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
The GABAergic System In Eye Growth Control And Myopia
Funder
National Health and Medical Research Council
Funding Amount
$318,142.00
Summary
Shortsightedness (myopia) is the most common visual disorder. High myopia is associated with an increased risk of eye diseases. Current treatments do not stop myopia developing or decrease the associated risk of eye disease. The continued worsening of myopia is very concerning. A safe effective treatment that can either prevent myopia or stop its progression to extreme levels is needed. We have data showing that GABA ergic drugs modify myopia. This proposal will determine the mechanisms.
Identifying Novel Disease Genes In Abnormalities Of The Eye
Funder
National Health and Medical Research Council
Funding Amount
$123,454.00
Summary
The macula is located in the centre at the back of the eye and is essential for detailed and colour vision. There are familial forms of macular abnormalities and many elderly patients suffer from age-related macular degeneration. The gene function that is critical for the maintenance of a healthy macula is not fully known. In this project, a novel process in maintaining macular health will be investigated to identify the underlying genetic cause and associated functional defects.
The fovea is a specialized part of the retina which enables us to see fine detail. The fovea is characterised by an extremely high concentration of photoreceptor cells in a small, prescribed area to detect detail in the pattern of light reaching the retina. Each of these photoreceptor cells is connected to at least four other cells within the retina, which further refine the information coded by the photoreceptors. Because this circuitry involves so many cells, the retina has a tendency to be th ....The fovea is a specialized part of the retina which enables us to see fine detail. The fovea is characterised by an extremely high concentration of photoreceptor cells in a small, prescribed area to detect detail in the pattern of light reaching the retina. Each of these photoreceptor cells is connected to at least four other cells within the retina, which further refine the information coded by the photoreceptors. Because this circuitry involves so many cells, the retina has a tendency to be thick at the specialized area. However, in development the cells connected to the foveal photoreceptors move away from the central concentration of photoreceptors, still keeping their contacts with them. This results in thinning of the retina locally, so it has a volcanoe-like formation at the fovea, in which photoreceptors are concentrated within the crater and the displaced cells are accumulated on the rim. The events which trigger these cell displacements that form the fovea are unknown. We propose to investigate growth factors which signal between the fovea and the developing blood supply, and the relationship between the formation of the fovea and neuronal activity. This study will provide a new perspective on factors which affect central visual function and its vulnerability to insult in premature infants and in aging.Read moreRead less
Optical And Neural Limits Of Visual Performance In Myopia
Funder
National Health and Medical Research Council
Funding Amount
$191,902.00
Summary
Short-sightedness (myopia) is one of our most common eye problems, affecting approximately 20% of people. It is usually due to the eye becoming too long for its power. While we can correct short-sight with contact lenses, spectacles and more recently refractive surgery, recent evidence shows that the vision of corrected myopes is poorer than that of people who have good distance vision without the need for an optical correction. This reduction is present even when the optical minification of spe ....Short-sightedness (myopia) is one of our most common eye problems, affecting approximately 20% of people. It is usually due to the eye becoming too long for its power. While we can correct short-sight with contact lenses, spectacles and more recently refractive surgery, recent evidence shows that the vision of corrected myopes is poorer than that of people who have good distance vision without the need for an optical correction. This reduction is present even when the optical minification of spectacle lenses is taken into account (the lenses used to correct short-sightedness make objects look smaller). It is possible that the anatomical changes to the eye that occur in short-sightedness are the cause of the reduced vision. Even if the optics can be fully corrected with refractive surgery, as is now being proposed, this may not result in excellent vision. The anatomical changes may occur in different parts of the eye and depending on where they occur the nature of the visual reduction will vary. The location of the retinal changes may also be important in terms of eventual pharmacological treatments for short-sightedness. In addition, the significance of the visual reduction, in terms of its effect on the functioning of short-sighted people, e.g. ability to perform under less than optimal visual conditions such as in the presence of glare or reduced light levels, is not known. We plan to investigate this by identifying the optical and neural contributions to visual performance in short-sighted people.Read moreRead less
I am a medical retinal specialist who is involved in a spectrum of basic and clinical research into the cause, risk factors, prevention and treatment of age related macular degeneration, the most common cause of vision loss in Australia.
Development Of A Slit Scanning Laser Ophthalmoscope As A Screening Tool In Glaucoma Diagnostics
Funder
National Health and Medical Research Council
Funding Amount
$195,830.00
Summary
Glaucoma is typified by progressive optic disc cupping and loss of fibres with consequent characteristic field defects. Direct imaging of the retina and quantitative assessment of such images greatly increases early diagnosis of this blinding disease. The proposed device, a laser line scanning ophthalmoscope, could support non-invasive imaging to obtain 3-D information in a simple and cost effective way. This could provide objective clinical parameters to support the decision making process.
Cataract Surgery And Risk Of Age-related Macular Degeneration (AMD)
Funder
National Health and Medical Research Council
Funding Amount
$339,750.00
Summary
Cataract surgery currently ranks as one of the most frequently performed and successful surgical procedures in Australia (125,000 operations-year). Age-related macular degeneration (AMD) is the principal cause of moderate visual impairment and blindness, currently accounting for blindness in between 17,300 and 30,400 Australians. Past studies have not shown a definite relationship between cataract and AMD. Follow-up data from clinical case series and from two older population-based studies (the ....Cataract surgery currently ranks as one of the most frequently performed and successful surgical procedures in Australia (125,000 operations-year). Age-related macular degeneration (AMD) is the principal cause of moderate visual impairment and blindness, currently accounting for blindness in between 17,300 and 30,400 Australians. Past studies have not shown a definite relationship between cataract and AMD. Follow-up data from clinical case series and from two older population-based studies (the Beaver Dam and Blue Mountains Eye Studies) suggested that cataract surgery might increase the risk of subsequent development of AMD in operated eyes of older persons. Such an increased AMD risk in eyes after cataract surgery appears to be both short term (observation from clinical case series) and long term (evidence from population-based studies), and persists after taking into consideration age, sex, smoking, preexisting early stage lesions of the disease and correlation between both eyes. The proposed study is to follow a large number of older patients who are undergoing cataract surgery in Western Sydney Eye Hospital and in two ophthalmologists' private rooms. Rates of subsequent development of AMD will be compared between operated and non-operated eyes, and also between the surgical cohort and the Blue Mountains Eye Study cohort. We will document macular conditions carefully before and after surgery to exclude the possibility of confounding issues. We will also investigate whether the increased risk occurs in certain subgroups of patients at high risk of AMD. If an increased AMD risk from cataract surgery is confirmed in subgroups of patients, a modified clinical practice may be indicated, to maximize cataract surgery benefit and minimize the risk of vision loss from AMD after surgery. Changes may include additional patient information and consent about this risk, delayed cataract surgery within limits of visual function, and close postoperative follow up.Read moreRead less