Seeking new treatments for vision loss

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Carl Camras Center for Innovative Clinical Trials in Ophthalmology:
Diana V. Do, MD (Director and Vice Chair for Education) 

  • This Clinical Trials Center offers state-of-the-art diagnostic, medical, and surgical care.
  • Dr. Do and her research team have expertise in conducting clinical trials that have led to the development of new treatments for eye diseases such as:
    • Wet Age-Related Macular Degeneration (AMD): leading cause of blindness among individuals ages 55 years and older in developed countries. The research team was a major contributor to clinical trials that established vascular endothelial growth factor (VEGF) blockers as the new standard treatment for wet AMD.
    • Dry Age-Related Macular Degeneration (AMD): the most common form of AMD. The research team is investigating novel therapies for advanced dry AMD.
    • Diabetic Eye Disease: leading cause of blindness in working-age adults. The research team has led clinical trials that provided scientific evidence for the beneficial use of VEGF blockers for diabetic macular edema. They are currently investigating new therapies that may further enhance vision gains.
    • Ocular Inflammation: the team is studying new therapies to treat blinding inflammatory diseases that affect the eye.

Retinal Vein Occlusion: common condition that can affect the retinal veins and lead to vision loss. The research team contributed to clinical trials that led to therapies which dramatically improved vision in patients with this condition.

Laboratory Research:

Dr. Margalit's research interests are in the field of visual rehabilitation of individuals blind from retinal diseases. He divides his research efforts between basic science projects in collaboration with Dr. Thoreson (electrophysiology of the retina during electrical stimulation), translational studies focusing on assembling a retinal prosthesis for patients blind from retinitis pigmentosa and age related macular degeneration, and clinical trials (steroid intraocualr injections for the treatment of branch and central vein occlusion, intraocular injections of non-steroidal anti-inflammatory drugs for the treatment of intraocular inflammation, new antibiotic drugs for the treatment of intraocular infections etc.). One of his goals is to involve residents and fellows with his research projects, to expand their medical education. Thus, residents and fellows participate and play major roles in most of the projects discussed above.

The glaucoma research team includes Drs. Rai, Gulati, Fan, and Toris. For many years, one area of their intensive research efforts has included prostaglandins, which have become the leading treatment for glaucoma throughout the world. Four prostaglandin analogs currently are commercially available to treat glaucoma. The group has evaluated the mechanisms by which prostaglandins reduce eye pressure and induce iris color darkening. They use a fluorophotometric method to determine how prostaglandin analogs and other drugs affect eye pressure. They have compared the efficacy, safety and mechanism of action of different prostaglandin analogs. They developed a unique model for iris color darkening in rabbit eyes in which input from a particular part of the nervous system is severed. This model has been useful in studying mechanisms by which prostaglandins cause iris color darkening. In collaboration with the Department of Pharmaceutical Sciences and the Department of Internal Medicine, Dr. Toris is studying diabetes and its effects on fluid transport and pressure in the eye.

Dr. Thoreson's laboratory is among the most productive of those utilizing electrophysiologic methods to study early mechanisms in vision. Dr. Thoreson and his colleagues have made significant progress in unraveling the mechanisms employed by rods and comes to signal their responses to other retinal neurons.

Dr. Ahmad’s is one of the leading labs studying the regulation of ocular stem cells, and using emerging information for regenerative medicine for blindness. His lab is identifying alternate sources of retinal progenitors in embryonic stem cells, and by reprogramming adult stem cells to facilitate ex-vivo stem cell therapy. His lab has shown that Muller glia, the support cells in the adult retina, are latent stem cells that can be potentially activated to treat retinal degeneration from within. In addition, they have identified a potential therapeutic target in a signaling pathway, known as the Notch signaling, to treat wet age-related macular degeneration (AMD), which accounts for most of the AMD-related vision loss.

Drs. Shinohara and Singh have studied retinal development and cataract formation when they were previously at Harvard Medical School. They are currently studying a novel growth factor called lens epithelium-derived growth factor (LEDGF). Although initially discovered in the eye, LEDGF is found throughout the body. Among other properties, LEDGF helps cells survive stressful conditions and thus holds promise as a possible therapeutic adjuvant for treating a variety of different eye diseases.