Age related macular degeneration (AMD) is one of the primary causes of blindness in the U.S. A wealth of powerful new treatments, especially anti-VEGF agents, have recently become available to restore visual function in choroidal neovascularization (CNV), the most severe form of AMD. The risk of ocular adverse events increases with repeated intravitreal treatment injections. Ideally a patient-specific dosing strategy with the minimally necessary number of anti-VEGF injections would be employed. This study will address which patient-specific properties of the intra- and sub-retinal fluid, cysts, and retinal layers of the macula (obtained from 3D spectral domain optical coherence tomography or OCT) (i) are associated with individual response to anti-VGEF treatment, and (ii) can predict proper treatment timing and response. The main hypothesis motivating the proposed research is that a model of retinal response to initial anti-VEGF treatment for CNV, based on quantitative 3D OCT-derived measures, can predict the timing of retreatment. We have identified the following specific aims:
Aim 1 : Further refine and validate a comprehensive set of analysis methods and approaches for 3D spectral OCT image analysis in the presence of wet AMD pathology (Symptomatic Exudate Associated Derangements or SEADs) and assess its performance by comparison to expert analyses.
Aim 2 : Determine associations between standard 2D Spectralis OCT clinical readings from retinal specialists and quantitative SEAD- and layer-derived measures from 3D Cirrus OCT.
Aim 3 : Determine how well the quantitative SEAD- and layer-derived measures from 3D OCT predict the patient-specific outcome parameters in response to post-induction anti-VEGF treatment in patients with CNV, in order to predict the timing of retreatment. The work will be performed prospectively in in-vivo spectral-domain OCT images acquired during the course of CNV disease treatment. We will repeatedly image 200 patients with choroidal neovascularization before and during treatment and during the 1-year follow-up phase.

Public Health Relevance

Three dimensional spectral OCT imaging provides a wealth of information about the morphology and tissue characteristics of human retinal. We propose to study structural and functional relationships of the macular intraretinal layers using this new 3-D OCT imaging device and relate the information about patient-specific retinal composition and structure with treatment outcome in age-related macular degeneration. This study has potentially important consequences for image guided treatment of this blindness-causing disease.

Agency
National Institute of Health (NIH)
Institute
National Eye Institute (NEI)
Type
Research Project (R01)
Project #
5R01EY019112-05
Application #
8657045
Study Section
Special Emphasis Panel (ZRG1)
Program Officer
Shen, Grace L
Project Start
2010-05-01
Project End
2015-04-30
Budget Start
2014-05-01
Budget End
2015-04-30
Support Year
5
Fiscal Year
2014
Total Cost
Indirect Cost
Name
University of Iowa
Department
Engineering (All Types)
Type
Biomed Engr/Col Engr/Engr Sta
DUNS #
City
Iowa City
State
IA
Country
United States
Zip Code
52242
Guo, Zhihui; Kwon, Young H; Lee, Kyungmoo et al. (2017) Optical Coherence Tomography Analysis Based Prediction of Humphrey 24-2 Visual Field Thresholds in Patients With Glaucoma. Invest Ophthalmol Vis Sci 58:3975-3985
Klein, Barbara E K; Johnson, Chris A; Meuer, Stacy M et al. (2017) Nerve Fiber Layer Thickness and Characteristics Associated with Glaucoma in Community Living Older Adults: Prelude to a Screening Trial? Ophthalmic Epidemiol 24:104-110
Philip, Ana-Maria; Gerendas, Bianca S; Zhang, Li et al. (2016) Choroidal thickness maps from spectral domain and swept source optical coherence tomography: algorithmic versus ground truth annotation. Br J Ophthalmol 100:1372-6
Zarei, Kasra; Scheetz, Todd E; Christopher, Mark et al. (2016) Automated Axon Counting in Rodent Optic Nerve Sections with AxonJ. Sci Rep 6:26559
Sohn, Elliott H; van Dijk, Hille W; Jiao, Chunhua et al. (2016) Retinal neurodegeneration may precede microvascular changes characteristic of diabetic retinopathy in diabetes mellitus. Proc Natl Acad Sci U S A 113:E2655-64
Choi, Catherine S; Zhang, Li; Abràmoff, Michael D et al. (2016) Evaluating Efficacy of Aflibercept in Refractory Exudative Age-Related Macular Degeneration With OCT Segmentation Volumetric Analysis. Ophthalmic Surg Lasers Imaging Retina 47:245-51
Oguz, Ipek; Abramoff, Michael D; Zhang, Li et al. (2016) 4D Graph-Based Segmentation for Reproducible and Sensitive Choroid Quantification From Longitudinal OCT Scans. Invest Ophthalmol Vis Sci 57:OCT621-OCT630
Christopher, Mark; Abràmoff, Michael D; Tang, Li et al. (2015) Stereo Photo Measured ONH Shape Predicts Development of POAG in Subjects With Ocular Hypertension. Invest Ophthalmol Vis Sci 56:4470-9
Shi, Fei; Chen, Xinjian; Zhao, Heming et al. (2015) Automated 3-D retinal layer segmentation of macular optical coherence tomography images with serous pigment epithelial detachments. IEEE Trans Med Imaging 34:441-52
Almeida, David R P; Zhang, Li; Chin, Eric K et al. (2015) Comparison of retinal and choriocapillaris thicknesses following sitting to supine transition in healthy individuals and patients with age-related macular degeneration. JAMA Ophthalmol 133:297-303

Showing the most recent 10 out of 53 publications