Vivek Patel, MD: Retinal Pathology and Alterations in the Brain

Vivek Patel, MD:

So our study was to essentially look at how the retinal and optic nerve disease processes might affect the outer retina or the inner retina. For the outer retina, we talked about things like photoreceptors and the retinal pigment epithelium, the deeper layers. And the inner layer being the ganlion cell complex as well as the nerve fiber layer.

We wanted to see how different disease processes at the level of the eye, what impact they would have in the central visual pathways -- essentially, the part of the visual system that's inside the brain.

We think that there probably is some degree of degeneration that could take place over time, in the context of having retinal or optic nerve disease. Now we have the imaging modalities, functional as well as structural, to be able to see at the retinal level and at the cortical level and the brain level, what's actually going on.

We think that will be relevant in the future, in particular when there's sight restoration therapies that've become more mainstream, like stem cell therapies, cortical vision implants, retinal implants, we need to know what's actually going on centrally in the brain downstream.

Once we start to figure out ways to fix the problem at the level of the eye, the assumption that we're making is that the central visual pathway is still unchanged. So that has great implications for functional recovery, structural recovery, and something called cross-modal plasticity, meaning that one area of the brain is naturally geared toward one type of function, but over time, over depravation, will that switch over to another sensory modality?

I think the everyday ophthalmologist will be really excited about this work, given that we're all used to looking at really high-resolution images of the retina in the context of OCT. But now we can actually see the brain at that degree of discreet level of processing, discreet level of structural integrity.

I think down the road when we are offering therapies for people, at the level of the retina or optic nerve, seeing the brain is obviously very important and knowing what type of processing ability the brain has, and how it's changing, over the context of depravation or whatever sensory modality there is.

So I think that this will be something in the future that will be really relevant because the brain is really where most of the vision is being processed. Now that we have a better handle on what we can see at the level of the brain, it'll have implications more broadly.

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