State-of-the-art imaging equipment is being used by researchers at the University of Michigan to spy on cells in the eye in order to detect eye disease at a very early stage. They say that their technique could pick up signs of serious problems, such as glaucoma, early enough for patients to be treated before their vision is affected.

The researchers' method looks for metabolic changes in the cells of the retina and optic nerve due to disease. Those effects begin long before the first obvious signs normally hit, such as vision loss or structural abnormalities.

Using a sophisticated camera system coupled with customized imaging software, the researchers were able to detect changes in the eyes of patients with a brain disorder that can affect the optic nerve, and in people with glaucoma and diabetic retinopathy, two of the most common causes of blindness.

"We believe that this is going to be useful in a variety of diseases that affect the eye," says Victor Elner, an ophthalmologist and pathologist at the University of Michigan. The new test takes less than six minutes, and Elner says that it could be developed as a "point and shoot" system in which images are analyzed on a computer, either in an ophthalmologist's office or at a centralized location.

If the technique proves effective, "it could provide an early warning that cells have become sick," says Joseph Rizzo, a neuro-ophthalmologist at the Massachusetts Eye and Ear Infirmary, who was not involved in the work. That would allow physicians to start aggressive treatment before patients begin to go blind. If they are treated early, progressive eye diseases like glaucoma can be controlled, which slows or prevents damage to the eye and preserves vision. "It's potentially truly wonderful," Rizzo says of the detection technique.

In a study reported in the current issue of Archives of Ophthalmology, Elner and four colleagues at the University of Michigan tested their imaging technique on six women who had recently been diagnosed with a condition called pseudotumor cerebri (PTC), a disorder in which a buildup of pressure in the brain causes symptoms similar to those of a brain tumor. In some PTC patients, pressure on the optic nerve can lead to vision loss.

The researchers began by administering standard vision tests to the women. They all had good visual acuity. Visual field testing, which measures the area seen by the eye and is routinely used to screen for diseases like glaucoma, indicated subtle abnormalities in some of the women.