As they age, older adults face the possibility of an increasing number of impairments including vision loss. These changes can have significant implications for the independence and quality of life of those affected, which differ dramatically from one patient to the next.
Caitlin Murphy (GrDip 08, MSc 10) is a postdoctoral research fellow at the Concordia Vision Lab. Her research investigates the physiology of the retina in individuals with visual impairment using optical coherence tomography. She is currently building a database of images of individuals with visual impairment, which will allow researchers to pursue interdisciplinary projects on vision and aging. She also hopes it will help clinicians to better understand how vision loss impacts other areas of health.
Vision impairment affects many aspects of life
How does this specific image (top right) relate to your research at Concordia?
Caitlin Murphy: This is an image of a retina, which is the tissue at the back of your eye. The bottom image is the surface of the retina and the top image shows the layers of the retina, as if you cut through the bottom image at the green line. This image was taken with optical coherence tomography, which is like ultrasound, but uses light instead of sound. It allows clinicians and researchers to see the structure of a retina in a non-invasive manner.
My work is using this imaging modality to create a database of retinal images from older adults to learn more about how structural changes to the retina affect visual function. Normal aging and eye diseases like age-related macular degeneration (AMD), diabetic retinopathy and glaucoma affect the structural integrity of the retina, which can impair visual function. For example, more than one million Canadians live with AMD and although they have the same diagnosis, they have vastly different functional abilities that interfere with domains of life. These include cognition, mobility and social interactions that are all important for maintaining independence and quality of life.
This database will be a research resource for interdisciplinary projects on vision and aging. It will also be a teaching tool for those training in ophthalmology, optometry and vision therapy.
What is the hoped-for result of your project?
CM: Vision impairment affects many aspects of life. Population-based studies have linked vision impairment with fall risk, depression, isolation and cognitive impairment. These large studies concentrate on correlational data and adequate participant numbers, often using visual acuity as the main measure. Visual function is so much more complicated than reading from a letter chart.
It is my hope that through the creation of this database, we can gather more information on the individual. When you have large amounts of data from many individuals, you can learn more about causal relationships, like how retinal structure affects visual function and the role impaired visual function plays in other areas of life.
What impact could you see it having on people’s lives?
CM: This database will make research easier for vision scientists by giving them access to a wealth of data and a potential participant pool. It will also be a teaching resource. Students in ophthalmology, optometry and vision therapy will be able to familiarize themselves with the retina, related pathologies and visual outcomes before they start working with patients. This will make student clinicians more confident and efficient, making the experience more pleasant for patients.
What are some of the major challenges you face in your research?
CM: Two of the major challenges in my line of research are funding and recruitment. Funding is limited and tends to prioritize the cure or treatment for future generations over achieving a better understanding of how to live with it now, which is the focus here.
Recruitment is also difficult. Due to the imaging, data collection is not mobile. Participants have to come to one of our test sites. Transportation is difficult for older adults with vision impairment. Many of them are not comfortable with public transport on their own or live far away and don’t come into the city anymore. Once in a while we have a spouse or adult child accompany a participant, which is really appreciated.
What first inspired you to study this subject?
CM: My Gran. She lived with AMD for nearly 15 years. Growing up with her, I learned a lot about AMD, low vision rehabilitation and what it meant to be legally blind. She was diagnosed in the late 1980s. Back then, research, treatment and technology surrounding age-related vision impairment were limited. My grandmother was resilient; she taught herself to use what sight she had left. In doing this she was able to live on her own and continue her favourite activities, which included cryptic crosswords, cards and knitting.
Sadly, this is not the case for many aging individuals with vision loss. As a result, this field is one I am passionate about and am determined to make a difference in. Gran was truly an inspiration and even though she has been gone for many years, her memory continues to motivate me.
What advice would you give interested science, technology, engineering and math (STEM) students to get involved in this line of research?
CM: I would advise students to develop their communication skills as much as they concentrate on math and science. Clinical research involves collaborating with people at every level. Ethics and grant applications require efficient and effective written communication, while your research participants require your patience and active listening skills.
The approach you have to disseminating results vastly differs depending on whether you are addressing research peers, clinicians or patients. Communication skills are not a “one size fits all.” You have to know who your audience is and how best to reach them.
What do you like best about being at Concordia?
CM: I appreciate the support and collaborative attitudes that researchers at Concordia have. You get so much farther when you have brains with different perspectives working together. Also, grant agencies are funding team grants more now than ever, so it is important to be able to work in a team and build interdisciplinary projects.
Are there any partners, agencies or other funding/support attached to your research?
CM: Yes, of course. Our primary testing site is the Lethbridge-Layton-Mackay Rehabilitation Centre du CIUSSS du Centre-Ouest-de-l’Île-de-Montréal. We are supported by the Vision Health Research Network of the Fonds de recherche du Quebec – Santé (FRQS) and the Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal.
We collaborate with the School of Optometry Clinic at Université de Montréal, the Department of Ophthalmology at the Jewish General Hospital and the Institut Nazareth et Louis-Braille. We are also setting up American sites at Lighthouse Guild New York and Envision University in Kansas.