Cataract detector

A compact system developed for the space programme can provide early detection of cataracts, the leading cause of vision loss.

Researchers from the US National Eye Institute (NEI), part of the National Institutes of Health, and the National Aeronautics and Space Administration (NASA) collaborated to develop the system, which can be used to conduct a simple, safe eye test for measuring a protein related to cataract formation.

If subtle protein changes can be detected before a cataract develops, people may be able to reduce their cataract risk by making simple lifestyle changes, such as decreasing sun exposure, quitting smoking, stopping certain medications and controlling diabetes.

‘By the time the eye’s lens appears cloudy from a cataract, it is too late to reverse or medically treat this process,’ said Dr Manuel B Datiles, NEI’s medical officer. ‘This technology can detect the earliest damage to lens proteins, triggering an early warning for cataract formation and blindness.’

The new system is based on a technique called dynamic light scattering (DLS). It was initially developed to analyse the growth of protein crystals in a zero-gravity space environment.

NASA’s Dr Rafat R Ansari, a senior scientist at the John H Glenn Research Center, brought the technology’s possible clinical applications to the attention of NEI vision researchers when he learned that his father’s cataracts were caused by changes in lens proteins.

Several proteins are involved in cataract formation, but one known as alpha-crystallin serves as the eye’s own anti-cataract molecule. Alpha-crystallin binds to other proteins when they become damaged, thus preventing them from bunching together to form a cataract. However, humans are born with a fixed amount of alpha-crystallin, so if the supply becomes depleted due to radiation exposure, smoking, diabetes or other causes, a cataract can result.

‘We have shown that this non-invasive technology can now be used to look at the early signs of protein damage due to oxidative stress, a key process involved in many medical conditions, including age-related cataract and diabetes, as well as neurodegenerative diseases such as Alzheimer’s and Parkinson’s,’ said NASA’s Dr Ansari.

A recent NEI-NASA clinical trial looked at 380 eyes of people aged seven to 86, who had lenses ranging from clear to severe cloudiness from a cataract. Researchers used the DLS system to shine a low-power laser light through the lenses. They had previously determined alpha-crystallin’s light-scattering ability, which was then used to detect and measure the amount of alpha-crystallin in the lenses.

They found that as cloudiness increased, alpha-crystallin in the lenses decreased. Alpha-crystallin amounts also decreased as the participants’ ages increased, even when the lenses were still transparent. These age-related, pre-cataract changes would remain undetected by currently available imaging tools.

The DLS technique will now assist scientists in looking at long-term lens changes due to ageing, smoking, diabetes, LASIK surgery, eye drops for treating glaucoma, and surgical removal of the vitreous gel within the eye, a procedure known to cause cataracts within six months to one year. It may also help in the early diagnosis of Alzheimer’s disease, in which an abnormal protein may be found in the lens. In addition, NASA researchers will continue to use the device to look at the impact of long-term space travel on the visual system.

‘During a three-year mission to Mars, astronauts will experience increased exposure to space radiation that can cause cataracts and other problems,’ said Dr Ansari. ‘In the absence of proper countermeasures, this may pose a risk for NASA. This technology could help us understand the mechanism for cataract formation so we can work to develop effective countermeasures to mitigate the risk and prevent it in astronauts.’

Dr Manuel B Datiles demonstrates the dynamic light scattering (DLS) system