Mechanistic-Based Non-Invasive Assessment of Retinal Damage in HAART Era

描述（由申请人提供）：hiv患者对高活性抗逆转录病毒治疗（HAART）反应良好。然而，我们的研究小组和其他人已经表明，尽管CD4细胞计数升高，视力下降仍会继续发生。在这项资助中，我们计划借助两种非侵入性成像技术——扫描激光偏振（SLP）和光学相干断层扫描（OCT），评估和量化视网膜神经纤维层（RNFL）和正常视网膜组织的视网膜损伤。我们将检验可能解释视力丧失的两种不同假设——一种是细胞因子介导的视神经病变，另一种是视网膜微血管缺血。我们研究的第一个具体目的是在横断面和纵向研究中通过SLP，传统OCT和高分辨率（HR） OCT来量化RNFL缺陷。RNFL缺损沿着视神经头周围的圆周测量，方法类似于青光眼研究。第二个具体目标是在横断面和纵向研究中通过HR-OCT量化整个后极的视网膜缺陷。这些视网膜缺陷可以发生在整个视网膜上，并将通过3d图像成像。第三个具体目标是将两种成像仪器检测到的RNFL和视网膜缺陷与标准视野功能测试、短波自动视野测量和其他结构和功能数据相关联。我们的研究团队包括一群具有各种专业知识的高素质人才。我们的团队包括视网膜成像专家、hiv相关眼部并发症研究专家、神经行为研究专家和高分辨率光学相干断层扫描专家。

DESCRIPTION (provided by applicant): Patients with HIV-disease have responded well to the highly activated antiretroviral therapy (HAART). However, our research group and others have shown that vision loss continues to occur despite elevated CD4 counts. In this grant we plan to assess and quantify retinal damage to the retinal nerve fiber layer (RNFL) and normal retinal tissue with the help of 2 non-invasive imaging techniques -- scanning laser polarimetry (SLP) and optical coherence tomography (OCT). We will test 2 different hypotheses that might explain the vision loss -- 1 is cytokine mediated optic neuropathy and the other is microvascular ischemia in the retina. The first specific aim of our study is to quantify RNFL defects by SLP, conventional OCT and high-resolution (HR) OCT in a cross-sectional and longitudinal study. RNFL defects are measured along a circumference around the optic nerve head in a manner analogous to studies in glaucoma research. The second specific aim is to quantify retinal defects throughout the posterior pole by HR-OCT in a cross-sectional and longitudinal study, as well. These retinal defects can occur throughout the retina and will be imaged by 3-D images. The third specific aim is correlate the RNFL and retinal defects detected with both imaging instruments with standard visual field function testing, short-wavelength automated perimetry and other structural and function data. Our research team encompasses a group of highly-qualified individuals with various expertise. Our team includes experts on retinal imaging, an expert in the study of HIV-related ocular complications, an expert in neurobehavioral research, and an expert on high-resolution optical coherence tomography.