Erik Anderson, M.D., John Stroger Hospital of Cook County

Monocyte Tracking after Corneal Transplantation in Mice

Anderson

Corneal transplantation is a surgical procedure where a damaged or diseased cornea is replaced by donated corneal tissue (the graft). Although graft survival is generally favorable, rejection occurs frequently and leads to poor vision and repeat surgical procedures. Our goal is to create a murine model of corneal inflammation using a special strain of mice that carry a green fluorescent protein that allows for the real-time visualization of a type of white blood cell called monocytes. This will allow study of monocyte mobilization and ultimately new treatment strategies that selectively target immune cells.

 

Matthew Asano, M.D., John Stroger Hospital of Cook County

Identification of differentially expressed proteins in the aqueous humor of diabetic macular edema

Asano

Diabetic macular edema (DME), is a condition that occurs in patients with diabetes, and is defined as edema (swelling) of the macula, or region of the retina responsible for central vision. DME is one of the most common causes of vision loss in the U.S., and is a potentially treatable condition, but many patients are still faced with vision loss. In this project, we plan to analyze the aqueous humor (fluid in the anterior segment of the eye) of patients with DME in an attempt to identify new intraocular proteins that may be involved in DME pathogenesis. The findings of this study may help researchers further define the pathogenesis of DME and identify new treatments for this potentially blinding condition.

 

Pablo Barrionuevo, PhD, University of Illinois Chicago

Melanopsin photoresponse defeficit in glaucoma

Barrionueva

Intrinsically photosensitive retinal ganglion cells (ipRGCs) are activated by melanopsin photopigment transduction and also by rod and cone inputs. Since ipRGCs are uniformly dispersed in the retina and glaucoma effects start from the peripheral visual field; rod, cone and melanopsin signals in ipRGCs could be affected differentially even in early-stage glaucoma. We will employ stimuli that preferentially activate melanopsin, rods or cones independently and we will then measure variations in pupil responses, which are controlled by ipRGCs. The study outcomes will enable a clearer understanding of the impact of glaucoma on ipRGC activation and could be used for early-glaucoma testing.

 

Wells Brambl, Loyola University Chicago

Role of TGFB and NF-kB in the pathogenesis of Keratoconus

Brambl

Keratoconus is a progressive disease affecting 1 in every 500 Americans and causes abnormal protrusion of the cornea resulting in visual impairment requiring corneal transplantation. Keratoconus usually presents in the second decade of life and progresses into the third and fourth decades affecting both genders and all ethnicities. There are several causes of keratoconus and it is often associated with eye rubbing and atopic diseases such as asthma, allergies and eczema. There are certain proteins, TGF-β and NF-κB, that may be increased within the cells of the cornea, the most transparent membrane of the eye. Changes in the levels of these proteins may cause thinning and abnormal protrusion of this transparent membrane leading to visual impairment. In this study we aim to detect the presence or absence of these proteins through specialized chemical staining of the corneas obtained from normal human donors and those from patients with keratoconus, which will be removed at the time of Corneal transplantation. The results of the proposed study will shed light on the sequential steps in the causation of this disease process so as to formulate effective treatment strategies.

 

Laura Burke, M.D., Loyola University Chicago

Use of Chlorpromazine to control post-operative pain in patients after enucleation or evisceration.

Burke

Patients with blind, painful eyes have the option of undergoing enucleation or evisceration surgery to relieve intractable pain. Immediately following surgery patients can experience discomfort related to the operation. Ophthalmologists use a combination of intra-operative injections and oral narcotics to control pain, however most patients continue to experience some degree of discomfort. This study will determine if an additional medication, chlorpromazine, could improve post-operative pain control. Chlorpromazine is an injectable medication currently used by glaucoma specialists. If found to be effective, the results of this study may help to improve patient comfort after enucleation or evisceration surgery.

 

Liza Cohen, Medical Student, Northwestern University

Pupillometry and optical coherence tomography in patients with vision loss

Cohen

Vision loss can result from disease of the optic nerve. Response of the pupil to light is a way of testing optic nerve function; however, clinical examination is subjective and not easily quantifiable. Pupillometry is an easy-to-use, objective, non-invasive, computerized means of testing and recording the pupillary response. Our purpose is to investigate pupillometry as a clinical screening tool and evaluate the pupil’s response as a measure of optic nerve function using optical coherence tomography. This research may benefit patients with diseases of the optic nerve, as pupillometry can lead to earlier diagnosis and be used to follow disease progression.

 

Matthew Flood, M.D., Loyola University Chicago

De-novo biotransformation in human retinal pigmented epithlium

Flood

Age related macular degeneration (ARMD) is form of retinal degeneration characterized by abnormalities in the layer of pigmented cells that support retinal function. The cause for the degeneration of these special cells, termed the retinal pigmented epithelium (RPE) is speculative. While various forms of cell stress such as chronic sunlight exposure and/or inflammation as well as genetic factors are thought to play a role in AMD other as yet unknown factors are likely involved. In this study we will examine if RPE cells are capable of drug metabolism similar to mechanisms found in the liver that act to alter the chemistry of systemic drugs so they may be eliminated from the body. Although the process of drug elimination is fairly safe, in some case toxic metabolites are formed that can be detrimental to cells. If this happens in the RPE it may lead to additional stress on the retina that acts in concert with other forms of retinal injury such as inflammation to initiate macular degeneration.

 

Andrew Francis, M.D., University of Illinois Chicago

Abnormalities in Retinal Layer Thickness due to Diabetes Assessed with Spectral Domain Optical Coherence Tomography

Francis

Diabetic retinopathy (DR) affects approximately 93 million people worldwide. There is evidence to suggest neurodegenerative events precede clinically detectable microvascular retinopathy. Studies with transgenic diabetic rodents have demonstrated similar pathologic changes with the human retina making it an ideal animal model. Combined with high-resolution spectral domain optical coherence tomography (SDOCT) imaging systems, the capability exists to quantitatively assess microscopic alterations in retinal structure that occur in early DR. The purpose of this study is to quantitatively assess abnormalities in retinal structure due to diabetes in the experimental diabetic Ins2(Akita) mouse and in human subjects with early DR using SDOCT.

 

Sachin Jain, M.D., University of Illinois Chicago

Functional Measures as Surrogates for Vision-Related Quality of Life in Patients with Glaucoma

Jain

Glaucoma is the leading cause of irreversible blindness worldwide. Most of the testing that is routinely performed in glaucoma patients looks for progression of the disease, but does not provide much information about its impact on the patient’s life. Quality of life (QOL) measures are not routinely used due to the significant amount of time required for their use, but provide important information about the impact of the disease on a patient. This project will work to determine if there is a strong link between tests routinely performed to monitor glaucoma patients and their quality of life. It will also assess a newer method of contrast testing, as contrast sensitivity can be affected by glaucoma, but traditional methods of testing are quite cumbersome. The study will recruit glaucoma patients to undergo a series of tests to determine which one provides the best correlation with quality of life measures.

 

Joel Kaluzny, Medical Student, Northwestern University

Retinal Oximetry as a Diagnostic Tool for Diabetic Retinopathy

 

Northwestern University, Feinberg School of Medicine 2014 Alumni Weekend

In patients with diabetic retinopathy, early detection of retinal hypoxia can help prevent irreversible damage and blindness. Novel imaging technologies, such as hyperspectral snapshot imaging, allow for the in-vivo quantification of retinal blood supply in the form of oximetry measurements2. These metrics can potentially provide clinicians a tool for diagnosing diabetic retinopathy in its earliest stages, and the possibility of preventing blindness in a growing population with diabetes. Our goal is to use a hyperspectral imaging system to measure the retinal blood-oxygen saturation of control and diabetic patients to study retinal oximetry as a potential marker of diabetic retinopathy.

 

Brianna Knoll, Medical Student, Northwestern University

Early Detection of Alzheimer’s Disease Through the Eye

Knoll

Early diagnosis of AD has remained a highly sought after but elusive goal with none of the current psychophysical, molecular, or imaging approaches establishing a specific standard for early detection. We are studying the ocular findings in subjects with preclinical stages of Alzheimer’s disease (Mild cognitive impairment, MCI) and comparing them to healthy controls. By utilizing the eye as a means for diagnosis, we could have a both safe and affordable means for detection. Once we identify ocular changes in MCI, we would then monitor them to determine if these biomarkers predict progression to AD.

 

Jonathan Lautz, Graduate Student, Edward J. Hines VA Hospital

Effect of elevated atmospheric pressure on ET-1 dependent induction of retinal ganglion cell death

Lautz

Primary open-angle glaucoma (POAG) is a leading cause of blindness worldwide and currently remains an extraordinarily significant health care concern. In the majority of POAG patients, retinal ganglion cell (RGC) death is strongly associated with a pathological elevation of intraocular pressure (IOP). Mechanisms that predispose RGC neurons to glaucomatous injury remain, however, unknown. In this study, we propose that aberrant elevation of IOP predisposes primary RGC neurons to TGF-β2 mediated ET-1 dependent induction of apoptosis. Improved management of the glaucomatous patients can only be realized when mechanisms responsible for pressure-dependent induction of RGC death have been elucidated.

 

Olga Lekakh, Medical Student, Loyola University Chicago

Correlation of ocular profusion pressure responses to continuous positive airway pressure

Lekakh

Studies have shown that obstructive sleep apnea (OSA) is related to eye pathology and Primary Open-Angle Glaucoma. Continuous positive airway pressure (CPAP) treatment for OSA has been correlated with fluctuating eye pressures. Increased intraocular eye pressure maybe a significant and controllable risk factor for the onset and progression of glaucoma. We are interested in the relationship between CPAP use and ocular perfusion pressure and will perform a prospective clinical study of patient’s eye pressures while they are using their CPAP machines. Our hypothesis is that increasing levels of CPAP will decrease ocular perfusion pressure and increase intraocular pressure.

 

Danielle Leong, O.D., Illinois College of Optometry

Longitudinal Visual Structure and Function in Contract Sport Athletes

Leong

Recent research suggests that the development of chronic, progressive, nerve damage in the brain may be a result of repetitive head trauma. This investigation will determine how visual pathways, which comprise at least 50% of the brain’s circuits, and visual structure-function correlation can capture possible signs of neurologic dysfunction in vivo among active and retired athletes from elite-level, high-risk contact sports, such as football, hockey and boxing. Results may potentially enhance the evaluation of athletes and other populations such as the military in the assessment of long-term sequelae of multiple concussive and sub-concussive injuries.

 

Hao Li, PhD, Northwestern University

Translational photoacoustic ophthalmoscopy for RPE melanin concentration quantification

Li

The RPE melanin is believed to play a key role in age-related macular degeneration. Quantitative investigation of the RPE melanin relies on accurate optical absorption measurement. Photoacoustic ophthalmoscopy (PAOM) has the potential to directly measures optical absorption in the RPE to quantify melanin concentration non-invasively. However, current PAOM doesn’t have sufficient axial resolution to resolve RPE. Moreover, physical contact of piezoelectric ultrasonic detector with the eye in the current PAOM isn’t preferred for clinical applications. We propose to develop an optically-transparent, fiber-based ultrasonic detector and to integrate it with a powerless contact lens to solve these issues in PAOM.

 

Hieu Nguyen, PhD, Northwestern University

GLYX-13 neuroprotection of the visual areas of the brain and implications for a thalamic visual prosethesis

Nguyen

Glaucoma is an incurable neurodegenerative disease characterized by loss of retinal ganglion cells (RGC) and associated neurons of the lateral geniculate nucleus (LGN). In this proposal, we test the neuroprotective effect of the GLYX-13 NMDA partial agonist in the visual areas of the brain following a glaucoma model in mice. We will assess GLYX-13 efficacy in preventing neuron loss by measuring LGN cell density, volume, shape, and inflammation. Furthermore, this data will provide information on the geometry and capability for electrical excitation of the LGN, essential to our group’s long term goal of developing a thalamic visual prosthesis.

 

Sapna Tibrewal, M.D., University of Illinois Chicago

Role of Neutrophils in Pathogensis of Chronic Ocular Graft versus Host Disease

Tibrewal

Graft-vs.-host disease (GVHD) is an important complication after stem cell transplant surgery. We hypothesize that neutrophils of patients with GVHD have increased tendency to release their nucleic acids and proteins on the eye surface, which can cause severe dry eye disease. We will isolate neutrophils from blood of GVHD patients, and analyze their ability to release their nucleic acids and proteins, as compared to healthy volunteers. This will help understand mechanisms leading to excessive inflammation of the eye surface. Understanding the molecular basis will help develop specifically targeted therapy for dry eye disease in patients with GVHD.

 

Gautam Vangipuram, Medical Student, University of Illinois Chicago

Association between retinal vein size and short-term intracranial pressure changes in idiopathic intracranial hypertension

Vangipuram

Idiopathic intracranial hypertension, defined by elevated pressure in the brain without other cause, can compress the optic nerve resulting in irreversible vision loss. Tracking disease progression due to changes in intracranial pressure (ICP) remains a challenge. Changes in sizes of blood vessels inside the eye have been observed in association with long-term changes in ICP, and are an attractive marker since they are measured non-invasively. This study aims to determine if eye blood vessel sizes change with short-term changes in ICP in humans with IIH. The results will have implications for monitoring and treatment of this potentially blinding condition.

 

Hongyu Ying, PhD, University of Illinois Chicago

Supression of Ocular Fibrosis by SiRNA-Nonoparticle Technology

Ying

Glaucoma filtration surgery (GFS) is a common treatment in glaucoma, a blindness disease. However, the surgery often fails due to scarring (fibrosis) under the conjunctiva. Transforming growth factor beta (TGFβ) was found to be a significant contributor to subconjunctival scarring. Through RNA interference (RNAi) technology, we plan to silence the expression of TGFβ receptor type II (TβRII) by small interference RNA (siRNA), to block TGFβ action and minimize its adverse consequences. We will further combine RNAi with nanotechnology for siRNA delivery, allowing siRNA to enter cells rapidly and efficiently and be protected from degradation inside of the cells.

 

Optometric Resident Awards

Jasleen Jhajj, OD, Illinois College of Optometry

A Reference Database of Optical Coherence Tomography Parameters in a Pediatric Population

Jhajj

The Cirrus 4000 Optical Coherence Tomographer (OCT) is a non-invasive imaging device that is routinely used in practice to measure the landscape and thickness of the retina, macula, and optic nerve at the back of the eye. The OCT measures with extreme precision and is therefore also helpful in monitoring for pathological changes in the back of the eye. There is currently no age, sex, or race matched reference data available to interpret scans from the Cirrus 4000-OCT in patients less than 18 years of age. This poses a clinical problem because the patient population at the school based clinic at the Illinois Eye Institute (IEI) at Princeton is composed of patients under 18 who are predominantly Black or Hispanic. The purpose of this study is to establish a reference database of retinal, macular and optic nerve head characteristics in patients aged 9 to 17 at the IEI at Princeton.

 

Jackson Lau, O.D., Illinois College of Optometry

The Effect of Scleral Contact Lens Wear on Tear Osmolarity

Lau

Large diameter contact lenses, called scleral lenses, are used in managing eye conditions such as irregular corneas and dry eye. However, not much is known about the short and long term effects of these lenses on the eye. Our project will study the effect of scleral lenses on tear osmolarity, an important measure of dry eye and inflammation. Tear osmolarity is the concentration of water and salt in our tears, and can be drastically altered with contact lens wear. Given the enormous growth of these medical devices, this study will increase our understanding of these lenses and improve patient care.

 

Patrick Lee, O.D., Illinois College of Optometry

GPS Usage in a Population of Low Vision Drivers

Lee

Maintaining independence through driving is a common goal throughout the low vision population. Global positioning systems (GPS) are currently used by 30% of American drivers. GPS can serve as an additional “passenger” when utilized during travel to an unfamiliar territory. This study will survey low vision patients in the Chicago area on their knowledge and usage of GPS and correlate findings to their level of functional vision and areas of travel. The anticipated results will serve as a tool to guide doctors in incorporating the use of GPS to improve safety and comfort level of low vision drivers.