Pedram Hamrah, M.D.
Assistant Professor of Ophthalmology, Department of Ophthalmology
Director, Ocular Surface Imaging Center
Dr. Hamrah has initiated numerous translational research projects that include the use of in vivo confocal microscopy and anterior segment OCT in the diagnosis and monitoring of treatment for various types of infectious keratitis and dry eye disease. With his laboratory, Dr. Hamrah investigates how circulating blood cells find their way to the cornea, employing intravital microscopy to study the molecular mechanisms of interactions between blood cells and the vascular wall by direct observation in anesthetized mice. He also studies the role of the nervous system in these interactions. Another major focus of his laboratory is to understand how antigen-presenting cells migrate and function within the cornea and draining lymph nodes in vivo.
Imaging: Dr. Hamrah's laboratory is the first to use the most powerful imaging technology available today to study the cornea in animals and humans. In collaboration with Harvard Professor Ulrich von Andrian, MD, PhD, the pioneer who developed these imaging technologies we have modified this technique to image different immune cell types, including the recently discovered “antigen presenting cells” in the cornea. These cells, which are present in other parts of the body, were not known to be in the corneal center until this discovery. The ability to produce four-dimensional imaging over time allows us to study their migratory behavior in and out of the cornea. Immune cells circulate in the blood and subsets of these cells enter, move and interact within, then leave the ocular surface and cornea tissue. We don’t understand how exactly this happens. Using non-invasive imaging our long term research aims to develop new molecular targets for pharmacological intervention in inflammatory and autoimmune eye disease. Unlike the current steroid treatments for inflammation, these treatments would be highly specific and can be of benefit to the health and recovery of the cornea.
Infection: Herpes simplex virus (HSV) is the most common infectious cause of corneal blindness in the Western Hemisphere, with up to 500,000 cases diagnosed annually in the United States alone. HSV is a multifaceted disease capable of inducing some of the most difficult management problems, including neurotrophic keratopathy. Herpetic neurotrophic keratopathy often presents with decreased corneal sensation and significantly impairs the ability of the corneal epithelium to heal itself after corneal injuries, leading to corneal ulcers in the absence of active virus. Neurotrophic keratopathy can also develop after Herpes Zoster (shingles) which leads to chronic epithelial disease and loss of vision. The persistence of decreased corneal sensation and its association with the degree of nerve damage in the cornea are still unknown. In collaboration with Dr. Deborah Pavan-Langston, director of Ocular Virology, we are currently studying the nerve changes and cellular changes in herpetic disease. Through the use of the new state of the art HRT/RCM confocal microscope, which allows a revolutionary layer-by-layer analysis of the cornea and a magnification of up to 800 times, we are able to perform non-invasive examination of the cornea and obtain images of corneal layers and cells.