European Journal of Case Reports and Clinical Images
Researchers have identified distinct
differences among the cells comprising a tissue in the retina, findings that
could help develop precise therapies for retinal diseases.
In a new study, researchers form the US
National Eye Institute (NEI) have identified distinct differences among the
cells comprising a tissue in the retina that is vital to human visual
perception. The scientists discovered five subpopulations of retinal pigment epithelium
(RPE), a layer of tissue that nourishes and supports the retinas light-sensing
photoreceptors. Using artificial intelligence (AI), the researchers analysed
images of RPE at single-cell resolution to create a reference map that locates
each subpopulation within the eye. The ground-breaking research, which was
recently published in Proceedings of the National Academy of Science, could
help find more precise cell and gene therapies for retinal diseases.
Age and disease can cause metabolic
changes in RPE cells that can lead to photoreceptor degeneration. The impact on
vision from these RPE changes varies dramatically by severity and where the RPE
cells reside within the retina. For example, late-onset retinal degeneration
(L-ORD) affects mostly peripheral retina and, therefore, peripheral vision.
Age-related macular degeneration (AMD), a leading cause of vision loss,
primarily affects RPE cells in the macula, which is crucial for central vision.
The researchers aimed to determine if
there are different RPE subpopulations that might explain the wide spectrum of
retinal disease phenotypes. They used AI to analyse RPE cell morphometry, the
external shape and dimensions of each cell. They trained a computer using
fluorescently labelled images of RPE to analyse the entire human RPE monolayer
from nine cadaver donors with no history of significant eye disease.
Morphometry features were calculated
for each RPE cell on average, about 2.8 million cells per donor; 47.6 million
cells were analysed in total. The algorithm assessed each cells area, aspect
ratio (width to height), hexagonality, and number of neighbours. Previous
studies had suggested that RPE function is tied to the tightness of cellular
junctions; the more crowded, the better for indicating cellular health.
Based on morphometry, they identified
five distinct RPE cell subpopulations, referred to as P1-P5, organised in
concentric circles around the fovea, which is the centre of the macula and the
most light-sensitive region of the retina. Compared to RPE in the periphery,
foveal RPE tend to be perfectly hexagonal and more compactly situated, with
higher numbers of neighbouring cells.
Next, they analysed RPE from cadavers
with AMD. Foveal (P1) RPE tended to be absent due to disease damage, and the
differences among cells in the P2-P5 subpopulations were not statistically
significant. Overall, the AMD RPE subpopulations tended to be elongated
relative to RPE cells not affected by AMD.
To further test the hypothesis that
different retinal degenerations affect specific RPE subpopulations, they
analysed ultrawide-field fundus autofluorescence images from patients affected
by chloridaemia, L-ORD, or a retinal degeneration with no identified molecular
cauase. While these studies were conducted at a single point in time, they
still demonstrated that different RPE subpopulations are vulnerable to
different types of retinal degenerative diseases.
Age-related morphometric changes also may appear in some RPE subpopulations
before there detectable in others. These finding could help inform future
studies using non-invasive imaging technologies, such as adaptive optics, which
resolve retinal cells in unprecedented detail and could potentially be used to
predict changes in RPE health in living patients.