Retinal Nerve Fiber Layer Area in Aging and Glaucoma

描述(由申请人提供)：本职业培训提案的主要目标是为学术验光师提供成为独立研究人员所需的教学和实验室培训。该项目的目标是提高视网膜神经纤维层(RNFL)活体测量的精确度和准确性，RNFL是眼睛内神经节细胞含量的替代指标，使用定制的扫描来早期检测或进展青光眼。青光眼是一组疾病，如果不治疗，可能会导致不可逆转的失明。据估计，到2030年，全世界将有3700万人因这种疾病而失明，其中82%的人年龄在50岁以上。在美国，青光眼是一个重大的公共卫生问题，影响着220万人，是导致失明的主要原因。由于青光眼的病因难以捉摸，诊断或进展通常是通过直接评估视神经、评估视网膜神经纤维层(RNFL)的完整性和测量视野的敏感性来做出的。成像技术的进步使得对视网膜和视神经的客观评估成为可能。具体地说，光谱域光学相干层析成像(SD-OCT)允许高达75m的轴向分辨率。临床上常采用以视神经为中心的12度环形扫描测量视网膜神经纤维层的厚度。为了准确和准确地评估RNFL，重要的是要考虑到诸如眼球放大和非神经元内容物的贡献等因素。使用非侵入性方法测量眼睛生物测量，可以计算出眼睛的放大倍数。虽然SD-OCT扫描不能显示胶质组织和小的视网膜血管，但主要的视网膜血管在下面的组织上投射阴影，可以被考虑在内。该项目的目标是在考虑到眼球放大和主要视网膜血管系统的补偿后，研究RNFL的厚度和面积测量。特别是，这些方法将被用来1)在非人类灵长类动物模型中调查青光眼疾病进展过程中RNFL的厚度和横截面积的变化；2)研究正常衰老时RNFL的测量方法和血管对RNFL的贡献；3)研究青光眼患者的RNFL测量方法及其与视野的功能关系。这项技术的临床应用将提高青光眼患者的诊断准确性和治疗结果。

DESCRIPTION (provided by applicant): The primary objective of this career training proposal is the provide an academic optometrist with the didactic and laboratory training necessary to be an independent researcher. The objective of this project is to improve the precision and accuracy of in vivo measures of the retinal nerve fiber layer (RNFL), a surrogate for the ganglion cell content within the eye, using customized scans for the early detection or progression of glaucoma. Glaucoma is a group of diseases that can lead to irreversible blindness if left untreated. It is estimated that by the year 2030, 37 million individuals worldwide will be blinded by this disease, with 82% of these individuals being over the age of 50. In the United States, glaucoma is a significant public health problem, affecting 2.2 million individuals, and being a leading cause of blindness. Having an elusive cause, the diagnosis or progression of glaucoma is often made by direct assessment of the optic nerve, evaluating the integrity of the retinal nerve fiber layer (RNFL) and measuring the sensitivity of the visual field. Advances in imaging technology allow for an objective assessment of the retina and optic nerve. Specifically, spectral domain optical coherence tomography (SD-OCT) allow for up to 75m axial resolution. A 12 degree circular scan centered on the optic nerve is often used clinically for measuring the thickness of the RNFL. For an accurate and precise assessment of the RNFL, it is important to account for factors such as ocular magnification and the contribution of the non-neuronal content. Using non-invasive methodologies to measure ocular biometry, ocular magnification can be computed. Although glial tissue and small retinal vessels cannot be visualized in SD-OCT scans, the major retinal vessels cast shadows on the underlying tissues, and can be accounted for. The goal of the project is to investigate RNFL thickness and area measures after consideration of ocular magnification and compensation for major retinal vasculature. In particular, these methodologies will be used to 1) investigate changes in the thickness and cross sectional area of the RNFL with glaucoma disease progression in the non-human primate model; 2) investigate RNFL measures and the vascular contribution to the RNFL that occur with normal ageing; 3) investigate RNFL measures and the functional relationship to visual fields in glaucoma patients. Clinical implementation of this technology will improve the diagnostic accuracy and treatment outcomes of patients with glaucoma.