Clin-STAR Journey Story

An Optometry–Neuropsychology Collaboration Launches a Career in Aging Research

Since the time she was an undergraduate, an interest in the health of older adults has guided the career path of Sima Mozdbar, OD, MPH. She had the opportunity then to join a clinical neuroscience lab that was studying modifiable risk factors for cognitive decline. "That really sparked my interest in aging research," she says.

But another undergraduate experience diverted Dr. Mozdbar from following a traditional path of becoming an MD and specializing in geriatrics. She worked in a doctor's office, became fascinated by the eye-brain connection in eye care, and decided to study optometry.

While pursuing her Doctor of Optometry at the University of Houston, she learned about the overlapping mechanisms between age-related eye diseases and neurodegeneration. At the same time, she says, "I noticed that in order to take better care of our aging population, predominantly those with these age-related eye conditions, I needed a better understanding of how to take care of them as a whole. This includes improving their quality of life, not only through vision care, but also understanding more about their cognitive function and how that plays a role in their overall health."

Dr. Mozdbar joined the University of Texas Health Science Center in 2018 as an Assistant Professor and Director of the Ophthalmic Clinical Research Center. Funded by small grants, she began research on cognitive dysfunction and visual function. Then, in 2020, Dr. Mozdbar became one of the inaugural recipients of the Clin-STAR Transdisciplinary Aging Research Pilot Grants.

The Clin-STAR pilot grants are made to junior clinician investigators for collaborative projects—research that brings together junior and senior investigators, different disciplines and researchers in different institutions—in emerging or understudied areas of clinical aging research.

Dr. Mozdbar's Clin-STAR project investigates biomarkers in the retina of the eye to determine their usefulness in screening patients for Alzheimer's disease. "The eye is the only part of the body where we can noninvasively visualize live tissue," she explains. A scan of this retinal tissue, called optical coherence tomography (OCT), is often part of a routine eye exam. OCT has long been used to detect retinopathy from diabetes and other conditions. Previous studies have shown that the layers of retinal tissue at the back of the eye become thinner in people with Alzheimer's disease.

"Another thing we're looking at is inclusion bodies in the retina, which are thought to contain amyloid beta, the same protein that occurs in the brain in Alzheimer's," says Dr. Mozdbar. Some studies have correlated retinal amyloid beta with amyloid detected in PET scans of the brain.

Dr. Mozdbar's primary collaborator and research mentor is Sid O'Bryant, PhD, executive director of the Institute for Translational Research at the University of North Texas Health Science Center. Dr. O'Bryant heads the Alzheimer's Disease in Primary Care Study, which seeks to identify blood-based biomarkers for Alzheimer's.

Dr. Mozdbar's retinal biomarker study leverages study participants and infrastructure from Dr. O'Bryant's larger, NIH-funded project. She is currently recruiting participants from the blood biomarker research to undergo retinal scans. Ultimately the combined results could lead to a relatively simple screening process in primary care settings, through blood tests and retinal scans, that could be used as a basis for referring patients for more expensive and/or invasive diagnostic tests and/or procedures.

Using OCT scans to identify retinal biomarkers also poses a challenge: scanning devices from different manufacturers do not necessarily provide comparable results. Dr. Mozdbar is addressing this issue through a collaboration with researchers from the University of Rhode Island and other institutions, to find ways to standardize scans for Alzheimer's screening.

Caring for older adults became a clinical passion for Dr. Mozdbar while she was working toward her OD. One of her courses included guest lectures from geriatricians and other specialists who interact with older adults, to provide a whole picture of their care.

Today, Dr. Mozdbar gives guest lectures in the course, and she continues to serve geriatric patients in the clinic. Being able to improve her patients' quality of life through improvements in their vision has "been the drive of my research," she says. "If we can identify early biomarkers through something like retinal scans, that could be used as part of a way to detect Alzheimer's earlier, then we have the potential to improve quality of life for those patients."