Professor Michael Belin | New Tools for Early Diagnosis and Treatment of Keratoconus

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Professor Michael Belin | New Tools for Early Diagnosis and Treatment of Keratoconus

Mar 20, 2024 | health and medicine

About this episode

Keratoconus is an eye disease affecting millions of individuals worldwide. The condition causes the transparent layer on the front of the eye, named the cornea, to become progressively thinner and irregularly shaped. Keratoconus causes distorted or blurred vision, increases light sensitivity, and can severely impact one’s ability to function. The first signs of keratoconus typically emerge in children as young as 8 years old. However, the disease usually remains undiagnosed until several years later, due to a lack of reliable screening tests and the tendency of affected individuals to only seek help when their vision has become significantly impaired.

Professor Michael Belin, a researcher at the University of Arizona and Chief Medical Officer at Epion Therapeutics, recently developed corneal imaging tools to assist in the diagnosis and treatment of this condition in its early stages, prior to permanent eye damage.

Belin and his collaborator Renato Ambrosio developed a keratoconus screening test called the Belin/Ambrosio Display. This test allows eye-care practitioners to detect the earliest changes in the cornea, allowing early intervention to stabilize the cornea before the patient experiences vision loss.

Once keratoconus has been detected, a surgical procedure called corneal crosslinking can be performed to prevent the disease from progressing. This procedure utilises Vitamin B2 – also known as Riboflavin – and ultraviolet light to form new bonds between collagen molecules in the eye, helping to stiffen the cornea.

Although corneal crosslinking is effective, the current approach involves removing the cornea’s outer layer – named the epithelium – to allow Riboflavin to penetrate. Removing this outer layer can be painful and is associated with a slow recovery and occasional corneal scarring. An investigational approach that does not require the removal of the cornea’s outer layer is currently undergoing a phase 3 FDA clinical trial.

Named EpiSmart, the new approach relies on a modified form of Riboflavin. This formulation penetrates deep into the cornea, without the need to remove the outer layer. The procedure lasts approximately 50 minutes, including 30 minutes during which the formulation is applied to the eye, and 20 minutes of ultraviolet treatment.

Since EpiSmart does not require the removal of the corneal outer layer or epithelium, most patients were able to return to normal activities quickly and reported improvements in their visual performance. As it is less painful than standard epithelium-off corneal crosslinking, EpiSmart can be used to treat both eyes in a single session.

Belin’s research efforts could greatly contribute to the early diagnosis and treatment of keratoconus. His team’s diagnostic and therapeutic tools could soon be used by eye-care physicians worldwide, preventing long-term vision loss caused by this devastating condition.