Glaucoma is a leading cause of blindness. Diagnosis and monitoring of glaucoma is of particular importance because the onset is insidious and the visual damage is irreversible. The goal of the Advanced Imaging for Glaucoma (AIG) study (www.AIGStudy.net) is to improve early detection and long-term monitoring of glaucoma by advancing the technology of optical coherence tomography (OCT), which is uniquely capable of imaging eye structures affected by glaucoma with micrometer precision. In AIG Phase I, very high-speed Fourier-domain (FD) OCT achieved higher diagnostic accuracy than other quantitative imaging technologies. Significantly, glaucoma diagnosis was made using OCT maps of macular ganglion cells and measurement of retinal blood flow. In the proposed Phase II, the next generation OCT hardware and analytic software will be developed. A longitudinal clinical study will demonstrate advantages in the early detection and prediction of disease progression.
The specific aims are: 1. Develop image processing and diagnostic analysis for 3-dimensional (3D) OCT data. We will improve 3D image processing software to detect the loss of ganglion cells, nerve fibers, optic disc rim, and track glaucoma progression. 2. Develop ultrafast OCT systems for imaging the macula and optic nerve head. We will develop the next generation technology that is up to 40 times faster (1 MHz) than current FD-OCT. It will be capable of capturing full tissue volume in 0.1-0.2 second to achieve 3D sampling without significant motion error. 3. Develop Doppler OCT to measure retinal perfusion. Retinal blood flow measurement with Doppler OCT correlates very well with glaucoma status. This ground-breaking advance in functional imaging will be made practical with higher speed and automated software. 4. Evaluate OCT technologies in a longitudinal clinical study. An extension of the ongoing clinical study is proposed. Participants (665 including 400+ already enrolled) in normal, glaucoma suspect, and glaucoma groups will be followed. OCT and other imaging technologies will be compared for diagnostic accuracy, detection of early progression, and prediction of future visual field loss. The impact of intraocular pressure on retinal blood flow and how flow affects the risk of glaucoma will also be studied. Quantitative imaging technologies such as OCT have improved glaucoma management by reducing reliance on insensitive tests such as perimetry and subjective disc grading. The AIG Partnership comprises engineers and clinicians who co-invented OCT. We propose to further improve its performance with higher speed, more sophisticated software, and novel functional measurements. The eventual goal is to save vision by basing glaucoma treatment decisions on speedy and reliable imaging tests.

Public Health Relevance

Glaucoma is a chronic and irreversible degeneration of the retina and optic nerve that is often caught only in the later stages by current standard tests such as visual field and clinical optic disc evaluation. This project aims to improve the detection of glaucoma and the measurement of its progression using optical coherence tomography (OCT), the only imaging technology that can measure retinal degeneration with microscopic resolution. Accurate monitoring of glaucoma with OCT will improve treatment decisions regarding surgery or eye drops, both of which are effective but also carry significant side effects and risks.

Agency
National Institute of Health (NIH)
Institute
National Eye Institute (NEI)
Type
Research Project (R01)
Project #
5R01EY013516-10
Application #
8330891
Study Section
Special Emphasis Panel (ZRG1-BDCN-F (12))
Program Officer
Chin, Hemin R
Project Start
2001-06-01
Project End
2014-08-31
Budget Start
2012-09-01
Budget End
2014-08-31
Support Year
10
Fiscal Year
2012
Total Cost
$1,856,721
Indirect Cost
$248,304
Name
Oregon Health and Science University
Department
Ophthalmology
Type
Schools of Medicine
DUNS #
096997515
City
Portland
State
OR
Country
United States
Zip Code
97239
Tan, Ou; Liu, Liang; Zhang, Xinbo et al. (2016) Glaucoma Increases Retinal Surface Contour Variability as Measured by Optical Coherence Tomography. Invest Ophthalmol Vis Sci 57:OCT438-43
Zhang, Xinbo; Dastiridou, Anna; Francis, Brian A et al. (2016) Baseline Fourier-Domain Optical Coherence Tomography Structural Risk Factors for Visual Field Progression in the Advanced Imaging for Glaucoma Study. Am J Ophthalmol 172:94-103
Zhang, Xinbo; Francis, Brian A; Dastiridou, Anna et al. (2016) Longitudinal and Cross-Sectional Analyses of Age Effects on Retinal Nerve Fiber Layer and Ganglion Cell Complex Thickness by Fourier-Domain OCT. Transl Vis Sci Technol 5:1
Richter, Grace M; Zhang, Xinbo; Tan, Ou et al. (2016) Regression Analysis of Optical Coherence Tomography Disc Variables for Glaucoma Diagnosis. J Glaucoma 25:634-42
Zhang, Xinbo; Loewen, Nils; Tan, Ou et al. (2016) Predicting Development of Glaucomatous Visual Field Conversion Using Baseline Fourier-Domain Optical Coherence Tomography. Am J Ophthalmol 163:29-37
Regatieri, Caio V; Novais, Eduardo A; Branchini, Lauren et al. (2016) Choroidal thickness in older patients with central serous chorioretinopathy. Int J Retina Vitreous 2:22
Le, Phuc V; Zhang, Xinbo; Francis, Brian A et al. (2015) Advanced imaging for glaucoma study: design, baseline characteristics, and inter-site comparison. Am J Ophthalmol 159:393-403.e2
Loewen, Nils A; Zhang, Xinbo; Tan, Ou et al. (2015) Combining measurements from three anatomical areas for glaucoma diagnosis using Fourier-domain optical coherence tomography. Br J Ophthalmol 99:1224-9
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
Zhang, Xinbo; Iverson, Shawn M; Tan, Ou et al. (2015) Effect of Signal Intensity on Measurement of Ganglion Cell Complex and Retinal Nerve Fiber Layer Scans in Fourier-Domain Optical Coherence Tomography. Transl Vis Sci Technol 4:7

Showing the most recent 10 out of 117 publications