Glaucoma Assessment Using A Multimodality Image Analysis Approach

描述(由申请人提供) 这一职业发展奖-2(CDA-2)是为了表彰一名早期职业生涯中的工程学教师提供三年的支持。它将提供培训手段，培训目前在多种眼科模式和临床领域的一种眼科成像模式(光学相干断层扫描，OCT)方面拥有广泛图像分析经验和狭隘专业知识的年轻研究人员，特别是青光眼。虽然被提名人已经被证明是退伍军人管理局临床医生跨学科团队的一名成功成员，也是爱荷华市退伍军人事务部预防和治疗视力损失卓越中心的研究员，但这项CDA是专门为增强她的眼科临床知识而设计的，使她能够发展成为一名眼科图像分析专家，对于一名受过工程训练的学者来说，她具有前所未有的临床理解水平，并能够为退伍军人感兴趣的跨学科转化性和临床眼科研究做出重大贡献。由于目前与诊断和评估青光眼的标准功能测量相关的可变性，该研究计划旨在努力获得更好的结构参数，以实现(1)更好的诊断能力，(2)疾病分期的客观基础，以及(3)更好的衡量疾病进展的能力。更具体地说，总体假设来自立体眼底照相和光谱域OCT(SD-OCT)的信息的多模式组合将使(在正常受试者中)能够发现与青光眼的诊断、治疗或理解相关的变量较少且更具重复性的结构参数，该计划针对以下具体目标：7目标1：开发新的多模式方法以获得用于青光眼评估的较少变化的层厚度和更多可重复性的视神经头结构参数。-目标1a：开发同时分割眼底照片和SD-OCT体积中的血管的方法。根据SD-OCT和/或眼底照相中血管的存在，改进校正SD-OCT体积中视网膜神经纤维层厚度/体积和神经节细胞层厚度/体积的方法。验证这样的校正导致正常受试者的区域厚度测量的变异性较低。-目标1b：开发在SD-OCT图像和立体眼底照片中同时分割视盘、神经管开口和视杯的方法。计算这些测量在正常眼和青光眼中的重复性。7目的2：描述正常眼和不同屈光度、眼轴长度和年龄变化的眼的视网膜内层和外层之间的关系。确定这种关系是否能够减少正常受试者视网膜内厚度测量的变异性，并使青光眼受试者的厚度参数与疾病状态更好地关联。7目的3：在正常人和青光眼受试者中，视网膜内层含有神经节细胞的厚度/体积(基于血管的存在而校正和未校正的)与a)视网膜神经纤维层的厚度(基于血管的校正和未校正的)和b)边缘组织在神经管开口平面上的横截面积有关。除了与青光眼直接相关外，作为研究计划的一部分开发的图像分析方法将与远程医疗应用和其他眼科(和系统)疾病相关。因此，这将使退伍军人进一步受益，并将为被提名者今后在这些领域的研究奠定基础。

DESCRIPTION (provided by applicant) This Career Development Award-2 (CDA-2) is for supporting an early-career engineering faculty member for three years. It will provide the means to train a young researcher currently possessing broad image analysis experience and narrowly focused expertise in one ophthalmic imaging modality (optical coherence tomography, OCT) in a multitude of ophthalmic modalities and clinical areas, with a special focus on glaucoma. While the nominee has already demonstrated success as a member of interdisciplinary teams with VA clinicians and is an investigator associated with the Iowa City VA Center of Excellence for the Prevention and Treatment of Visual Loss, this CDA is specifically designed to enhance her ophthalmic clinical knowledge to enable her to develop into an ophthalmic image analysis expert with an unprecedented level of clinical understanding for an engineering-trained scholar and with the ability to contribute substantially to interdisciplinary translational and clinically oriented ophthalmic research of interest to veterans. Because of the current variability associated with standard functional measurements for the diagnosis and assessment of glaucoma, the research plan is designed to work towards obtaining better structural parameters to enable (1) improved diagnostic capabilities, (2) an objective basis for disease staging, and (3) an improved ability to measure disease progression. More specifically, with the overall hypothesis that the multimodal combination of information from stereo fundus photography and spectral-domain OCT (SD-OCT) will enable the discovery of less variable (across normal subjects) and more reproducible structural parameters relevant to the diagnosis, management, or understanding of glaucoma, the plan addresses the following specific aims: 7 Aim 1: Develop the novel multimodal methodology for obtaining less variable layer-thickness and more reproducible optic-nerve-head structural parameters for the assessment of glaucoma. - Aim 1a: Develop the methodology for simultaneously segmenting the blood vessels in fundus photographs and SD-OCT volumes. Refine the methodology for correcting the retinal nerve fiber layer thickness/volume and ganglion cell layer thickness/volume in SD-OCT volumes based on the presence of blood vessels derived from SD-OCT and/or fundus photography. Verify that such a correction results in a lower variability in regional thickness measurements across normal subjects. - Aim 1b: Develop the methodology for simultaneously segmenting the optic disc, neural canal opening, and cup in SD-OCT images and stereo fundus photographs. Compute the reproducibility of such measurements in normal eyes and in eyes with glaucoma. 7 Aim 2: Characterize the relationship between the inner layers of the retina and the outer layers of the retina in normal eyes and in eyes varying in refractive error, axial eye length, and age. Determine whether this relationship will enable reduced variability of inner retinal thickness measurements across normal subjects and better correlation of thickness parameters with disease status in glaucoma subjects. 7 Aim 3: Relate the thickness/volume of the inner retinal layer containing ganglion cells (corrected and uncorrected based on the presence of vessels) to a) the retinal nerve fiber layer thickness (corrected and uncorrected based on the presence of vessels) and b) the cross-sectional area of the rim tissue at the plane of the neural canal opening in normal and glaucoma subjects. In addition to its direct relevance to glaucoma, the image analysis methodology developed as part of the research plan will be relevant to telemedical applications and other ophthalmic (and systemic) diseases. This will thus enable further benefit for the veteran population and will set the stage for future research in these areas by the nominee.