Listen to your eye

listen to your eye

It is the week of vision in Germany (www.woche-des-sehens.de). For the 14th time, the nationwide initiative informs about the importance of a healthy sight.

Online material is accompanied by various events all over Germany, addressing topics around vision, diseases causing visual impairments, their prevention, and the situation of blind people in Germany.

Inspired by this initiative, in this article I would like to outline the importance of the visual sense and the eye from a clinical research perspective.

The Eye – gateway to medical insight

The eye is not only our window to the world. Reversing perspectives, it also serves as a valuable access point to examine the human body inside out. Indeed, a look through the pupil provides insight into a patient’s overall health status!

Looking into the eye, we may observe not only pathologies affecting the eye itself; but we may also be able to draw deductions on the presence of diseases elsewhere in the body, or even to detect systemic diseases.

As an ontogenetic derivative of the neuroectoderm the eye shares many of the brain’s features, and thus its examination allows for drawing inferences on pathologies in the central nervous system. Thus, ophthalmological diagnostic imaging is able to provide a wide range of insights into the course of internal and neurological diseases, often at an earlier time point than when the first cardinal symptoms of the disease occur.

As ophthalmological assessments provide important data on many different disease entities, they possess a wide applicability in clinical research.

Ophthalmology

Many ophthalmological diseases may be detected using standard diagnostic imaging. The most common entities include age-related macular degeneration (ARMD), glaucoma, diabetic retinopathy (DRP), and macular edema. Some of these diseases’ therapeutic regimens (e.g. ARMD, DRP) currently undergo a paradigm shift and warrant ongoing clinical research.

Internal medicine/Neurology

Detection of retinal neuronal abnormalities may provide information about neurodegeneration in its earliest stages (e.g. Parkinson‘s disease, Alzheimer‘s disease, multiple sclerosis). Microangiopathic retinal abnormalities correlate with cerebro-cardiovascular risk factors as well as neurodegenerative disorders (see box below).

  • Metabolic syndrome1

  • Cardiovascular diseases2

  • Age & arterial hypertension3

  • Stroke4

  • Myocardial infarction5

  • Alzheimer’s Disease6

Most patients suffering from internal or neurological diseases do not visit an ophthalmologist but rather see their local general practitioner, or a specialist in the area of the underlying disease.

Therefore, the main challenges for clinical research using ophthalmological diagnostics lie in obtaining and retrieving standardized, high-quality data from local ophthalmologists in the most efficient way.

Picture: @Vladimir Voronin /Fotolia.com

 

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  1. Wong TY et al., Investigative ophthalmology & visual science 2004, 45(9):2949-54Huchzermeyer C et al., Klinische Monatsblaetter fuer Augenheilkunde, 2011, 228(11):1003-8
  2. Huchzermeyer C et al., Klinische Monatsblaetter fuer Augenheilkunde, 2011, 228(11):1003-8Ikram K et al., Investigative ophthalmology & visual science 2004, 45(7):2129-34Adler W et al., Klinische Monatsblaetter fuer Augenheilkunde, 2010, 227(11):905-11
  3. Leung H et al., Investigative ophthalmology & visual science 2003, 44(7):2900-4
  4. Kobayashi S et al., Stroke 1997, 28(10):1932-9Wong TY et al., The Lancet, 2001, 358(9288):1134-40
  5. Wong TY et al., Ophthalmology 2003, 110(5):933-40
  6. Paquet C et al., Neuroscience Letters 2007, 420(2):97-9