7 ms·

Researchers launch "moonshot" to cure blindness through eye transplants

134 points by viewtransform 2y ago

cbanek 2y ago
As someone with optic nerve degeneration, if anyone who works here is looking for a CS person to help, let me know. I'll be watching this (pun intended) with great interest.
gnabgib 2y ago
Seems to be related (although competing?) New funding could make whole-eye transplants a reality (11 points, 3 days ago, no comments) https://news.ycombinator.com/item?id=42301313 https://news.ycombinator.com/item?id=42301313
- CuriousCosmic 2y ago
  These are all different projects awarded by ARPA-H as part of their THEA project [1]. They are all aimed at the same end goal but they have different approaches and specific focuses. Generally with ARPA and DARPA projects the best way to get a broad scope of what all is going on is via the proposers day videos [2]. And of course take a look at their teaming page to see what all 30-40 of the sub-projects/teams working on this overall project are doing [3]. 1. https://arpa-h.gov/research-and-funding/programs/thea https://arpa-h.gov/research-and-funding/programs/thea 2. https://www.youtube.com/watch?v=fRNpeU8_RLo https://www.youtube.com/watch?v=fRNpeU8_RLo 3. https://arpa-h.gov/research-and-funding/programs/thea/teaming https://arpa-h.gov/research-and-funding/programs/thea/teamin...
jmclnx 2y ago
I think this is great, but I doubt it will cure all blindness, but maybe most. For example, blindness due to glaucoma. From what I understand that is caused by damage to the optic nerve. Maybe fixing the optic nerve is part of it(?).
- thrdbndndn 2y ago
  I mean, even curing 1% of blindness would be a huge leap.
- CuriousCosmic 2y ago
  So it's a bit of an open question exactly what causes glaucoma. Optic nerve degeneration is one of the potential causes but nerve damage within the eye due to decreased blood flow or due to increased intraocular pressure are both possible. In the latter two cases, basically all of that damage is limited to within the nerves within the eye and the optic nerve head whereas more general degeneration of the optic nerve would likely occur across the entire optic nerve up to and potentially through and past the optic chiasma. This project (THEA) is primarily about pursuing whole functional eye (i.e. the entire eye "ball") transplants and reconnecting/regenerating the optic nerve to a new eye. If this succeeds it would mean that any degeneration in the retina or optic nerve head would be curable. And potentially the techniques pioneered in regenerating the optic nerve would provide a starting point for addressing degeneration further up the optic nerve all the way through the optic chiasma and optic track up into the brain. So TLDR: If this project is successful it should mean a functional cure for most degenerative eye diseases even including most forms of glaucoma. And potentially it could lead to inroads in curing dementia related vision loss and other cognitive decline related vision loss. https://arpa-h.gov/research-and-funding/programs/thea https://arpa-h.gov/research-and-funding/programs/thea
  - robwwilliams 2y ago
    There is no doubt that retinal ganglion cell death causes glaucoma. But you are right that what causes ganglion cells to die is more complex. Mitochondrial stress and metabolic decompensation are certainly critical. Axonal injury is a key trigger in many cases. High intraocular pressure is the most common cause for metabolic cellular stress leading to gsngliin cell death.
    - CuriousCosmic 2y ago
      Yep. I worded it a bit awkwardly but that was what I was getting at. And mostly I was trying to make the distinction between damage within the "eyeball" vs more comprehensive damage further up the optic nerve as that distinction would determine how viable a transplant would be at recovering lost vision.
delichon 2y ago
Though the spinal chord is far thicker, the optic nerve is far denser in neurons. So the number of neurons in a cross section is roughly the same. If they can regenerate a section of optic nerve maybe they could reconnect spinal chords too. That may be the toughest part of a head transplant.
- standardUser 2y ago
  Wouldn't the be a "body transplant"?
- robwwilliams 2y ago
  There are no neuronal cell bodies in the optic nerve or tract. Almost purely axons, glial cells and vasculature. The cell bodies that give rise to the axons/fibers in the optic nerve are in the retina.
wilg 2y ago
worked for tom cruise in minority report so sounds good to me
softbuilder 2y ago
I'm immediately reminded of John Mulaney's "Jerry Orbach's eyes" bit.
- evanmoran 2y ago
  https://youtu.be/_Im4-7LQQRk https://youtu.be/_Im4-7LQQRk
- Townley 2y ago
  Wait I remember those ads and I’m now confused. If vision-restoring eye transplants are the novel domain of futuristic moonshot research, how did Jerry Orbach’s eye donation give the “gift of sight for two New Yorkers” twenty years ago? EDIT: Ah I follow now: he donated his corneas, which is a more routine procedure than an aspirational, vision-restoring full eye transplant
jessriedel 2y ago
Can someone explain why this isn’t crazy? ARPA-H is new and supposed to be ambitious, but I assume they are still tethered to reality, so I must be misinderstanding. Physically transplanting the eye ball and having it survive and not be rejected by the body is a challenging feat, but it’s been done quite recently and is based on known principles and techniques. However, that is like 1% of the difficulty. The hard part is making the eye nerves, which are basically an extension of the brain, talk coherently to the rest of the brain. Seems like it’s only slightly less hard than trying to take a chunk of donor brain, implant it in someones skull, sew it to their brain, and hope that they can use it to think. (Yes you can wave your hands and say “brain plasticity”, but brains adapting to damage by routing around it is just a completely different thing than getting pieces that have been mechanically severed to heal and interact usefully.) Is there any reason this wouldn’t start in animals decades before it could work in humans? To my knowledge, no one has ever shown an animal can get any useful vision info from a transplanted eye, and that seems confirmed by the article. Like, I don’t think we can even get cats raised from birth in weird optical environments (lack of horizontal lines) to see fully normally. You need to like completely reset the biological development stage of the animal. If we thought we could do that using stem-cell-whatever magic, wouldn’t it be a lot easier to start by treating minor developmental eye disorders than do full-on eye transplants?
- adgjlsfhk1 2y ago
  I agree that it would be totally bonkers to go from 0 to humans, but I think a lot of the theory is that human brains are pretty malleable so if you manage to get an electrical signal from the eye to the brain, the brain will probably be able to do something with it (even if it's not what a "normally" connected eye would provide)
  - tantalor 2y ago
    Imagine all you got was noise. Woof. Torture.
    - deleted 2y ago
      [deleted]
greenavocado 2y ago
Reminds me of the eye designer in the original Bladerunner
- vFunct 2y ago
  “Chu, If only you could see what I’ve seen with your eyes”
davidrjones1977 2y ago
Here is the ARPA-H THEA program website, for anyone interested: https://arpa-h.gov/research-and-funding/programs/thea https://arpa-h.gov/research-and-funding/programs/thea Dr. Cal Roberts, head of the program, has given an expected timeline of 3-6 years to see successful results. (Not sure if he meant proof of principle or clinical results, but probably the former, if there is an approval process required before wide-scale treatment of patients). Patients with complete blindness will be given preferential priority over patients with partial blindness when this reaches the clinic.
cat_plus_plus 2y ago
I volunteer to donate my brain to an otherwise young and healthy person who is lacking one!
reassembled 2y ago
Sorry, Bob, but your damaged Apple iEye was cryptographically tied to your iBrain account so a transplant of a generic SeeWorld eye is not possible. We still don’t have wetware right-to-repair laws on the books in 2124.
dudeinjapan 2y ago
I saw this is a K-drama once. A girl went blind so her boyfriend donated his eyes to her. This tech must already exist in Korea.
- fakedang 2y ago
  It might not be a whole-eye transplant but a section of it? The first whole eye transplant operation was only done last year.
  - dudeinjapan 2y ago
    In K-dramas, all things are possible!
7e 2y ago
Putting a person on the moon was a lot less risky than this. It was merely an engineering problem.
ma737 2y ago
This is insane advancement, tech in bio
- deleted 2y ago
  [deleted]
tapper 2y ago
Blind from berth here. Would not want! I am blind and blind is me. All though I am now 42 years old so learning to use a new set of eyes would be hard if not impossible. Having to take a bunch of pills for the rest of your life to stop your body from casting your eyes out of your face is not for me! This could be a grate thing for young kids that have had eye trauma or cancer. Your brain does not learn to use your eyes until the age of about 7 anyway so that could help in the brain learning to use the new eyes.
- svantana 2y ago
  That's a good point. Similarly, there is resistance against cochlear implants in the deaf community. Side note: your writing is full of homophones (berth, grate, all though). While not a big deal, I would assume that modern NLP tools could fix that pretty reliably. Finally a solid use case for LLMs :)

134 points by viewtransform 2y ago

As someone with optic nerve degeneration, if anyone who works here is looking for a CS person to help, let me know. I'll be watching this (pun intended) with great interest.

gnabgib 2y ago

Seems to be related (although competing?) New funding could make whole-eye transplants a reality (11 points, 3 days ago, no comments) https://news.ycombinator.com/item?id=42301313 https://news.ycombinator.com/item?id=42301313

CuriousCosmic 2y ago
These are all different projects awarded by ARPA-H as part of their THEA project [1]. They are all aimed at the same end goal but they have different approaches and specific focuses. Generally with ARPA and DARPA projects the best way to get a broad scope of what all is going on is via the proposers day videos [2]. And of course take a look at their teaming page to see what all 30-40 of the sub-projects/teams working on this overall project are doing [3]. 1. https://arpa-h.gov/research-and-funding/programs/thea https://arpa-h.gov/research-and-funding/programs/thea 2. https://www.youtube.com/watch?v=fRNpeU8_RLo https://www.youtube.com/watch?v=fRNpeU8_RLo 3. https://arpa-h.gov/research-and-funding/programs/thea/teaming https://arpa-h.gov/research-and-funding/programs/thea/teamin...

jmclnx 2y ago

I think this is great, but I doubt it will cure all blindness, but maybe most. For example, blindness due to glaucoma. From what I understand that is caused by damage to the optic nerve. Maybe fixing the optic nerve is part of it(?).

thrdbndndn 2y ago
I mean, even curing 1% of blindness would be a huge leap.
CuriousCosmic 2y ago
So it's a bit of an open question exactly what causes glaucoma. Optic nerve degeneration is one of the potential causes but nerve damage within the eye due to decreased blood flow or due to increased intraocular pressure are both possible. In the latter two cases, basically all of that damage is limited to within the nerves within the eye and the optic nerve head whereas more general degeneration of the optic nerve would likely occur across the entire optic nerve up to and potentially through and past the optic chiasma. This project (THEA) is primarily about pursuing whole functional eye (i.e. the entire eye "ball") transplants and reconnecting/regenerating the optic nerve to a new eye. If this succeeds it would mean that any degeneration in the retina or optic nerve head would be curable. And potentially the techniques pioneered in regenerating the optic nerve would provide a starting point for addressing degeneration further up the optic nerve all the way through the optic chiasma and optic track up into the brain. So TLDR: If this project is successful it should mean a functional cure for most degenerative eye diseases even including most forms of glaucoma. And potentially it could lead to inroads in curing dementia related vision loss and other cognitive decline related vision loss. https://arpa-h.gov/research-and-funding/programs/thea https://arpa-h.gov/research-and-funding/programs/thea
- robwwilliams 2y ago
  There is no doubt that retinal ganglion cell death causes glaucoma. But you are right that what causes ganglion cells to die is more complex. Mitochondrial stress and metabolic decompensation are certainly critical. Axonal injury is a key trigger in many cases. High intraocular pressure is the most common cause for metabolic cellular stress leading to gsngliin cell death.
  - CuriousCosmic 2y ago
    Yep. I worded it a bit awkwardly but that was what I was getting at. And mostly I was trying to make the distinction between damage within the "eyeball" vs more comprehensive damage further up the optic nerve as that distinction would determine how viable a transplant would be at recovering lost vision.

delichon 2y ago

Though the spinal chord is far thicker, the optic nerve is far denser in neurons. So the number of neurons in a cross section is roughly the same. If they can regenerate a section of optic nerve maybe they could reconnect spinal chords too. That may be the toughest part of a head transplant.

standardUser 2y ago
Wouldn't the be a "body transplant"?
robwwilliams 2y ago
There are no neuronal cell bodies in the optic nerve or tract. Almost purely axons, glial cells and vasculature. The cell bodies that give rise to the axons/fibers in the optic nerve are in the retina.

wilg 2y ago

worked for tom cruise in minority report so sounds good to me

softbuilder 2y ago

I'm immediately reminded of John Mulaney's "Jerry Orbach's eyes" bit.

evanmoran 2y ago
https://youtu.be/_Im4-7LQQRk https://youtu.be/_Im4-7LQQRk
Townley 2y ago
Wait I remember those ads and I’m now confused. If vision-restoring eye transplants are the novel domain of futuristic moonshot research, how did Jerry Orbach’s eye donation give the “gift of sight for two New Yorkers” twenty years ago? EDIT: Ah I follow now: he donated his corneas, which is a more routine procedure than an aspirational, vision-restoring full eye transplant

jessriedel 2y ago

Can someone explain why this isn’t crazy? ARPA-H is new and supposed to be ambitious, but I assume they are still tethered to reality, so I must be misinderstanding. Physically transplanting the eye ball and having it survive and not be rejected by the body is a challenging feat, but it’s been done quite recently and is based on known principles and techniques. However, that is like 1% of the difficulty. The hard part is making the eye nerves, which are basically an extension of the brain, talk coherently to the rest of the brain. Seems like it’s only slightly less hard than trying to take a chunk of donor brain, implant it in someones skull, sew it to their brain, and hope that they can use it to think. (Yes you can wave your hands and say “brain plasticity”, but brains adapting to damage by routing around it is just a completely different thing than getting pieces that have been mechanically severed to heal and interact usefully.) Is there any reason this wouldn’t start in animals decades before it could work in humans? To my knowledge, no one has ever shown an animal can get any useful vision info from a transplanted eye, and that seems confirmed by the article. Like, I don’t think we can even get cats raised from birth in weird optical environments (lack of horizontal lines) to see fully normally. You need to like completely reset the biological development stage of the animal. If we thought we could do that using stem-cell-whatever magic, wouldn’t it be a lot easier to start by treating minor developmental eye disorders than do full-on eye transplants?

adgjlsfhk1 2y ago
I agree that it would be totally bonkers to go from 0 to humans, but I think a lot of the theory is that human brains are pretty malleable so if you manage to get an electrical signal from the eye to the brain, the brain will probably be able to do something with it (even if it's not what a "normally" connected eye would provide)
- tantalor 2y ago
  Imagine all you got was noise. Woof. Torture.
  - deleted 2y ago
    [deleted]

greenavocado 2y ago

Reminds me of the eye designer in the original Bladerunner

vFunct 2y ago
“Chu, If only you could see what I’ve seen with your eyes”

davidrjones1977 2y ago

Here is the ARPA-H THEA program website, for anyone interested: https://arpa-h.gov/research-and-funding/programs/thea https://arpa-h.gov/research-and-funding/programs/thea Dr. Cal Roberts, head of the program, has given an expected timeline of 3-6 years to see successful results. (Not sure if he meant proof of principle or clinical results, but probably the former, if there is an approval process required before wide-scale treatment of patients). Patients with complete blindness will be given preferential priority over patients with partial blindness when this reaches the clinic.

cat_plus_plus 2y ago

I volunteer to donate my brain to an otherwise young and healthy person who is lacking one!

reassembled 2y ago

Sorry, Bob, but your damaged Apple iEye was cryptographically tied to your iBrain account so a transplant of a generic SeeWorld eye is not possible. We still don’t have wetware right-to-repair laws on the books in 2124.

dudeinjapan 2y ago

I saw this is a K-drama once. A girl went blind so her boyfriend donated his eyes to her. This tech must already exist in Korea.

fakedang 2y ago
It might not be a whole-eye transplant but a section of it? The first whole eye transplant operation was only done last year.
- dudeinjapan 2y ago
  In K-dramas, all things are possible!

7e 2y ago

Putting a person on the moon was a lot less risky than this. It was merely an engineering problem.

ma737 2y ago

This is insane advancement, tech in bio

deleted 2y ago
[deleted]

tapper 2y ago

Blind from berth here. Would not want! I am blind and blind is me. All though I am now 42 years old so learning to use a new set of eyes would be hard if not impossible. Having to take a bunch of pills for the rest of your life to stop your body from casting your eyes out of your face is not for me! This could be a grate thing for young kids that have had eye trauma or cancer. Your brain does not learn to use your eyes until the age of about 7 anyway so that could help in the brain learning to use the new eyes.

svantana 2y ago
That's a good point. Similarly, there is resistance against cochlear implants in the deaf community. Side note: your writing is full of homophones (berth, grate, all though). While not a big deal, I would assume that modern NLP tools could fix that pretty reliably. Finally a solid use case for LLMs :)