3D RNFL Structure And High-Resolution Perimetry For Assessing Glaucomatous Damage

7.项目摘要摘要 青光眼是可预防失明的主要原因之一，而目前可用的治疗方法还不是 足以阻止许多患者的病情进展。虽然人们对青光眼的生物学已经有了很多了解， 新的治疗形式的开发受到三个障碍的阻碍：受试者之间的高度变异性 正常眼的神经节细胞数量，青光眼患者视野检查的受试者内高变异性，以及 疾病进展的缓慢速度。建议的研究将神经建模和临床相结合。 研究开发诊断青光眼和评估进展的改进方法 失明。这些结果旨在改善临床试验和持续患者护理的措施，同时 同时提高对青光眼病理生理学的基础科学认识，为青光眼的防治提供科学依据。 疾病过程的生物学研究指南。临床设备的创新使用将指导测试 自定义系统和统计分析将利用结构和功能措施之间的协同作用 青光眼损害。将进行视网膜神经纤维层(RNFL)的高分辨率视网膜成像 使用定制高级自适应光学扫描激光眼底镜(AOSLO)治疗青光眼 以及光谱域光学相干层析成像(SD-OCT)的定制使用。高分辨率视野检查将 使用抗光学的定制刺激，在视野的相应区域中执行 影响常规视野的人工制品。特异性目标1将确定神经节细胞功能障碍在 临床观察到的反射率所对应的视力损失量在受试者之间的差异 缺陷，并评估纵向变化。具体目标2将利用结构性和结构性之间的协同作用 开发与有关RNFL的信息动态交互的周界算法的功能措施 结构。具体目标3将开发显著提高检测楔形缺陷的能力的方法，这些缺陷 用传统的视野检查抽样很差。

7. Project Summary Abstract Glaucoma is one of the leading causes of preventable blindness, and currently available treatments are not sufficient to halt progression in many patients. While much has been learned about the biology of glaucoma, development of new forms of treatment has been stymied by three barriers: high between-subject variability in ganglion cell number in normal eyes, high within-subject variability for perimetry in patients with glaucoma, and the slow rate of progression of the disease. The proposed research integrates neural modeling and clinical research to develop improved methods for diagnosing glaucoma and for assessing progression towards blindness. The results are intended to improve measures for both clinical trials and ongoing patient care, while at the same time improving basic science understanding of the pathophysiology of glaucoma and providing guidance for biological studies of the disease process. Innovative uses of clinical devices will guide testing with custom systems, and statistical analyses will utilize the synergy between structural and functional measures of glaucomatous damage. High-resolution retinal imaging of retinal nerve fiber layer (RNFL) will be performed on patients with glaucoma using a custom advanced adaptive optics scanning laser ophthalmoscope (AOSLO) as well as custom use of spectral domain optical coherence tomography (SD-OCT). High-resolution perimetry will be performed in corresponding regions of the visual field, using custom stimuli that are resistant to optical artifacts that affect conventional perimetry. Specific Aim 1 will determine the role of ganglion cell dysfunction in between-subject differences in the amount of visual loss corresponding to clinically observed reflectance defects, and assess longitudinal changes. Specific Aim 2 will utilize the synergy between structural and functional measures to develop perimetric algorithms that interact dynamically with information about RNFL structure. Specific Aim 3 will develop methods that dramatically improve the ability to detect wedge defects that are poorly sampled by conventional perimetry.