Clinical corneal Imaging
Photo credit Thor Balkhed
The use of non-invasive, in vivo imaging techniques such as optical coherence tomography, specular microscopy, and in particular in vivo confocal microscopy, have begun to transform the field of clinical corneal diagnostics.
In addition, these methods are elucidating new information about the pathogenic mechanisms of corneal disease and how these manifest at the tissue level.
One ongoing project investigates how corneal nerves mirror the pathogenesis of ocular and systemic disease, for example in corneal dystrophies, keratoconus, dry eye, aniridia, and type 2 Diabetes Mellitus.
Ocular Angiogenesis and Inflammation
The cornea is used as a model to study the growth of new blood vessels (angiogenesis) and their regression. These vessels are pathologic and cause the loss of corneal transparency, while in the retina the vessels are leaky and lead to the progression of age-related macular degeneration.
In one project, we are investigating the genetic and molecular-level triggers causing blood vessels to mature and resist standard anti-VEGF treatment, using murine cornea and zebrafish retina models.
Another project involves induction of inflammatory angiogenesis and the elucidation of key genetic pathways and inflammatory cytokines suppressed by steroid treatment but not by targeted VEGF antibodies. The goal is to identify new target pathways and molecules for potential therapeutic applications.
Transplantation, Wound Healing, and Regenerative Medicine
In one series of studies we are investigating the use of new treatments to improve corneal wound healing after trauma, surgery, or in disease, and the effect of these interventions on the corneal cells, nerves, and extracellular matrix. These agents are natural molecules such as biglycan, or heparin-mimicking substances.
In another line of research, we are developing new biomaterials to supplement the scarce supply of human donor corneas for transplantation. These new materials have the capacity to facilitate regeneration of new corneal nerves and extracellular matrix.
As part of this work, we are investigating new surgical techniques to facilitate implantation these biomaterials without triggering an inflammatory wound healing response and with minimal disturbance to surrounding healthy tissue. One such technique we have developed is the FLISK method (femtosecond laser-assisted intra-stromal keratoplasty).
