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Research
Shedding light on glaucoma’s secrets
Pioneering CERA research is shedding light on new cell types that may hold clues for the future of glaucoma treatments.
Pioneering CERA research is shedding light on new cell types that may hold clues for the future of glaucoma treatments.
For many years, glaucoma has been treated by lowering eye pressure through medication and surgery to prevent further vision loss.
CERA Head of Visual Neuroscience Dr Anna Wang says while this approach is life-changing for many, for others the disease continues to progress.
“While lowering eye pressure is essential, we know that a significant proportion
of patients still experience vision loss despite this treatment. So, it’s important to investigate what other factors are contributing to cell death.”
Dr Wang is taking a deeper look at the retina at the back of the eye to identify the cells directly affected by glaucoma.
“We’ve found that certain cell types are more vulnerable to the damage caused by glaucoma. If we can identify the specific cells affected, and understand why they are more susceptible, it could lead to new ways to detect the disease earlier and even develop treatments that target these cells directly,” she says.
Identifying new cells
The retina is a thin layer of light-sensitive nerve tissue made up of several different cell types, arranged in layers.
“You could picture it like a layer cake,” Dr Wang says. “The cells on the top layer convert light into electrical signals that reach the retinal ganglion cells at the bottom layer.”
Retinal ganglion cells send information to the brain through long axons, which make up the optic nerve.
In glaucoma, retinal ganglion cells die, disrupting this vital communication and eventually leading to vision loss.
Humans have up to 12 different types of retinal ganglion cells – each processing different aspects of our vision, such as contrast, colour and even edges.
But we don’t yet understand all of these cells and how they are affected in glaucoma. Studying the special roles of different retinal ganglion cell types could reveal clues that one day help doctors diagnose the disease.
Pioneering discovery
Dr Wang made her first significant discovery at the University of California, Berkeley, before joining CERA.
She found a certain retinal ganglion cell type in primates, including humans, that was previously thought to be absent.
These ON-type direction-selective ganglion cells play a crucial role in stabilising moving images on the retina – a function that could potentially be disrupted in glaucoma.
“Without this function, our eyes would have repetitive uncontrolled movements, resulting in blurry vision, dizziness and loss of balance,” Dr Wang says.
“We don’t know how vulnerable this cell type is in glaucoma, but it opens up new avenues for investigation.”
Dr Wang is now harnessing the same powerful imaging technique used at Berkeley, two-photon microscopy, to look at retinal ganglion cells in new detail.
“The setup allows us to better understand the properties of different cell types and test different treatments in a controlled environment,” she says.
Dr Wang is also using this technology in a new collaboration with CERA Head of Visual Neurovascular Research Dr Luis Alarcon-Martinez – investigating the connection between blood flow in the eye and the loss of retinal ganglion cells in glaucoma.
“We can see how different cell types behave when pressure is increased in a living eye – and how they are affected by the regulation of blood flow,” she says.
Looking ahead
Dr Wang’s research understanding the unique vulnerabilities of different retinal ganglion cell types could pave the way for more personalised approaches to glaucoma management, like treatment strategies tailored to individual patients.
“Our ultimate goal is getting to the root of what’s causing vision loss in glaucoma, not just treat the symptoms,” Dr Wang says.
“By exploring alternative pathways, like boosting the strength of certain retinal ganglion cell types, we may eventually develop more targeted treatments that protect the optic nerve and help save vision.”
Dr Wang’s research is supported by the DHB Foundation Equity Fellowship and a grant in partnership between The Jack Brockhoff Foundation, and Peter Griffin and Terry Swann.