Resuscitating eyes to speed up clinical research in vision impairment

  • An international consortium of researchers from five countries proposes a new method to bring eyes back to life for experimental purposes
  • The project has been awarded a sum of over 3.5 million euros to develop a device that will keep donor eyes alive for close to 15 times longer than is currently possible
  • This development is expected to contribute largely to the research of vision ailments including some that currently result in irreversible vision loss

Vision impairment affects over 250 million people worldwide, with thirty-six million of those being blind. Retinal degeneration, which is associated to old age, is often incurable. In connection with this, increasingly ageing populations worldwide will represent major social and economic challenges.

An international consortium of researchers from five countries is developing a new method to bring eyes from dead body donors back to life for clinical research purposes. Coordinated by Pia Cosma at the Centre for Genomic Regulation (CRG), based in Barcelona, the group is creating a device that resuscitates eyes from the deceased.

An eye fundus photo showing intermediate age-related macular degeneration.
An eye fundus photo showing intermediate age-related macular degeneration.

The research group will develop artificial blood to provide cells with oxygen and nutrients, kick-starting the activity of nerve cells and restoring total eye function. Artificial vitreous humour will maintain the ocular pressure of the eye.

ECaBox, eye in a box:

The device, codenamed ECaBox, will be a transparent, cubic box that mimics conditions in the living human eye, maintaining the eye’s temperature and pH levels while avoiding blood clots and removing metabolic waste and toxins. The project has been awarded 3.5 million euros by the European Union’s Future and Emerging Technologies Open research programme, which funds radical new technologies.

Current technological limitations mean that eyes can only be kept at 4ºC for a period of 48 hours before irreversible degradation. This greatly limits their use for experiments, particularly to test the effectiveness of new drugs and treatments.

While advances in human organoids (growing tissues in a petri dish) are successfully mimicking the function of the eye, they fail to encapsulate the eye’s physiological complexity, such as its immune, vasculature, and metabolism systems.

Conceptualization of ECaBox: a transparent, cubic box that mimics conditions in the living human eye for scientific research
Conceptualization of ECaBox: a transparent, cubic box that mimics conditions in the living human eye for scientific research

The new method will circumvent these limitations by reviving eyes and maintaining them healthy for at least one month, helping researchers assess the efficacy, efficiency, and safety of new regenerative therapies and drug testing. Using resuscitated eyes can also bypass several ethical restrictions of preclinical animal testing, as well as human experimentation.

“There are a huge number of potential new treatments and therapies for eye damage and vision loss, but the eyewatering cost of running a clinical trial can mean they never reach the market,” says Pia Cosma, ICREA Research Professor and Group Leader at the Centre for Genomic Regulation (CRG) and coordinator of the project. “Our new method can greatly improve the preclinical validation steps for these treatments, supporting the screening of a larger number of candidates and helping promising drugs escape the ‘valley of death’ imposed by cost-benefit analyses in the pharmaceutical industry.”

Timing and prospects for ECaBox

An early prototype of the device is expected to be built by end of 2023. Upon completion, the group plans to use the device to test their own retinal regenerative therapies pioneered at the CRG. “A theory developed in the late 90s suggests that fusing cells of different types can result in new hybrid cells that can differentiate into specialized retinal cells, but the technology to test how this works in practice has been limited,” says Pia Cosma. “We will use this new device to explore this approach for the first time in human eyes, a therapeutic approach we pioneered at the CRG.”

Sight of the sea, as seen from the PRBB, which houses the facilities of the CRG and other SOMMa members
Sight of the sea, as seen from the PRBB, which houses the facilities of the CRG and other SOMMa members

ECaBox will be created by an interdisciplinary collaboration between seven research centres. In Barcelona, the project will be coordinated by Pia Cosma at the CRG in collaboration with researchers of two other Spanish institutions– Ricardo Casaroli at the University of Barcelona and Núria Montserrat at the SOMMa member institution Institute for Bioengineering of Catalonia (IBEC). International collaborators include King’s College London in the UK, the Association for the Advancement of Tissue Engineering and Cell Based Technologies & Therapies (A4TEC) in Portugal, AFERETICA in Italy and the Bar-Ilan University (BIU) in Israel.

Image credits:

Frontpage picture eye close-up of person looking is in the public domain and was downloaded from Photostock Editor.

Eye fundus by the US National Eye Institute is in the public domain and was downlodaded from Wikimedia Commons.

ECaBox conceptualization picture was kindly provided by CRG and re-used with permission.

Picture of the sea as seen from the PRBB was downlodaded from Flickr and licensed via a Creative Commons Attribution-NonCommercial-NoDerivs 2.0 Generic (CC BY-NC-ND 2.0) license.