New technology facilitates studies of the macula

Using new technology it is possible to get a detailed colour image of all retinal layers without inserting any instrument into the eye. The technology will be used by eye researcher Elisabeth Wittström, who studies diseases of the macula. Her colleague, Linnéa Taylor, is researching the link between inflammation and damage to the retina, which could lead to new treatments.

Ögon

Photo of the eyeground of a patient experiencing changes in the macula.

Elisabeth Wittström is a physician at the ophthalmology clinic in Lund and often meets patients with impaired vision due to the disease macular degeneration that causes damage to the macula. Molecular biologist Linnéa Taylor is a laboratory researcher at Biomedical Centre (BMC) in Lund. Although they use different research methods, their focus is on the eye retina, and they have both recently received SEK 600 000 each from the Consul Thure Carlsson Memorial Foundation.

Elisabeth Wittström’s research focuses on damage to the macula – the millimetre-sized part of the retina where our vision is the sharpest.

Age-related macular degeneration is common: one in three people over 70 have the disease to some degree. Even if it does not lead to blindness, the lack of visual acuity often prevents patients from reading, driving and engaging in other activities that require good eyesight, thereby significantly reducing their quality of life.

Some may also experience macular degeneration earlier in life.

“The disease comes in various forms, which are very difficult to distinguish. Sure, we can see changes in the retina, but if we don’t know what kind of disease we are dealing with, we won’t be able to provide the best treatment for every patient”, says Elisabeth Wittström.

Today there is no optimal treatment of damage to the macula, but new opportunities beckon in the future. One form of the disease, which often affects young people, is genetic. In this case the solution could be gene therapy, which will soon be tested in Lund for a different eye disease. Another form of the disease seems to be caused by the antibodies of the immune system. This could perhaps be treated with immune system therapy.

Obviously, a condition for such treatments is being able to distinguish between the various forms of the disease. This will be the focus of Elisabeth Wittström’s research. With the help of Region Skåne’s new Centre for Molecular Diagnostics, she wants her research subjects to undergo genetic testing, among other things. This will allow her to determine whether or not the patients’ eye diseases are genetic.

Using another new technology, known as OCTA*, she will examine the subjects’ eyes. The OCTA technology provides both multi-coloured cross-section images of the retina and images that look like a three-dimensional map with hills and valleys.

Elisabeth Wittström is excited about the new opportunities that this machine will provide.

“It’s actually really amazing! You can see all retinal layers, and in the future we will be able to monitor the effects of a treatment”, she says.

Linnéa Taylor is also happy, especially about the opportunities she has at BMC. She thinks the unit is operating precisely as intended, providing connections across subject boundaries and opportunities for laboratory researchers and medical doctors to work together.

“Being so well off is a privilege”, she says emphatically.

Her collaboration with Associate Professor Tomas Deierborg of the Neuroinflammation research team at the Department of Experimental Medical Science has been crucial to her eye research.

“We met at the gym at BMC and started talking. Tomas is studying the inflammatory cells of the brain, known as glial cells. Since the eyes are part of the central nervous system, we thought that inflammation in the brain could possibly affect people’s vision as well”, says Linnea Taylor.

The doctoral student working with her, Oscar Manouchehrian, has studied this possibility by reducing the blood flow to the brain in mice test subjects. Less blood means a lack of oxygen which appeared to cause inflammation – not only in the brain but also in the eyes. The mice experienced damage to the retina and started to behave as if they were half blind.

Many diseases, including rheumatoid arthritis and type 1 diabetes, are caused by an overreaction of the body’s immune system. The brain does not have the regular immune cells, but the glial cells perform some of the same tasks.

“We now believe that overactive glial cells are the cause of many eye diseases. There may have been some initial damage, such as an excessive intraocular pressure or retinal detachment, which is worsened by the reactions of the glial cells”, says Linnéa Taylor.

If this is the case, she is hopeful that the overreaction of the glial cells can be curbed. Although the initial damage would remain, at least it would not get any worse.

“Even a minor visual improvement would mean a great deal to the affected patient. Being able to see shapes better, or having an easier time distinguishing between light and dark, can be crucial to the patient’s ability of leading an independent life. This is why the research is so important”, says Linnéa Taylor.

Text: Ingela Björck

Photo: Kennet Ruona

 *OCTA = Optical Coherence Tomography Angiography