Ophthalmology

• NAME/TRAINING:

Carol B. Toris, Ph.D.

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ACADEMIC DEGREES:
M.S.     Department of Animal Science, University of Minnesota, St. Paul, MN
Ph.D.    Department of Physiology, University of Minnesota, Minneapolis, MN

Other training:
Post-doctoral training: Department of Physiology, University of Minnesota, Mpls, MN
Sabbatical:  Allergan Laboratories, Irvine, CA

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Contact Name:	Carol B. Toris, Ph.D. Department of Ophthalmology 985840 Nebraska Medical Center Omaha, NE  68198-5840
Phone Number:	402-559-7492 Secretary's Phone: 402-559-4276
e-mail address:	ctoris@unmc.edu

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• GRANT SUPPORT (last 3 years):

Alcon, Pfizer, Santen, Allergan

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• PUBLICATIONS (last 3-5 years):

Lane JT, Toris CB, Nakhle S, Chacko DM, Wang Y-L, Yablonski ME. Acute effects of insulin on aqueous humor flow in patients with type 1 diabetes. Am J Ophthalmol 132:321‑327, 2001.Wang Y-L, Hayashi M, Yablonski ME  and Toris CB: Effects of multiple-dosing of epinephrine on aqueous humor dynamics in human eyes. J Ocular Pharm 18:53-63, 2002. 

Toris CB, Koepsell S, Camras CB, Yablonski ME. Aqueous humor dynamics in ocular hypertensive patients. J. Glaucoma 11:253-258, 2002 

Weinreb RN, Toris CB, Gabelt BT, Lindsey JD, Kaufman PL. Effects of prostaglandins on the aqueous humor outflow pathways. Surv Ophthalmol 47, Suppl 1:S53-S64, 2002. 

Toris CB, Alm A, Camras CB: Latanoprost and cholinergic agonists in combination. Surv Ophthalmol 47, Suppl 1:S141-S147, 2002. 

Eisenberg DL, Toris CB, Camras CB. Bimatoprost and Travoprost  A review of recent studies of two new glaucoma drugs. Surv Ophthalmol 47, Suppl 1:S105-S115, 2002. 

Diestelhorst M, Nordmann J-P, Toris CB. Combined Therapy of Pilocarpine or Latanoprost With Timolol Versus Latanoprost Monotherapy. Surv Ophthalmol 47, Suppl 1:S155-S161, 2002. 

Lawlor D, Toris CB, Camras CB. Chapter 35  Prostaglandins. In, Glaucoma: Science and Practice, Morrison and Pollack (eds), Thieme Medical Publishers, Inc. New York, 2002. 

Toris CB. Chapter 7. Clinical assessment of aqueous humor dynamics. Glaucoma: Science and Practice, Morrison and Pollack (eds), Thieme Medical Publishers, Inc. New York, 2002. 

Morrison JC, Freddo TF, Toris CB. Anatomy and physiology of aqueous humor formation. Chapter 3. In, Glaucoma: Science and Practice, Morrison and Pollack (eds), Thieme Medical Publishers, Inc. New York, 2002.

Zhan GL, Lee PY, Ball DC, Mayberger C, Tafoya ME, Camras CB, Toris CB: Time-dependent effects of sympathetic denervation on aqueous humor dynamics and ocular blood flow in rabbits. Current Eye Research, 25:99-105, 2002.

Toris CB, Zhan GL, McLaughlin MA: Effects of brinzolamide on aqueous humor dynamics in monkeys and rabbits.J Ocul Pharmacol Ther, 19: 397-404,2003.

Zhan GL, Toris CB, Meza JL, Camras CB: Unoprostone Isopropyl Ester Darkens Iris Color in Pigmented Rabbits with Sympathetic Denervation. J. of Glaucoma,12(4): 383-9, 2003.

Toris CB, Zhan GL, Camras CB: Unoprostone increases outflow facility in ocular hypertensive patients. Arch. Ophthalmol, 122:1782-1787, 2004

Camras CB, Toris CB, Sjoquist B, Milleson MA, Thorngren J-O, Hejkal TW, Patel N, Barnett EM, Smolyak R, Hasan SF, Hellman C, Meza JL, Wax MB, Stjernschantz J: Detection of the free acid of bimatoprost in aqueous humor samples from human eyes treated with bimatoprost prior to cataract surgery. Ophthalmology 111:2193-2198, 2004

Haecker NR and Toris CB: Bimatoprost, xPharm,  Elsevier Science, 2004, http://www.xpharm.com/citation?Article_ID=7976

Toris CB: Brimonidine xPharm,  Elsevier Science, 2004, http://www.xpharm.com/citation?Article_ID=8002

Haecker NR and Toris CB: Travoprost, xPharm,  Elsevier Science, 2004, http://www.xpharm.com/citation?Article_ID=9659

Missoi TG, Toris CB: Levobunolol, xPharm,  Elsevier Science, 2004, http://www.xpharm.com/citation?Article_ID=8785

Missoi TG, Toris CB: Metipranolol, xPharm,  Elsevier Science, 2004, http://www.xpharm.com/citation?Article_ID=8948

Toris CB: Glaucoma, xPharm,  Elsevier Science, 2004, http://www.xpharm.com/citation?Article_ID=1162

Toris CB, Sneddon N: Apraclonidine, xPharm,  Elsevier Science, 2004, http://www.xpharm.com/citation?Article_ID=7891

Toris CB, Zhan GL, Camras CB, McLaughlin: Effects of travoprost on aqueous humor dynamics in monkeys. J. of Glaucoma 14:70-73, 2005

Zhan GL, Camras CB, Palmberg PF, Toris CB. Case Report

Effects of marijuana on aqueous humor dynamics in a glaucoma patient. J. of Glaucoma 14:175-177, 2005

Toris CB,  Zhan GL, Feilmeier MR, Camras CB, McLaughlin MA Effects of a prostaglandin DP receptor agonist, AL-6598, on aqueous humor dynamics in a  nonhuman primate model of glaucoma. JOPT, 2006, in press.

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• PREVIOUS GRADUATE STUDENTS/POST-DOCTORAL FELLOWS (present location):

Shilpa Kaushik: currently at Elanco Animal Health, a Division of Eli Lilly and Company,
Greenfield, IN 46140

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• CURRENT RESEARCH PROJECTS:

My main research interest in the Gifford Research Laboratory of Ophthalmology is the study of the production and drainage of aqueous humor in the eye. This is important because the dynamics of this fluid maintains a healthy intraocular pressure. When the intraocular pressure becomes elevated, there is increased risk of glaucomatous damage to the optic nerve. Such damage is irreversible and blindness is too often the final result. I use a noninvasive fluorophotometric method to study ocular fluid dynamics in human volunteers. With this method I and my colleagues and students have investigated the effects on the eye of aging, various pathological states (including diabetes, pigmentary dispersion syndrome, and ocular hypertension), new therapeutic agents and combinations of therapeutic treatments. We also are involved in phase III and IV clinical trials of new glaucoma medications.  

When research cannot be done or answers cannot be found in human volunteers, we turn our attention to animal research. In primates with elevated intraocular pressure, we are determining the mechanism by which experimental drugs reduce this pressure. These are necessary preclinical studies. One day some of the drugs tested may be entered into phase III clinical trials and may develop into clinically useful glaucoma treatments.

Recently we have been successful in measuring parameters of aqueous humor dynamics and intraocular pressure in mice. The small size of the eye makes these studies challenging. However, the benefits would be enormous as this will open up research in the area of the genetics of glaucoma.

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• SPECIALIZED LABORATORY/CLINICAL RESEARCH RESOURCES:

Clinical research:
Ocular scanning fluorophotometer, used to measure the disappearance rate of a fluorescent dye from the eye which allows us to estimate the production and drainage rates of ocular aqueous humor.

Episcleral venomanometer, measures the pressure in the episcleral veins, the veins that drain the aqueous humor from the eye.

Pneumatonometer, an instrument to measure the eye pressure. 

Heidelberg retinal blood flow device, measures the blood flow in the retinal blood vessels near the optic nerve. 

Langham flow probe, a tonometer that is equipped to measure blood flow in the entire globe. 

Pacscan, an ultrasound device to measure the size of the globe, the thickness of the cornea and the depth of the anterior chamber, necessary measurements to calculate aqueous flow rate.

Pascal tonometer, a new design to measure intraocular pressure that presumably avoids artifacts caused by cornea thickness.

IOL Master, an instrument to measure physical dimensions of the eye.

Tonopen, a portable tonometer.

Schiotz tonometer, a classic old tonometer that enables us to measure scleral rigidity.

Animal research:
Computerized system to measure outflow facility. This setup includes, syringe pumps, pressure transducers, water manometer, computer and customized software.

Fundus camera to photograph the back of the eye and the iris.

Argon laser to treat the trabecular meshwork to create an experimental model of elevated intraocular pressure.

Ultrasound device to measure the anterior chamber depth.

The lab is equipped with instruments to conduct eye exams in animals and perform all the measurements that are done in humans, i.e., fluorophotometry, tonometry, venomanometry, slitlamp examination and blood flow analysis.

We use core facilities and work in the labs of colleagues to perform histology, ELISAs, Western blots, spectrophotometry, electron microscopy, PCR.

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