For the past 20 years his laboratory has been NIH funded to study the effects of aging and experimental glaucoma on the neural and connective tissues of the monkey optic nerve head within 3D histomorphometric reconstructions. This work now extends to studying the cell biology of connective tissue remodeling and axonal insult early in the disease. Building upon its 3D capabilities, his laboratory is also funded to use Optical Coherence Tomography (OCT) to phenotype the deep tissues of the monkey and human optic nerve head and peripapillary sclera.
Dr. Fortune’s research interests can be characterized generally as being about the anatomy and physiology of the visual system with an emphasis on understanding pathophysiology of disease and development of clinical diagnostic techniques. More specifically, Dr. Fortune’s research focus is on the pathophysiology of glaucoma and methods for detecting early-stage abnormalities of retinal ganglion cell function and sub-cellular structure in the living eye. To carry out the aims of their studies, Dr. Fortune and his research collaborators use a variety of ophthalmic imaging techniques, including optical coherence tomography (OCT), confocal scanning laser ophthalmoscopy (CSLO) and scanning laser polarimetry (SLP), as well as advanced methods for assessment of retinal function by electroretinography (ERG) and visual evoked cortical potential (VECP) testing. Their overall goal is to facilitate the translation of findings from laboratory studies to the clinical care and management of glaucoma.
Dr. Gardiner’s research focuses on improving testing methods for glaucoma. This includes both functional testing (perimetry) and structural testing (imaging, OCT), and the way they fit together to give information about the patient’s vision, and how it may change over the next few years. He is funded by the National Institutes of Health to investigate ways to improve functional testing, making the tests more reliable and more useful. He works closely with Dr. Demirel on a longitudinal study to see how the disease progresses, and to try to predict how quickly it is likely to progress in order to better inform clinicians considering different treatment options. He also works with Dr. Burgoyne on ways to analyze the information obtained from OCT, an imaging device that is becoming widely used clinically. Thanks to his training in statistics, he helps other investigators with their studies, both in Legacy Devers Eye Institute and elsewhere in Legacy Health.
By using an optic nerve ischemia model, Dr. Wang and his colleagues have demonstrated that inducing local ischemia around the optic nerve causes glaucomatous-like damage. It was further demonstrated that blood flow in the optic nerve surprisingly increases during the early stage before a progressive decline. The second surprising insight was that the autoregulation dysfunction within the optic nerve head manifests very differently to that seen in other tissues, and does not follow the general concept of autoregulation. These unique hemodynamic changes in autoregulation during diseased conditions lead to a new research direction. In a project recently funded by the National Institutes of Health, Dr. Wang will be investigating the role of glial cells in blood flow autoregulation by using devices that are capable of simultaneously monitoring the vasculature and activities of glial cells while intravascular and extravascular pressures are instrumentally controlled. The research conducted by Dr. Wang is expected to benefit glaucoma patients by helping us to better understand mechanisms of blood flow autoregulation, and the relationship between ocular microcirculation and glaucomatous optic nerve damage.