Could keratoconus be successfully treated with a simple eye drop? This is the question a team of New Zealand researchers is now investigating, with a little help from their woolly friends.
Over the past few years, Associate Professor Trevor Sherwin and his colleagues at The University of Auckland have been trying to determine if an eye drop can permanently stabilise and reshape the cornea, and thus provide a treatment for patients with corneal disease such as keratoconus.
How does it work?
Corneal cells – or keratocytes – are arranged in organised layers to make the transparent cornea, or front surface of the eye. These cells normally only produce strengthening collagen in embryos, but Prof Sherwin’s team is investigating if these cells can be stimulated to ‘remember’ how to produce collagen, even in adult corneas. They have developed a stimulating eye drop that combines low levels of a steroid with growth factors. This combination has been shown to successfully produce this type of collagen in lab studies as well as in live rat corneas. Stiffening and strengthening the cornea in this way does not affect the optical properties.
The research is now continuing on sheep, and will aim to demonstrate the effectiveness of the eye drop in thickening and stiffening the cornea. If it proves successful, the eye drop could be used to treat keratoconus patients by thickening and stabilising their corneas. An optometrist has joined the team to conduct corneal thickness and shape measurements on the sheep’s eyes.
Results from the sheep trial is expected in 2017, and after that, the research team plan to run clinical trials of the eye drop. The ingredients of the formula (steroid and growth factors) have previously been used individually in other clinical trials, which will speed up the approval process.
The next step after human trials would be to treat end-stage keratoconus patients in order to help them avoid a corneal graft. Following that, the treatment could be applied to patients with earlier disease, to help reshape and ‘freeze’ the cornea in the new shape.
A future treatment for myopia?
Associate Professor Trevor Sherwin, who leads the research, is keen to take the technology to another level, by applying it to myopic (short-sighted) eyes. Stabilising the corneas of these patients would have the potential to slow or halt the progression of their myopia. The eye drops may work in combination with corneal reshaping contact lenses for best results. The cornea would be reshaped first, using the lens, and once the desired shape was attained, it could then be thickened and stiffened through use of the eyedrops for a permanent effect. Success in this area could lead to treatments for adults and children with myopia.
Watch this space for the latest updates on this exciting research.
Cells from the adult corneal stroma can be reprogrammed to a neuron-like cell using exogenous growth factors.
Greene CA, Chang CY et al. Exp Cell Res. 2014 Mar 10;322(1):122-32.
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