Scientist works to interrupt early changes resulting in diabetic vision loss

Years before an overgrowth of vessels destroys the sight of diabetics, vital nerve cells in the retina begin to die.

The dying cells have a characteristic appearance. "They are often adjacent to cells that appear normal; it's kind of a civilized death," says Dr. Sylvia Smith, retinal cell biologist at the Medical College of Georgia, as she looks at a microscopic image of the dying cells.

While the specific initiating event that leads to late-onset vascular changes is not certain, the death of these neurons may contribute to the complex cascade of events that disrupts the beautifully organized retina over years; eventually, this back portion of the eye begins to grow new blood vessels, presumably in an attempt to rescue dying cells by providing more blood and oxygen.

Unfortunately, the growth of new vessels obstructs vision. They can leak and cause scarring in a condition called diabetic retinopathy, the number-one cause of vision loss in working-age adults.

Dr. Smith recently received a $1 million, four-year grant from the National Eye Institute to understand better how these dying ganglion cells live and why the increased glucose levels in diabetics prompt their death.

Better still, she wants to know if drugs called sigma receptor ligands can preserve ganglion cells and stop the destructive blood vessel proliferation that seems to follow.

"We are not studying the vascular problems in this project as they set in after many years of diabetes in humans and animal models. We are interested in the early changes and we have evidence that there are changes in the nerve cells in the retina long before you have these gross blood vessels growing," she says.

Problems seem to start with ganglion cells, nerve cells found in the inner part of the retina. "The axons of these cells join to form the optic nerve, which then goes to the brain and delivers a visual image," she says. While the idea that these cells might

Contact: Toni Baker
Medical College of Georgia

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