Center for the Prevention and Treatment of Visual Loss
“Become a VA and national leader in providing innovative strategies for detecting visual disorders and providing new solutions for their treatment.”
“The Center for the Prevention and Treatment of Visual Loss conducts cutting edge research in the diagnosis of visual loss, understanding the underlying mechanisms and causes of visual loss, and new approaches toward rehabilitation and treatment of visual loss, while improving education and clinical care of our nation’s veterans.”
About the Center
Research at the Center, located in Iowa City, Iowa, focuses on the early detection of potential blinding disorders of the Veteran and general population, including retinal disease, glaucoma, and traumatic brain injury. The Center tests new ways of determining the earlier signs of progression and response to treatment, and develops new treatment innovations. Areas of exploration include the use of telemedicine and computer aided diagnosis for the detection of eye disease, as well as neuroprotection and neurotrophic growth factors for prevention and healing.
Relevance to the Veteran Population
1.5 million Veterans have vision threatening eye disease including diabetic retinopathy (976,000), age related macular degeneration (190,000), glaucoma (285,000) and traumatic brain injury or TBI (20,000). Loss of vision leads to tremendous functional disability and social isolation. Additionally, the VA spends a significant portion of its medical care dollars toward detecting and monitoring of treatment of vision loss, requiring approximately 5 million visits per year, which is increasing. The Center of Excellence for the Prevention and Treatment of Visual Loss helps solve this problem through new detection, understanding the underlying mechanisms of disease, developing new treatment strategies and telemedicine initiatives. The Center’s efforts focus on prevention of blindness using innovative telemedicine efforts for detection and monitoring of disease and molecular approaches to new treatments.
The current status of work in the field has moved toward finding methods of imaging that are low cost and do not require patients to be transported to Medical Centers, which often interferes with detection and monitoring of eye disorders. Present attempts at telediagnosis in ophthalmology are limited by the cost of retinal cameras and the cost of expert interpretation of the retinal and optic nerve images at certified reading centers. Our efforts will help solve this problem through the invention of low-cost portable retinal cameras and the development of automated computerized image analysis that will diagnose and grade the severity of eye disease at the point of image acquisition at remote sites. Efforts are also being made to understand the molecular, structural, and functional dysfunction caused by TBI and develop new treatments to reduce the damage and improve outcome using animal models of blast injury. In humans, the Center is investigating new methods of diagnosing and treating visual dysfunction after TBI.
Unique Role of the Center
This program will reduce backlogs in VA ophthalmology clinics through automated telemedical screening, including remote sites having no ophthalmologist or optometrist available, and will aid in halting the progression of vision loss. Current diagnostic strategies require expertise in diagnostic modalities that often require costly contracted care to affiliate programs. The Center will ultimately reduce contract fees, and provide more acceptable and timely patient care options for Veterans. The Center will also provide a basis for objective vision testing and monitoring of suspected TBI and will develop greater interface with the newly established Department Of Defence/VA Vision Center of Excellence.
Goals and Objectives
a) Develop and implement new approaches for the early detection of visual loss and identification of risk factors for visual loss from diabetic retinopathy, glaucoma, aging macular degeneration, ischemic optic neuropathy, compressive optic neuropathy and traumatic brain injury (TBI).
b) Implement new methods for detection of true progression and treatment effects on structural and functional manifestations of retinal and optic nerve diseases being studied.
c) Develop and commercialize new treatment approaches for the prevention of blindness, including chronic intravitreal production of nerve growth factors acting as neuro-protectants. Specifically, we have genetically engineered bone marrow mesenchymal cells to produce brain-derived neurotrophic growth factor that are implanted in the eye.