Advancing visible light optical coherence tomography in glaucoma detection

项目总结 青光眼是一种慢性、进行性、不治之症，在美国有200多万人患有青光眼 仅此一项，全球就超过6000万人。早期青光眼损害的敏感检测不仅对 视力保护，还可以促进新的神经保护疗法的发展。在这项提案中，我们将重点放在 关于可见光光学相干层析成像(VIS-OCT)实现的两个新的成像标记，即 视网膜神经纤维层反射光谱标记物(RNFL)与黄斑耗氧量。我们展示了 在我们最近的横断面临床研究中，乳头周围RNFL反射光谱标记物和动静脉 黄斑区血氧饱和度差异更好地区分可疑青光眼早期/前期青光眼 周围型青光眼与黄斑神经节细胞复合体的关系(GCC) 厚度。这些有希望的结果导致了该项目的三个具体目标。首先，我们将开发第二个- 生成双通道VIS-OCT设备，以提高分辨率、总成像范围和图像质量，以 获得接近散粒噪声极限的性能。其次，我们建议对黄斑部的氧气进行表征 结合血氧饱和度和血流量的消耗量与青光眼严重程度相关。黄斑 区域含有视网膜中总RGC的30%，并与青光眼的早期事件有关。黄斑视觉 损害对生活质量的影响最大，因为它是我们视野的中心。第一次，我们将提供 黄斑耗氧量在青光眼严重程度谱系中的定量评估 血管功能在早期青光眼中的病理作用最后，我们提出了一项前瞻性研究。 VIS-OCT成像标记物的相关性，包括RNFL反射光谱标记物和黄斑血氧 标记物，随着青光眼的恶化。我们将评估VIS-OCT标记物是否能检测到早期 损害赔偿继续到后来的视觉功能丧失。对公众健康的影响：成功的 该计划的完成将严格评估新的VIS-OCT标记物在早期的临床表现 青光眼检测，对临床护理和防盲有很大影响。

PROJECT SUMMARY Glaucoma is a chronic, progressive, incurable disease that affects over 2 million individuals in the United States alone and over 60 million worldwide. Sensitive detection of early glaucoma damage is not only essential for vision preservation, but also can facilitate new neuroprotective therapy developments. In this proposal, we focus on two novel imaging markers enabled by visible light optical coherence tomography (VIS-OCT), namely the reflectance spectral marker from retinal nerve fiber layer (RNFL) and macular oxygen consumption. We showed in our recent cross-sectional clinical study that peripapillary RNFL reflectance spectral marker and arteriovenous oxygen saturation difference in the macular region better separated early stage of glaucoma suspect/pre- perimetric glaucoma eyes from normal ones than circumpapillary RNFL and macular ganglion cell complex (GCC) thickness. These promising results lead to three specific goals in the project. First, we will develop a second- generation dual channel VIS-OCT device to improve the resolution, total imaging range, and image quality to achieve near shot-noise limit performance. Second, we propose to characterize the macular oxygen consumption by combining blood oxygen saturation and flow and correlated with glaucoma severity. Macular region contains >30% of total RGCs in retina and is involved in early events in glaucoma. The macular visual damage impacts the quality of life the most since it is at the center of our vision. For the first time, we will provide quantitative assessment of macular oxygen consumption in a spectrum of glaucoma severity and shed light in the pathological role of vascular function in the early-stage glaucoma. Finally, we propose a prospective study to correlate VIS-OCT imaging markers, including RNFL reflectance spectral markers and macular oxygen markers, with the glaucoma worsening. We will evaluate whether VIS-OCT markers can detect the early damages proceeding to vision functional loss at a later point. IMPACT ON PUBLIC HEALTH: The successful completion of this program will rigorously evaluate the clinical performances of new VIS-OCT markers for early glaucoma detection, which is highly impactful in clinical care and blindness prevention.