Glaucoma is a leading cause of blindness in the United States and worldwide. Technologies to aid in the diagnosis and monitoring of glaucoma are of critical importance because the disease may develop and progress unnoticed until severe damage has developed, and this damage is then irreversible. Optical coherence tomography (OCT) is a relatively new technology which permits visualization and precise measurement of the retinal layers in the living eye, including the retinal nerve fiber layer and the ganglion cell layer that are damaged by glaucoma. Thus, the primary goal of the NIH supported Advanced Imaging for Glaucoma ( is to improve the early detection and long-term monitoring of glaucoma by advancing the technology of optical coherence tomography (OCT). One of the major discoveries of the AIG project was the finding that measurement of retinal blood flow using new Doppler OCT technology provided a potential new way of measuring the severity of glaucoma and for assessing which individuals may be at risk for further progression. The excitement from this initial discovery generated interest from many glaucoma specialists around the country including the clinical centers within the AIG group. For Doppler OCT based retinal blood measurement to become an important clinical tool for caring for patients with glaucoma or suspected to have glaucoma, considerable additional data is required. For example, normal values and variability of retinal blood flow in a large group of individuals, and a better understanding of what other factors affect flow measurements in patients with and without glaucoma is of critical importance. At present until fully automatic software can be produced, rapidly generating accurate retinal blood flow measurements requires some input from trained expert humans in specialized image "reading" centers. The objective of this revision/supplement application is to support and expand such a center to generate the large amounts of Doppler OCT retinal blood data required to answer critical questions on how retinal blood flow can best be used to diagnose and monitor patients with glaucoma. In particular we will make progress towards establishing a normative database for retinal blood flow and identify which factors influence or affect blood flow measurements. We will also study the predictive value of blood measurements for glaucoma progression as well as the effect of glaucoma surgery on retinal blood blow. Given the high prevalence of glaucoma, the development of these approaches has the potential to make a significant impact on preventing visual loss in the United States and worldwide.

Public Health Relevance

Development of new strategies, such as Doppler OCT-derived retinal blood flow measurements, may allow for earlier and more reliable detection of glaucoma, and more precise and careful monitoring of the disease. Blood flow measurements may also provide new insights into the pathogenesis of glaucoma, which could lead to improved strategies for prevention and treatment. Given that glaucoma is a major cause of blindness in the United States, this research could have considerable public health benefit.

National Institute of Health (NIH)
National Eye Institute (NEI)
Research Project (R01)
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Special Emphasis Panel (NOIT)
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Chin, Hemin R
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Oregon Health and Science University
Schools of Medicine
United States
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Martino, Amy Z; Iverson, Shawn; Feuer, William J et al. (2015) Surgical outcomes of superior versus inferior glaucoma drainage device implantation. J Glaucoma 24:32-6
Wang, Xiaogang; Jia, Yali; Spain, Rebecca et al. (2014) Optical coherence tomography angiography of optic nerve head and parafovea in multiple sclerosis. Br J Ophthalmol 98:1368-73
Sehi, Mitra; Goharian, Iman; Konduru, Ranjith et al. (2014) Retinal blood flow in glaucomatous eyes with single-hemifield damage. Ophthalmology 121:750-8
Jia, Yali; Wei, Eric; Wang, Xiaogang et al. (2014) Optical coherence tomography angiography of optic disc perfusion in glaucoma. Ophthalmology 121:1322-32
Wang, Mingwu; Lu, Ake Tzu-Hui; Varma, Rohit et al. (2014) Combining information from 3 anatomic regions in the diagnosis of glaucoma with time-domain optical coherence tomography. J Glaucoma 23:129-35
Bhavsar, Kavita V; Branchini, Lauren; Shah, Heeral et al. (2014) Choroidal thickness in retinal pigment epithelial tear as measured by spectral domain optical coherence tomography. Retina 34:63-8
Fein, Jordana G; Branchini, Lauren A; Manjunath, Varsha et al. (2014) Analysis of short-term change in subfoveal choroidal thickness in eyes with age-related macular degeneration using optical coherence tomography. Ophthalmic Surg Lasers Imaging Retina 45:32-7
Jia, Yali; Bailey, Steven T; Wilson, David J et al. (2014) Quantitative optical coherence tomography angiography of choroidal neovascularization in age-related macular degeneration. Ophthalmology 121:1435-44
Iverson, Shawn M; Feuer, William J; Shi, Wei et al. (2014) Frequency of abnormal retinal nerve fibre layer and ganglion cell layer SDOCT scans in healthy eyes and glaucoma suspects in a prospective longitudinal study. Br J Ophthalmol 98:920-5
Adhi, Mehreen; Liu, Jonathan J; Qavi, Ahmed H et al. (2014) Choroidal analysis in healthy eyes using swept-source optical coherence tomography compared to spectral domain optical coherence tomography. Am J Ophthalmol 157:1272-1281.e1

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