Ocular Biomarkers of Microvascular, Neural and Metabolic Function in Diabetes

 描述（由申请人提供）：糖尿病视网膜病变（DR）目前是工作年龄成人视力丧失的主要原因。随着糖尿病人口的预期增长，无法工作或照顾自己的视力受损糖尿病患者的数量将继续成为一个主要的公共卫生问题。已知糖尿病会引起视网膜微血管和组织的改变，从而逐渐导致视力损害。目前，预防DR引起的视力丧失需要早期诊断、定期监测和及时治疗干预。然而，一个关键的障碍是区分糖尿病个体谁将发展视网膜病变和进展到视力威胁的糖尿病黄斑水肿或增殖性DR。此外，还不知道为什么抗血管内皮生长因子治疗糖尿病黄斑水肿是有效的，在改善视力只有一些人。由于多种伴随因素可能导致DR的病理生理学，因此视网膜结构的单一生物标志物在预测DR进展和治疗结果方面的成功有限。目前的研究建议将克服这一限制，通过一种创新的方法，全面和比较表征的解剖和生理眼睛生物标志物。具体目标是确定微血管，神经和代谢功能的眼部生物标志物，这些生物标志物可预测DR的发展，进展和治疗结果。这些眼部生物标志物将通过非侵入性多模态光学成像技术获得。这些发现还将深入了解微血管，神经和代谢生物标志物如何协同作用，促进DR和其他糖尿病并发症的发展。未来将鉴定的眼部生物标志物纳入临床实践将有助于预防视力损害，从而显著影响糖尿病患者的生活质量。

 DESCRIPTION (provided by applicant): Diabetic retinopathy (DR) is currently the leading cause of vision loss in working-aged adults. With the anticipated growth of the diabetic population, the number of visually impaired diabetic people who cannot work or care for themselves will continue to be a major public health concern. Diabetes is known to cause alterations in the retinal microvasculature and tissue that can progressively lead to visual impairment. Currently, prevention of vision loss due to DR requires early diagnosis, regular monitoring, and timely therapeutic intervention. However, a key impediment is distinguishing diabetic individuals who will develop retinopathy and progress to vision-threatening diabetic macular edema or proliferative DR. Furthermore, it is not known why anti-vascular endothelium growth factor treatment of diabetic macular edema is effective in improving vision of only some individuals. Since multiple concomitant factors likely contribute to the pathophysiology of DR, single biomarkers of retinal structure have had limited success in predicting DR progression and treatment outcome. The current research proposal will overcome this limitation by an innovative approach of comprehensive and comparative characterization of both anatomical and physiological ocular biomarkers. The specific aims are to identify ocular biomarkers of microvascular, neural, and metabolic function that are predictive of development, progression, and treatment outcome of DR. These ocular biomarkers will be obtained by non-invasive multimodal optical imaging technologies. The findings will also provide insight into how microvascular, neural and metabolic biomarkers interact synergistically in contributing to the development of DR and other diabetes complications. Future incorporation of the identified ocular biomarkers into clinical practice will aid in prevention of visual impairment, thereby significantly impacting the quality of life of diabetic people.