Retinal Neurovascular Patterning in Preterm Infants

应聘者：我目前是玻璃体视网膜研究员，长期的职业目标是 成为独立的临床科学家和视网膜神经血管发育和治疗领域公认的领导者 儿科视网膜成像。我的研究议程集中在研究视网膜神经元和 使用尖端床边非侵入性OCT成像的血管发育和疾病。我有博士学位 对神经科学感兴趣，对神经和血管系统的发展长期感兴趣。我的 目前提议的直接职业目标是同时进行视网膜成像 早产儿黄斑和视网膜周边的神经元和血管微结构，以及 早产儿的这些变化与早产儿视网膜病变(ROP)相关。带着K23 导师以病人为本的研究事业发展奖，我将获得额外的教学 临床研究培训和儿童视网膜发育方面的指导研究经验， 视网膜成像、光子学、临床研究和负责任的研究行为。 环境：咨询委员会的指导和专业知识，以及 杜克大学杜克眼科中心和生物医学工程系，以及重要的 机构承诺将为我提供成功过渡到 独立研究生涯。 研究：这项提议的重点是检验视网膜神经元和血管 发育是协调的，血管病理与缺陷神经元的发育是平行的 ROP。我们将使用高级视网膜来同时评估视网膜神经元和血管的发育 光学相干层析(OCT)成像技术。在具体目标1中，我们将实现 新生儿OCT研究系统捕捉黄斑血管发育并分析相关性 早产儿神经和血管发育之间的关系。具体地说，我们将评估 和黄斑中心凹无血流区的血管形态，并与黄斑凹陷深度和 视网膜微结构。在特定目标2中，我们将研究病理性神经血管 ROP婴儿视网膜周围的模式，并确定早期亚临床特征 这可能预示着需要治疗的疾病。在具体目标3中，我们将描述因素和/或 影响早产儿视网膜神经血管发育和模式的系统性疾病， 例如ROP分期、是否存在疾病、是否存在早产儿黄斑水肿、存在 减弱的神经纤维层、ROP治疗(抗血管内皮生长因子或激光治疗)和全身 低氧等因素。这项工作将构成R01赠款的基础，将 加深对视网膜神经血管构型和儿童视网膜发病机制的认识 血管疾病，如ROP。

Candidate: I am currently a vitreoretinal fellow with the long-term career goal of becoming an independent clinician-scientist and a recognized leader in the field of retinal neurovascular development and pediatric retinal imaging. My research agenda is focused on investigating retinal neuronal and vascular development and disease using cutting-edge bedside noninvasive OCT imaging. I have a PhD in neuroscience and a longstanding interest in the development of neuronal and vascular systems. My immediate career goal in the current proposal is to perform simultaneous imaging of the retinal neuronal and vascular microstructures in the macula and retinal periphery in preterm infants, and correlate these changes in preterm infants with retinopathy of prematurity (ROP). With a K23 Mentored Patient-Oriented Research Career Development Award, I will acquire additional didactic training in clinical research and mentored research experience in pediatric retinal development, retinal imaging, photonics, clinical research and responsible conduct of research. Environment: The mentorship and expertise of the advisory committee, the extensive resources at Duke Eye Center and Department of Biomedical Engineering at Duke University, and the significant institutional commitment will provide me with the support needed to transition successfully into an independent research career. Research: The focus of this proposal is to test the hypothesis that retinal neuronal and vascular development are coordinated, and vascular pathology parallels defective neuronal development during ROP. We will assess simultaneously retinal neuronal and vascular development using advanced retinal optical coherence tomography (OCT) imaging technologies. In Specific Aim 1, we will implement a neonatal OCT research system to capture macular vascular development and analyze the correlation between neuronal and vascular development in preterm infants. Specifically, we will assess the size and vascular pattern of the foveal avascular zone and correlate with the foveal pit depth and retinal microstructures. In Specific Aim 2, we will investigate pathological neurovascular patterning in the retinal periphery in infants with ROP, and identify earlier subclinical features that may predict treatment-requiring disease. In Specific Aim 3, we will delineate factors and/or systemic diseases that affect retinal neurovascular development and patterning in preterm infants, such as stage of ROP, presence of plus disease, presence of macular edema of prematurity, presence of attenuated nerve fiber layers, ROP treatments (anti-VEGF or laser treatments) and systemic factors such as hypoxia. This body of work, which will constitute the basis of an R01 grant, will advance our understanding of retinal neurovascular patterning and pathogenesis of pediatric retinal vascular diseases such as ROP.