The road to treatment 11
In some patients, ADOA has developed significantly and a large portion of the optic nerve cells have already died. This results in a vision loss of 5-10%. Fortunately, there are researchers trying to determine if it is possible to help patients with significant optic nerve cell loss. One of the leading researchers in this field, Thomas V. Johnson, recently published an article in Opthalomolgy Times (read) in which he explains recent developments and prospects. Peter Makai has made a summary of it.
Regeneration
The article is about how doctors are trying to find ways to help people who suffer from optic neuropathies such as ADOA, which cause them to lose their vision. There are currently no treatments for this condition, but scientists are studying a special approach called regenerative medicine to see if it might help patients in the future.
Optic neuropathies damage the optic nerve, specifically the retinal ganglion cells (RGCs). RGCs are important for vision, but they cannot repair themselves like other cells in our body.
However, scientists have discovered a way to create new RGCs using stem cells. These stem cells are taken from a person's skin, blood, or even urine, and then turned into RGCs in a laboratory. The idea is to place these new RGCs in the eyes of people with optic neuropathy and restore their vision.
But there are two bigger challenges to overcome. RGCs are complex cells that must connect to the retina at the front to receive visual information, and at the back to relay that information to the brain.
The first challenge is to connect to the retina. There is a barrier between the retina and the moist space behind the retina (vitreous space), the so-called internal limiting membrane. When this membrane is removed, the new RGCs can find their place in the retina and form a connection. This membrane is regularly removed in other eye conditions, and doctors have experience with this.
The second challenge is to ensure that the new RGCs grow so-called axons and can find their way to the right parts of the eye and brain. This does not happen automatically. Scientists study how this happens naturally in animals and try to find ways to make it happen in humans too. A number of molecules have been discovered that can help the axons grow correctly.
Given the complexity of the task, collaboration between scientists with different areas of expertise is crucial. The RGC Repopulation, Stem Cell Transplantation and Optic Nerve Regeneration Consortium was established to bring together researchers in ophthalmology and neuroscience from around the world. By working together and sharing knowledge, they hope to overcome the challenges and advance the field towards clinical trials. The hope is that they can develop new treatments that work and help people with optic neuropathy see again.
While there is still much work to be done, advances in regenerative medicine and collaboration between scientists give hope that we can one day restore vision to people with optic neuropathy, such as ADOA.
