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大家好久不见，最近忙于工作。五天前VDM的编辑发消息给我说他们更新了项目最新进展，并帮我们将Sebag博士的视频加上了英文字幕，方便我们观看。
在此之前一直都有在和VDM联络，他们在忙于基金会的成立，好消息是他们已经在英国成立了基金会，这对于所有飞蚊症患者应该都是重磅好消息。
看到有人已经发了关于此视频的帖子，但是不够完整。今天抽空，将此次Sebag博士的更新总结如下（蓝体字）：
此次更新是由VMR Research Foundation的Dr. Sebag代表发布。VMR Research Foundation是一个专注于研究玻璃体浮动物的非营利组织。视频首先感谢所有为该组织提供支持的人，并回答了一些来自VDM项目网站的问题。其中一个问题是VMR Research Foundation正在进行哪些研究项目，哪些项目需要紧急资金支持。
Dr. Sebag回答说，VMR Research Foundation最近的研究涉及到近视患者的玻璃体病变（Myopic Vitreopathy），以及与此相关的飞蚊症的临床意义。通过对近视患者进行研究，他们发现近视度数与玻璃体密度、对灰度的识别能力以及对视觉质量的影响之间存在多种相关性。这项研究在最近的国际视网膜成像研讨会上受到了好评，并引起了光学工程师们的兴趣，他们计划开发一个新的三维OCT系统来更好地了解玻璃体混浊的起源和进一步研究。
Dr. Sebag还介绍了他们即将参加的世界上最大的眼科研究会议ARVO，并分享了他们在此次会议上将展示的四项研究。其中包括一个量化玻璃体混浊对患者生活质量影响的问卷调查，以及研究如何利用先进的光学方法研究玻璃体中的光散射现象。
总之，此次更新主要介绍了VMR Research Foundation正在进行的研究项目和最新进展，以及ARVO眼科研究会议上将展示的研究成果。文章提到了该组织需要紧急资金支持来继续推进研究，并呼吁公众提供支持。
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以下为字幕中英文翻译：
Hello. Dr. Sebag here, on behalf of the VMR Research Foundation. Many of you have connected with us via the VDM Project set up by Fabio Gallerani and all of his associates, a very useful outreach program to the global community at large in search of patients suffering from vitreous floaters to provide education and support and to promote research towards a better understanding of this disease and improvement of therapies and cures. Thank you for all of the support that many of you have provided over recent years. We appreciate that and look forward to the continued support. My purpose today is to answer some questions that some of you have submitted as part of your interaction with the VDM Project website. So the first of these questions is: What research projects is the VMR Research Foundation working on right now, and which ones require urgent funding? The most recent update is actually very current. We've done a lot of work over recent years and published these, and all of that information is available to you. You just have to reach out to us, and we'll be happy to provide all of the details. But for an overview of what's actually happening right now, I can share that two days ago I presented a lecture at the International Retional Imaging Symposium which was held at UCLA in Los Angeles, California.
你好。我是Sebag博士，代表VMR研究基金会。你们中的许多人已经通过Fabio Gallerani及其所有合作伙伴设立的VDM项目与我们联系，这是一个非常有用的宣传计划，旨在寻找患有玻璃体混浊的患者，为他们提供教育和支持，并促进研究，以更好地理解这种疾病并改善治疗和治愈方法。感谢你们近年来提供的所有支持。我们感激这些支持，并期待继续得到支持。今天我来的目的是回答你们中的一些人在与VDM项目网站互动时提交的一些问题。因此，其中一个问题是：VMR研究基金会正在进行哪些研究项目，并且哪些项目需要紧急资金支持？最近的更新实际上非常及时。我们在过去几年中进行了大量的工作并发表了相关论文，所有这些信息都可供你们使用。你们只需要与我们联系，我们将乐意提供所有细节。但是为了概述目前正在发生的情况，我可以分享一下，两天前，我在加利福尼亚州洛杉矶市的UCLA举行的国际视网膜成像研讨会上发表了一场讲座。
The topic of my presentation was myopic vitreopathy and vision degrading myodesopsia. Myopic vitreopathy refers to the changes that occur in the center of the eye where the structure called vitreous is located, and the reason that's relevant is because clinically significant cases of vitreous floaters which are called vision degrading myodesopsia or VDM results in many many patients from myopia. In fact myopic vitreopathy, the abnormalities of vitreous associated with nearsightedness, is the second leading cause of clinically significant vitreous floaters, which we call VDM. So we performed a study on patients with myopia, and we correlated the degree of nearsightedness with the degree of unhappiness, with the degradation, and contrast sensitivity, which is their ability to discern shades of gray, and with the density of the vitreous body and found multiple correlations that help us understand the relationship between the vitreous body, nearsightedness, and the development of floaters. And it was very well received.
我的演讲主题是近视性玻璃体病变和影响视力的玻璃体混浊。近视性玻璃体病变指的是发生在眼睛中心处玻璃体结构的变化，而这个话题是相关的，因为临床上很多近视患者会出现被称为影响视力的玻璃体混浊或VDM的重要症状。事实上，近视性玻璃体病变，即与近视有关的玻璃体异常，是导致临床上显著的玻璃体混浊，即VDM的第二大原因。因此，我们对近视患者进行了一项研究，并将其近视程度与他们的不满程度、视力退化和对灰度的识别能力（对比敏感度）以及玻璃体体密度进行了相关性分析，发现了多种相关性，有助于我们理解玻璃体体、近视和混浊形成的关系。这个研究受到了很好的反响。
In fact, following the presentation I had conversations with optical engineers who have plans to develop a new three-dimensional OCT system. These are people who I've known for a while now, but in spite of previous discussions, it didn't seem to trigger the kind of interest that I sensed in my discussions with them. So we're going to be discussing ways that we can collaborate to help build a new imaging system of what's going on inside the eye that will enable us to measure these changes and better understand the origins of floaters so that we can better design new treatments for patient care. And so that I would say is one of the projects that's going to require urgent funding. I really don't know at this point how much, but any support that you can offer would be much appreciated. The second item in response to this question is to share with you that in three weeks the largest eye research meeting in the world will be held. The organization is called ARVO, which is an acronym for the Association for Research and Vision and Ophthalmology, and this meeting is global. This year it will be held in New Orleans, Louisiana. And it's a one-week meeting that features 10 or 12,000 people from all over the world coming together to share research on many different aspects of the eye and of vision.
事实上，在演讲之后，我和光学工程师进行了交谈，他们计划开发一种新的三维光学相干断层扫描系统（OCT）。这些人我认识已经有一段时间了，但是之前的讨论似乎没有引起他们的兴趣，而这一次我的讨论引起了他们的兴趣。所以我们将讨论如何合作，建立一个新的成像系统，以便我们能够测量这些变化，更好地了解眼内飘浮物的起源，以便更好地设计新的治疗方案来照顾患者。因此，我认为这是一个需要紧急资金支持的项目之一。我现在不知道需要多少资金，但是您能提供的任何支持都将不胜感激。第二个问题是，距今三周世界上最大的眼科研究会议将举行。该组织称为ARVO，是研究和眼科视觉协会的首字母缩写，这个会议是全球性的。今年的会议将在路易斯安那州的新奥尔良市举行。这是一个为期一周的会议，有来自世界各地的10或12,000人聚集在一起，分享关于眼睛和视觉的许多不同方面的研究。
And my collaborators and I have four presentations at this meeting. One involves the VFFQ, which is the Vitreous Floaters Functional Questionnaire. It's a questionnaire that we've developed to specifically query and quantify the degree of impact that floaters have on patients’ quality of life, and it's more insightful and powerful than any existing questionnaires, and we have over 300 respondents to this questionnaire. We analyze it in various different ways, and the details will be forthcoming in future publications, so I don't want to belabor this interaction with all of those details. But that's one of the presentations. Another presentation is the results of work that we're doing to study light scattering in vitreous of patients who have vitreous floaters that are debilitating and that cause them much suffering. In several of these cases I've excised the vitreous from the eye during surgery to cure the floaters. But rather than throw it away, I arranged with a laboratory at the University of Mercia in Spain to analyze this with very advanced optical methods, and we're correlating the results of those analyses with other aspects of these patients to get a better understanding of how does light interact with the vitreous to create floaters and to disturb vision and degrade quality of life.
我和我的合作者将有四个报告在这个会议上。其中一个涉及到“VFFQ”，即“玻璃体混浊功能问卷调查”。这是一个我们开发的问卷，专门查询和量化混浊对患者生活质量的影响程度。它比任何现有的问卷更具见解和影响力，我们已经收到了超过300个回复。我们以各种不同的方式对其进行分析，详细信息将在未来的出版物中公布，所以我不想在这个交互过程中详述所有这些细节。但这是其中一个报告。另一个报告是我们正在进行的研究，研究患有严重影响视力和引起很多痛苦的玻璃体混浊患者的玻璃体中的光散射。在其中几个案例中，我在手术期间切除了玻璃体以治疗混浊。但是，与其将其扔掉，我与西班牙墨尔西亚大学的实验室安排对其进行了非常先进的光学方法分析，并将这些分析的结果与这些患者的其他方面进行相关性分析，以更好地了解光如何与玻璃体相互作用，从而产生混浊，并扰乱视力并降低生活质量。
We also have a presentation on ultrasonography with a new ultrasound system. In the past we've had much success using ultrasound to image what's going on inside the eye in patients with floaters using a probe that has a single element, but the industry has developed a probe that has five elements integrated into one probe, and that should be significantly more powerful, more revealing, and more helpful in evaluating patients who complain of floaters to find out what's going on inside the center of their eye in the structure called vitreous that would enable us to understand and evaluate and treat patients with floaters. Lastly, I'm going to be giving a lecture on vision degrading myodesopsia and on surgery for VDM at this International Eye Research Conference, so I think we're going to be successful in promoting the cause of patients with floaters at this meeting. Giving a lecture at a podium exposes the topic to one or two thousand people. The other presentations have less outreach, but still it's very important to communicate to eye researchers and eye doctors how we need to emphasize more importance on the question of vitreous floaters.
我们还有一个关于新超声系统的超声学演示。过去，我们使用具有单个元素的探头在患有飞蚊症的患者内部成像使用超声技术已经取得了很大的成功，但是该行业已经开发出了一个集成了五个元素的探头，这应该会更强大，更具揭示性和更有助于评估抱怨飞蚊症的患者内部眼球结构中发生了什么，这称为玻璃体，从而使我们能够了解、评估和治疗飞蚊症患者。最后，我将在这个国际眼科研究会议上发表有关视力下降肌节视觉和VDM手术的讲座，因此我认为我们将在这次会议上成功推动飞蚊症患者的事业。在讲台上发表演讲可以将这个话题暴露给一两千人。其他演示的影响力较小，但向眼科研究人员和眼科医生传达我们需要更加强调玻璃体飞蚊症问题的重要性仍然非常重要。
So the ultrasound system research is funded by the NIH. We have a grant from the National Eye Institute, and so I would say that's not in need of urgent funding. But the development of the questionnaire, the support of the laboratory at the University of Mercia in Spain is in need of funding, and we also are working with a gentleman at Columbia University and a medical student at the University of Indiana who are developing a research project to identify and clarify the epidemiology of just how many people are out there with floaters and how severe are these floaters. It's a very important project that needs funding, and so if you could support the VDM Project, we would be in a better position to provide funding and conduct this research. Lastly, we also need funding for statistical validation of the VFFQ questionnaire which I described earlier. So I would say in answer to that question, there are several projects that are in need of funding, and we would appreciate your support in that regard.
因此，超声波系统的研究是由美国国立卫生研究院（NIH）资助的。我们从国家眼科研究所获得了一项资助，因此我认为这不需要紧急资金支持。但是问卷调查的开发，与西班牙墨尔西亚大学实验室的合作需要资金支持，我们还与哥伦比亚大学的一位绅士和印第安纳大学的一位医学生合作，开展一项研究项目，以确定和澄清有多少人患有飞蚊症，以及这些飞蚊症有多严重。这是一项非常重要的研究项目，需要资金支持，如果您能支持VDM项目，我们将能够提供资金并开展这项研究。最后，我们还需要为VFFQ问卷调查进行统计验证的资金支持，这是我之前提到的。因此，回答您的问题，有几个项目需要资金支持，我们将感激您在这方面的支持。
The second question asks whether we can have floaters severity classification. Can we have floaters recognized as a disease if we classify different severity levels? That's a good question, and I think that theoretically that is true. But in my experience, that's putting the cart before the horse, meaningthat I doubt that a classification system is going to stimulate disease acceptance. Rather, in my experience, disease acceptance comes first, leading to a need for a classification system. But I'm prepared to be proven wrong, and rather than just make decisions based on my opinion, I'm going to consult with the members of our Scientific Advisory Board to the VDM Project and see what their thoughts are, and I'll be happy in a future point in time to share the results of those discussions with all of you.
第二个问题问我们是否可以对混浊物的严重程度进行分类。如果我们分类不同的严重程度，能否将混浊物识别为一种疾病？这是一个很好的问题，理论上这是可能的。但根据我的经验，这是本末倒置，意味着我怀疑分类系统会促进疾病认可。相反，在我的经验中，疾病认可首先出现，导致对分类系统的需求。但我准备接受反驳，并且我将与我们的 VDM 项目科学顾问委员会成员商讨他们的想法，并乐意在将来的某个时间与大家分享这些讨论的结果。
The third question is concerning laser treatments. Is there any news on YAG laser or femtosecond laser treatments? YAG laser vitreolysis is performed frequently, but it's a difficult subject, and the reason is that there have never been any valid scientific studies proving that YAG laser vitreolysis works. Consequently, there's no support from governments or insurance companies in terms of financing YAG laser treatments, and patients have to do so out of pocket so that's one indication that there's a lot of information that's lacking from the implementation of YAG lasers to treat vitreous floaters. In fact, just a few months ago, the National Institute for Centres of Excellence in the United Kingdom, it's called NICE, that's the acronym, and they oversee the validity of various ways to practice medicine in different parts of the body, they did an analysis and concluded, I think because there is no evidence that YAG lasers work, the performance of YAG laser vitreolysis should only be done by retinal specialists and not general ophthalmologists and should only be done in the context of a research project. And so in response to that, I have initiated a collaboration with a colleague in London, a Professor Paulo Stanga who's a member of our Scientific Advisory Board to the VDM Project. And he and I are going to collaborate on a prospective scientific study to evaluate whether or not YAG laser treatment works.
第三个问题涉及激光治疗。关于YAG激光或飞秒激光治疗，有什么新消息吗？YAG激光玻璃体溶解术经常进行，但这是一个困难的课题，原因是从未有过任何有效的科学研究证明YAG激光玻璃体溶解术有效。因此，在YAG激光治疗方面，政府或保险公司在融资方面没有提供支持，患者必须自己掏钱，这表明在使用YAG激光治疗玻璃体混浊方面缺乏大量信息。事实上，就在几个月前，英国卓越中心国家研究所（简称NICE），他们负责监督在不同身体部位进行医学实践的有效性，进行了一项分析并得出结论，因为没有证据表明YAG激光有效，所以只有视网膜专家才能进行YAG激光玻璃体溶解术，并且只能在研究项目的背景下进行。因此，我已经与伦敦的一位同事保罗·斯坦加教授展开了合作，他是我们VDM项目科学顾问委员会的成员。他和我将合作进行前瞻性科学研究，以评估YAG激光治疗是否有效。
There's evidence to suggest that it doesn't, but within that evidence, there seems to be a subgroup of people who are happy with the results. And we don't know whether that's a placebo effect or whether there are actually changes in the vitreous structure and improvements in the contrast sensitivity that explain why this small subgroup of people are happy. So we're hoping to perform this prospective study and test people before, during, and after YAG laser treatments in order to get the answers to those questions and determine does it work or not, and if it works, who are the people that are most likely to respond because you don't want to treat everybody in the hopes of helping that subgroup of people. We would like to identify who they are and make recommendations as to not just whether or not they should be treated, but how they should be treated. So that's an exciting new project that we're working on that hopefully we’ll be able to share results in the coming months and years. The fourth question relates to the nanobubble project, and that refers to research that is being performed at the University of Ghent in Belgium, and I've collaborated with this group for a few years now. We've published a couple of papers together sharing with the world the results of our experiments.
有证据表明YAG激光玻璃体溶解术无效，但在这些证据中，似乎存在一小部分人对结果感到满意。我们不知道这是否是安慰剂效应，还是实际上玻璃体结构发生了变化，对比度敏感性得到了改善，这解释了为什么这个小的人群感到满意。因此，我们希望进行这项前瞻性研究，测试在YAG激光治疗之前、治疗期间和治疗后的人，以回答这些问题并确定它是否有效，如果有效，最可能对治疗做出反应的是哪些人，因为我们不想治疗每个人，只是希望帮助那个小的人群。我们希望确定他们是谁，并提出建议，不仅是他们是否应该接受治疗，还包括如何进行治疗。所以这是一个令人兴奋的新项目，我们正在进行中，希望在未来几个月和几年内能够分享结果。第四个问题涉及纳米气泡项目，这是在比利时根特大学进行的研究，我已经与该团队合作几年了。我们一起发表了几篇论文，与世界分享了我们实验的结果。
Initial experiments were done in vitro, which means in dishes in a laboratory, and subsequent to those successful experiments, we performed experiments in rabbits in collaboration with scientists at the University of Michigan in the United States. What those experiments were intended to show is whether it's safe and whether it's effective, meaning the use of nanoparticles that adhere to the opacities in the vitreous body that cause the visual phenomenon of floaters. We've shown preferential adherence, and we've shown that you can use a low-level laser light to create nanobubbles that break the opacities and improve the situation. But obviously we're not able to measure vision in rabbits. We're not able to ask them, “Are you happy?” So these are highly suggestive but not proof that there is a role for nanotechnology in the treatment of patients with vitreous floaters. We need to do extensive clinical testing to prove safety first and foremost, but also to prove efficacy, and in order to do that correctly requires the participation of partners--partners in government and partners in industry--and right now we are in the process of seeking those partners so that the right kind of clinical research can be performed to help people who are suffering from vitreous floaters.
这里提到的实验最初是在实验室的培养皿中进行的（即in vitro实验），之后我们与美国密歇根大学的科学家合作，在兔子身上进行了实验。这些实验的目的是证明使用纳米颗粒治疗玻璃体混浊是安全和有效的。我们已经证明了纳米颗粒能够优先附着在玻璃体中导致浮点现象的混浊区域上，并且可以使用低水平的激光光线产生纳米气泡，破坏混浊物，改善状况。但是显然，我们不能测量兔子的视力。我们无法问它们，“你感到满意吗？”因此，这些实验高度暗示了纳米技术在治疗患有玻璃体混浊的患者中发挥作用，但并不能作为证明。我们需要进行广泛的临床测试，首先证明其安全性，其次证明其疗效。为了正确地进行这些研究，需要政府和工业界的合作伙伴的参与，目前我们正在寻找这些合作伙伴，以便进行正确的临床研究，帮助那些遭受玻璃体混浊之苦的人们。
So that's a brief update of the things that we're working on, and I am very very appreciative of all the support that we've received from all of you that have helped us with the information that I just presented and the events that are occurring and the contribution to the fund of knowledge throughout the world, but also to increase the awareness within the scientific community, within the medical community, and with the world at large that vitreous floaters are not just a nuisance. In many cases they're an actual disease, and we call that disease vision degrading myodesopsia. It's worthy of the same respect and consideration that we offer people with other diseases whatever they might be, and floaters are that kind of condition, and we're hoping that the scientific evidence that we're producing will raise the level of awareness and raise the support from governments and industry. But the support begins with all of you, and Fabio Gallerani and I are very appreciative of your engagement in the VDM Project and your support of the VMR Research Foundation. Thank you very much for your attention, and have a good day.
这就是我们正在进行的项目的简要更新，我非常感激所有为我们提供信息、参与事件以及为世界各地的知识基金做出贡献的人们对我们的支持。我们也要提高科学界、医学界和世界各地的人们对玻璃体混浊的认识，让人们意识到玻璃体混浊不仅仅是个麻烦。在许多情况下，它们是一种实际的疾病，我们称之为视力下降的肌电感觉异常。它值得得到我们对待其他疾病的同样尊重和考虑。我们希望我们所产生的科学证据将提高人们的认识水平，并获得来自政府和工业界的支持。但支持始于你们所有人，Fabio Gallerani和我非常感谢您们参与VDM项目和支持VMR研究基金会。非常感谢您们的关注，祝你们有个愉快的一天。
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发表于 2023-4-28 17:35:25
发表于 2023-4-28 17:48:57
