Page 4 | Summer 2017 | DOHENY UPDATE S cientific and clinical research never fails to amaze. Projects by glaucoma specialist Alex Huang, MD, PhD, fit the bill. Dr. Huang is involved in NASA research that promises to boost efforts to prevent vision loss in astronauts during space travel. He’s also working on related projects for us earthlings, which recently earned him the Heidelberg Engineering Xtreme Research Award and recognition as the #1-ranked Rising Star ophthalmologist in the world by The Ophthalmologist magazine. The work includes creating a technology for showing the flow of intraocular fluid through microscopic vessels that connect the eye to the blood vessel system of the body. The vessels normally drain the intraocular fluid to maintain normal eye pressure. Blocked drainage causes fluid buildup and increased eye pressure. High pressure is a risk factor for glaucoma. (See sidebar.) The technique Dr. Huang uses to study the tiny vessels is called aqueous angiography. Aqueous refers to water. Angiography refers to a medical imaging technology for viewing the inside of vessels. Dr. Huang is pioneering the use of aqueous angiography in ophthalmology. WHERE NASA COMES IN Dr. Huang’s work with NASA begins with the blurry vision of astronaut John L. Phillips. At about the halfway point in a mission on the International Space Station, Phillips looked out the window expecting to see Earth in its usual splendor. Instead, he saw a blurry orb. The blur had nothing to do with clouds or haze but everything to do with a decline in his usual 20/20 vision. By the time Phillips returned to earth, his eyesight had declined to 20/100 – but that wasn’t all. His eyeballs had grown flatter, folds had developed in his retinas, and his optic nerve was swollen and distorted. He wasn’t the only astronaut to experience vision problems during space travel. NASA reports that it happens in 35% or more of astronauts during flight, especially on long missions. NASA has even given the problem a name, visual impairment intracranial pressure syndrome, or VIIP. A hypothesis is that the microgravity of space travel causes body fluids to shift upward toward the head where it exerts extra pressure on the eye and brain. “Astronauts say that all that extra fluid in the head is like having the flu,” says Dr. Huang, who NASA enlisted to help explain the fluid shift and its impact on the eye. “The problem has to be solved before NASA will send astronauts to a distant destination, like Mars,” adds Huang. “A safe landing could depend on good vision.” Right now, there is no remedy for preventing or treating fluid build-up in the eye during space travel, but it can be studied using a technique especially suited for Dr. Huang’s Doheny lab and office. Dr. Alex Huang Glaucoma is a group of disorders that cause permanent vision loss by damaging the eye’s optic nerve. Glaucoma is a leading cause of blindness worldwide. Dr. Huang seeks to find answers about the causes of glaucoma and to develop better treatments. One of his goals is to detect poorly functioning drainage vessels in the eye of individual glaucoma patients and to use that information to optimize the placement of specialized drainage devices. Glaucoma, NASA, and Doheny’s Amazing Dr. Alex Huang Not only did Dr. Huang have the right technology, but as a glaucoma expert he also had expertise on the effects of pressure on the optic nerve.