high resolution imaging of retinal vessels – ReVeal

Diseases affecting small vessels (less than 150µm diameter) are important causes of morbidity and mortality from cardiovascular and cerebrovascular causes, alone or in association with diseases of large arteries. Predictive biomarkers are obtained from vascular imaging for large vessels. Research on these biomarkers has increased considerably in recent years, because they are more predictive of cardiovascular events than traditional risk factors such as blood pressure. However, at present, these biomarkers are mainly dedicated to the study of large arteries (carotid, aorta). There is indeed no procedure allowing quantitative imaging of small vessels which had proved its interest in the care of patients, due to limitations of imaging technology at this scale. The issue is nevertheless important because high blood pressure and diabetes mainly affects small vessels.
In recent years, adaptive optics (AO) imaging of the retina has demonstrated its ability to document retinal structures at the micrometer scale in humans. This technology has now reached sufficient technical maturity to enter clinical routine in a short delay. In continuation of a multidisciplinary collaborative project involving ophthalmologists, engineers, researchers and the manufacturer of an AO camera (the iPhot project, funded by ANR TecSan 2009), we incidentally observed that the latest version of the prototype allowed to document the structure of small arteries, so far inaccessible by other imaging methods. This opens the possibility to develop one or more quantitative biomarkers of the microcirculation.
The objective of the ReVeal project is to make vascular imaging by AO simple, efficient and medically useful. For this, we will aim at validating technically and medically new biomarkers measured from small vessel images of OA, in an integrated approach combining an interactive technological developments and medical evaluation. This industrial development project includes four workpackages to be undertaken in parallel: 1- transverse and longitudinal evaluation of vascular imaging in controls and well characterized patients through a multidisciplinary medical network (Head: Clinical Investigation Center 503); 2-implementation of new technology solutions dedicated to vascular imaging (responsible: Imagine Eyes, with Onera-DOTA) 3-Development of software for image processing (co-leaders: Onera-DTIM and L2TI), and 4 - Development of software for data analysis (co-leaders: Telecom ParisTech and ISEP). Eventually it is expected that vascular imaging by OA will play a pivotal role in assessing and monitoring treatment against hypertension and diabetes.