Novel Glaucoma Diagnostics for Structure and Function

我们广泛的长期目标仍然是开发精确测量视神经和视网膜变化的技术，这将使青光眼和青光眼进展的早期检测成为可能。这个转化研究项目是由匹兹堡大学、塔夫茨大学医学院、麻省理工学院和卡内基梅隆大学的眼科医生、工程师、计算机科学家和物理学家组成的多学科团队共同努力的结果。我们的具体目标是：(1)通过客观、定量的结构和功能评估，尽早发现青光眼损伤和进展的证据。我们将比较眼结构测量（OCT， CSLO， SLP）和眼功能测量（视野测量和多焦视觉诱发电位），使用我们长期纵向波士顿队列亚组的历史和前瞻性检查和我们匹兹堡队列的新纵向前瞻性检查。我们预计，用结构措施检测到的变化将先于用功能技术检测到的变化。(2)确定结合结构和视界数据的协同对应指数是否能加速检测青光眼视界异常或进展的能力。本前瞻性实验将评估结构与功能相结合的对应指数对早期至中度青光眼患者视野结果的可靠预测能力。这样的指标可以减少或消除未来对确证性周界检查的需求。(3)利用OCT测量技术推进微米尺度的断层成像，用于青光眼的早期检测和更敏感的进展鉴别。我们开发了一种新的高速高分辨率仪器，每秒可进行16,000次轴向扫描，提供约1-3 μ m的轴向分辨率。我们将在健康、可疑和青光眼受试者中评估这一技术以及我们正在开发的其他技术策略的能力，包括跟踪oct和光谱域oct，以提供更好的图像配准、测量再现性和鉴别能力。该项目解决了国家视觉研究计划中提出的战略研究重点，“…开发改进的诊断措施，以检测视神经疾病的发病、进展和治疗效果。”

DESCRIPTION: Our broad, long term objective continues to be the development of technologies for precisely measuring optic nerve and retinal changes that will enable early detection of glaucoma and of glaucoma progression. This translational research project is a collaborative effort of our multidisciplinary team of ophthalmologists, engineers, computer scientists and physicists at the University of Pittsburgh, Tufts University School of Medicine, Massachusetts Institute of Technology and Carnegie Mellon University. Our Specific Aims are (1) To detect the earliest possible evidence of glaucomatous damage and progression through objective, quantitative structural and functional assessment. We will compare ocular structural measurements (OCT, CSLO, SLP) and ocular function measurements (perimetry and multifocal visual evoked potential) using the historical and prospective examinations on the subgroups in our long-term longitudinal Boston cohort and new longitudinal prospective examinations on our Pittsburgh cohort. We expect that changes detected with structural measures will precede those detected with functional techniques. (2) To determine whether a synergistic index of correspondence, that combines structural and perimetric data, accelerates the ability to detect perimetric abnormality or progression in glaucoma. This prospective experiment will evaluate the ability of combined structural and functional correspondence indices to reliably predict visual field results in early to moderate glaucoma patients. Such an index could reduce or eliminate the need for confirmatory perimetric testing in the future and (3) To advance micron-scale tomographic imaging using OCT measurement technology for early detection of glaucoma and for more sensitive discrimination of progression. A new, high speed, high resolution instrument that we have developed provides about 1-3 mu m axial resolution at 16,000 axial scans per second. We will evaluate in healthy, suspect and glaucomatous subjects the ability of this and other technologic strategies that we are developing - including, tracking-OCT and spectral-domain-OCT - to provide even better image registration, measurement reproducibility and discriminating power. This project addresses the Strategic Research Priorities stated in the National Plan for Vision Research, to ".. .develop improved diagnostic measures to detect optic nerve disease onset, progression, and treatment effectiveness."