Clinical optical coherence tomography for retinal metabolic imaging

PROJECT SUMMARY Diabetic retinopathyDRis a complication of diabetes and a leading cause of blindness in the worldAlthough it is widely accepted that DR is driven by ischemiathe current grading of DR severity is based only on structural alterations such as the presence of abnormal retinal microvasculature in non proliferative DR or angiogenesis in proliferative DRAs a resultmost patients have already developed irreversible retinal functional impairment when they first receive their DR diagnosisDR develops through progressively increasing capillary non perfusion leading to insufficient blood supply to meet the metabolic demand of the inner retinal neuronsThis causes retinal ischemiawhich activates signaling pathways that promote angiogenesis and herald the proliferative phase of retinopathyIf not managed in a timely fashionproliferative DR can ultimately lead to blindnessThereforenon invasive imaging of retinal metabolic rate of oxygen is expected to improve our understanding of DR pathophysiology as well as significantly enhance our ability to diagnose and manage high risk DRThis proposal aims to maximize the likelihood of translation and integration of a novel visible light optical coherence tomography or vis OCT into clinical management of DRWe seek to designdevelopand optimize the first clinical prototype vis OCT instrument to quantify retinal metabolic rate of oxygen in normal human subjects as well as in patients with diabetesWe believe that the proposed technology has the potential to transform the existing clinical practice of DR from anatomy based approach to a more sensitive and objective function based approachThe proposed work is built on Opticent Health s successful meeting the goals in the Phase I project and on close collaboration with leading clinician scientists PROJECT NARRATIVE Clinical management of diabetic retinopathy is currently based on structural assessment that does not take into account the retinal functional and metabolic statusDiagnosis and treatment of retinopathy would benefit significantly if clinicians had access to non invasive functional measures of the retina to use for objective guidanceThis project seeks to develop and validate first of its kindnon invasivefunctional imaging technologieswith an immediate clinical application to monitor retinal functions in diabetic retinopathy patients receiving laser therapy