Cataracts are the foremost cause of blindness in the world and currently can be treated only by surgical removal. Surgery, although easily available and safely performed in the U.S., is not easily available nor safely performed in many undeveloped regions in the world like Asia, Africa, the Middle East and South America. Hence we are studying ways to treat cataracts non-surgically, and a new device promises to help us find out what happens to the human lens that may cause cataracts, which will then help us find a cure for cataracts. One theory on the cause of cataracts is that some factors such as sunlight or lack of protective anti-oxidant vitamins may cause the proteins inside the lens to aggregate to form opaque high molecular weight """"""""aggregates"""""""". Recently, a device (the Dynamic Light Scattering device or DLS), has been created to determine molecular interactions, including lens crystalline interactions that occur in the nucleus of the lens. Using the new DLS device on animal models of cataract, we have found evidence of this lens protein aggregation as a cataract develops. Preliminary studies have shown its potential in the detection of the earliest changes occurring in cataract, at the stage where anticataract treatment would theoretically be most effective in reversing, delaying or preventing cataracts. A new miniaturized version of this device has been developed by NASA using lower energy lasers and offered for further development and clinical testing at the NEI. We mounted the DLS device successfully on the Keratoscope, which had a 3-D aiming system to enhance repeatability. We recently conducted a pilot study on normal human volunteers (Phase 1) to evaluate the usefulness and reproducibility of this instrument for quantitating lens changes, and found good reproducibility. We also determined that the most useful parameter to use is mean particle size derived from particle size distribution. We are now in Phase 2 of this project, studying clinical changes in the human lens in vivo due to aging (age related changes), as well as molecular changes found in the three representative types of cataracts (nuclear, cortical and PSC). We found that with normal aging, there is a shift of both low and high molecular weight lens proteins toward increasing higher molecular weights. During cataract formation, we have observed loss of low molecular weight proteins and dramatic increases in high molecular weight proteins, so that all the proteins could end up in a single large molecular weight peak, especially in nuclear cararact. In some cortical and posterior subcapsular cataracts, there are marked molecular changes in the lens nucleus even when the nucleus remains clear and does not seem to be affected. These data will help characterize molecular changes in the human lens associated with normal aging as well as those associated with cataract formation. This information will help us to better understand the underlying causes of cataracts and, thereby help us develop and test (in Clinical Trials) medications to delay or prevent cataract formation. These in vivo, non invasive and sensitive normal lens aging and cataract studies were heretofore been impossible to conduct due to the absence of a method to detect and quantify these lens and cataract changes in the molecular level. The development of this safe clinical method and creation of this miniature and operator- and patient- friendly device is a first in this field of clinical cataract studies. It also offers a new more sensitive and precise method to conduct clinical (in vivo) lens studies and trials of conditions and medications that can either cause the development of cataract (toxic side effect) or prevent cataract development (beneficial effect) in man. If successful, the development of this technique will result in shorter and therefore less expensive longitudinal clinical lens and cataract studies.
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| Datiles 3rd, Manuel B; Ansari, Rafat R; Reed, George F (2002) A clinical study of the human lens with a dynamic light scattering device. Exp Eye Res 74:93-102 |
