Defining the Relationships of Retinal Microcirculation with Glaucoma, Systemic Disease, and Ocular Anatomic Factors in African Americans

项目总结 这份K23申请是由Grace Richter，医学博士，公共卫生硕士，眼科学助理教授提交的 南加州大学凯克医学院南加州大学罗斯基眼科研究所青光眼科 加利福尼亚。这项K23职业发展计划的主要目标是：1)提供 具有指导临床所需的额外培训和指导研究经验的青光眼专家 独立研究；以及2)进行横断面研究，调查不同性别之间的关系 原发性开角型青光眼(POAG)全身血管视网膜微循环灌注参数 非洲裔美国人的疾病和眼解剖因素，与非裔美国人相比，他们有更大的POAG负担 其他种群。总之，这将为我建立一个独立的临床 使用光学相干断层扫描血管成像(OCTA)研究影响OBF的因素的研究计划 并在R01赞助的一项纵向临床研究中阐明OBF对青光眼的影响。虽然我已经 拥有公共卫生硕士学位(MPH)，这项K23培训计划将为以下人员提供额外的必要培训 这项研究。我的培训工作将集中在四个方面：(1)使用OCTA的船舶量化方法；(2) 基于人群和临床队列研究的方法；(3)流行病学的先进生物统计学方法 和临床研究；以及(4)不同人群的最佳研究实践。除了正式的课程作业外， 通过定期与知名导师(罗希特·瓦尔马博士、瑞康博士)举行会议，将大大加强培训 王博士、詹姆斯·高德曼博士和罗伯塔·麦基恩-考丁博士)，以及参与当地和 国际会议。这项研究提案将利用OCTA收集的关于非洲 美国眼病研究确定四种不同的视网膜灌注指标与以下指标的关系：(1) 青光眼，包括结构性和功能性措施；(2)包括糖尿病在内的系统性血管疾病 和高血压；(3)眼解剖特征，包括眼压、中央角膜厚度、 青光眼和非青光眼患者的轴性近视。这些系统和眼睛因素被认为是 是青光眼的危险因素，但其潜在的机制还不是很清楚。定义 这些实体与视网膜血流参数的关系将使我们更好地了解其发病机制。 并将改进青光眼病理生理学假说。这项研究将提供 为后续纵向研究提供关键数据，并为可能的干预措施生成完善的假设 学习。最终，它将导致改进的治疗方法，以防止青光眼致盲。

PROJECT SUMMARY This K23 application is submitted by Grace Richter, MD, MPH, an Assistant Professor of Ophthalmology in the Glaucoma Division at the USC Roski Eye Institute at Keck School of Medicine of University of Southern California. The primary objectives of this K23 career development proposal are: 1) to provide an academic glaucoma specialist with the additional training and mentored research experience necessary to direct clinical studies independently; and 2) to perform cross-sectional research investigating the relationships of various retinal microcirculation perfusion parameters with primary open angle glaucoma (POAG), systemic vascular disease, and ocular anatomic factors in African Americans, who have a greater burden of POAG compared to other populations. Together, this will provide the foundation for me to establish an independent clinical research program using optical coherence tomography angiography (OCTA) to study factors that affect OBF and to elucidate how OBF affects glaucoma in an R01-sponsored longitudinal clinical study. While I already have a Masters in Public Health (MPH), this K23 training program will provide additional necessary training for this research. My training efforts will focus on four areas: (1) vessel quantification methods using OCTA; (2) methods in population-based and clinical cohort studies; (3) advanced biostatistical methods for epidemiology and clinical research; and (4) best research practices in diverse populations. In addition to formal coursework, training will be greatly enhanced by regular meetings with renowned mentors (Dr. Rohit Varma, Dr. Ruikang Wang, Dr. James Gauderman, and Dr. Roberta McKean-Cowdin), as well as participation in local and international meetings. This research proposal will utilize OCTA data collected on participants of the African American Eye Disease Study to define the relationships of 4 different measures of retinal perfusion with: (1) glaucoma, including both structural and functional measures; (2) systemic vascular diseases including diabetes and hypertension; and (3) ocular anatomic features including intraocular pressure, central corneal thickness, and axial myopia in glaucoma and non-glaucoma patients. These systemic and ocular factors are thought to be risk factors for glaucoma, but the underlying mechanisms are not well understood. Defining the relationships of these entities with retinal perfusion parameters will give us better insight into the pathogenesis of glaucoma and will generate improved hypotheses for glaucoma pathophysiology. This research will provide key data for subsequent longitudinal studies and generate refined hypotheses for possible interventional studies. Ultimately, it will lead to improved treatments that prevent blindness from glaucoma.