Instructor, Department of Ophthalmology
Clinical Scientist, Schepens Eye Research Institute
Fuchs’ Endothelial Corneal Dystrophy (FECD)
The first goal of Dr. Jurkunas’ research is to identify the cause of FECD, which is one of the most common causes of blindness from corneal swelling and a second most common cause of corneal transplants done in the U.S. Because little is known of what triggers corneal endothelial cells to die in FECD, there is no effective treatment, and corneal transplantation is the only currently available measure to restore lost vision. Over past several years, Dr. Jurkunas has developed techniques to analyze differences in protein composition between normal and FECD corneal endothelial cells. The most striking findings were the discovery of an intricate protein system in normal endothelium that regulates cellular ability to respond to oxidative stress and regulates cell-to-cell interactions. Altered amounts of these crucial proteins were noted in FECD cells, implicating a potential cellular mechanism of the disease. Such insights into the mechanism of what triggers corneal endothelium to die will lead to the development of preventive and therapeutic approaches to this common blinding condition.
Corneal Stem Cell Deficiency
Dr. Jurkunas’ second main area of research is the development of alternative corneal transplantation techniques for the patients suffering from the destruction of corneal stem cells. Corneal epithelial stem cells are located in the periphery of the cornea and are very susceptible to multiple infections and inflammatory disorders. The attempts to treat the ocular surface with a standard corneal transplant in these patients have been unsuccessful due to immunologic rejection and subsequent graft failure. Dr. Jurkunas is in the process of investigating the alternative sources of corneal epithelium, one of which is oral (mouth) mucosa. Dr. Jurkunas has been successful in harvesting mouth cells and is now planning to transfer this technique to the patient care. The development of the methodology of cultivated oral mucosal epithelial transplantation gives a great promise in the area of regenerative medicine and offers hope for a significant number of blind patients worldwide.
This is a magnified view of corneal endothelium of a Fuchs’ endothelial corneal dystrophy patient. Increased amounts of TGFI protein (green) and clusterin (red) have been detected.
Jurkunas U, Azar DT. Potential Complications of Ocular Surgery in Patients with Coexistent Keratoconus
and Fuchs’ Endothelial Dystrophy. Ophthalmology. 2006; 113: 2187-2197.
Jurkunas U, Langston PD, Colby K. Use of Voriconazole in the Treatment of Fungal Keratitis. Int
Ophthalmol Clin. 2007; 47:47-59.
Chan SC, Jurkunas UJ. Keratorefractive Surgery Update. Ophthalmology Rounds.2007; 1 (7).
Dagher MH, Dana R, Jurkunas UJ. "Keratoglobus in association with Posterior Polymorphous
Dystrophy.” Cornea. 2007; 26:1288-91.
Jurkunas U, Colby K. Fungal keratitiss: Changing Pathogens, Risk Factors, and Treatment Options.”
Cornea; in press.
Jurkunas UV, Rawe I, Bitar M, Zhu C, Harris DL, Colby K, Joyce N. Decreased Expression of
Peroxiredoxins in Fuchs’ Edothelial Dystrophy. Invest Ophthalmol Vis Sci. 2008;49:2946-55.
Jurkunas UV, Bitar M, Rawe I, Harris DL, Colby K, Joyce N. Increase in Clusterin Expression in Fuchs’
Endothelial Dystrophy. Invest Ophthalmol Vis Sci. 2008;49:2956-63.
Jurkunas UV, Bitar M, Rawe I. Co-localization of Clusterin and TGFBIp in Guttae of Fuchs’ Endothelial
Dystrophy Patients. Invest Ophthalmol Vis Sci. 2008; in press.