NIH Award Supports Cerebral Small Vessel Disease Detection Through the Eye

Bascom Palmer Eye Institute and University of Miami researchers receive $4.7 million to fund a new approach to assessing capillary blood flow in the retina, which will enhance our understanding of brain health.

MIAMI, Oct. 2, 2024 /PRNewswire/ -- Researchers at the Bascom Palmer Eye Institute at the University of Miami Miller School of Medicine have received a $4.7 million award (1OT2OD038131-01) from the National Institutes of Health (NIH) Common Fund Venture Program Oculomics Initiative. The funding will support the creation of novel imaging techniques to identify precise changes in capillary function by measuring blood flow in retinal capillaries to detect and characterize cerebral small vessel disease (CSVD), a prevalent central nervous system disorder contributing to cognitive impairment and dementia. 

"Using the eye as a window to the central nervous system, Jianhua (Jay) Wang, M.D., Ph.D., a professor of ophthalmology at the Bascom Palmer Eye Institute and lead principal investigator of the award, has assembled a multidisciplinary team to create an advanced non-invasive ophthalmic imaging device that will read capillary blood flow through the retina and establish new biomarkers for cerebral small vessel disease. This is transformational research that will benefit thousands of patients," said Eduardo C. Alfonso, M.D., director and chair of Bascom Palmer.

Dr. Wang's large and expert team includes scientists, clinical researchers, and computer experts. Co-principal investigators include Yuhua Zhang, Ph.D., a principal investigator at Doheny Eye Institute and professor of ophthalmology at the University of California, Los Angeles, and Liang Liang, Ph.D., an assistant professor of computer science at the University of Miami.  Dr. Zhang, an expert in adaptive optics, high-resolution imaging, and retinal hemodynamics, will make the instrument with his team at the Doheny Eye Institute.  Dr. Liang will support efforts to develop Artificial Intelligence (AI) and other computational approaches.

 "Cerebral small vessel disease is a systemic condition in which the capillary network becomes unhealthy or even gets remodeled, impairing blood flow," said Dr. Wang, scientific co-director of Bascom Palmer's Experimental Imaging Laboratory. "Without proper blood profusion, tissues are starved, which is particularly dangerous in the brain."  Dr. Wang has developed a wide range of imaging modalities at Bascom Palmer that study structural and functional alterations in eyes during normal aging and eyes with various disorders.

Current technologies like MRI can detect blood flow in larger vessels but fail in tiny capillaries. This has significant ramifications, as capillary blood flow is much like the ubiquitous small package trucks that course through neighborhoods. Without local delivery, cells do not receive enough nutrition and oxygen.

"As we age, CSVD can play a major role in dementia," said Dr. Wang. "Though it probably does not cause Parkinson's, Alzheimer's, or other brain conditions, it certainly contributes to them and probably accelerates the disease process."

Oculomics uses the eye as a window into health and disease and could provide the technological boost to better understand what's happening in the brain. The instrument Dr. Wang and colleagues are developing is called a high-speed, widefield adaptive optics near-confocal ophthalmoscope (AONCO). This novel device will read capillary blood flow through the retina, help establish new biomarkers to detect CSVD, and use machine learning and other means to infer capillary health in the brain and possibly throughout the body.

Bascom Palmer physicians and scientists on the team project include Hong Jiang, M.D., Ph.D., a professor of clinical ophthalmology and neurology, who will conduct the screening and clinical efforts; Felipe Medeiros, M.D., Ph.D., professor of ophthalmology and Bascom Palmer's vice-chair of research, who will provide expertise in data science, bioinformatics, and clinical studies; and Robert O'Brien, Ph.D., a statistician who will use AI to further improve the methodology.

Additional Miller School collaborators include physicians and scientists from the departments of radiology and neurology, including Tatjana Rundek, M.D., Ph.D., scientific director of the Evelyn F. McKnight Brain Institute; Jose Romano, M.D., chair of the Department of Neurology; Victor Jose Del Brutto Andrade, M.D., a vascular neurologist; Pradip M, Pattany, Ph.D., a research professor in the Department of Radiology; and Juan Pablo de Rivero Vaccari, Ph.D., a research associate professor of neurological surgery and The Miami Project to Cure Paralysis. In addition, John Detre, M.D., professor of neurology and radiology at the Perelman School of Medicine at the University of Pennsylvania, an expert on blood flow in the brain, will consult on the project. 

"This is a complex problem, and we have assembled a diverse team of scientists to solve it," said Dr. Wang. "We have experts in neurology, neuro-ophthalmology, engineering, computer science, and many other disciplines. The potential for this device over the next 20 to 30 years is huge. Together, we will develop an instrument that can illuminate capillary health in the brain and provide much-needed insights into these challenging neurological diseases."

To learn more about the vision research taking place at the Bascom Palmer Eye Institute, visit www.bascompalmer.org

About Bascom Palmer Eye Institute
Bascom Palmer Eye Institute has earned an international reputation as one of the premier providers of eye care in the world and is the largest ophthalmic care, research, and educational facility in the southeastern United States.  For 23 years, Bascom Palmer has been recognized as the nation's leading eye hospital by U.S. News & World Report.  Approximately 300,000 patients are treated yearly for nearly every ophthalmic condition, and more than 21,000 surgeries are performed annually.  The Institute is the Department of Ophthalmology for the University of Miami Miller School of Medicine, part of UHealth-University of Miami Health System. For more information visit: www.bascompalmer.org

SOURCE Bascom Palmer Eye Institute