the photoreceptors. This includes the retinal pigment epithelium and retinal vascular changes. To investigate photoreceptor function, we will continue to develop novel methods to measure that photopigment within cones and rods in patients or regions of the retina not previously amenable to study. To our existing methods, we are adding new polarimetry techniques, including a multi-wavelength, scanning laser polarimeter. One unusual aspect is the use of multiply scattered light to provide information about pathology in and beneath the retina, otherwise obscured by the reflective retinal surface. Many of our methods use near infrared light, which improves patient comfort and provides views of the retina through moderate lens changes and fluid in the retina.