Research at Casey Eye Institute

Dr. Shandiz Tehrani viewing images of the eye obtained through his research in the lab

Innovators in vision research

OHSU Casey Eye Institute has one of the top ophthalmic research programs in the country. Our scientists and clinicians have worked together to perform research studies that have revolutionized the practice of ophthalmology, and we continue to explore, innovate, and find new treatments for eye disease. 

OHSU Casey Eye Institute's faculty are responsible for many of the most recent advances in ophthalmology, which have revolutionized the diagnosis and treatment of many ophthalmic conditions. Advances in optical coherence tomography, ophthalmic informatics, corneal refractive, retina and pediatric eye care have been pioneered at Casey.

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Research programs

Patients receiving care at Casey receive the most up-to-date and innovative approaches to diagnosis and management. We are proud to be ranked in the top 10 NEI-funded Eye Research Institute in the U.S.

For the past several years, our average ranking for federally funded research has been fifth out of about 140 programs in the country. Our research faculty are making significant contributions in many areas including stem cell therapy, gene therapy, glaucoma, inflammatory eye disease and retinal disease. 

We are known world-wide for our advances in eye research, including:

Featured research programs

Informatics and telemedicine is the way of the future

OHSU Casey Eye Institute is an international leader in ophthalmology informatics, which is the application of computer and information technologies to improve the quality and delivery of eye care. Casey's Elks Center for Ophthalmic Informatics is led by Michael F. Chiang, M.D., an international expert on informatics in ophthalmology. He and colleagues J. Peter Campbell, M.D., M.P.H., Thomas Hwang, M.D., and Michelle Hribar, Ph.D., have helped Casey become a leader in:

  • Using telemedicine to improve the quality and delivery of ophthalmic care.
  • Using artificial intelligence to help diagnose retinopathy of prematurity (ROP). Casey has helped develop and validate computer-based tools that diagnose ROP more accurately than ophthalmologists.
  • Using “big data” to better coordinate patient visits and doctors' time, increasing clinic efficiency and decreasing patient wait times.

Learn more about informatics at Casey.

Dr. Chiang reviews images of the eye sent from another hospital to diagnose retinopathy of prematurity in infants.

Leading the field in gene therapy

Gene therapy involves doctors surgically injecting a healthy gene to replace a malfunctioning gene that causes eye disease. These remarkable treatments have successfully improved the vision of patients with legal blindness caused by inherited retinal degenerations. Because of our expertise in gene therapy, the Gene Therapy Center conducts more ocular gene therapy clinical trials than any other center in the world, including:

  • The world's first gene therapy treatment for juvenile macular degeneration.
  • The world's first gene therapy treatment for Usher syndrome.
  • The world's first stem cell therapy for retinitis pigmentosa.
  • Being one of seven sites in the U.S. offering the first FDA-approved gene therapy for a genetic disease, Luxturna. 

Learn more about gene therapy trials and treatments at Casey.

Doctor looking at computer image of gene therapy surgery

Glaucoma research

Researchers at the Casey Eye Institute are working to understand the causes of this blinding eye disease, improve its diagnosis and treatment, and ultimately find a cure.

What Is Glaucoma?

Glaucoma is the leading cause of irreversible blindness in the world. It occurs in 2-3 million people in the USA and more than 66 million people worldwide. There are approximately 50 types of glaucoma, although the most common form in the United States is primary open angle glaucoma. Others include angle closure glaucoma, congenital glaucoma and a number of glaucomas that occur secondary to underlying ocular or systemic diseases.

How The Disease Progresses

Glaucoma involves both the front (anterior) and back (posterior) tissues of the eye. In the front, aqueous humor fluid continuously drains out of the anterior chamber through a filter-like tissue called the trabecular meshwork. In glaucoma, aqueous drainage is impaired and this leads to elevated intraocular pressure. This increased pressure pushes the lens and vitreous backwards, putting stress on the optic disk in the posterior eye. This damages the optic nerve (a bundle of about one million nerve fibers that carries visual information from the retina to the brain) and results in progressive loss of peripheral, and ultimately central vision. This is called glaucomatous optic neuropathy. We can detect and monitor damage by viewing the optic disk, performing nerve fiber layer analysis with optical coherence tomography (OCT), and conducting visual field testing.

Causes and Treatments

A clear understanding of the causes of this disease remains elusive. Major risk factors include age, race, elevated intraocular pressure and family history. Researchers have mapped over 120 different genes with defects responsible for primary open-angle glaucoma, mostly acting in pairs or small groups. Studies attempting to use this information to treat individual glaucomas are ongoing. Conventional glaucoma treatments include several types of eye drops, laser surgery, and several surgical methods. However, none of these is perfect or universally effective and improved therapies are still needed.

Research focus areas

  • Understanding how normal intraocular pressure regulation is lost in glaucoma and how to restore it in order to lower eye pressure.
  • Understanding how normal and glaucomatous trabecular meshwork cells communicate.
  • Investigating how the genes associated with hereditary glaucomas cause elevated eye pressure and developing approaches to reverse this.
  • Determining how to treat the loss of intraocular pressure regulation using adult, patient-derived stem cells.
  • Understanding the molecular and cellular mechanisms of glaucomatous optic nerve damage.
  • Developing new therapeutic and drug delivery strategies to protect the optic nerve.
  • Determining the impact of glaucoma on visual processing in retinal circuits.
  • Developing new imaging technologies such as optical coherence tomography angiography to improve clinical diagnosis and monitoring of glaucoma
  • Improving delivery of glaucoma care by developing remote glaucoma management systems through established community health centers.
Dr. David Huang, co-inventor of OCT, talks about the history, impact and implications of this non-invasive technology in ophthalmology and eye care.

Advanced technology: Optical Coherence Tomography (OCT) and OCT Angiography (OCT-A)

Casey's Center for Ophthalmic Optics and Lasers (COOL Lab) is one of the leading ophthalmic imaging research groups in the world. It includes the co-inventor of OCT imaging, David Huang, M.D., Ph.D., which has revolutionized how ophthalmologists across the world diagnose and treat eye conditions.

Casey's Dr. Huang and Yali Jia, Ph.D., are now also pioneers in OCT-A, which allows doctors to map out the eye's smallest blood vessels and measure blood flow. This has potential to further transform diagnosis and treatment for common eye conditions like glaucoma, macular degeneration and diabetic eye disease. 

Learn more about OCT research at Casey.

Diving deep into the "why" of uveitis and ocular inflammatory disease

Our doctors are world-renowned for their contributions to basic laboratory research in the field of uveitis and ocular inflammatory disease, where their research is helping clinicians and scientists alike understand why patients develop uveitis and other inflammatory diseases. This knowledge will be crucial in advancing our ability to diagnose and treat uveitis and ocular inflammatory diseases in the future and in developing better treatments in the future.  

Understanding how the microbiome affects uveitis

One area of our research focus is to better understanding the microbiome. The microbiome is comprised of the many bacteria and other organisms which live in our bodies normally, especially in our colons and digestive tract.  The interaction between these bacteria and the cells of our human immune systems may play a critical role in human health, and also in certain disease states, such as uveitis.  Our group is a world leader in developing better understanding of these interactions, which in the future may hopefully be a target to be manipulated to benefit patients with inflammatory diseases. 

Advancing diagnosis technology

Another area of our expertise is in the growing area of multimodal imaging for diagnosing inflammatory eye diseases. Imaging technology is growing exponentially and with it we are better able to and diagnose disease in tissues of the eye. Casey doctors and physicians are leaders in using this technology to diagnose and treat patients with uveitis.

Advancing treatment through clinical trials

Our center is one of the leading uveitis clinical trial groups in the country.  We have taken part in the design, conduct, and analysis of some of the biggest and most influential clinical trials in uveitis over the last three decades. We have particular expertise in the area of biologic drugs for the treatment of uveitis, where our study group has conducted and published some of the earliest and most influential clinical trial results in this area.

We are currently involved in a large, multicenter, placebo-controlled trial of filgotinib, a drug which is taken orally, but has the promise of similar effectiveness to other potent immune suppressing drugs which must be taken intravenously or by subcutaneous injection.  This study is placebo controlled and is sponsored by Gilead, the maker of the study drug (filgotinib).  We have also recently been involved in clinical trials which led to the FDA approval of adalimumab (Humira) for the treatment of non-infectious intermediate, posterior, and panuveitis, and investigations for several other promising new medications for the treatment of ocular inflammatory disease.

Clinical trials

Clinical trials are research studies involving volunteer participants in which scientists learn whether a new medication or treatment is safe and effective in people. Trials are conducted in phases, often over a number of years.

Patients who participate in clinical trials have access to the newest medications that are being studied for potential approval. We are grateful for patients who participate in clinical trials for contributing to the evaluation of new treatments that may benefit future generations.

Casey conducts clinical trials focusing on several areas, including age-related macular degeneration, glaucoma, neuro-ophthalmology and gene therapy treatments for inherited eye conditions. 

Casey Research Day

Every spring, the residents, fellows, students, post-doctoral candidates and faculty engaged in ophthalmic research present their original work in clinical, basic, and translational research on Research Day. This forum is designed to educate trainees, celebrate mentorship, and exchange ideas for discovery. You can find last year’s Research Day program here to see a sampling of scholarly work done by our residents.

Casey Reading Center

The Casey Reading Center is made up of a team of talented physicians, scientists, and staff who work with clinical trial sponsors to ensure that trials are of the highest quality and allow for the best possible scientific insights into the results.

Since we started operating in 2009, we have developed operating procedures for clinical trials that comply with both domestic and international regulatory requirements and are considered "best in class" by clinical trial experts.

Drug registry

Casey helps to support and coordinate the National Registry of Drug-Induced Ocular Side Effects, with support from the American Academy of Ophthalmology.

The registry, founded in 1976, is an international clearinghouse of information on how drugs, chemicals, herbs and herbal supplements can cause adverse events in eye conditions or vision.

The registry's goal is to offer eye professionals information on early signals of an adverse eye reaction. 

Research training programs

OHSU Casey Eye Institute offers several training programs for students and clinicians who are interested in pursuing vision research opportunities, including two prestigious vision research training programs funded by the National Institutes of Health.