Guided by vision: Dr. Gary Abrams on building the future of vision research

At the Wayne State University School of Medicine’s Kresge Eye Institute, discovery abounds. In the laboratories and clinics that make up this cornerstone of Detroit’s medical research community, ophthalmologists and scientists work side by side to protect and restore sight.

Few have done more to shape that mission than Gary Abrams, M.D., professor of Ophthalmology, head of the Retina Service and director of the Vitreoretinal Fellowship Program in the WSU Department of Ophthalmology, Visual and Anatomical Sciences.

“Research is alive and well at KEI,” Dr. Abrams said. “When Dr. [Mark] Juzych became chair after I stepped down in 2011, he and Dr. [Linda] Hazlett decided to merge Ophthalmology with Anatomical and Visual Sciences.”

That integration has allowed researchers to work across boundaries, pairing clinicians who see the daily realities of vision loss with scientists exploring the fundamental biology of sight.

Over the past decade, the department and KEI have formed a number of translational research focus groups in areas such as retina, diabetes, cornea and glaucoma. Dr. Abrams participates in both the retina and diabetes groups.

“The focus groups aim to stimulate translational research, bench to bedside, taking what is found in the basic science laboratory to the clinic to find ways to better treat patients,” he said. “This is an important part of research in that basic science becomes crucial when we develop new ways of understanding and treating disease. The only way to do this is getting basic scientists and clinicians together.”

Seeing the impact of collaboration
Dr. Abrams pointed to an ongoing research project on proliferative vitreoretinopathy, a serious complication that affects about 7% of primary retinal detachment surgeries.

“We wanted to know: Where are these cells coming from?” he explained.

Working with scientists Ryan Thummel, Ph.D., Tiffany Cook, Ph.D., and resident Ashley Kramer-Amobi, M.D., the team developed a novel technique using single-cell transcriptomics to analyze smaller tissue samples than ever before. Their findings may one day help prevent scar tissue formation that can cause vision loss after surgery.

In another group, world-renowned diabetes researcher and Professor and Director of Translational Research in the department, Renu Kowluru, Ph.D., studies the epigenetic changes that occur in diabetic retinopathy; changes that may explain why some patients’ vision worsens despite treatment. Drs. Kowluru, Abrams and colleagues are exploring how today’s injectable therapies might influence those genetic markers, an idea now being presented at national conferences.

Philanthropy propels beginnings of new advancements 
“These are examples of innovative research that started small,” Dr. Abrams said. 

Those “small starts” are often made possible through philanthropy. One of the most influential gifts to Kresge and the department came from Robert Ligon, a successful engineer and businessman who was determined to leave a legacy that would help mankind. The generosity of Ligon and his family established the Ligon Research Center of Vision at Kresge in 1998, with the mission of fueling research to prevent vision loss and restore vision in the blind.

Dr. Abrams and Professor Zhuo-Hua Pan, Ph.D., scientific director of the Ligon Research Center of Vision, are advancing one of the most promising frontiers in vision restoration: optogenetics.

“The Ligons’ gift made possible the formation and work of the Ligon Center, where Dr. Pan has developed a promising treatment for inherited retinal degenerations,” Dr. Abrams said. “This would not have happened without him. [Mr. Ligon’s] gift stimulated a whole new field of research with great potential returns for patients with severe vision loss.”

Optogenetic therapy uses light-sensitive proteins to restore vision in eyes blinded by lost or damaged photoreceptors in the retina in patients with hereditary vision loss, a condition called retinitis pigmentosa. Optogenetics uses a gene therapy technique to insert the light sensitive protein into inner retinal neurons that normally have no ability to detect light. Visual function is restored with the technique by detecting light signals with the inner retinal neurons and transmitting them to the brain, in effect, replacing the lost photoreceptors.

 “It’s highly significant,” Dr. Abrams said. “Gene therapies are limited to single, rare conditions. Optogenetic therapy is agnostic to the cause of photoreceptor degeneration and has wide applicability.”

In addition to retinitis pigmentosa, efforts are now directed at treating geographic atrophy, a form of age-related macular degeneration, the most common cause of vision loss in older people.

These breakthroughs now extend beyond the university. Dr. Abrams serves as a clinical advisor for Ray Therapeutics, a biotechnology company translating this Wayne State innovation into potential therapies for patients worldwide. The university established a license agreement and research contract with Ray Therapeutics to continue developing the technology.

“Drug development is a very difficult and expensive undertaking,” Dr. Abrams said. “There is a high cost and high level of expertise needed to take a new idea through (U.S. Food and Drug Administration) approval. That’s where tech transfer comes in. It takes a dedicated team [of partners] to move a discovery from the lab to helping patients.”

Translational Research Innovation Grants bridge ideas and implementation
At Kresge, many discoveries begin with a Translational Research Innovation Grant, a program largely funded by philanthropic gifts, including a transformative contribution from Waltraud Prechter in 2022. The Prechter Family Endowed Fund now supports TRIG grants in perpetuity, giving more researchers the freedom to test high-risk, high-reward ideas that might otherwise go unfunded.

The TRIG grants have become a vital bridge between imagination and implementation. They allow promising studies to generate early results that can attract competitive external funding. Perhaps just as importantly, the grants give medical students, residents and fellows the opportunity to participate in meaningful research early in their careers. “We are the fortunate ones,” Dr. Abrams said. “We get to interact with these bright young people who want to listen, learn and contribute.”

Envisioning the future
Still, funding of new ideas is difficult to obtain, Dr. Abrams said. “There is a tendency for agencies to fund projects that study known processes, rather than new ones. While that’s understandable, we need new ideas to be developed to make progress in the future. Philanthropy is sometimes the only way to [do this].”

Dr. Abrams’s career embodies the collaborative, mission-driven spirit of Kresge. As a surgeon, he has helped thousands of patients regain or preserve their sight. As a mentor, he has trained generations of retinal specialists. As a leader, he has helped shape a department and research institute where discovery thrives and innovation is celebrated.

Department chair Mark Juzych, M.D., M.S.H.A., described Dr. Abrams as someone who “lives the Hippocratic Oath with every patient he treats,” a physician whose integrity and compassion define both his practice and his leadership.

“Do your best; that’s all we can do,” Dr. Abrams often tells his fellows. “That’s what I always tell them: Show up every day with a good attitude and just do your best.”

Today, Kresge’s research ecosystem stands as a testament to that philosophy. Collaboration between clinicians and scientists is stronger than ever, and opportunities for students and fellows continue to expand. Continued philanthropic support ensures that the next breakthrough can happen here, in Detroit, at Wayne State University. Every new idea begins as a question. Through the generosity of others, Kresge researchers continue to have the ability to pursue answers that change lives.

To learn more about supporting the Department of Ophthalmology, Visual and Anatomical Sciences, and Kresge Eye Institute, please contact Kelley Denk at kdenk@med.wayne.edu.