Retinal vessel features as a marker of idiopathic intracranial hypertension treatment response: a secondary analysis of the idiopathic intracranial hypertension treatment trial

项目摘要 迫切需要开发高颅内压（ICP）和对高血压反应的标志物和预测物。 高ICP治疗，这将指导临床医生适当个性化治疗特发性颅内 高血压（IIH），针对保守治疗无效的患者进行积极干预 或有视力丧失的风险。本申请寻求开发对后视网膜中视网膜血管变化的测量。 眼作为新的临床相关的生物标志物，以满足这一需求。这些是有前途的生物标志物候选者， 初步数据。此外，它们是特定的，客观的，定量的，并且可以从非侵入性的 技术.本研究的长期目标是了解视网膜血管的时程和变异性， 与ICP变化相关的变化。虽然已经描述了与ICP相关的一些视网膜血管变化， 其他的还没有被系统地研究过。此外，视网膜血管变化如何与其他眼睛变化相关 与ICP的关系知之甚少。我们的中心假设是视网膜血管的变化， 治疗先于其他眼科变化，这些变化预测了长期的治疗反应。的 这项提案的目的是对作为NIH资助的一部分收集的眼底照片进行二次分析 特发性颅内高血压治疗试验（IIHTT，clinicaltrials.gov标识符NCT 01003639），以定义视网膜病变 IIH治疗期间在其他疾病标志物的背景下发生的血管变化。第一个目标是定义 通过比较视网膜血管特征，在IIH的药物治疗期间发生的视网膜血管变化谱 从基线和研究结论时的眼底照片中提取。第二个目标是建立早期视网膜病变 通过研究初始研究访视之间的变化，将血管变化作为IIH药物治疗反应的标志 (0-1 6个月）预测6个月的结果。

PROJECT SUMMARY There is a critical need for developing markers and predictors of both high intracranial pressure (ICP) and response to high ICP treatment, that will guide clinicians to appropriately personalize treatment for idiopathic intracranial hypertension (IIH) by targeting aggressive interventions to patients who are not responding to conservative treatments or are at risk of vision loss. This application seeks to develop measurements of retinal vascular changes in the posterior eye as novel clinically-relevant biomarkers to meet this need. These are promising biomarker candidates based on preliminary data. Furthermore, they are specific, objective, quantitative and can be derived from non-invasive technologies. The long-term goal of this research is to understand the time course and variability of retinal vascular changes associated with ICP changes. Though some retinal vascular changes in association with ICP have been described, others have not been systematically studied. Furthermore, how retinal vascular changes relate to other eye changes associated with ICP is poorly understood. Our central hypothesis is that retinal vascular changes in response to ICP treatment precede other ophthalmic changes and that these predict treatment response over the longer term. The objective of this proposal is to perform a secondary analysis of fundus photos collected as part of the NIH funded Idiopathic Intracranial Hypertension Treatment Trial (IIHTT, clinicaltrials.gov identifier NCT01003639) to define retinal vascular changes occurring during IIH treatment in the context of other markers of disease. The first aim is to define the spectrum of retinal vascular changes that occur during medical treatment of IIH by comparing retinal vascular features extracted from fundus photographs at baseline and study conclusion. The second aim is to establish early retinal vascular change as a marker of response to medical treatment in IIH by studying how changes between initial study visits (0-1 month) predict outcomes at 6 months.