MULTI-CENTRED CLINICAL EVALUATION OF A NOVEL KERATOPROSTHESIS
Funder
National Health and Medical Research Council
Funding Amount
$515,091.00
Summary
The prosthesis developed by applicants, known also as Chirila keratoprosthesis, is an artificial implantable device designed to replace a diseased cornea or a failed corneal graft, and can be used in patients with no hope for a conventional replacement of the cornea with donor tissue. The device may ultimately find a wider application, as it has the potential to give better visual results than human donor grafts. Even when not rejected, the donor grafts may lead to problematic healing patterns a ....The prosthesis developed by applicants, known also as Chirila keratoprosthesis, is an artificial implantable device designed to replace a diseased cornea or a failed corneal graft, and can be used in patients with no hope for a conventional replacement of the cornea with donor tissue. The device may ultimately find a wider application, as it has the potential to give better visual results than human donor grafts. Even when not rejected, the donor grafts may lead to problematic healing patterns and astigmatism, both limiting the final vision of patients. From the 45 million blind people worldwide, at least 10 million are due to corneal diseases or trauma. The figures released by WHO suggest a doubling of this number by year 2020. Many countries are unable to provide sufficient donor corneas, sometimes for cultural-religious reasons. In developed countries, the replacement with donor tissue is a common procedure, but many patients remain untreated because their prognosis for successful grafting is poor. Figures released in Australia show that long-term success of donor transplantation is unlikely in the patients identified as high-risk recipients. Furthermore, even technically successful cases show disppointing final vision. The significance of the applicants' artificial cornea is that allows high-risk, or otherwise untreatable corneal blind patients, to have their vision restored, and it could ultimately reduce the need for donor corneal tissue. A phase I pilot study has been completed, and Phase II is currently underway with support from NH and MRC. These studies showed that the Chirila KPro is an effective means of reversible replacement of a diseased cornea.The proposed Phase III will evaluate both safety and effectiveness in different categories of patients in comparison with published outcomes of donor grafting, and will establish unequivocally the clinical potential of this prosthesis.Read moreRead less
Identifying tear lipids, their deposition onto contact lenses and their role in the development of dry eye. Lipids provide a critical layer in the human tear film that retards evaporation and helps nourish and protect the eye. We will identify the molecules within this essential "oil slick" to better understand dry eye syndrome and the discomfort associated with wearing contact lenses. This may lead to new treatments for dry eye and novel technologies that provide greater comfort for the ~120,00 ....Identifying tear lipids, their deposition onto contact lenses and their role in the development of dry eye. Lipids provide a critical layer in the human tear film that retards evaporation and helps nourish and protect the eye. We will identify the molecules within this essential "oil slick" to better understand dry eye syndrome and the discomfort associated with wearing contact lenses. This may lead to new treatments for dry eye and novel technologies that provide greater comfort for the ~120,000 Australians who wear contact lenses. This collaborative research directly supports the mission of a respected non-profit organisation (Institute for Eye Research) and will train scientists in world-leading analytical technologies that are essential to Australia's emerging biotechnology industries.Read moreRead less
Analysis Of FGF Receptor Signalling Involved In Lens Cell Proliferation And Differentiation
Funder
National Health and Medical Research Council
Funding Amount
$343,028.00
Summary
Cataract, the loss of transparency of the eye lens, is the leading cause of blindness in the world. An eventual cure for cataract depends on a better understanding of the basic molecular processes in the normal and cataractous lens. Our research has focussed on identifying the molecules that control the formation and maintenance of the lens. Growth factors are important regulators of cell behaviour and our studies have provided compelling evidence that members of the FGF growth factor family pla ....Cataract, the loss of transparency of the eye lens, is the leading cause of blindness in the world. An eventual cure for cataract depends on a better understanding of the basic molecular processes in the normal and cataractous lens. Our research has focussed on identifying the molecules that control the formation and maintenance of the lens. Growth factors are important regulators of cell behaviour and our studies have provided compelling evidence that members of the FGF growth factor family play pivotal roles in lens developmental biology by influencing lens cell proliferation and differentiation. An important finding from our laboratory is that FGF induces lens epithelial cell proliferation and differentiation at different concentrations. The FGFs elicit intracellular responses upon binding to and activating cell surface FGF receptors (FGFRs). The FGFRs are membrane bound tyrosine kinases which upon activation, activate specific signalling pathways leading to a specific cellular response. To understand how FGFs mediate and regulate different responses in lens cells, namely cell proliferation and fibre differentiation, we plan to examine the role of FGFRs in normal lens development using genetically altered FGFRs that will be expressed specifically in lenses of transgenic mice. While it is known that four different FGF receptor genes are expressed by the normal developing lens, it is unknown what role each of these play in the process of lens cell proliferation and differentiation. In addition, as we can reproduce a specific FGF-induced lens cellular response in vitro, we will use our lens explant culture system to dissect the signalling pathway(s) downstream from specific receptor activation and correlate this with a specific cellular response. By identifying the molecules and mechanisms that control the cellular processes essential for normal lens development, we can better understand how disruptions of these processes lead to cataract formation.Read moreRead less
Functional Recovery From Retinal Degeneration: Genetic, Environmental And Senescent Models
Funder
National Health and Medical Research Council
Funding Amount
$265,888.00
Summary
This project is directed towards treatment for the blindness caused by retinal degeneration. The retina of the eye degenerates in several groups of diseases, and from several causes. Many cases affect young people and result from small genetic mutations in key proteins. Many appear to be caused by environmental damage to the retina, perhaps at birth. Retinal degeneration causes progressive blindness in a minority of younger people (about 1 in 4,000, so 5,000 Australians and 1-2 million people wo ....This project is directed towards treatment for the blindness caused by retinal degeneration. The retina of the eye degenerates in several groups of diseases, and from several causes. Many cases affect young people and result from small genetic mutations in key proteins. Many appear to be caused by environmental damage to the retina, perhaps at birth. Retinal degeneration causes progressive blindness in a minority of younger people (about 1 in 4,000, so 5,000 Australians and 1-2 million people world-wide). This condition is known as Retinitis pigmentosa. However, the normal retinal undergoes a slow loss of photoreceptors whose effect is cumulative, so that the vision of all peoples slowly fades towards the blindness of old age. In this form, retinal degeneration affects potentially everyone. We have recently published an 'oxygen toxicity' theory of retinal degeneration to account for both retinitis pigmentosa and senescent degeneration. The theory applies whether the dystrophy is preciptated by genetic mutation or by environmental factors . By the time a person becomes aware of blindness (commonly night blindness) from retinal degeneration, the loss of vision results (it is argued) from 2 causes: the death of some photoreceptors (the retinal cells which detect light) and damage to surviving photoreceptors. Both death and damage are caused by oxygen toxicity, arising from particular features of the retina's metabolism and blood supply. Further, the relentless progression of the blindness is inherent in the mechanisms of oxygen toxicity. In preliminary work we have been able to slow retinal degenerations and, importantly, to restore function in degenerating retinas by countering the oxygen toxicity. Experiments are proposed to expand this evidence and explore the time course, permanence and generality of these effects. The tests of retinal recovery and stability, and the mechanisms of countering oxygen toxicity will be readily applicable to clinical trials.Read moreRead less
Design and Analysis of Optimal Algorithms for Automated Perimetry. Australian demographic studies reveal that visual impairment contributes significantly to disability in the elderly. Glaucoma, the second leading cause of blindness in developed nations, may be slowed if detected early, however recent studies estimate 50% of Australians with glaucoma are undiagnosed. Automated perimetry is used to detect and track such vision loss, but perimetry algorithms perform poorly. This project will design ....Design and Analysis of Optimal Algorithms for Automated Perimetry. Australian demographic studies reveal that visual impairment contributes significantly to disability in the elderly. Glaucoma, the second leading cause of blindness in developed nations, may be slowed if detected early, however recent studies estimate 50% of Australians with glaucoma are undiagnosed. Automated perimetry is used to detect and track such vision loss, but perimetry algorithms perform poorly. This project will design and analyse new algorithms with superior accuracy and efficiency, improving detection and monitoring of vision loss. Enhanced tools for community vision screening will also result, crucial for the ARC's priority goals of ?ageing well, ageing productively? and ?preventative healthcare?Read moreRead less
Resolving multi-sensory conflict as we age: audio-visual integration and the role of normal and abnormal sensory decline. Australia has an ageing population. Even the healthiest older individuals undergo some deterioration of vision and hearing, however, these senses are almost invariably studied in isolation. The real world is multisensory. This project will enhance our knowledge of how ageing impacts on the interpretation of visual and auditory information regarding the timing and location of ....Resolving multi-sensory conflict as we age: audio-visual integration and the role of normal and abnormal sensory decline. Australia has an ageing population. Even the healthiest older individuals undergo some deterioration of vision and hearing, however, these senses are almost invariably studied in isolation. The real world is multisensory. This project will enhance our knowledge of how ageing impacts on the interpretation of visual and auditory information regarding the timing and location of objects; essential precursors to many real world tasks, for example: driving, interpreting speech, and hazard avoidance. This knowledge is essential for the optimisation of audio-visual environments for the elderly, and for the development of tools to improve performance in the presence of sensory decline due to age-related eye disease.Read moreRead less
Studies Of Antigen Presenting Cells In The Anterior Segment Of The Eye And Their Role In Immune-mediated Ocular Disease
Funder
National Health and Medical Research Council
Funding Amount
$241,018.00
Summary
Dendritic cells (DC) are considered the 'sentinels' of the immune system because they are capable of trapping antigenic material derived from invading organisms such as bacteria and viruses in peripheral tissues-organs (skin, gut, respiratory tract etc) and then transporting these antigens to the lymphoid organs where they 'alert' the immune system to potential 'dangers' and elicit appropriate T cell responses. If the antigens are novel this mechanism forms the basis of primary cell-mediated imm ....Dendritic cells (DC) are considered the 'sentinels' of the immune system because they are capable of trapping antigenic material derived from invading organisms such as bacteria and viruses in peripheral tissues-organs (skin, gut, respiratory tract etc) and then transporting these antigens to the lymphoid organs where they 'alert' the immune system to potential 'dangers' and elicit appropriate T cell responses. If the antigens are novel this mechanism forms the basis of primary cell-mediated immune responses. Previously 'educated' T cells may upon contact with antigens in the periphery (when presented by other antigen presenting cells [APCs], such as macrophages) become activated. This forms the basis for secondary immune responses. Immune and inflammatory responses in the eye are held in check to avoid permanent damage to the delicate tissues and maintain visual function. The mechanisms which regulate immunological responses in the eye are only now becoming clear. Studies in the Chief Investigators laboratory over the last 7 years have been aimed at unravelling the life cycle and function of APCs in the eye. The present study has three specific aims: 1) Determining whether DC in the eye once they have taken up antigens migrate to the spleen or local lymph nodes? 2) The second aim of this project is to use an animal model of uveitis and transfer fluorescent labelled donor T cells to study the events in the living eye which lead to autoimmune uveoretinitis. In particular we wish to identify the cells that present antigen to infiltrating lymphocytes. 3) Patients often develop posterior uveitis (an autoimmune condition) after a cold or bacterial infection. We aim to mimic conditions of acute inflammation in the eye to see whether this may secondarily predispose the eye to attack by autoreactive lymphocytes.Read moreRead less
Web-based Multimedia Information Management System For Use In Remote Diagnosis Of Eye Diseases
Funder
National Health and Medical Research Council
Funding Amount
$196,000.00
Summary
Our aim is to develop a web-based multimedia information management system for use in remote diagnosis of eye diseases. The proposed system will provide medical advice and diagnosis, information and distance education for those working in health care as well as the community, computer-aided diagnosis and assistance in the operational and medical decision-making process. Less expensive health care personnel should be able to use the system with little training in remote and rural areas. Significa ....Our aim is to develop a web-based multimedia information management system for use in remote diagnosis of eye diseases. The proposed system will provide medical advice and diagnosis, information and distance education for those working in health care as well as the community, computer-aided diagnosis and assistance in the operational and medical decision-making process. Less expensive health care personnel should be able to use the system with little training in remote and rural areas. Significantly, the project should empower remote general doctors and nurses by proper access to expert advice, save many remote patients from unnecessary visits to specialist centres on the one hand and allow more proper diagnosis and intervention on the other. It has the potential for significant reductions in the cost of health care delivery, should strengthening the bond between medical services in remote and city areas, provide training and education of local GPs, nurses, health care workers and optometrists and provide web-based disease management systems will provide instant access to health care information. The outcomes of this project are potentially of great significance to remote and rural communities in Australia and around the world. There will be an enormous impact on current health care practices. Significantly, the project should empower remote general doctors and nurses by proper access to expert advice, save many remote patients from unnecessary visits to specialist centres on the one hand and allow more proper diagnosis and intervention on the other. It has the potential for significant reductions in the cost of health care delivery, should strengthening the bond between medical services in remote and city areas, provide training and education of local GPs, nurses, health care workers and optometrists and provide web-based disease management systems will provide instant access to health care information. The outcomes of this project are potentially of great significance to remote and rural communities in Australia and around the world. There will be an enormous impact on current health care practices.Read moreRead less
Special Research Initiatives - Grant ID: SR0354517
Funder
Australian Research Council
Funding Amount
$20,000.00
Summary
Adaptive Optics for Australian Astronomy, Medicine, Industry, and Defence. Adaptive optics is a technique for correcting wavefront distortions in light beams to improve optical imaging performance. The Research Network for Adaptive Optics aims to draw together isolated Australian and New Zealand research groups working on adaptive optics applications in disparate areas to achieve a critical mass of researchers in this burgeoning field. Adaptive optics has wide application in areas as diverse as ....Adaptive Optics for Australian Astronomy, Medicine, Industry, and Defence. Adaptive optics is a technique for correcting wavefront distortions in light beams to improve optical imaging performance. The Research Network for Adaptive Optics aims to draw together isolated Australian and New Zealand research groups working on adaptive optics applications in disparate areas to achieve a critical mass of researchers in this burgeoning field. Adaptive optics has wide application in areas as diverse as astronomy, vision science, ophthalmology, microscopy, optical communications, laser radar, and laser beam shaping. The Research Network will coordinate and expand Australian involvement in these areas and inform industry, as have similar networks in the USA and Europe.Read moreRead less