Shereif Haykal

What changes the brain in glaucoma?

Supervisors:

Prof. Frans W. Cornelissen

Prof. Nomdo M. Jansonius

Background and interests:

My name is Shereif Haykal and I am from Egypt. I studied medicine at Ain Shams Universtiy, Cairo. Shortly after graduating, I started a residency program in diagnostic radiology at the university’s hospital. During my training, I developed an interest in (neuro)imaging research, so I decided to take some time off from clinical work to pursue my interest in research. And so I joined a Maser’s degree program in Biomedical Imaging at the University of Turku, Finland.

For my Master’s thesis, I analyzed cardiac CT images of aortic stenosis patients who underwent transcatheter aortic valve implantation (or TAVI), and correlated my findings with the clinical outcome of the procedure. I also produced a protocol for pre-procedural interpretation of cardiac CT images of potential TAVI subjects, aiming to improve the outcome through better patient selection. Upon obtaining my Master’s degree, I moved back home to finish my radiology training, after which I joined the EGRET+ program.

Aim of the project:

The traditional view of glaucoma is that of an eye disease in which an elevation of intraocular pressure (IOP) causes the death of retinal ganglion cells through simple mechanical stress, leading to characteristic visual field defects. However, between 30-39% of glaucoma patients have normal IOP on presentation, a condition referred to as normal-tension glaucoma. Furthermore, ocular hypertension commonly exists as an independent entity in the absence of glaucomatous retinal changes. This lack of consistency in the relationship between IOP and glaucomatous retinal changes challenges our conventional view of glaucoma. A proposed hypothesis is that glaucoma is a neurodegenerative disease of the whole brain, with retinal glaucomatous changes being an extension of that degeneration, and not a primary pathology of the retina. Indeed, numerous MRI studies investigating structural brain changes in glaucoma patients have found evidence of neurodegeneration both within the visual system and elsewhere in the brain, favoring the hypothesis that glaucoma is a global neurodegenerative disorder. My project aims to further study brain changes in glaucoma patients using structural MRI imaging techniques, such as diffusion tensor imaging (DTI), in order to better understand the underlying mechanisms of the glaucomatous disease process.