Today, age-related macular degeneration (AMD) is the most common cause of vision loss in people over 50 years of age. Although, the beneficial effect of laser photocoagulation treatment of subretinal neovacularization due to AMD has been established, diagnosis of this condition at a treatable stage has become a challenging clinical problem. At the present, only a small number of cases can be treated because most are poorly defined or detected when they are within 200 microns of the fovea. Even with the use of clinical methods of fluorescein and indocyanine green angiography, subretinal neovascularization cannot be detected in over 50% of eyes. Thus, alternative methods for enhanced visualization of the subretinal structure and vasculature are needed to address the inadequacy of the clinical methods. The purpose of the proposed project is to develop and evaluate an optical system for imaging the chorioretinal interface to delineate subtle structural and vascular abnormalities. Cross sectional images of the structure and vasculature at the chorio-retinal interface, incorporating an area of the retina, will be generated that are not attainable by the presently available conventional or experimental techniques. The optically sectioned images will be processed and analyzed to delineate topographic variations at the vitreo- and chorio-retinal interfaces. Tomographic images of the vasculature will be generated to enhance visualization of the retinal and subretinal vasculatures. The performance of the system in image acquisition and analysis will be evaluated and optimized in human eyes. The validity and reliability of the optical system for imaging alterations in the topography and vasculature at the chorio-retinal interface will be assessed. The optical imaging system provides images to enhance detection of topographic and angiographic anomalies due to neovascularization. Once refined, it promises to be a beneficial diagnostic tool for clinical detection of subretinal neovascularization that can be managed by conventional treatments and for fundamental studies to acquire knowledge about the disease pathophysiology. Thus, the aim of the proposed project coincides with one of the National Eye institute's important research goals for the next 5 years, """"""""To develop noninvasive techniques for the early diagnosis of macular degeneration and devise prevention and treatment paradigms.""""""""
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