Glaucoma, Primary Open Angle
Conditions
Brief summary
The objective of the study is to collect and assess adaptive optics (AO) retinal images from human subjects in support of projects to demonstrate, advance, and enhance clinical use of AO technology.
Detailed description
Objective: The objective of the study is to collect and assess adaptive optics (AO) retinal images from human subjects in support of projects to demonstrate, advance, and enhance clinical use of AO technology. Study Population: One hundred (100) healthy volunteers without eye disease and fifty (50) subjects with primary open angle glaucoma (POAG) will be enrolled. Design: This is an interventional study protocol where participants will be imaged with investigational multimodal AO retinal imaging systems that include optical coherence tomography (OCT) and scanning laser ophthalmoscopy (SLO) channels. High resolution OCT and SLO videos will be collected while the instruments automatically detect and correct for image distortion caused by ocular aberrations. In general, videos of different retinal structures will be acquired from several retinal locations using various imaging modes. Outcome Measures: The primary outcomes for this protocol are qualitative and quantitative assessment of the AO images and investigation of the cellular morphological and physiological changes due to glaucoma.
Interventions
OTHERoxygen inhalation
Subjects will breath 100% oxygen through a mask.
DEVICEAdaptive optics imaging
Adaptive optics scanning laser ophthalmoscopy (AOSLO) and adaptive optics - optical coherence tomography (AO-OCT) retinal imaging
Sponsors
Food and Drug Administration (FDA)
University of Maryland, Baltimore
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
BASIC_SCIENCE
Masking
NONE
Intervention model description
One cohort of subjects with clinically diagnosed glaucoma and one cohort of age-matched healthy controls with no evidence of ocular disease
Eligibility
Sex/Gender
ALL
Age
21 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
1. Are 21 years of age or older. 2. Have the ability to cooperate with instructions during adaptive optics imaging (similar to instructions given during a clinical eye exam). 3. Have the ability to understand and sign an informed consent. 4. Have been diagnosed with POAG (cohort 2).
Exclusion criteria
1. Are under 21 years of age. 2. Have a condition which prevents adequate images from being obtained (e.g. unstable fixation or media opacity). 3. Have visual correction outside of the range +4 diopters (D) to -8 D. 4. Have a history of adverse reaction to mydriatic drops. 5. Have a predisposition to (i.e., narrow iridocorneal angle) or any history of acute angle closure glaucoma (AACG). 6. Do not meet the criteria for POAG as defined by the American Academy of Ophthalmology Practice Patterns (cohort 2) 7. Have any health conditions that would contraindicate oxygen supplementation, including chronic obstructive pulmonary disease (COPD), emphysema, asthma, or any other obstructive or restrictive lung disease (RBF experiment participants only). 8. Have a dependency on oxygen support or a baseline oxygen saturation \<95% (RBF experiment participants only). 9. Have tested positive for COVID-19 at initial enrollment or have acute or chronic photophobia as a result of contraction. 10. Are working under the direct supervision of Dr. Hammer.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Retinal blood flow (RBF) with oxygen inhalation | RBF will be measured in all subjects twice during a single AO imaging session - once before and once during pure oxygen inhalation. Subjects will be imaged only once; there is no longitudinal component to this outcome measure. | RBF \[uL/min\] will be measured from ensemble RBC velocity \[mm/s\] measurements from line-scan AOSLO videos and vessel diameter \[mm\] measurements from average AO-OCT volumes. |
| Retinal ganglion cell (RGC) density | RGC density will be calculated once at the AO imaging session in which RGCs are the target. For the reproducibility/longitudinal study portion, RGC density will be quantified three times over 1.5 years (visits separated by 6 months). | RGC density will be calculated at specific retinal eccentricities from cells counted in average AO-OCT volumes. |
| RGC soma diameter | RGC diameter will be calculated once at the AO imaging session in which RGCs are the target. For the reproducibility/longitudinal portion of the study, RGC soma diameter will be quantified three times over 1.5 years (visits separated by 6 months). | RGC soma diameter will be calculated at specific retinal eccentricities from cells segmented in average AO-OCT volumes. |
| Retinal pigment epithelium (RPE) cell organelle motility | RPE organelle motility will be calculated once at the AO imaging session in which RPE cells are the target. For the reproducibility portion of the study, RPE organelle motility will be quantified three times over six weeks (visits separated by 2 weeks). | RPE cell organelle motility will be calculated from the decorrelation time constant for cells segmented from a sequence of AO-OCT volumes. |
| Photoreceptor (PR) cell function | PR function will be calculated once at the AO imaging session in which photoreceptors are stimulated. For the reproducibility portion of the study, PR function will be quantified three times over six weeks (visits separated by 2 weeks). | Photoreceptor cell (cone) function will be measured from phase changes between inner segment - outer segment junction and cone outer segment tip signals in a sequence of AO-OCT volumes collected during visible light stimulation. |
Countries
United States
Contacts
CONTACTDaniel X Hammer, Ph.D.
CONTACTZhuolin Liu, Ph.D.
PRINCIPAL_INVESTIGATORDaniel X Hammer, Ph.D.
Food and Drug Administration (FDA)
Outcome results
None listed