New Device Could Facilitate Precision Medicine for Eye Diseases

September 30, 2020 - A new tool designed to collect eye fluid samples could help providers develop specific treatment plans for patients, facilitating precision medicine for eye diseases.

Researchers from the University of Michigan Kellogg Eye Center and Penn State Health Milton S. Hershey Medical Center are working to build a safe device that can be used in the clinic room and ensures adequate samples are taken every time.

Many eye diseases, including age-related macular degeneration, a condition that damages the retina, and diabetic retinopathy, which can lead to blindness, look similar when examined by ophthalmologists, the team noted.

“Inflammatory conditions in the eye look similar,” said Thomas Gardner, MD, MS, an ophthalmologist at the University of Michigan Kellogg Eye Center. “And although infection has specific features that make it identifiable, these features aren’t unique to any particular infection.”

Treatments are non-specific for many inflammatory eye conditions, so a patient might just get steroids to try and reduce the inflammation. Additionally, the eyes are one organ that don’t have routine molecular diagnostic tests, which can have serious consequences for diagnosing and treating potentially vision-threatening eye conditions.

“Many clinicians are hesitant to put a needle in someone’s eye without a strong indication that something is wrong, and that’s normally when there’s an infection,” said Gardner. "And for those that do get a diagnostic test done, it’s often difficult to get an adequate sample.”

Currently, there isn’t a standard process for collecting the eye’s gel-like fluid samples. Retina surgeons often collect these samples in the operating room from patients that need surgery, because this is the easiest way to get adequate samples. But surgery can be expensive, and patients shouldn’t have to be in the operating room in order for doctors to obtain a fluid sample.

Moreover, the needle used to collect a good sample doesn’t always work because the fluid is gelatinous and can clog it.

“Regular needles don’t work all the time, and we need them to work all the time,” Gardner said.

To make the process of collecting a sample easier, researchers are developing a handheld, disposable device specifically designed for getting a substantial sample. The device, called the Mini-Vit, contains a needle inside a larger needle that can cut the gelatinous fluid.

The project started with funds from the Fast Forward Medical Innovation’s Kickstart Program, an initiative offering resources and support to biomedical researchers at the University of Michigan and across the state.

The project is now funded by the Colter Translational Research Partnership Program and the Taubman Institute, both of which are efforts by the University of Michigan to promote technology development in healthcare.

These funds will also help create a standard process for analyzing fluid samples at the molecular level, which will further accelerate precision medicine.

Researchers are also working to develop a repository of patient samples and design new computational tools clinicians can use to compare to a large database of samples. This repository will help clinicians identify or create the most specific and effective treatment plan for a given patient, or group of patients.

The group expects that the Mini-Vit device could help accelerate precision medicine for eye care, a much-needed development in the field of ophthalmology.

“These processes of collecting, analyzing and comparing patient samples could significantly advance Kellogg Eye Center’s approach to vision-threatening conditions, as well as provide more treatment options for patients that may have previously thought there weren’t any,” Gardner said.