More Than Meets the Eye

Colorful neurons with cell nuclei in a microscopy image.
Microscopic image of ganglion cells in a mouse retina, a valuable research tool.

Early Detection of Cognitive Diseases

Principal investigator (PI), Xin Duan, PhD, and his team, which includes both co-PI Erik Ullian, PhD, and Kongyan Wu, PhD, seek to address a vital problem in neurodegeneration: how can nerve-damaging diseases be identified earlier to prevent more extensive damage?

Conceptually, Dr. Duan’s team aims to use the retina to establish a way to identify early signs of disease. Instead of simply focusing on the cell biology of degenerating neurons, this team of leading-edge investigators propose to investigate the problem by taking a larger view of the neural circuits within the eye and its component parts.

“There is increasing evidence that the visual system is involved in most neurogenerative diseases and thus could provide a novel early diagnostic inroad to common diseases such as Alzheimer’s and frontotemporal degeneration (FTD)/amyotrophic lateral sclerosis (ALS),” Dr. Ullian contributed. “Furthermore, we can map circuit function with unprecedented precision in the visual system, so it will undoubtedly give us greater insight into specific mechanisms of neuronal and circuit dysfunction in these diseases.”

Visual circuits – the neural networks that give us sight – offer great advantages for analyzing general neural circuits as they are highly accessible with well-characterized synaptic contacts and functional properties. Moreover, the retina and the visual pathways have recently been shown to be easily observable clinically.

Dr. Duan reasons that neural circuit studies represent a major advancement in the analysis of neurodegeneration-related changes.

Dr. Duan’s studies in visual circuits will shed light on other neural circuits across the central nervous system and may lead to early detection of Alzheimer’s disease in patients. They are investigating potential synergies in neurodegenerative disease research, including both glaucoma and Alzheimer’s. Dr. Duan and his team aim to establish a way to detect disease onset, evaluate its progression, and establish a platform to discover dysfunctional neural circuits – with the ultimate goal of preventing neurodegeneration and restoring circuit functions.

ALS, Dementia, Glaucoma: A Genetic Link

 

Erik M. Ullian, PhD, is a UCSF neurobiologist and principal investigator seeking to understand the genetic mechanisms underlying neurodegenerative diseases (the degeneration or death of nerve cells, causing debilitating conditions).

Dr. Ullian first became interested in this area through studies indicating a mysterious genetic link connecting a specific group of genes to both glaucoma and the neurodegenerative diseases of amyotrophic lateral sclerosis (ALS) and frontotemporal dementia (FTD). Strangely, some cases showed the loss of function of a specific gene is implicated in ALS but the gain of function of the same gene is implicated in glaucoma. This suggests that the genes may have different relative functional roles in some cell types, or that some cell types have different sensitivities to the functions of these genes.

Utilizing novel Clustered Regularly Interspaced Short Palindromic Repeats (CRISPR) approaches, Dr. Ullian seeks to understand how this group of genes function in both the central nervous system and in the retina – and why their dysfunction can lead to cell death. Understanding this could unravel the mystery of these genetic cell-type susceptibilities that can lead to either ALS or glaucoma or, in some cases, both.

In addition, Dr. Ullian has developed complex 3D models showing a remarkable ability to reproduce many of the hallmarks of neurodegeneration currently missing from animal models. The hope is to use these models as a platform for drug screening, finding new therapeutic strategies to target disease. This approach is attracting the attention of industry, inspiring speedy drug discovery to bona fide treatments.

Top-Tier Rankings in 2020!

 
This year we ranked #2 for NIH awards to Departments of Ophthalmology nationwide and #1 for research grant awards from the NIH National Eye Institute. We also continued to be ranked in the top 10 Departments of Ophthalmology nationwide by the 2020 US News and World Report.  Twenty-two vision scientists in the Department of Ophthalmology and Proctor Foundation currently serve as principal investigators for 33 grants awarded by the US National Institutes of Health. In the past several years, the merit of UCSF faculty research is also reflected in the annual publication of more than 200 peer-reviewed articles in prestigious journals including The New England Journal of Medicine, Nature Genetics, Neuron, Ophthalmology, and Proceedings of the National Academy of Sciences. These insights and successes bring us closer to a world with sight for all.  We are proud of our Principal Investigators with active NIH Research Grants and New Awards!

Learn more about teaching and mentorship of our residency program and post-residency fellowships.

We hope you will enjoy this video presentation about what makes our residency and post-resident fellowship programs great! You can learn much more about these teaching programs and how to apply by going to our residency home page and our fellowships home page.

 

Video: Bryn Mawr Communications

Top 10 in the Nation and Best in Northern California!

The UCSF Medical Center has been recognized in the 2020-21 Best Hospitals Honor Roll! For the fifth year in a row, UCSF’s Department of Ophthalmology has been named one of the Top 10 eye institutions in the nation AND the Best in Northern California by U.S. News & World Report!

To help support the important research, medical education, and patient care provided by the Department of Ophthalmology and the Francis I. Proctor Foundation, please click here.

Vision care for the underserved community – Dr. Alejandra de Alba Campomanes, MD, Unsung Hero

In celebration of the initiative “2020: Year of the Eye” the American Academy of Ophthalmology (AAO) featured stories of ophthalmologists who give above and beyond to our community.  We were very proud to have our own Dr. de Alba included!  Please view the video about Dr. De Alba from the AAO, or click here to view their full article about her efforts as an unsung hero helping to improve vision and vision care for the underserved community.

 

Research to the Rescue (Action against COVID-19)

Close-up of a person's eyes with statistical analysis.
A novel artificial intelligence tool automatically generated measurements for eye characteristics from a digital image of Dr. Seanna Grob. The tool has the potential to diagnose external eye disorders from photos taken at home during the pandemic.

At press time, UCSF vision scientists had already launched 18 research projects to address aspects of the COVID-19 pandemic. Here are a few highlights.

 

Forecasting Viral Spread in California

Travis Porco, PhD, MPH; Lee Worden, PhD; Seth Blumberg, MD; and Rae Wannier, BS; of the Proctor Foundation are analyzing mathematical models to guide public health policy, in coordination with the San Francisco Department of Health. The team’s analysis focuses on real-time assessment of current control measures, as well as analysis of contact investigation, mask usage, and social distancing.

 

Using Artificial Intelligence and Selfies to Diagnose Eye Diseases

Luca Della Santina, PhD, and Michael Deiner, PhD, lead a team of clinicians and computer scientists to develop “deep learning” methods that can identify conditions that affect the surface of the eye (external disorders) from selfie images taken by patients (or their families or caregivers) at home. This tool has strong potential to support telemedicine for vision care during and after the pandemic. Collaborators include Seanna Grob, MD; Julius Oatts, MD; Gerami Seitzman, MD; Tom Lietman, MD; and M. Reza Vagefi, MD.

 

Home Testing for Glaucoma Patients

Yvonne Ou, MD, and Michael Deiner, PhD, are studying whether a novel mobile visual field test for glaucoma patients can provide an effective at-home alternative to conventional in-clinic testing during the pandemic. Co-developed with Vivid Vision, Inc., the test uses inexpensive virtual reality headsets and oculokinetic perimetry methods pioneered by Bertil Damato, MD, PhD, FRCOphth. Dr. Ou can quickly evaluate the results of tests that her patients perform in their homes.

 

Two healthcare workers in protective gear at a UCSF Health tent.
At a COVID-19 screening tent, a Proctor fellow and a nurse study virus aerosolization caused by speech.

Pinpointing Short-Distance Viral Spread

Julie Schallhorn, MD, and Gerami Seitzman, MD, lead two investigations to determine the presence and prevalence of aerosolized SARS-CoV2 viral particles emitted when patients speak (or sing!). One focuses on people at a testing site and the other on patients convalescing at home. The team also includes Thuy Doan, MD, PhD, who performs the genetic diagnostic testing, and Miel Sundararajan, MD. Findings will inform future safety guidelines.

 

UCSF East Bay Vision Clinic

Providing vision care in comprehensive ophthalmology, glaucoma, retina, oculoplastics, and optometry. Call 415.353.2800 to discuss moving your vision care.

Research support is provided by the National Institutes of Health, Research to Prevent Blindness, and That Man May See.