Andrea Blitzer, Edward Hines VA Hospital
ET-1 in the aqueous humor of patients with POAG
Increased pressure within the eye is typically the first indicator of glaucoma, a major cause of irreversible blindness worldwide. In some glaucomatous patients, eye pressure increases by a mechanism that is poorly understood. The abundance of two bioactive factors, transforming growth factor-β2 (TGF-β2) and endothelin-1 (ET-1), have been reported elevated within the eyes of glaucomatous individuals. Recently, we reported a causal link between these two factors. To begin to address whether TGF-β2 enhances ET-1 content in glaucomatous patients, we propose here to quantify the content of both TGF-β2 and ET-1 present in the eyes of non-glaucomatous and glaucomatous patients.
Faheemah Saeed, OD, Illinois College of Optometry
Validity and reliability of the new Evans Letter Contrast Sensitivity Test in a low vision sample population
The ability to accurately monitor the disease status or improve the visual function of low vision patients requires reliable and repeatable vision tests. It is generally accepted that measures of visual function in the low vision patient population are more variable than normally sighted individuals. This may decrease the reliability of standard visual tests when applied to the low vision population. The purpose of our study is to measure the reliability and repeatability of two new tests that measure the contrast detection; the M&S smart system II single letter contrast test and the iPad letter test. These results will be compared with those obtained from the Pelli-Robson test which is well-established and clinically accepted but no longer in production. In addition we will also ask subjects if amber/yellow lenses improve their subjective perception of text and will then determine if those subjects who experience a subjective improvement in contrast had the greatest initial reduction in contrast.
Ashley Speilburg, OD, Illinois College of Optometry
Is peripheral retinal ischemia associated with systemic atherosclerosis?
Diabetes and carotid artery wall thickness are well-known risk factors for heart disease and atherosclerosis. Previous studies have found that patients with diabetic retinopathy (DR) have a higher carotid artery wall thickness than diabetic patients without retinopathy and patients with severe DR are more likely to have undetected vascular disease. The purpose of this study is to investigate whether there is a correlation between peripheral retinal ischemia and carotid artery wall thickness in patients DR. A positive correlation might suggest that identification of peripheral retinal ischemia may warrant further cardiovascular evaluation in diabetic patients.
Huizi Yin, OD, Illinois College of Optometry
A prospective study on diagnosing optic nerve hypoplasia and treatment of associated amblyopia
Diabetic retinopathy (DR) is a leading cause of blindness in American adults and the most common diabetic eye disease. Over 60% of diabetic patients develop DR over a long time span of 15-20 years. Once it reaches late stage, DR is incurable, thus early diagnosis becomes critical for early intervention and treatment. By using a new technique called visible light optical coherence tomography (vis-OCT), we proposed to functionally quantify the oxygen saturation (sO2) and further the metabolic rate. With the quantified functionality, we intend to further test the feasibility and stability of vis-OCT in rodent model. The significance is that the metabolic functionality of retinal can be potentially serves as biomarkers for early DR diagnosis.
Lindsay Ambrecht, MD, Loyola University
The mechanism of neuroprotective effects of sulforaphone on retinal ischemia-reperfusion injury
Sulforaphane, a chemical found in vegetables such as broccoli, has been reported to protect neural cells in cell culture and in animal models after stroke. In some forms of glaucoma and diabetic eye disease, injury of the retina often results in blindness. In this study, we will determine whether sulforaphane protects the retina from injury after ischemia and the mechanism underlying sulforaphane’s protective effects. We plan to determine if the neuroprotective effects of sulforaphane on ischemic retinal injury depend on the presence of Nrf2 by quantifying relative changes in Nrf2 and its downstream effecter HO-1 by immunohistochemistry in wild type mice. This study will advance our knowledge in developing therapies against retinal ischemic degeneration diseases.
Shivani Kamat, MD, Loyola University
The effect of continuous, pre-recorded instructions using headphones during perimetry
Perimetry is a test that determines light sensitivity for points across the visual field. It is extremely useful in managing diseases like glaucoma, however it can be difficult obtaining reliable data because the test is long and requires considerable concentration. Repeating the test to improve reliability is common. Instructions and feedback vary widely depending on the personnel administering the test. Our observation is that cursory instructions with little or no subsequent feedback adversely affect test reliability. We want to investigate whether prolonged instructions and encouragement throughout the test provided by continuous pre-recorded instructions via headphones will improve outcome reliability.
Nicole Mitchell, Loyola University
HLA alleles as biomarkers for genetic susceptibility of cotrimoxazole-induced Stevens Johnson syndrome and toxic epidermal necrolysis
Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are life-threatening diseases that result in extensive skin detachment and serious ocular morbidity including blindness. Although rare, the diseases are triggered by either infections or certain drugs including cotrimoxazole (trade name: Bactrim). The purpose of this study is to identify a genetic link, in the form of HLA alleles, as a risk factor for developing SJS/TEN after ingestion of cotrimoxazole. The findings of this study could allow clinicians to help predict or prevent these life-threatening illnesses when prescribing cotrimoxazole.
Nicole Nikolic, Loyola University
Selective update of vital stains in the orbital tissues: nerve, muscle, and adipose
Fluorescein-guided biopsy and resection of tumors is a relatively new modality being used in surgical subspecialties such as neurosurgery and urology, with recent literature describing the stain’s ability to allow surgeons to obtain clearer margins when resecting tumors in the operating room. As ophthalmology has long used various vital stains to better examine different tissue types without causing toxic damage to living cells in the eye and orbit, we are interested in further exploring the staining properties of fluorescein, rose bengal, lissamine green, trypan blue, and indocyanine green. Specifically, the focus of our investigation will be to determine if there is selective uptake of these vital stains in adipose, muscle and nervous tissue. The aim of this study is to both advance our knowledge of vital stain characteristics and to provide a foundation for the use of specific vital stains for in vivo resection of various cancers.
Albara Ottman, Loyola University
The effects of aspirin and its metabolites on human retinal pigment epithelial cells – implications in the pathophysiology of age-related macular degeneration
Age-related macular degeneration is one of the leading causes of blindness in the world. Recently, a large clinical trial reported that the long-term use of aspirin was responsible for its occurrence. In this study we propose to determine the effects of aspirin and its toxic metabolites on human retinal pigment epithelial cells maintained in culture medium. The levels of biomarkers such as Vascular Endothelial Growth Factor (VEGF), Noxa and other markers of cell death will be determined. This study will unravel the toxic metabolites of aspirin responsible in the process leading to age-related macular degeneration.
Andrew Pittner, Loyola University
Assessing inter observer variability in grading cataract surgery using a video modification of a standardized assessment rubic: can residents assess their surgery as well as their attending?
Cataract surgery is one of the most frequently performed surgical procedures in the world. The Accreditation Council on Graduate Medical Education (ACGME) and the American Board of Ophthalmology (ABO) are establishing a new paradigm in resident education; shifting from simply meeting minimum quantity of cases to ensuring quality by measuring outcomes. We are adapting the International Committee on Ophthalmology Surgical Competency Assessment Rubric (ICO-OSCAR) into an interactive video model in a pioneer city-wide collaboration. We will train residents to become expert judges of cataract surgical skill to lower inter-grader variability and better prepare them to facilitate their surgical skill improvement.
Diana Tamboli, MD, Loyola University
The natural history of Cystoid Macular Edema after cyclophotocoagulation treatment in patients with Glaucoma
Cyclophotocoagulation is often used for glaucomatous patients with poor visual potential or those who are refractory to less invasive treatments and may be poor candidates for surgical treatments. Known complications include prolonged hypotony, pain, inflammation, phthisbulbi and cystoid macular edema (CME). While some patients have mild CME, others with more severe CME can result in permanent vision loss. External ciliary body epithelium ablation is relatively contraindicated in eyes with good vision because of the risk of loss of visual acuity. Our study aims to reveal the incidence and natural history of CME in glaucomatous patients who require CPC treatment.
Joseph Simonett, Northwestern University
Ocular manifestations, optic nerve changes and genotype/phenotype correlation in patients with amyotrophic lateral sclerosis (ALS)
Amyotrophic lateral sclerosis (ALS or Lou Gehrig’s disease) is a rare and complex neurodegenerative disorder characterized by muscle wasting, progressive paralysis and breathing failure. Previous studies have shown that ALS patients suffer from vision problems, however no one has investigated changes occurring in the back of the eye in this patient population. Through collaboration with the Northwestern University ALS Center of Excellence, we will perform detailed eye imaging to characterize the ocular changes that correlate with these patients’ vision problems. Furthermore, we will correlate these findings with patients’ genetic mutation and degree of generalized neurologic damage. Understanding these new eye findings may help us identify a new target for treatment or a new modality of ALS disease monitoring through the eye.
Ji Yi, PhD, Northwestern University
Non-invasively quantifying retinal oxygen saturation by visible-light optical coherence tomography
Optic nerve hypoplasia (ONH) is a condition with a smaller than normal nerve connecting the eye to the brain. It is one of three leading causes of blindness among children in United States. Thus, an accurate and early diagnosis is critical. This study will investigate whether using Optical Coherence Tomography (a high-definition scan) would have an advantage in diagnosing ONH. Additionally, Amblyopia (a lazy eye) may develop along with ONH. Another aim of the study is to evaluate whether patching the better-seeing eyes would improve vision of the ONH eyes in participants younger than 18 years old.
Vinay Aakalu, MD, MPH, University of Illinois Chicago
Accessory lacrimal tissue precursor cell biology
Dry eye disease is a painful, irritating disease which causes significant diminution of quality of life in many patients. It is frequently caused by decreased production of tears from the tear (lacrimal) gland and accessory tear gland. Recently studies have shown that the main tear gland in humans and animals contain stem cells which, if properly isolated and understood, may represent a source of tissue to replace the tear gland that has been damaged in many dry eye patients. No one has studied the accessory tear glands. We are attempting to find and isolate stem cells from the accessory glands.
Joseph Bogaard, University of Illinois Chicago
CYP2C9 mediated neuroprotection in retinal degenerative disease
Photoreceptors are the light sensing cells of the eye. Their loss is the primary cause of vision loss in retinitis pigmentosa. Prior work in our lab has shown that inhibition of a cytochrome P450 enzyme called CYP2C9 is a novel approach that increases photoreceptor survival. We recently found that sulfaphenazole, a previously approved FDA compound that inhibits CYP2C9, is protective for photoreceptors in a cell-based model of photoreceptor death using bright white light. In the present study, we seek to test whether sulfaphenazole is also protective in an animal model that exposes rats to bright white light.
Joshua Hou, MD, University of Illinois Chicago
Characterization of melt-associated retroprosthetic membranes in patients with the Boston Keratoprosthesis using immunohistochemistry and in-situ hybridization
The Boston Type I Keratoprosthesis (KPro) is an artificial cornea used as a last-resort treatment for severe corneal diseases. Though the artificial cornea has restored vision to numerous patients, a number of complications still limit its use. The most common complication is growth of a membrane behind the artificial cornea which can obscure the vision and even compromise the integrity of the implant. The purpose of this study is to microscopically examine membranes obtained from KPro patients using immunohistochemistry and in-situ hybridization to determine where they come from and how they can contribute to loss of the implant.
Heather Moss, MD University of Illinois Chicago
Ganglion cell function in papilledema
Idiopathic intracranial hypertension (IIH), defined by elevated pressure in the brain without other cause, produces blindness by compromising the function of the optic nerve, which transmits visual information from the eye to the brain. This project will characterize pupil and retina responses to different types of light stimuli in the eyes of people with and without IIH using non-invasive methods. This will determine if these methods detect optic nerve injury from IIH. The results will have implications for monitoring and treatment of this potentially blinding condition and will advance our understanding regarding mechanisms of vision loss in people with IIH.
Rajni Parthasarathy, PhD, University of Illinois Chicago
Detection and quantification of amyloid-beta protein in eye tissues
Amyloid Beta (Aβ) is a well-known component of amyloid plaques in the brain that are associated with neurodegenerative diseases such as Alzheimer’s disease (AD). There is growing evidence that cellular toxicity exhibited by excessive Aβ may be significant in retinal degenerative diseases such as age-related macular degeneration (AMD). Using a recently developed monoclonal antibody (MOAB-2) with unprecedented selectivity for Aβ, through ELISA and immunohistochemistry (IHC) techniques, I will obtain information on the distribution and amounts of Aβ in mouse eye tissues. The results will represent a step toward designing future investigational and ultimately therapeutic studies aimed at engineering the control of Aβ levels in eye tissues.
Joy Sarkar, PhD University of Illinois Chicago
Extracellular DNA in tear fluid: innate mechanism of ocular surface inflammation
An imbalance between production of tear film nuclease and clearance of extracellular DNA (eDNA) from the ocular surface contributes to inflammation in patients with Dry Eye Disease (DED) due to Sjögren’s Syndrome. Our recent findings demonstrate deficiency of nuclease activity and abundance of eDNA on the ocular surface in patients with DED. Currently, there is no biological assay to determine tear fluid DNA abundance. In this proposal, we will determine eDNA abundance and tear fluid nuclease activity in patients with DED using a new Real-Time DNase assay (ReDA) which could direct specific treatment strategies to reduce inflammation in the future.
Vanessa Braimah, Illinois College of Optometry
Usage of accessibility options for the iPhone/iPad in a visually impaired population
The ability to successfully perform activities of daily living when it pertains to technology is a cause for concern among the visually impaired and legally blind population. This study will survey low vision patients in the Chicago area on their knowledge and usage of built in low vision accessibility features on the iPhone and iPad and correlate results to their level of functional vision. The results will guide doctors to incorporate this technology and to recommend and train patients in the use of accessibility features that are most suited to patient’s level of vision and ocular diagnosis.
Stephanie Fromstein, Illinois College of Optometry
Effectiveness of Orthokeratology in Decreasing Myopic Progression in a Young Adult Population Enrolled in a Professional Optometric Curriculum
The high prevalence of myopia (nearsightedness) is well documented, as are the sight-threatening complications of high myopia. Specialty rigid lenses have been shown to lessen this progression in the pediatric population; orthokeratology (ortho-k) lenses are worn at night and change the corneal topography to correct moderate amounts of nearsightedness. Our project seeks to investigate the efficacy of ortho-k in slowing myopic progression in subjects age 21-30. Results will help elucidate what role these specialty lenses may have in the management of the myopic patient throughout their development, as well as what potential they have in prevention of associated degenerative changes.
Christina Morettin, Illinois College of Optometry
Visual Structure and Function in Contact Sports Athletes
It is estimated sports-related concussion afflicts 3.8 million American athletes each year. We are studying a structure in the back of the eye, the retina, in active or retired professional contact sport athletes with a high risk of concussion (mainly football). As the eye is an extension of the brain, we are trying to determine if professional contact sports athletes have a greater amount of thinning in the retina compared to people who have not participated in contact sports, and whether the thinning is related to decreased function of their vision. Identifying retinal thinning is done using simple, non-invasive testing and may be a future indicator to help detect and monitor chronic, progressive brain dama