Novel Diagnostic, Prognostic, and Therapeutic Tools for Battlefield Optic Nerve Trauma
Abstract
Our ability to see is based on the eye and the brain working together. The eye functions like a camera, where an inner membrane called the retina is similar to the film of an old-style camera or the sensor of a modern camera. The eyeball itself is like the protective case of the camera. While the eye simply collects the visual information, it is the brain that processes and understands what we see. This is why damage to either the eye or the brain can both cause blindness. But blindness is sometimes caused by damage to the optic nerve, which is the connection between the eye and the brain, like a cable between a camera and a computer. The optic nerve contains more than one million small fibers that carry visual information from the eye to the brain. One of the serious effects of trauma to the head is damage to the optic nerve. This condition is called traumatic optic neuropathy, or TON in its abbreviated form. TON is the diagnosis given when trauma results in the eye not being able to send its signals through the optic nerve to the brain, resulting in visual loss. TON is particularly common in Soldiers on the battlefield for two reasons: (1) trauma to the head is common in this environment, and (2) TON can result from even a small amount of trauma. Military ophthalmologists have reported that the percentage of Soldiers who suffered from visual loss on the battlefield as a result of TON was 20%. This means that almost one-fifth of Soldiers with visual loss after trauma can have TON and it therefore is a serious cause of visual disability for our Armed Forces. Given that there is no treatment for TON, and that patients likelihood of regaining vision is somewhat low, TON can be a significant source of burden for many Veterans and their families. Finding a better way to diagnose, assess, and treat TON in wounded Soldiers would have significant health benefits for our Armed Forces. Moreover, TON can also occur in the civilian population as a result of bicycle or car accidents or other causes of head trauma. The diagnosis and treatment tools developed by this program will therefore benefit many people who suffer from TON as a result of head trauma. The main goal of the proposed program is to find ways to diagnose, assess, and treat TON. Currently, no treatment has been proven to work reliably. Although some patients with TON will improve spontaneously over time, most remain with blindness or visual loss. We have assembled three complementary teams at three different institutions within Montreal, made up of scientists who are world experts in vision and the optic nerve. The programs Lead PI, Dr. Leonard Levin, helped lead the International Optic Nerve Trauma Study, conducted years ago, which showed that no existing TON treatment was particularly effective. Three team members are experts in finding treatments for optic nerve damage, and they have developed drugs shown to be effective in animal models in preventing degeneration and vision loss following optic nerve damage. Each of our three teams has a specific role. Team 1 will test potential treatments in rats, which are excellent models to assess the fundamental mechanisms of TON in a controlled laboratory environment. Team 2 will identify and generate novel potential treatments using a library of drug compounds that have already been tested for other types of optic nerve problems and eye diseases. Team 3 will test whether radiology techniques of the brains visual centers can be used to make an early diagnosis of TON without requiring specialized expertise. TON can be difficult to diagnose in some cases, and early diagnosis is essential to determine which injured Soldier should receive which kind of therapy. In addition, Team 3 will develop tools to identify who is likely to improve and who will most benefit from treatment. The overall team approach assembles colleagues who have successfully worked together over the last few years to meeting the goals of the current
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Nov 19, 2019
- Source ID
- W81XWH1910853
Entities
People
- Leonard Levin
Organizations
- McGill University
- United States Army