Focal Structure-Function Relationships in Macular Layers from 3D Spectral OCT

描述(申请人提供)：本提案旨在阐明视野阈值敏感度和视网膜各层结构特征之间的结构-功能关系。这项研究将解决黄斑层的哪些结构特性--通过光谱域光学相干断层扫描(3-D OCT)的三维图像分析获得--与视觉敏感度相关，视觉敏感度是一种功能衡量标准。具体地说，我们将调查黄斑局部柱状区域的结构测量，包括层厚度和纹理，如何与在中央10度角相应位置用10-2视野测量的那些黄斑柱的阈值敏感度相关联。该项目是由一个重要的临床问题推动的-视野作为衡量包括青光眼在内的视神经疾病中视网膜神经节细胞及其轴突的不可逆转损害的指标，可靠性和重复性较差。如果黄斑层光谱域OCT的三维图像分析证实了预期的相关性，新的方法有可能成为对损害状态的功能评估的一种客观和可重复性的补充。支持这项研究的最重要的假设是，黄斑视觉敏感度可以从黄斑结构和纹理特性中预测出来，通过对三维光谱域OCT的综合分析进行成像和量化。我们确定了以下具体目标：目标1：改进和验证我们现有的从三维光谱OCT图像中分割视网膜层的方法；得出正常眼睛和青光眼和前部缺血性视神经病变患者视网膜乳头周围和黄斑区每一层视网膜的整体和局部结构指数，如厚度和纹理。目的2：确定黄斑内视网膜神经节细胞和其他视网膜内层的结构指数与视网膜神经纤维层中相应神经节细胞轴突的厚度之间的关系。这将在正常眼睛和青光眼和前部缺血性视神经病变引起的广泛黄斑敏感度丧失的眼睛中得到证实。目的3：通过比较和记录68个部位的视觉敏感度(Humphrey 10-2测试，平均重复3次)与其相应节段层的结构指数，来模拟黄斑的结构-功能关系。根据AIM 2中使用的同一组正常和受损眼睛的黄斑层结构特性推导出功能预测模型。这项工作将在体内采集的3-D OCT图像中进行，并伴随着来自30名正常、5名青光眼和20名单侧前部缺血性视神经病变受试者的视野敏感性测试数据。与公众健康相关：三维光谱OCT成像提供了有关视网膜各层的形态和组织特征的丰富信息。我们建议使用这种新的三维OCT成像设备来研究黄斑视网膜内层的结构和功能关系。这项研究对青光眼、前部缺血性神经病和其他视网膜疾病的诊断和治疗具有潜在的重要影响。

DESCRIPTION (provided by applicant): This proposal seeks to elucidate the structure-function relationships between visual field threshold sensitivity and the structural features of the retinal layers. The study will address which structural properties of the layers of the macula - obtained from three-dimensional image analysis of spectral domain optical coherence tomography (3-D OCT) - are associated with visual sensitivity, a measure of function. Specifically, we will investigate how structural measures of localized columnar regions of the macula, including layer thickness and texture, are associated with the threshold sensitivity of those macular columns measured at corresponding locations in the central 10 degrees with 10-2 perimetry. The project is driven by an important clinical problem - the poor reliability and reproducibility of the visual field as a measure of irreversible damage to the retinal ganglion cells and their axons in optic neuropathies including glaucoma. If the expected associations are confirmed by 3-D image analysis of spectral domain OCT of the macular layers, the new approach has the potential to become an objective and reproducible addition to the functional assessment of the status of damage. The overriding hypothesis motivating the proposed research is that macular visual sensitivity can be predicted from macular structure and texture properties as imaged and quantified by comprehensive analysis of 3-D spectral-domain OCT. We have identified the following specific aims: Aim 1: Refine and validate our existing method of segmenting retinal layers from 3-D spectral OCT images; derive global and focal structural indices, such as thickness and texture, of each retinal layer in the peripapillary and the macular regions of the retina in normal eyes and in eyes with central visual field damage from glaucoma and anterior ischemic optic neuropathy. Aim 2: Determine how the structural indices derived from the retinal ganglion cell and other intraretinal layers in the macula correlate with the thickness of the corresponding ganglion cell axons in the retinal nerve fiber layer. This will be demonstrated in normal eyes and in eyes with a wide range of macular sensitivity loss from glaucoma and anterior ischemic optic neuropathy. Aim 3: Model the structural-functional relationships in the macula by comparing and registering visual sensitivity at 68 locations (Humphrey 10-2 test averaged over 3 repeats) with their corresponding structural indices of the segmented layers. Derive a predictive model of function from structural properties of the macular layers in the same set of normal and damaged eyes used in Aim 2. The work will be performed in in-vivo acquired 3-D OCT images accompanied by visual field sensitivity test data from 30 normal, 5 glaucoma, and 20 unilateral anterior ischemic optic neuropathy subjects. PUBLIC HEALTH RELEVANCE: Three dimensional spectral OCT imaging provides a wealth of information about the morphology and tissue characteristics of retinal layers. We propose to study structural and functional relationships of the macular intraretinal layers using this new 3-D OCT imaging device. This study has potentially important consequences for glaucoma, anterior ischemic neural neuropathy, and other retinal disease diagnosis and treatment.