Division of Eye and Vision
The Division of Eye and vision which is located at St. Erik Eye Hospital, conducts education at the undergraduate, advanced and postgraduate levels, as well as research with the aim of developing the eye care of the future.
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Retinal ganglion cell repopulation for vision restoration in optic neuropathy: a roadmap from the RReSTORe Consortium
Retinal ganglion cell (RGC) death in glaucoma and other optic neuropathies results in irreversible vision loss due to the mammalian central nervous system’s limited regenerative capacity. RGC repopulation is a promising therapeutic approach to reverse vision loss from optic neuropathies if the newly introduced neurons can reestablish functional retinal and thalamic circuits.
The RReSTORe Consortium
Pete Williams and James Tribble have been part of a consortium to protect, regenerate, and repopulate the optic nerve and the retina as senior investigator
Goals of the consortium are to define and prioritize the most critical challenges and questions related to RGC regeneration over the next five years and to brainstorm innovative tools and experimental approaches to meeting these challenges while fostering opportunities for collaborative scientific investigation among diverse investigators.
Pete Williams is awarded 3 MSEK from StratNeuro for eye treatment with nanotechnology
Pete Williams, associate professor and research group leader at Karolinska Institutet and St. Erik Eye Hospital, has been awarded 3 MSEK from the Strategic Research Area Neuroscience (StratNeuro) at Karolinska Institutet to develop methods for delivering neuroprotective drugs to the eye using nanocarriers.
Brachytherapy With 15- Versus 20-mm Ruthenium 106 Plaques Without Verification of Plaque Position Is Associated With Local Tumor Recurrence and Death in Posterior Uveal Melanoma
Compared with 20-mm plaques, brachytherapy with 15-mm ruthenium plaques is associated with a higher risk for tumor recurrence and death. These adverse outcomes may be avoided by increasing safety margins and implementing effective methods to verify accurate plaque positioning.
DSAEK versus DMEK for Fuchs´ endothelial corneal dystrophy: a national register-based comparison
The visual acuity improved in the majority of cases (90%) with all three surgical methods. However, DMEK and phaco/DSAEK reached higher levels of visual acuity two years after the surgery and phaco/DSAEK was superior considering the graft survival rate. All three surgical procedures showed both strengths and weaknesses suggesting that the choice of surgical method should be individualized and take into consideration not only cornea but patient´s complete medical status as well as the whole course of postoperative medical care.
Neuroprotection in glaucoma: Mechanisms beyond intraocular pressure lowering
James Tribble and Pete Williams have written a comprehensive review article highlighting the progress of research into new glaucoma treatments. The article, written with colleagues in Australia and Canada, offers a perspective on non-IOP lowering treatments for glaucoma focusing on both pre-clinical and clinical research. In particular, the team discusses the rapid advancement in understanding of metabolic dysfunction in the retina in glaucoma.
-We hope that this article will be an excellent starting point for scientists and clinicians entering the research field as well as an important resource for those wishing to learn more about where the future of glaucoma management may lie.
Broad overview published on strategies to protect neurons in glaucoma
James Tribble, Assistant Professor at Karolinska Institutet and St. Erik Eye Hospital, has written an overview article with colleagues in Australia and Canada on how research into new glaucoma treatments is progressing.
Abinaya Venkataraman - New docent
- I am very happy and thrilled to be awarded docent in Optometry. This is a great honor and an important milestone in my career. I am excited to continue contributing to pedagogic and research development in Optometry and vision science.
Pete Williams receives 400,000 from Hedlund Foundation
Researcher Pete Williams receives 400,000 from the Hedlund Foundation for evaluation of new NAD-generating drugs to prevent neurodegeneration. The research group is mechanistically testing NAD-regulation in sensory neuron health and disease using the model organism C. elegans.
Gustav Stålhammar, nominated as one of the emerging and promising young researchers from the Nordic countries.
Acta Board have been nominated Gustav Stålhammar as one of the emerging and promising young researchers from the Nordic countries.
followed by a session with four young speakers from the Scandinavian countries, each of whom will talk about their own research. We invite you to be one of these speakers.
On the occasion of the 100th of Acta anniversary in Maastricht in June, Gustav is invited together with Joni Turunen, Finland och Cecilie Bredrup, Norway to speak about their own research.
Title of Gustavs lecture is: ”Uveal melanoma past, present, and future -Towards adjuvant treatment”
Repeatability of a fully automated swept-source optical coherence tomography biometer and agreement with a low coherence reflectometry biometer
In conclusion, our results demonstrate that the Eyestar 900 and Lenstar LS 900 provide repeatable measurements for the different parameters analyzed. Comparing the instruments, we believe that despite the statistically significant differences reported in CCT and LT and the LoA values, we consider them negligible from a clinical standpoint. Hence, the two biometers can be used interchangeably.
Vision impairment is common in non-hospitalised patients with post-COVID-19 syndrome
Vision-related symptoms and impairments were prevalent in the study group. The Developmental Eye Movement Test and the Visual Motion Sensitivity Clinical Test Protocol showed promise for clinical assessment of saccadic performance and sensitivity to movement in the environment. Further study will be required to explore the utility of these tools.
Digital morphometry and cluster analysis identifies four types of melanocyte during uveal melanoma progression
Four basic cell types can be outlined in uveal melanoma progression: normal, spindle A and B, and epithelioid. Differential expression of tumor suppressors, growth factors, and immune checkpoints could contribute to their relative over- and underrepresentation in benign, primary tumor, and metastatic samples.
The integrity of psychophysical visual function in non-immunocompromised PLHIV (NIPLHIV) without retinitis on antiretroviral therapy (ART)
The present study investigated the integrity of contrast sensitivity (CS), colour vision, and pattern evoked vision potentials (VEP) in non-immunocompromised people living with HIV (NIPLHIV) without retinitis.
Obesity paradox in uveal melanoma: high body mass index is associated with low metastatic risk
Metabolic factors and obesity may influence the development and progression of cancer. In this study, we examine their association with the risk of developing metastases of uveal melanoma.
Conclusion; Obesity and elevated serum leptin levels are associated with a lower risk for developing metastases and dying from uveal melanoma.
Multiorgan Involvement of Dormant Uveal Melanoma Micrometastases in Postmortem Tissue From Patients Without Coexisting Macrometastases
We demonstrate multiorgan involvement of apparently dormant micrometastases in patients with uveal melanoma. This suggests that micrometastases are present in nearly all patients diagnosed with primary uveal melanoma, regardless of coexisting macrometastases.
A serum protein signature at the time of Uveal Melanoma diagnosis predicts long-term patient survival
A prognostic test based on a single peripheral venous blood sample at the time of uveal melanoma diagnosis stratifies patients into low, intermediate, and high metastatic risk categories. Prospective validation will facilitate its clinical utility.
Adjuvant melatonin for uveal melanoma (AMUM): protocol for a randomized open-label phase III study
In this trial, 100 subjects with non-metastatic uveal melanoma will be randomized to either treatment with melatonin 20 mg at 10 pm for 5 years or to a control group. The main objective is to investigate whether treatment with melatonin can reduce the risk of developing metastases after 5 years. Only subjects at high risk for metastasis development will be included in the trial. As uveal melanoma has a relatively low incidence rate compared to other cancers, the recruitment period is estimated to take 3 to 4 years.
Glaucoma research receives grant from the Glaucoma Research Foundation
James Tribble, Assistant Professor at Karolinska Institutet and St. Erik Eye Hospital, has been granted 0,5 MSEK from the Glaucoma Research Foundation. In this one year project, James Tribble’s lab will identify ways to turn down damaging inflammation that can occur in the retina in glaucoma as nerve cells become dysfunctional and break down.
Translation and validation of a Swedish version of the Visual Vertigo Analogue Scale
The present study aimed to construct and validate a Swedish translation (VVAS-S) of the Visual Vertigo Analogue Scale (VVAS).
The Swedish version of the Visual Vertigo Analogue Scale is a questionnaire suitable for evaluating visually induced dizziness in a Swedish population. This study found that the Swedish questionnaire was comparable to the original in terms of internal consistency. The Swedish Visual vertigo Analogue Scale can be found as an appendix to this article.
Concussed patients with visually induced dizziness exhibit increased ocular torsion and vertical vergence during optokinetic gaze-stabilization
Visually Induced Dizziness (VID) is a common post-concussion sequalae that remains poorly understood and difficult to quantify. The present study aims to identify biomarkers for VID in the form of gaze-stabilizing eye movements. Nine patients with post-commotio VID and nine age-matched healthy controls were recruited by physiotherapists at a local neurorehabilitation centre.
In conclusion, post-commotio VID was associated with faster slow-phases during optokinetic gaze-stabilization, with both vergence and torsion being correlated to symptom intensity. As torsional tracking remains inaccessible using commercial eye-trackers, vertical vergence may prove particularly accessible for clinical utility.
Transplantation of vision cells made from embryonic stem cells can restore lost vision
A new study published in the scientific journal Molecular Therapy, shows that transplanted vision cells made from embryonic stem cells can restore vision.
Glaucoma researcher Pete Williams is awarded the 2023 Pfizer Ophthalmics Carl Camras Translational Research Award
Pete Williams and his research team have focused on studying and understanding the changes in the eye that lead to glaucoma rather than managing the risk factors. Several studies on how nicotinamide (a variant of vitamin B) can slow down the degenerating processes and protect the optic nerve have led to the start of a larger clinical study in the spring of 2022.
Kristina Teär Fahnehjelm - New adjunct professor in ophthalmology
On January 24, 2023, Kristina Teär Fahnehjelm was employed as adjunct professor of ophthalmology at the Department of Clinical Neuroscience. The position is combined with Kristina's work as a doctor at St. Erik's Eye Hospital.
NAD salvage pathway machinery expression in normal and glaucomatous retina and optic nerve
These findings demonstrate that the inner retina and optic nerve head is highly enriched with the machinery to directly utilize nicotinamide through the salvage pathway and that the ability to do so is maintained, but the capacity to do so may be lower in glaucoma.
Overrepresentation of human epidermal growth factor receptor 2 positive- and Luminal B breast cancer metastases in the eyes and orbit
Vi visar att 4 av 5 bröstcancermetastaser i ögonen och orbita är av typen Luminal B, och att fler än hälften är positiva för HER2.
Vidare ser vi även att subtypen av bröstcancer ofta ändras mellan primärtumören i bröstet och metastasen i ögat.
Glaucoma affects millions of people. Could a readily available vitamin supplement help?
Glaucoma involves the gradual loss of the nerve cells in the eye — the retinal ganglion cells — which provide communication between the eye and the brain so we can see.
Pete Williams and his team found that as we got older, our eyes create less NAD, leaving the retinal ganglion cells potentially starved of energy. Dr Williams and his team found that nicotinamide supplementation prevented a lot of the nerve damage in the mice that would typically appear with glaucoma.
Doctoral funding from KI strengthens research on lack of oxygen in the eye tissue
Research group leader Helder André at St. Erik Eye Hospital and Karolinska Institutet has been awarded funds from KI's special grant for training a doctoral candidate. The funding enables the employment of a doctoral student for the project The translational role of hypoxia in blinding neovascular diseases for four years.
Glaucoma research receives 4,8 MSEK grant from the Swedish Research Council
Pete Williams, Associate Professor at Karolinska Institutet and St. Erik Eye Hospital, has been granted 4,8 MSEK from the Swedish Research Council.
Over the next four years, Pete Williams' research group will develop protective treatments for the nerve cells that are broken down in glaucoma and other eye diseases, focusing on the metabolism of the NAD, an important metabolite for the health of the neuron.
Start of large clinical study of melatonin against uveal melanoma
In a clinical study involving about a hundred patients with uveal melanoma, researchers at St. Erik Eye Hospital will test whether an additional treatment with melatonin can prevent the development of metastases.
The study has a planned duration of up to ten years.
Study confirms inflammation of the eye with glaucoma
A study at St Erik Eye Hospital and Karolinska Institutet is now able to confirm that inflammation of the retina and optic nerve occurs in patients with glaucoma. The results are published in the journal Acta Neuropathologica Communications.
Large clinical study on promising potential glaucoma treatment to begin this spring
In the spring of 2022, researchers at Umeå University, Karolinska Institutet, and St. Erik Eye Hospital will begin a large clinical study on nicotinamide (a form of vitamin B3) as a neuroprotective agent in glaucoma. In the longer term, the study could result in a new form of treatment for glaucoma.
We are very pleased to have reached this stage where we will evaluate the effectiveness of nicotinamide supplementation. If the treatment also shows the long-term effects we are hoping for, it will be an extremely important finding for glaucoma patients, says Pete Williams, associate professor and research group leader at Karolinska Institutet and St. Erik Eye Hospital.
The prognostic implication of visual acuity at the time of uveal melanoma diagnosis
What was known before
Visual outcomes after treatment of uveal melanoma have been investigated repeatedly. Surprisingly few studies have examined the correlation between visual acuity before primary tumour treatment with long-term patient outcomes.
What this study adds
In a cohort of 1809 patients, we find that uveal melanoma patients with low visual acuity before treatment have greater incidence of uveal-melanoma-related mortality in competing risk analysis, and that they have shorter overall survival. This is likely related to the fact that patients with low visual acuity had significantly larger tumours. In the second cohort with 137 enucleated eyes, however, there were no significant relations between low visual acuity and any one of 13 examined tumour histological factors at a Bonferroni-corrected significance level.
Sex-based differences in early and late uveal melanoma-related mortality
Women with uveal melanoma have better survival in the first decade after diagnosis. Thereafter, female survivors are significantly older than men and have a higher incidence of uveal melanoma-related mortality.
Optical Coherence Tomography Can Predict Visual Acuity in Children with Optic Nerve Hypoplasia
OCT can facilitate the diagnosis of ONH. Parameters such as pRNFL, GCC and BMO can be predictors of visual acuity whereas GCC and pRNFL thinning can indicate location and severity of visual field defects.
Visual outcome, ocular findings, and visual quality of life in patients with Fabry disease
BCVA in FD-patients was good despite corneal and lens pathology. Ocular variables did not show an association with TSS in adult patients.
Corneal or lens opacities should also lead to a suspicion of FD in children.
The Integrity of Retinal Morphology in Non-immunocompromised People Living with HIV on Antiretroviral Therapy
Macula thickness and volumetric differences do exist in NIPLHIV. Practitioners should keep NIPLHIV under retinal morphometric surveillance because they live longer. Associations of cerebral atrophy with retinal morphology may be used to monitor cerebral atrophy in NIPLIV on ART.
No differences in the long-term prognosis of iris and choroidal melanomas when adjusting for tumor thickness and diameter
To assess the long-term prognosis for patients with iris melanomas and compare it with the prognosis for small choroidal melanomas.
Nicotinamide and Pyruvate for Neuroenhancement in Open-Angle Glaucoma
A combination of nicotinamide and pyruvate yielded significant short-term improvement in visual function, supporting prior experimental research suggesting a role for these agents in neuroprotection for individuals with glaucoma and confirming the need for long-term studies to establish their usefulness in slowing progression.
The relationship between retinal structure and visual function in non-immuno-compromised people living with HIV without retinitis on antiretroviral therapy
The recognition of associations may be the first step in the proposal to develop a framework for the surveillance of vision in patients with NIPLHIV. We recommend a study of the sample population to track the stability of these observations before general recommendations for clinical care.
Gain of Chromosome 6p Correlates with Severe Anaplasia, Cellular Hyperchromasia, and Extraocular Spread of Retinoblastoma
Ökning av antalet kopior av kromosom 6 i Retinoblastom ökar risken för spridning av tumören utanför ögat. I ett samarbete mellan två amerikanska universitet och forskare från S:t Eriks Ögonsjukhus har man kartlagt hur antalet kopior av den korta armen av kromosom 6 korrelerar med risken för att Retinoblastom ska sprida sig utanför ögat.Gustav Stålhammar, specialistläkare i ögonsjukdomar och patologi, och docent vid Karolinska Institutet, var huvudansvarig för studien.
Agreement of different OCT scan directions for individual retinal-layer thickness measurements in multiple sclerosis subjects with prior unilateral optic neuritis
The similarities between horizontal and vertical Optical Coherence Tomography (OCT) scans for the individual retinal layer thickness measurements in the macula was evaluated. The larger limit of agreement intervals seen for different layers and sectors suggests that the scan direction must be same for the follow-up OCT measurements and in clinical studies.
Optical Coherence Tomography Identifies Visual Pathway Involvement Earlier than Visual Function Tests in Children with MRI-Verified Optic Pathway Gliomas
Retrograde degeneration of the eye’s retinal ganglion cells, causing visual loss and even blindness, is a feared consequence of optic pathway gliomas. Optical coherence tomography (OCT) is a patient-friendly, high-resolution imaging technique enabling objective measurements of the integrity of the retinal ganglion cell layer.
Structural impact of arrested foveal development in children born extremely preterm without ROP at 6.5 years of age
Extreme prematurity without impact of ROP is associated with increased GCL + , ONL, and RT thickness at FC as well as reduced FD compared to full-term controls at age 6.5. This indicates that prematurity per se may have a profound effect on foveal anatomical maturation during the first months after birth. Our results suggest RT at FC to be a simple and useful measure of foveal anatomical immaturity.
Conserved subcortical processing in visuo-vestibular gaze control
Gaze stabilization compensates for movements of the head or external environment to minimize image blurring. Multisensory information stabilizes the scene on the retina via the vestibulo-ocular (VOR) and optokinetic (OKR) reflexes. While the organization of neuronal circuits underlying VOR is well-described across vertebrates, less is known about the contribution and evolution of the OKR and the basic structures allowing visuo-vestibular integration. To analyze these neuronal pathways underlying visuo-vestibular integration, we developed a setup using a lamprey eye-brain-labyrinth preparation, which allowed coordinating electrophysiological recordings, vestibular stimulation with a moving platform, and visual stimulation via screens.
Foveal and peripheral visual quality and accommodation with multifocal contact lenses
The short-term effect on foveal and peripheral vision of two multifocal contact lenses was measured; 1) the MiSight 1-day center-distance (CD) contact lens (treatment zones +2.00D, CooperVision) and 2) the Acuvue Moist 1-day center-near (CN) contact lens (high add +2.50D, Johnson & Johnson). In summary, MiSight contact lenses differed from spectacles with more astigmatism and coma, worsened peripheral low-contrast resolution acuity, and increased accommodative response. These differences may be the myopia control properties of the MiSight lens. It is noteworthy that the reduced peripheral low-contrast vision with the MiSight lenses was not because of a more myopic RPR, which is the common belief about the effect of these lenses.
Valproic Acid Reduces Neuroinflammation to Provide Retinal Ganglion Cell Neuroprotection in the Retina Axotomy Model
The retinal explant model is a useful tool to explore resident neuroinflammation. Neuroinflammation can be modulated and explored on a rapid timescale whilst maintaining a complex system of cell interactions. VPA can attenuate resident glial inflammation in the retina and is a useful tool to further explore inhibition of pro-inflammatory glia in neurodegenerative disease.
Neurodevelopmental disorders and somatic diagnoses in a national cohort of children born before 24 weeks of gestation
The study showed that 75% of infants born EPT, before 24 weeks of gestation, were affected by neurodevelopmental disorders during childhood and 88% had somatic disorders. The most common issues included asthma and childhood bronchopulmonary dysplasia, speech disorders, intellectual disabilities, failure to thrive, ADHD and ASD. Boys were more likely to have intellectual disabilities than girls.
Risk for Acute Myocardial Infarction After Ophthalmologic Procedures
Do surgeries lead to an increased risk of heart attack?The simple answer is no. New study in Annals of Internal Medicine.
The long-term prognosis of patients with untreated primary uveal melanoma: A systematic review and meta-analysis
Among the exceedingly rare published patients with untreated primary uveal melanoma, 80–90% have developed metastases and their disease-specific survival seems to be shorter than treated patients. This could indicate that some metastases might be prevented by primary tumor treatment.
One million in grants for age-related macular degeneration researcher Helder André
Helder André, research group leader at St. Erik Eye Hospital and at Karolinska Institutet, is awarded one million kronor from the ARMEC Lindeberg Foundation for his research project Novel Gene Therapy Strategies for the Sustainable Treatment of Age-related Macular Degeneration.
Jan Ygge awarded the 2021 Silver Medal
Praised for research on eye motor skills. Jan Ygge, Professor Emeritus at the Department of Clinical Neuroscience, is awarded the Silver Medal for his excellent research efforts in ocular motor function. He has also contributed greatly to both teaching and pedagogical development at KI.
Maria Nilsson - New docent
- I feel proud and happy! Optician is a female-dominated profession and it therefore feels extra fun to be the first female associate professor in optometry in Sweden. Now I look forward to continuing to contribute to the scientific and pedagogical development of the subject.
Pete Williams - New docent
I am delighted to be awarded Docent in Neuroscience. I am excited to continue to contribute to, and benefit from, the rich pre-clinical and clinical environment that is afforded to me here at the Division of Eye and Vision at St. Erik Eye Hospital.
Alcon USD 75,000 grant awarded to glaucoma researcher Pete Williams
Assistant Professor and Research Group Leader Pete Williams at St. Erik Eye Hospital and Karolinska Institutet has been appointed the 2021 Alcon Research Institute (ARI)
Researchers propose a new way to discover new glaucoma treatments
In a study recently published in the Journal of Clinical Medicine, researchers at Karolinska Institutet and St. Erik Eye Hospital, present a new way of identifying potential therapeutics based on exploring common genetic changes in models of glaucoma. The study showed that by using this approach, multiple glaucoma-relevant therapies could be pre-clinically tested. Enhancing the ability to identify potential therapeutics is vital for improving patient outcomes in the future.
Shorter path to new treatments
The research facilities in the new St. Erik Eye Hospital are now fully functional for researchers at St. Erik/Karolinska Institutet. The environment aims to provide optimal conditions for translating the research results faster and more efficiently from basic research to clinical reality for the patients.
New study on vitamin B₃ as a possible treatment for glaucoma
Glaucoma involves a high risk of losing sight. Researchers at Karolinska Institutet and St. Erik Eye Hospital, among others, have now studied the effects of nicotinamide, the amide of vitamin B₃, on animal and cell models for glaucoma. The study, published in Redox Biology, may be a future neuroprotective therapy in glaucoma in humans. A clinical trial will start in the autumn.
Clinically transplantable photoreceptors researcher recruited thanks to philanthropic donation
A private philanthropic donation has made it possible for St. Erik Eye Hospital to finance the Karolinska Institutet appointment of stem cell researcher David Brenière-Letuffe.
New knowledge about hyaluronic acid may help patients with severe dry eye disease
High molecular weight hyaluronic eye drops 0.15 per cent, provided superior improvement of symptoms in patients with severe dry eye disease, when compared to other lubricant eye drops. This is the result of a clinical study from 2016–2020 published in the Journal of Clinical Medicine, coordinated by Ophthalmologist and Docent Gysbert van Setten at St. Erik Eye Hospital and Karolinska Institutet.
Not just a few tears
Only a few scientists devote their research to the problem with teary eyes. Oculoplastic Surgeon and researcher Elin Bohman is an exception. Her research has led to a new insight into how blocked tear ducts should be operated and new clues to the inner workings of the tear ducts.
Glaucoma researcher Pete Williams is awarded the Axel Hirsch Prize 2021
Assistant Professor and Research Group Leader Pete Williams at Karolinska Institutet and St. Erik Eye Hospital receives the Axel Hirsch Prize 2021. He is awarded for his groundbreaking studies on glaucoma and the discovery that metabolic dysfunction casues mitochondrial abnormalities and neurodegeneration in patients with glaucoma.
Eye research expands when research group is split
Eye research at St. Erik Eye Hospital and Karolinska Institutet is advancing when the existing research group in retina and ocular oncology is divided into two to refine the research lines. Ophthalmologist and Associate Professor Gustav Stålhammar and researcher Helder André step in as new research group leaders.
He does research with the aim to reduce mortality from eye tumours
Unlike most other types of cancer, the survival in ocular melanoma has not improved in several decades. This is something that eye specialist and researcher Gustav Stålhammar wants to change. "It is time we give this disease a fight. We need to investigate if it’s better to prevent the development of metastases rather than treating them once they appear", he says.