Clinical optical coherence tomography for retinal metabolic imaging

项目总结 糖尿病视网膜病变(DR)是糖尿病的一种并发症，也是世界上主要的致盲原因。虽然 人们普遍认为DR是由缺血驱动的，目前对DR严重程度的分级仅基于 结构改变，如非增殖性糖尿病视网膜病变的视网膜微血管异常 增生期DR的血管生成结果是，大多数患者已经发展成不可逆转的视网膜 当他们第一次收到DR诊断时，他们会出现功能障碍。DR通过循序渐进的方式发展 毛细血管非灌注性增加导致血液供应不足，不能满足机体的代谢需求 视网膜内神经元。这会导致视网膜缺血，激活信号通路，促进 血管生成，并预示着视网膜病变的增殖期。如果不及时管理，就会扩散 糖尿病视网膜病变最终会导致失明。因此，无创成像的视网膜氧代谢率是 预计将提高我们对DR病理生理学的理解，并显著增强我们的能力 诊断和管理高危DR。 这一建议旨在最大限度地提高一种新型可见光光学器件的平移和集成的可能性 相干断层扫描或VIS-OCT在DR临床管理中的应用我们寻求设计、开发和优化 第一台临床样机VIS-OCT视网膜氧代谢率定量仪器 受试者以及糖尿病患者。我们相信，拟议的技术有可能 将现有的DR临床实践从以解剖为基础的方法转变为更敏感和客观的方法 基于功能的方法。拟议的工作建立在Opticent Health成功实现 第一阶段项目，并与领先的临床医生和科学家密切合作。

PROJECT SUMMARY Diabetic retinopathy (DR) is a complication of diabetes and a leading cause of blindness in the world. Although it is widely accepted that DR is driven by ischemia, the current grading of DR severity is based only on structural alterations such as the presence of abnormal retinal microvasculature in non-proliferative DR or angiogenesis in proliferative DR. As a result, most patients have already developed irreversible retinal functional impairment when they first receive their DR diagnosis. DR develops through progressively increasing capillary non-perfusion leading to insufficient blood supply to meet the metabolic demand of the inner retinal neurons. This causes retinal ischemia, which activates signaling pathways that promote angiogenesis and herald the proliferative phase of retinopathy. If not managed in a timely fashion, proliferative DR can ultimately lead to blindness. Therefore, non-invasive imaging of retinal metabolic rate of oxygen is expected to improve our understanding of DR pathophysiology as well as significantly enhance our ability to diagnose and manage high-risk DR. This proposal aims to maximize the likelihood of translation and integration of a novel visible-light optical coherence tomography or vis-OCT into clinical management of DR. We seek to design, develop, and optimize the first clinical-prototype vis-OCT instrument to quantify retinal metabolic rate of oxygen in normal human subjects as well as in patients with diabetes. We believe that the proposed technology has the potential to transform the existing clinical practice of DR from anatomy-based approach to a more sensitive and objective function-based approach. The proposed work is built on Opticent Health’s successful meeting the goals in the Phase I project and on close collaboration with leading clinician-scientists.