Researchers at the University of Rochester Medical Center developed a new imaging technique that can diagnose eye diseases earlier, which could potentially prevent vision loss. Research was published in the Proceedings of the National Academy of Sciences.

Glaucoma is the leading cause of blindness, according to the Glaucoma Research Foundation. There is currently no cure for the disease, but with medication and/or surgery it's possible to prevent further vision loss.

The technique can noninvasively image a patient's retina and distinguish individual retinal ganglion cells, which are mostly responsible for transmitting visual information to the brain. When RGCs die, it causes vision loss in glaucoma.
There has been great interest among the research community in imaging RGCs because of their connection to glaucoma, but no one has been able to capture images of individual RGCs because they are transparent.

Ophthalmologists diagnose glaucoma by evaluating the thickness of the nerve fibers that project from the RGCs to the brain. But by the time retinal nerve fiber thickness has changed that much, a patient could have lost over 100,000 RGCs, and there are only 1.2 million in the whole eye.

The researchers created the new imaging technique, called multi-offset detection, by modifying existing technology, called confocal adaptive optics scanning light opthalmoscopy.

The technique was performed at the university on animal and human volunteers that either had normal vision or age-related macular degeneration.

Multi-offset detection allowed the researchers to visualize individual RGCs, and structures within the cells could be distinguished in animals. If they can achieve that level of resolution in humans, they may be able to diagnose glaucoma before the retinal nerve fiber thins.

RGCs aren't the only type of cell that can be imaged using this technique. In age-related macular degeneration, cone photoreceptors that detect colors and are essential for central vision are the first to die.

AOSLO can image cones but the cells were hard to see in certain areas. With the multi-offset technique, the health of cones can be evaluated in those areas where the retina has been damaged.

The researchers cautioned that this study only included a small number of patients and that more research is needed to improve the technique and ensure the results are reproducible.

One of the researchers is setting up their own lab at the University of Pittsburgh, and plans to continue to work with the group to assess the technique's ability to detect changes in retinal cells over the course of retinal diseases.

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