New Military Medical Research Focuses on Saving Warfighters’ Sight

By August 15, 2011August 6th, 2014General, Science and Technology
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By Barb Ruppert

Today’s warfighters face numerous threats to their vision, from blasts to chemical, biohazard, laser, and environmental exposure. According to the National Alliance for Eye and Vision Research, traumatic eye injuries from penetrating wounds and visual disorders related to brain injury together rank as the second most common injury among active-duty military personnel. Compounding the problem, eye-injured Soldiers have only a 20 percent return-to-duty rate, compared with 80 percent for other battle trauma injuries.

The U.S. Army Medical Research and Materiel Command (USAMRMC) Telemedicine and Advanced Technology Research Center (TATRC) is funding research projects as a multidisciplinary, integrated approach to preventing and treating vision disorders. It is collaborating with universities and research institutes worldwide in this effort.

“We’ve purposefully funded these projects as a group because we believe they will work together most quickly and effectively to develop treatments and products to save the sight of our warfighters,” said TATRC Director COL Karl Friedl.

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Dr. Randy Kardon is one investigator funded through the Peer Reviewed VRP. Here, Kardon (right) and researcher Pieter Poolman work on a new system that uses four separate cameras to simultaneously track head, eye, and pupil movements to determine how accurately a patient’s eyes track targets. (Photo courtesy of Dr. Randy Kardon, University of Iowa)

The TATRC projects address critical gaps in vision research.

“Each partner is working on a very important piece of the puzzle,” said Robert Read, who manages TATRC’s vision research portfolio. “We chose these 12 recipients from 120 research submissions because they best address these critical areas.”

The most recent projects began in late 2010. They include:

Quick, Portable Tests for Early Diagnosis

The key to restoring sight after a blast injury is early diagnosis and treatment. Dr. Randy Kardon of the University of Iowa and Dr. Yury Petrov of Northeastern University are developing tests that use the eye’s natural reflexes to determine the extent of visual processing disorders. Kardon’s, for example, uses eye-tracking technology developed for gaming and is geared toward a smartphone application.

Dr. Stacey Choi of the New England College of Optometry is combining new optical technology with current retinal imaging systems to detect cellular changes at the back of the eye. Because of  its sensitivity, this imaging technique could be valuable as a diagnostic tool when a blast was too weak to cause damage detectable by standard screening standards, yet visual symptoms exist.

RNA Treament Therapies

Researchers are hoping to develop drugs that use interfering RNA (ribonucleic acid, a type of genetic material) to inactivate specific genes that regulate cellular processes involved in injury. Drs. Colin Doherty and Peter Humphries of St. James Hospital, Ireland, are seeking to modulate the blood-brain barrier to reduce dangerous brain swelling and thus treat visual dysfunction associated with brain injury. Dr. Gregory Schultz of the University of Florida is applying RNA technology to reduce corneal scarring and resulting vision loss after burn and blast injuries. Dr. Nicholas Brecha of the University of California, Los Angeles is exploring ways to reduce excessive intracellular calcium levels to slow or stop loss of vision in traumatic optic neuropathies. Optic nerve injuries are not always immediately detected and treated because there is often no visible damage.

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Drs. Colin Doherty and Peter Humphries are developing a therapy based on interfering RNA to suppress brain swelling that could lead to visual dysfunction. In this 3-D magnetic resonance image from their mouse model, the region of brain injury appears as a yellow/red mass in the visual cortex. (Image courtesy of Dr. Matthew Campbell, Trinity College, Dublin)

Other Treatments for Vision Disorders

Dr. Kenneth Ciuffreda of the State University of New York College of Optometry and Dr. Uri Polat of Tel Aviv University, Israel, are exploring rehabilitative behavior-training therapies for visual disorders associated with brain injury. Dr. James Weiland of the University of Southern California is working on a project similar to synthetic vision work in aviation, exploring how to render visual information to an individual in a nonvisual way. Weiland’s project uses artificial intelligence to help a person determine what input is most important to pay attention to (for example, a moving car as opposed to a building in the background).

Computational Models of Blast Injury to the Eye

Understanding the mechanism of injury has great potential value in preventing and treating vision loss. Models could also be used to evaluate protective eyewear. Investigators developing computational models include Dr. Thao Nguyen of Johns Hopkins University, Dr. Tonia Rex of the University of Tennessee, and Dr. Richard Regueiro of the University of Colorado. These are funded through the Peer Reviewed Vision Research Program (VRP) line item in the Defense Appropriations portion of the federal budget.

TATRC manages the VRP, as well as vision research funds from USAMRMC’s Clinical and Rehabilitative Medicine Research Program.

Those involved in strategic planning and execution of the vision portfolio include COL Donald Gagliano and Dr. Robert Mazzoli, Director and Deputy Director of the DOD/Department of Veterans Affairs Vision Center of Excellence; Walter Reed Comprehensive Ophthalmologist LTC Michael Mines; TATRC Senior Scientist Dr. Francis McVeigh, OD; and Marc Mitchell, Grant Officer’s Representative and Project Officer.

    • BARB RUPPERT is a science and technology writer for USAMRMC TATRC. She holds a B.A. in English from the University of Virginia and an M.A. in education from Virginia Tech.