Evaluation of photoreceptors health and function in diabetic retinopathy patients using a high-resolution retinal imaging device with controlled light stimulus

项目摘要/摘要 物理科学公司(PSI)与乔斯林糖尿病中心(JDC)合作，建议实现 客观表征光感受器对光的反应，从而量化两者之间的差异 通过在现有的高分辨率视网膜上增加受控的光刺激功能，使正常和患病的眼睛 成像平台，并在JDC的一群志愿者上进行验证。我们的目标是展示诱导的能力 并测量血管直径的变化，并归纳和测量反射率、透射率和长度 视锥细胞光感受器的变化旨在开发糖尿病视网膜病变的可靠生物标志物 (DR)。视网膜电路的功能测试可以对一个人的视力进行公正的评估，并使 早期发现视网膜疾病并监测治疗结果。 PSI一直在开发和提供多种类型的商用高分辨率视网膜成像仪 超过十五年，作为该领域的领导者之一而广为人知。基于这一经验，我们 建议在我们的多通道自适应光学视网膜中开发和实施光闪烁刺激功能 成像(Maori-X5)平台，客观测试视网膜功能。毛利-X5结合了声光辅助光学 相干断层扫描(OCT)和扫描激光眼底镜(SLO)在一台仪器中提供 视网膜微结构的活体细胞水平分辨率成像。没有商业上可用的SLO或 具有灯光闪烁功能的OCT系统。我们建议填补这一空白，并增强我们的能力 视网膜成像平台通过实现两种类型的光闪烁：局部、锥体水平照明，用于测试 光感受器的健康和功能，以及用于测试神经血管耦合的大面积照明。两者都有 不同类型的测量将以细胞级别的分辨率揭示光刺激的影响。增加刺激 对毛利-X5的能力使研究神经血管偶联和功能评估成为可能 商业平台上的视网膜光感受器。我们将验证这项技术的能力 在第一阶段测量细胞水平效应，作为对非常有限的10个队列的原则验证演示 JDC的志愿者与我们的临床合作伙伴Jennifer Sun博士合作。一项更广泛的研究将是 建议量化这些影响，并在随后的第二阶段证明临床有效性。 PSI开发先进的眼科成像系统的经验使我们具有竞争优势 在开发拟议的功能方面。成功完成第一阶段和随后的第二阶段 开发将为临床医生提供用于功能成像的高性能视网膜成像平台。 研究界对这项技术的早期适应将增加我们对视觉和 它被DR破坏，并将使研究新药和疗法的效果成为可能。PSI，唯一的 一家在全球范围内提供商用AO-SLO-OCT仪器的公司，计划开发下一代 视网膜成像研究仪器是临床量化DR对视力影响的可靠工具。

Project Summary/Abstract Physical Sciences Inc (PSI), in collaboration with Joslin Diabetes Center (JDC), proposes to enable objective characterization of the photoreceptor response to light and thus quantification of differences between normal and diseased eyes by adding controlled light stimulus capabilities to an existing high-resolution retinal imaging platform and validating it on a group of volunteers at JDC. We aim to demonstrate the ability to induce and measure vessel diameter changes and to induce and measure reflectivity, transmission, and length changes in cone photoreceptors with the purpose of developing robust biomarkers for diabetic retinopathy (DR). Functional testing of retinal circuitry can provide an unbiased evaluation of one’s vision and enable early detection of retinal diseases and monitoring treatment results. PSI has been developing and offering multiple types of commercial high-resolution retinal imagers for more than fifteen years and is well known as one of the leaders in the field. Based on this experience, we propose to develop and implement light flicker stimulus capabilities in our multichannel adaptive optics retinal imaging (MAORI-X5) platform to objectively test retinal function. MAORI-X5 combines AO-assisted optical coherence tomography (OCT) and scanning laser ophthalmoscopy (SLO) in one instrument and provides in vivo cellular-level resolution imaging of retinal microstuctures. There is no commercially available SLO or OCT system with light flicker capabilities. We propose to fill in this gap and enhance the capabilities of our retinal imaging platform by implementing two types of light flicker: local, cone-level illumination for testing the health and function of photoreceptors, and large area illumination for testing neurovascular coupling. Both types of measurements will reveal the effects of light stimulation with cellular-level resolution. Adding stimulus capabilities to MAORI-X5 enables investigations of neurovascular coupling and functional assessment of retinal photoreceptors on a commercially available platform. We will validate the ability of the technique to measure cellular level effects in Phase I as a proof-of-principle demonstration on a very limited cohort of ten volunteers in collaboration with our clinical partner, Dr. Jennifer Sun, at JDC. A more extensive study will be proposed to quantify these effects and demonstrate clinical usefulness in a subsequent Phase II. PSI prior experience developing advanced ophthalmic imaging systems gives us a competitive advantage in developing the proposed functionality. A successful completion of the Phase I and a subsequent Phase II development will provide clinicians with a high-performance retinal imaging platform for functional imaging. Early adaptors of this technology within the research community will grow our understanding of vision and its disruption by DR, and will enable the investigation of the effects of new drugs and therapies. PSI, the only company worldwide offering commercially AO-SLO-OCT instruments, proposes to develop the next generation of retinal imaging research instruments as a reliable tool to quantify clinically the effects of DR on vision.