New discovery could pave the way for treating a leading cause of corneal blindness
Researchers uncover how tiny bumps inside the cornea contribute to cell death, opening a potential path to treatments that could reduce the need for transplants
University of Waterloo researchers have discovered how tiny bumps inside the eye contribute to Fuchs endothelial corneal dystrophy (FECD), an eye disease that can cause severe vision loss. With donated corneas in short supply worldwide, the finding could lead to alternative treatment strategies and reduce the need for corneal transplants in some patients.
“Our ultimate goal is the development of alternative treatments, which could mean fewer people will need transplants for corneal blindness due to Fuchs endothelial corneal dystrophy in the future,” said Dr. Evelyn Yim, a chemical engineering professor at Waterloo and the Canada Research Chair in Nanomaterials for Regenerative Medicine.
Dr. Evelyn Yim in her lab at the University of Waterloo.
The cornea is the clear, dome-shaped outer layer at the front of the eye that helps focus light. When it becomes cloudy, vision can become blurred or severely impaired.
A thin layer of cells on the inside of the cornea acts like a tiny pump, constantly removing excess fluid to keep it clear. In people with FECD, these cells gradually die. As fluid builds up, the cornea swells and becomes cloudy, making it increasingly difficult to see.
For years, scientists have known that tiny bumps develop beneath these cells in people with FECD.
But the bumps were largely thought to be a sign of the disease, rather than a cause of further damage.
Using a laboratory model that recreated the tiny bumps found in diseased corneas, the Waterloo researchers discovered that the bumps themselves can contribute to cell death by placing physical stress on the cells.
The discovery could help researchers develop new ways to treat FECD by addressing the underlying causes of cell damage. Potential approaches include cell-based therapies to replace damaged cells or procedures to remove the bumps that contribute to their death. Although further research is needed, such strategies could eventually reduce the need for corneal transplants in some patients.
“When the cornea becomes cloudy, the condition is in an advanced stage,” said Lexie Xi, a Waterloo PhD candidate in chemical engineering and first author of the study. “We aim to understand the disease mechanism to develop better alternative treatments.”
The research team also included Dr. Stephan Ong Tone, a corneal surgeon at the Sunnybrook Research Institute in Toronto and Dr. Gary S.L. Peh and Dr. Jodhbir S. Mehta from the Singapore Eye Research Institute.
The study, Corneal guttata-like microtopography induces corneal endothelial cell apoptosis by modulating mechanotransduction, was recently published in the journal Cell Biomaterials.