Quantitative Analysis of Optic Disc/Ocular Hypertension

描述（由申请人提供）：本申请描述了对高眼压治疗研究（OHTS）的共聚焦扫描激光检眼镜（CSLO）辅助研究的额外五年资金的竞争性更新。本研究的总体目的是确定CSLO在客观定量检测高眼压患者视盘青光眼改变的有效性，并评估低血压治疗对视盘形貌的影响。具体目标：1；治疗对视盘形貌变化的影响。估计视盘地形随时间的变化率，并确定眼压治疗对高眼压患者视盘地形的影响。比较视盘立体摄影与CSLO检测青光眼视盘变化的能力。2. 种族、视盘地形与青光眼易感性。确定非裔美国人OHTS参与者中较高的POAG发生率是否至少部分归因于几个因素之间的复杂关系，包括更大的视盘面积、视盘地形的更大变化、更高的测量IOP和更薄的角膜。3. 改进POAG预测。利用基线HRT地形视盘测量或这些测量的变化来提高OHTS风险模型预测POAG的精度和完整性。方法：21个OHTS研究中心中的7个参与了这项辅助研究；451名高眼压患者同意参与本研究。至少352人（78%）仍然活跃在研究中，对324名参与者进行了至少5年的随访。CSLO图像每年在扩张OHTS就诊时获得。加州大学圣地亚哥分校的CSLO阅读中心负责处理和分析图像，并每月向OHTS数据协调中心提供地形光盘数据。这些数据将被定量评估青光眼损伤和改变的证据，并与OHTS中获得的原发性开角型青光眼终点的结构和功能测量进行比较。本研究将评估眼底成像技术的这些进步是否可以提高我们检测、预测和监测青光眼视神经病变的精度。

DESCRIPTION (provided by applicant): This application describes a competitive renewal for an additional five years of funding for the confocal scanning laser ophthalmoscopy (CSLO) ancillary study to the Ocular Hypertension Treatment Study (OHTS). The overall goal of this study is to determine the effectiveness of CSLO to objectively and quantitatively detect glaucomatous changes of the optic disc in ocular hypertensive patients and to assess the effect of ocular hypotensive treatment on optic disc topography. Specific Aims: 1. Effect of treatment on change in optic disc topography. To estimate the rate of change in optic disc topography over time, and determine the effect of ocular hypotensive treatment on optic disc topography in ocular hypertensive patients. The ability of optic disc stereophotography and CSLO to detect glaucomatous optic disc change will be compared. 2. Race, optic disc topography and glaucoma susceptibility. To determine whether the higher incidence of POAG found in African American OHTS participants is due at least in part to a complex relationship among several factors including a larger optic disc area, larger changes in optic disc topography, higher measured IOP and thinner corneas. 3. Improving Prediction of POAG. To utilize baseline HRT topographic optic disc measures or changes in these measures to increase the precision and completeness of the OHTS risk model to predict POAG. Methods: Seven of the 21 OHTS study centers participate in this ancillary study; 451 ocular hypertensive patients have consented to participate in the study. At least 352 (78%) are still active in the study with at least 5 years of follow-up on 324 participants. CSLO images are acquired annually at the dilated OHTS visit. The CSLO Reading Center at University of California, San Diego is responsible for processing and analyzing the images and providing the OHTS Data Coordinating Center with topographic optic disc data monthly. These data will be evaluated quantitatively for evidence of glaucomatous damage and change, and compared with structural and functional measures of primary open angle glaucoma endpoints obtained in the OHTS. This study will evaluate whether these advances in fundus imaging technology can improve the precision with which we can detect, predict and monitor glaucomatous optic neuropathy.