We Orioles fans appreciate that Adam isn’t marveling at how well his eyes are tracking the ball during its quick, 300-foot journey. That, of course, might distract him from catching it.

But for many researchers fighting blindness, understanding the complex process of vision, and how the retina makes it possible, is their game.

Take, for example, Erika Ellis, a medical student at the University of California, San Diego, and Howard Hughes Medical Institute research fellow, who is receiving a one-year career development award from FFB to study retinal ganglion cells. Erika will be researching how these cells refine and package visual information and send it through the optic nerve to the brain, where the final images are created and interpreted.

While the process of seeing begins when photoreceptors convert light into electrical signals, it’s up to many other types of downstream retinal cells — including ganglion, amacrine and bipolar cells — to contextualize and enhance the signals so we can perceive motion, contrast, edges and boundaries and other visual details.

Researchers like Erika are particularly interested in how ganglion cells map to different regions of the brain. There are approximately one million axons — fibers in the optic nerve — connecting the retina’s ganglion cells to the brain, so the task is daunting. But documenting the brain-retina relationship will enable experts to better understand how they work together and how well emerging retinal treatments are restoring vision.

Ganglion cells are also an attractive target for vision-restoring treatments, because they survive long after photoreceptors degenerate from diseases like retinitis pigmentosa and macular degeneration. Emerging optogenetic therapies are designed to empower ganglion cells to respond to light, so they can function somewhat like photoreceptors and restore vision. While their research is at an early stage, it holds promise for people who have lost their photoreceptors to the most advanced retinal conditions.

If you are interested in learning more about ganglion cells, optogenetics and the Foundation’s diverse research portfolio, there’s still time to register for our VISIONS 2013 conference, taking place in Baltimore June 27-30. You’ll also get the opportunity to meet nearly 50  of the Foundation’s research all–stars.

And if you happen to be a baseball fan, the Yankees are also in town that weekend, playing at Camden Yards, right down the road from the conference hotel. Come root for Oriole standouts like Adam, Chris Davis, Manny Machado, Matt Wieters and Nick Markakis. The Yankees have some players as well, but I can’t recall who they are.

Pictured, top, Baltimore Orioles centerfielder, and Golden Glove recipient, Adam Jones; and, above, HHMI-FFB Medical Fellow Erika Ellis.

An M.I.T. Institute Professor, Dr. Langer has founded 20 companies — 18 funded by McGuire’s firm, Polaris — and has more than 800 patents issued or pending. He has received dozens of awards, accolades and honorary degrees, including, recently, FFB’s Visionary Award.

But early in his career, no one thought his ideas for treating cancer would work. And for a long time, they didn’t.

In 1974, Dr. Langer began his post-doctoral work in Dr. Judah Folkman’s laboratory in Boston Children’s Hospital. Their goal was to develop a treatment to halt the proliferation of blood vessels that enables tumors to grow. Known as angiogenesis, it is the same process that leads to the growth of vision-robbing blood vessels in wet age-related macular degeneration (AMD), which, at that time, inevitably led to catastrophic loss of central vision.

However, Dr. Langer had two big problems: 1) Inhibiting angiogenesis was a controversial approach to treating cancer; and 2) no one believed he could provide sustained delivery of such a treatment to knock tumors out.

Dr. Langer proposed using polymers — a mixture of chemicals acting like a sponge — which could be injected into tumors and provide slow release of anti-angiogenic proteins to stop cancer growth.

“No one had ever developed a polymer system to release these large proteins. The chemical engineering and chemistry communities reported it couldn’t be done,” Dr. Langer recalled, during the symposium. “My advantage at the time was that I hadn’t read any of their research papers.”

He experimented — and failed — for several years; “We found 200 ways to not get it to work,” he said.

But finally, it did work, though it took Boston Children’s Hospital lawyers seven years to patent the technology. “They were ready to give up,” recalled Dr. Langer.

Today, angiogenesis-inhibiting drugs are the gold standard for treating wet AMD and many cancers. Dr. Langer’s drug delivery systems are also used in pharmaceutical therapies for people with a wide range of conditions, including schizophrenia, diabetes and alcohol and cocaine addiction.

His latest invention is a tiny, drug-releasing microchip that’s controlled remotely. It’s currently being tested in a clinical trial in Denmark for delivering parathyroid hormone therapy to women with osteoporosis — a treatment that would otherwise be injected.

The Langer Lab at M.I.T. is developing a similar technology for ophthalmic indications. Dr. Langer noted that microchips can also be designed to deliver multiple drugs. “It’s like a pharmacy on a chip,” he said.

At the end of his presentation at the symposium, someone from the audience asked him how he found the resilience to move beyond his early failures.

“I don’t know that I’ve done anything special. It is easy to talk about it now at this age,” said Dr. Langer. “But at the time, I was depressed for several months to see that I wasn’t able to get any grants and probably keep my job. I didn’t see any alternatives, so I decided to keep my head down and keep plugging away.”

Pictured, above: Robert Langer (right) is presented with the Foundation’s Visionary Award by Terry McGuire, co-founder of Polaris Partners.

There is one exception to this phenomenon: Blue Man Group. No strangers to the innovative or avant garde, the multimedia theater troupe produced a lively performance about the retina that was captured on YouTube. I think you’ll find the video (and audio) to be entertaining and informative. Personally, I don’t know how they make it through an entire show wearing blue make-up with the consistency of acrylic paint.

One science correction: At the beginning of the performance, the blue guys say the retina has 3 million rods and cones. In reality, it has 125 million.

What’s signficant about many emerging neuroprotective therapies for the retina is that they have the potential to treat a wide range of diseases, regardless of the genetic mutation causing vision loss. With about 200 genes linked to retinal diseases, this is a huge plus. They might also be used in conjunction with a genetic therapy to enhance its vision-saving effects.

Though neuroprotection usually isn’t addressing the root cause of the disease, it may be nearly as beneficial as a permanent fix, if useful vision can be saved for a person’s lifetime.

Neuroprotective treatments are being developed in many forms — proteins, drugs (small molecules) and nutrients. And there are several ways to get a neuroprotective therapy to the retina, including eye drops and oral medications.

Imagine having a therapy factory in the retina — in the forms of transplanted cells or genes — that provides continual release of neuroprotective proteins. Well, researchers are working on those, too.

Here are three examples of emerging neuroprotective therapies for the retina:

Protecting Mitochondria — MitoChem Therapeutics, a Foundation-funded  start-up company, has identified two compounds, which show potential for saving vision for people affected by several retinal diseases, including retinitis pigmentosa (RP), cone-rod dystrophy, Bardet-Biedl syndrome, Usher syndrome, Stargardt disease and age-related macular degeneration (AMD).

The compounds work by protecting mitochondria, the power supplies for all cells in the body, including those in the retina. Investigators have refined the compounds to the point where they save virtually all of the photoreceptors in a mouse model of retinal degeneration. They’ve also demonstrated that eye drops can effectively deliver large amounts of one compound to retinas in eyes comparable in size to those in humans. Eye drops are beneficial, because they minimize potential systemic side effects.

Docosahexaenoic Acid (DHA) — DHA is an important structural component of cells in the brain and the retina. It appears to have many neuroprotective properties and is prescribed for a variety of conditions, including heart disease. Perhaps most relevant to retinal degenerative diseases, DHA can reduce the destructive effects of inflammation and oxidative stress. It also helps maintain the structure and metabolism of photoreceptors.

The Retina Foundation of the Southwest is completing a Foundation-funded clinical study of DHA for males with X-linked RP. Previous clinical studies conducted by Dr. Eliot Berson show that vitamin A combined with DHA can slow vision loss in people with RP. In 2014, the National Eye Institute will complete a clinical study of DHA and other nutrients for people at risk of advanced AMD. DHA can be obtained by eating salmon, tuna and other coldwater fish, or by taking fish-oil or algae supplements.

Rod-Derived Cone Viability Factor (RdCVF) — Drs. José Sahel and Thierry Léveillard, of the Institut de la Vision in Paris, received the Foundation’s Trustee Award for their discovery of Rod-derived Cone Viability Factor (RdCVF), a protein that preserves and rescues cones, the cells in the retina that provide central and color vision. They are now developing a gene therapy that provides sustained delivery of RdCVF after a single treatment. The protein could be beneficial to people affected by a broad range of retinal diseases, including several forms of retinitis pigmentosa. With Foundation funding, the researchers are working to move their RdCVF gene therapy into a clinical trial.

There are several other emerging neuroprotective therapies in the Foundation’s research portfolio. Stay tuned to Eye on the Cure and the Foundation’s website for updates on these emerging cross-cutting treatments.

Pictured, above: Some neuroprotective therapies may be delivered by eye drops. (Photo courtesy of the National Eye Institute.)

I’ll always remember my first Foundation Fighting Blindness conference, when I heard Dr. Dean Bok, of the University of California, Los Angeles, discuss the retina’s design and how it worked. I was new to the field and just learning. Dr. Bok opened his presentation by saying that, as a student, he was “seduced” by the beauty of retinal science. By the end of his impassioned talk, I, too, was hooked.

And, now, I’m always excited to speak and write about this magical piece of tissue. Even though the best retinal researchers still don’t understand the science completely, I think everyone can appreciate the basics, including how to keep their retinas as healthy as possible.

How the Retina Works

So what does the retina do? In simple terms, it converts light into electrical signals that are sent through the optic nerve to the brain, where they’re interpreted as vision. Put another way, the retina is like film in a camera — for those of us old enough to remember when film had to be loaded into a camera.

The photoreceptors — a.k.a., rods and cones — are the elongated retinal cells (like antennae) that transform light into electricity through a complex biochemical process fueled by vitamin A. Rods provide night and peripheral vision. Cones, which are concentrated in the macula (central retina), enable people to perceive details, colors and objects. Approximately 125 million photoreceptors are packed into each human retina.

While the retina is small — it’s a circular tissue just 35 millimeters in diameter (a little bigger than a quarter) and half a millimeter thick — it’s a real workhorse. In fact, the retina processes more oxygen for its size than any other tissue or organ in the body, including the heart and lungs. Not only does it provide vision during waking hours, the tips of photoreceptors are shed, disposed and regenerated during sleep. For the retina, there’s always work to be done.

Inherited retinal diseases often originate in photoreceptors, but there are a number of other cell types in the retina that can be affected. These other cells may provide nutrition, waste disposal and image-processing.

Keeping the Retina Healthy

Whether or not you have a retinal disease, there are things you can do to keep the retina healthy and functioning optimally. As we always say at the Foundation, what’s good for your heart is good for your eyes.

First and foremost, don’t smoke. It is the most significant modifiable risk factor for age-related macular degeneration, and research has shown that just one cigarette’s worth of nicotine reduces retinal sensitivity.

Also, eat lots of colorful vegetables and fruits, which are rich in antioxidants, such as lutein and zeaxanthin. In fact, these antioxidants are present in the retina, especially in the macula. They help protect the retina from light damage and daily wear-and-tear.

Docosahexaenoic acid (DHA), a healthy fat, is another important nutrient that protects retinal cells and keeps them functioning well. DHA is abundant in coldwater fish, such as tuna, salmon, herring and sardines. It is also available in fish oil or vegetarian supplements.

Protecting your eyes from bright sunlight is also important. Always wear sunglasses that screen out UV rays and a wide-brimmed hat when in the sunshine.

And, finally — again, whether or not you have a retinal disease — see an eye doctor immediately if you experience sudden changes in vision. The sooner you get help, the better chance the problem can be resolved and vision saved or restored.

Conditions like wet age-related macular degeneration and retinal detachments can be treated.  And while a doctor can’t yet treat an inherited retinal disease, there are related complications, such as cystoids macular edema (swelling), which may be resolved with a medication.

For More Information

To learn more about the retina and emerging treatments, visit the Foundation’s website and return regularly to Eye on the Cure. Both sites are chock-full of articles and posts on the latest advancements. Also, feel free to ask questions in the comments section of each blog post or send them to info@fightblindness.org. It’s our pleasure to keep you informed.

Pictured, above: An image of a mouse retina captured by Dr. Luca Della Santina, University of Washington.