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Medicine

망막 화상 진 찰을 사용 하 여 치 매 공부 하기

Published: November 06, 2017
doi:
10.3791/56137
, , , , , , ,
1Department of Ophthalmology and Visual Sciences,The Chinese University of Hong Kong, 2Department of Medicine & Therapeutics,The Chinese University of Hong Kong, 3Therese Pei Fong Chow Research Centre for Prevention of Dementia,The Chinese University of Hong Kong, 4Gerald Choa Neuroscience Centre,The Chinese University of Hong Kong, 5Memory Aging and Cognition Centre,National University Health System, 6Department of Pharmacology,National University of Singapore, 7Singapore Eye Research Institute,Singapore National Eye Centre, 8Duke-NUS Medical School,National University of Singapore

Summary

망막 뇌와 눈에 띄는 유사성을 공유 하 고 따라서 비 접촉 맥 관 구조와 뇌의 신경 구조를 공부 하는 독특한 창을 나타냅니다. 이 프로토콜에는 망막 이미징 기술을 사용 하 여 치 매를 공부 하는 방법을 설명 합니다. 이 방법은 잠재적으로 치 매 진단 및 위험 평가에 도움이 됩니다.

Abstract

망막은 독특한 “창” 중앙 신경 조직 (CNS)의 확장 이며 embryological 기원, 해 부 특징의 관점에서 뇌와 눈에 띄는 유사성을 공유로 치 매는 뇌에서의 병 태 생리 과정을 공부 하 고 생리 적 속성입니다.  망막의 혈관과 신경 구조 비 접촉 사용 하 여 쉽게 시각 망막 이미징 기술, 저 사진 등 광학 일관성 단층 촬영 (OCT), 그리고 반자동으로 사용 하 여 측정할 수 있습니다. 컴퓨터 기반 분석 프로그램입니다. 망막의 혈관과 신경 변화 및 치 매 사이 연결 공부 수 치 매에 대 한 우리의 이해를 향상 하 고, 잠재적으로, 진단 및 위험 평가에.  이 프로토콜 측정 하 고 잠재적으로 치 매와 관련 된 망막 맥 관 구조 및 신경 구조를 분석 하는 방법을 설명 하는 것을 목표로. 이 프로토콜도 치 매, 망막 과목 변경의 예를 제공 하 고 기술 문제 및 망막 화상의 현재 제한 사항에 설명 합니다.

Introduction

때문에 평균 수명 증가, 치 매 주요 의료 문제, 중요 한 사회에 기여 하 고 경제 건강 부담 세계적으로1,2,3,,45. 오늘, 미국에서 사람이 Alzheimer의 질병 (광고), 치 매, 모든 66 s6의 가장 일반적인 형태는 발전 한다. 그것은 2050 년까지 115 백만 사람들 것 이다 영향을 받을 광고7추정 되었다.

망막 뇌와 비슷한 해 부 및 생리 적 속성으로 인해 치 매 연구에 독특한 “창”을 제공 합니다. 맥 관 구조, 망막 arterioles 및 venules, 100 ~ 300 µ m 직경, 측정 끝 arterioles anastomoses, 장벽 기능 및 자동 제어8, 등 대뇌 작은 혈관과 비슷한 기능을 공유 9. 신경 구조, 망막 절 셀 (RGCs) 중앙 신경 시스템 (CNS) 10에에서 신경을 가진 일반적인 속성을 공유. 그들이 형성 측면 geniculate 핵을 우량한 colliculus 망막에서 시 신경 및 프로젝트 시각적 신호는 RGCs 눈에 띄게 두뇌와 연결 됩니다. 시 신경, CNS에 많은 신경 섬유와 유사한 oligodendrocytes에 의해 myelinated 이며 ensheathed meningeal 계층에 있습니다. 특히, 시 신경에 대 한 모욕이 될 수 있습니다 유사한 응답 다른 CNS 축 삭에서 관찰와 같은 역행 및 축 삭, 흉터 형성, myelin 파괴, 2 차 변성 및 科의 비정상적인 수준 참가자 변성 요인과 신경 전달 물질11,12,,1314. 일부 광고 환자에 시각적인 증 후의 외관 또한 망막 및 두뇌15,16간의 강력한 연결에 의해 설명 수 있습니다. 결과적으로, 그것은 제안 되었습니다 망막 치 매는 뇌에서의 병 적인 프로세스를 반영 수 있습니다 및 망막 화상 치 매 연구에 사용할 수 있습니다.

망막 맥 관 구조 및 신경 구조 지금 비 접촉 망막 이미징 기술을 사용 하 여 구상 될 수 있다. 예를 들어, 망막 저 사진 저 카메라를 사용 하 여 캡처할 수 있습니다 및 망막 맥 관 구조 (예: 선박 구경, tortuosity, 그리고 프랙탈 차원)의 특성 수 다음 측정할 수 컴퓨터 기반 분석을 사용 하 여 프로그램입니다. 또한, 매개 변수 (예: 신경 절의 세포 내 plexiform 레이어 [GC-IPL] 및 망막 신경 섬유 층 [RNFL]의 두께) 망막 신경 구조 또한 광학 일관성 단층 촬영 (OCT)를 사용 하 여 측정 될 수 있다 및 내장을 사용 하 여 정량 분석 알고리즘입니다.

치 매를 공부 하 고 망막 화상의 중요성에 비추어이 프로토콜 이미징 및 망막 맥 관 구조 및 신경 구조에 vivo에서 망막 이미징 기술을 사용 하 여 분석 하는 방법을 설명 하는 것을 목표로. 이 프로토콜도 치 매, 망막 과목 변경의 예를 제공 하 고 기술 문제 및 망막 화상의 현재 제한 사항에 설명 합니다.

Protocol

여기에서 설명한 모든 방법을 홍콩에서 지역 임상 연구 윤리 위원회에 의해 승인 되었습니다. 참고: 단순, 장비 재료의 테이블에에서 나열 된 망막 이미징 및 후속 분석의 절차를 설명 하기 위해 사용 됩니다. 망막 혈관 매개 변수 측정 싱가포르 I 선박 평가 프로그램 (시바) 17 (버전 4.0, 국립 싱가포르 대학교, 싱가포르)를 사용 하 여 보여 줍니?…

Representative Results

그림 10: 일반 주제와 광고 주제 망막 맥 관 구조에 차이 보여 예. 일반적인 주제에 비교 될 때 광고 주제의 저 사진 보여 좁은 그릇 구경 (CRAE 영역 B의, 116.4 µ m 대 156.4 µ m; 영역 B, 186.9 µ m 대 207.5 µ m; CRVE CRAE 영역 C, 138.5 µ m 대 165.8 µ m; 영역 C, 206.6 µ m <…

Discussion

이 프로토콜 비보에망막에 있는 신경 및 혈관 변화 측정의 절차를 설명 합니다. 망막은 뇌와 비슷한 embryological 기원, 기능 해 부 및 생리 속성 공유로이 망막 변화 맥 관 구조와 뇌의 신경 구조와 유사한 변화를 반영 수 있습니다.

그림 10 및 표 1에 표시 된 것 처럼 광고 주제 감소 선박 개조 건강 한 주제에 비교 될 때 보였다. 그것은 알…

Disclosures

The authors have nothing to disclose.

Acknowledgements

잠재적인 금융 관계에 관한 저자 티 엔 영 웡이이 문서에서 사용 되는 싱가포르 I 선박 평가 (시바) 프로그램의 공동 발명자 이다.

Materials

Non-mydriatic Retinal Camera  Topcon, Inc, Tokyo, Japan TRC 50DX  N/A
Singapore I Vessel Assessment Program National University of Singapore Version 4.0 N/A
CIRRUS HD-OCT  Carl Zeiss Meditec, Inc, Dublin, CA Model 4000 N/A
Mydriatic Agents  N/A N/A Prepared from 1% tropicamide and 2.5% phenylephrine hydrochloride
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Retinal ImagingDementiaAlzheimer’s DiseaseBiomarkersVascular ChangesNeuronal ChangesFundus CameraPupil DilationImage CaptureOptic DiscRetinaComputer-assisted Analysis

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Chan, V. T., Tso, T. H., Tang, F., Tham, C., Mok, V., Chen, C., Wong, T. Y., Cheung, C. Y. Using Retinal Imaging to Study Dementia. J. Vis. Exp. (129), e56137, doi:10.3791/56137 (2017).
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