Basic glaucoma research is essential
Glaucoma is a merciless enemy – a leading cause of irreversible blindness that often strikes without warning. At Casey Eye Institute, a dedicated battalion of researchers is fighting glaucoma on multiple fronts, their efforts fueled by a steady stream of funding from generous donors.
"We have made advances in treating glaucoma, but we need more basic research to truly understand and overcome this disease," says Casey researcher Kate Keller, Ph.D. New drugs and surgical techniques can slow the progression of the disease, but the root cause of glaucoma is still not completely understood.
That's why basic cell and genetic studies are so crucial in glaucoma research. "We look at cells derived from normal and glaucomatous human eyes to identify the key differences between them," explains Keller. Using cultured cells and eye bank tissues, Casey's glaucoma researchers analyze proteins, genes, and structures altered by glaucoma.
Other Casey research teams utilize animal models to study glaucoma. Continuing to use these models and conduct research at the molecular level is key to ultimately understanding – and interrupting – changes at the genetic and protein levels.
Casey Eye Institute has a decades-long history of innovative glaucoma research. Longtime supporters know John Morrison, M.D., Ted Acott, Ph.D., Mary Kelley, Ph.D., and other leaders in clinical and basic research have advanced the field to develop today’s clinical improvements.
Today, Casey continues to recruit top glaucoma researchers – and donor support makes this possible, as director of research David Huang, M.D., Ph.D., explains. “Each time we recruit a new faculty member, we support them with philanthropic funding for approximately three years. This allows them to get their research endeavors well under way at Casey, so they can apply for external grant funding.” Philanthropic support also allows established faculty to test new ideas in the laboratory before they become fully fledged research endeavors.
From Cells to Clinics: A Lengthy Journey
Transforming basic research insights into actual treatments for patients is an arduous, multi-stage process taking years or decades. While government grants from the National Institutes of Health and groups like Research to Prevent Blindness provide critical funding, these awards have cyclic gaps between funding periods. “Donor funding provides a ‘bridge’ while researchers wait for new or renewed funding,” Dr. Keller explains.
“To keep our research continuous, excellent, and innovative, we need donor support,” says Dr. Huang. As an example, with initial results generated in part from the support of donor funds, Dr. Keller was able to secure three major NIH grants totaling $2 million and take a lead role on a prestigious T32 training grant that supports two graduate students and a post-doctoral glaucoma researcher, helping launch the next generation of glaucoma researchers.
Donor funding also allowed Casey to support the clinical research of Aiyin Chen, M.D., a glaucoma specialist now developing an outreach and screening program that has the potential to help thousands of patients across the region and eventually, millions more.
“Dr. Chen is analyzing electronic health records (EHRs) to identify people who might need glaucoma screening,” Dr. Huang says. “We may be able to gather enough information from health records to know who needs to be screened with optical coherence tomography (OCT)” – a quick, precise and highly cost-effective imaging technology that Dr. Huang co-developed, and for which he has received many awards.
“Identified patients would be called in for an OCT scan and an eye pressure check,” Dr. Huang explains. “If the risk of glaucoma in the screened population is high enough, the cost of screening – which is very low with OCT – will be worthwhile.”
This donor-supported outreach program is “very important,” says Dr. Huang, for providing service to underserved patients and in supporting research. “The often-cited statistic that half the people with glaucoma don’t know they have it is still largely true. We have never managed to justify population-based glaucoma screening, so it is simply not done, and the disease damages eyesight before people ever know they have it. But this method could provide accurate screening at a low cost. It could have a major impact” – thanks to philanthropic support.
Finally, Dr. Keller notes that donor funds pay for cutting-edge equipment that accelerates research progress. "We can test new hypotheses or get results much faster with specialized instruments, which are so expensive that grant funding rarely covers them," she explains.
A relay race against blindness
From basic lab studies on cells and tissues, to animal models, to clinical trials in patients, the race to develop better glaucoma solutions requires an interdisciplinary team effort. Casey's unique strength is its ability to unite basic researchers with clinician-scientists under one roof.
"It's really helpful to have that link between the lab and patient care," says Dr. Keller. "Most institutions don't have clinicians and basic scientists connected as closely as we do at Casey and OHSU." Dr. Huang recently organized a cross-departmental retreat to bring together OHSU and Casey researchers and clinicians in glaucoma, neuro-ophthalmology, and neurology, sharing information and laying the groundwork for future research collaborations. This ensures a clear path for translating fundamental discoveries into potential new drugs, devices, or vision-preserving therapies that can be further developed and tested.
"When we get a new glaucoma treatment to patients, it's thanks to a combination of support from the donor community, NIH, industry partners, and many others," Dr. Keller says. "It takes a tremendous village working together tirelessly."
After centuries of leaving glaucoma's disabling impacts virtually untreated, modern medicine is finally beginning to shed light on this "silent thief of sight." With sustained philanthropic support bolstering the efforts of brilliant minds at Casey Eye Institute, there is hope for revolutionary progress in detecting, preventing, and curing this age-old scourge of blindness.