Focal Structure-Function Relationships in Macular Layers from 3D Spectral OCT

描述（由申请人提供）：本提案旨在阐明视野阈值灵敏度与视网膜层结构特征之间的结构-功能关系。该研究将解决黄斑层的哪些结构特性——从光谱域光学相干断层扫描（3-D OCT）的三维图像分析中获得——与视觉灵敏度（一种功能测量）有关。具体来说，我们将研究黄斑局部柱状区域的结构测量，包括层厚度和纹理，如何与在中心10度对应位置测量的黄斑柱的阈值灵敏度相关联。该项目是由一个重要的临床问题驱动的-视神经病变（包括青光眼）中，视场作为视网膜神经节细胞及其轴突不可逆损伤的衡量标准的可靠性和可重复性差。如果预期的关联通过黄斑层光谱域OCT的三维图像分析得到证实，新方法有可能成为损伤状态功能评估的客观和可重复的补充。本研究的最重要假设是，通过对三维光谱域OCT图像的综合分析，可以从黄斑的结构和纹理特性来预测黄斑的视觉灵敏度。我们确定了以下具体目标：目标1：改进和验证我们现有的从三维光谱OCT图像中分割视网膜层的方法；得出正常眼睛和青光眼和前缺血性视神经病变引起的中央视野损害的眼睛的视网膜乳头周围和黄斑区域各视网膜层的整体和局灶性结构指标，如厚度和质地。目的2：确定黄斑视网膜神经节细胞和其他视网膜内层的结构指标与视网膜神经纤维层中相应神经节细胞轴突的厚度之间的关系。这将在正常眼睛和青光眼和前缺血性视神经病变引起的大范围黄斑敏感性丧失的眼睛中得到证明。目的3：通过比较和登记68个位置的视觉灵敏度（Humphrey 10-2测试平均超过3次重复）及其相应的分割层结构指标，建立黄斑结构-功能关系模型。从目标2中使用的同一组正常和受损眼睛的黄斑层的结构特性中得出功能的预测模型。这项工作将在30名正常受试者、5名青光眼受试者和20名单侧前缺血性视神经病变受试者的体内获得的3d OCT图像以及视野灵敏度测试数据中进行。公共卫生相关性：三维光谱OCT成像提供了丰富的视网膜层形态和组织特征信息。我们建议使用这种新的三维OCT成像设备来研究黄斑视网膜内层的结构和功能关系。本研究对青光眼、前路缺血性神经病变和其他视网膜疾病的诊断和治疗具有潜在的重要意义。

DESCRIPTION (provided by applicant): This proposal seeks to elucidate the structure-function relationships between visual field threshold sensitivity and the structural features of the retinal layers. The study will address which structural properties of the layers of the macula - obtained from three-dimensional image analysis of spectral domain optical coherence tomography (3-D OCT) - are associated with visual sensitivity, a measure of function. Specifically, we will investigate how structural measures of localized columnar regions of the macula, including layer thickness and texture, are associated with the threshold sensitivity of those macular columns measured at corresponding locations in the central 10 degrees with 10-2 perimetry. The project is driven by an important clinical problem - the poor reliability and reproducibility of the visual field as a measure of irreversible damage to the retinal ganglion cells and their axons in optic neuropathies including glaucoma. If the expected associations are confirmed by 3-D image analysis of spectral domain OCT of the macular layers, the new approach has the potential to become an objective and reproducible addition to the functional assessment of the status of damage. The overriding hypothesis motivating the proposed research is that macular visual sensitivity can be predicted from macular structure and texture properties as imaged and quantified by comprehensive analysis of 3-D spectral-domain OCT. We have identified the following specific aims: Aim 1: Refine and validate our existing method of segmenting retinal layers from 3-D spectral OCT images; derive global and focal structural indices, such as thickness and texture, of each retinal layer in the peripapillary and the macular regions of the retina in normal eyes and in eyes with central visual field damage from glaucoma and anterior ischemic optic neuropathy. Aim 2: Determine how the structural indices derived from the retinal ganglion cell and other intraretinal layers in the macula correlate with the thickness of the corresponding ganglion cell axons in the retinal nerve fiber layer. This will be demonstrated in normal eyes and in eyes with a wide range of macular sensitivity loss from glaucoma and anterior ischemic optic neuropathy. Aim 3: Model the structural-functional relationships in the macula by comparing and registering visual sensitivity at 68 locations (Humphrey 10-2 test averaged over 3 repeats) with their corresponding structural indices of the segmented layers. Derive a predictive model of function from structural properties of the macular layers in the same set of normal and damaged eyes used in Aim 2. The work will be performed in in-vivo acquired 3-D OCT images accompanied by visual field sensitivity test data from 30 normal, 5 glaucoma, and 20 unilateral anterior ischemic optic neuropathy subjects. PUBLIC HEALTH RELEVANCE: Three dimensional spectral OCT imaging provides a wealth of information about the morphology and tissue characteristics of retinal layers. We propose to study structural and functional relationships of the macular intraretinal layers using this new 3-D OCT imaging device. This study has potentially important consequences for glaucoma, anterior ischemic neural neuropathy, and other retinal disease diagnosis and treatment.