Blog

A new study provides the first visual evidence showing that brain circuits in living animals can be activated by ultrasound waves projected into specific patterns (holograms). 

Led by scientists at NYU Langone Health and at the University of Zurich and ETH Zurich in Switzerland, the study describes a system that combines sources of ultrasound waves and a fiber scope connected to a camera to visualize in study mice brain targets that are directly activated by the sound. This lays the groundwork, the study authors say, for a new way to treat neurological diseases and mental health disorders from outside of the body.

Already, there are applications approved by the Food and Drug Administration and designed to reduce tremor symptoms seen in Parkinson’s disease, using intense sound waves to kill brain cells called neurons within neural pathways linked to tremors. Rather than kill neurons, the lower-intensity ultrasound waves used in the current work can temporarily activate them, the researchers say. The resulting effects can be widespread as neurons relay messages to other neurons within their circuits and between interconnected neuronal circuits.

Directly observing the effects of this technology, called transcranial ultrasound stimulation (TUS), in a living brain is difficult, but studying neurons in a dish in the lab does not accurately reflect the way ultrasound waves travel through the skull or behave in three-dimensional tissue. For TUS therapy to be safe and effective, researchers say, ultrasound waves need to target specific brain areas and must be calibrated so that the signal is strong enough to penetrate the skull, but not so strong as to damage delicate brain tissue.

Published in the journal Nature Biomedical Engineering online July 7, the current study featured experiments performed inside a living brain that accurately replicated how an activated neuron in one part of the brain can have far-reaching effects through connected circuits.

Our work shows that activating entire sets of neural networks with transcranial ultrasound stimulation in a living mouse brain is possible.”

Shy Shoham, PhD, study co-senior author 

The other co-senior author is Daniel Razansky, PhD, at the University of Zurich and ETH Zurich in Switzerland.

“We also found that, by focusing on circuits of neurons that are distributed across brain regions rather than in any individual region, TUS leverages inter-connections within the circuits to make targeted neurons 10 times more sensitive to ultrasound,” said Shoham, who is codirector of the Tech4Health Institute at NYU Langone Health, and a professor in the ophthalmology and neuroscience departments at the NYU Grossman School of Medicine. “This discovery potentially makes the technique more efficient, lowers the ultrasound power required, and could pave the way to safer transcranial ultrasound stimulation treatments in the future.”

In celebration of 50 years of innovation, Ophthalmology Times invited leading experts and rising voices across the field to reflect on the most pivotal advances in eye care. From anti-VEGF therapies to revolutionary imaging tools, the past 5 decades have redefined what’s possible in ophthalmology. What emerged was a striking consensus: progress has not only preserved vision—it has restored it, streamlined interventions, and deepened our understanding of ocular disease at a cellular level.

Anti-VEGF Therapy: A Defining Breakthrough

Many clinicians pointed to the advent of anti-VEGF therapy as the single most transformative innovation in modern ophthalmology.

Carl Danzig, MD, emphasized the dual revolution brought by anti-VEGF agents and OCT imaging, which together reshaped disease management and outcomes for patients with retinal vascular diseases. “You had a drug that treated conditions like wet AMD and DME, and a diagnostic tool that let you assess its impact in real time,” he said.

“Anti-VEGF injections have revolutionized our ability to treat diseases like wet AMD, diabetic retinopathy, RVO, and even retinopathy of prematurity,” said Nimesh Patel, MD. “These were once blinding conditions, now managed with minimally invasive medical treatments.”

Christine Kay, MD, added that anti-VEGF set the stage for subsequent breakthroughs in sustained delivery systems and gene therapy: “The 2017 approval of voretigene neparvovec for RPE65-associated retinal dystrophy marked a paradigm shift. We’re entering a new era of augmentation and gene replacement therapy.”

Ferhina Ali, MD, MPH, emphasized how the synergy between anti-VEGF agents and OCT imaging has preserved not just sight but quality of life. “Patients can now maintain 20/30 vision and continue driving, which was unthinkable 50 years ago.”

Multiple experts also underscored the broad utility of anti-VEGF agents across diseases. “It works for so many conditions—wet AMD, diabetic retinopathy, RVO, and even ROP,” said Nimesh Patel, MD. Others, including Anat Loewenstein, MD, and Dimitra Skondra, MD, PhD, noted that sustained-release formulations and gene therapies mark the next evolution in anti-VEGF-based treatment paradigms.

OCT and Imaging: Visualizing the Invisible

If anti-VEGF therapies transformed treatment, optical coherence tomography (OCT) revolutionized diagnosis and monitoring. OCT has allowed clinicians to visualize and monitor retinal pathology in vivo with precision and clarity. Numerous clinicians called OCT the most significant diagnostic advancement of the past 50 years. “It’s equivalent to Helmholtz discovering the ophthalmoscope,” said Alfredo Sadun, MD, PhD.

Yuhua Zhang, PhD, credited OCT and adaptive optics as catalysts for clinical and scientific discovery: “They enabled us to study retinal structure at the cellular level—something previously reserved for histology labs and donor tissue.”

Dilsher Dhoot, MD, FASRS, echoed the sentiment: “OCT fundamentally changed how we diagnose, monitor, and evaluate treatment efficacy. It’s a cornerstone of modern retina care.”

“OCT is like the ophthalmoscope of our era—it’s allowed us to see disease at a remarkable level.”— Alfredo Sadun, MD, PhD

Barsha Lal, PhD, and Paul Hammond, OD, FAAO, also highlighted OCT’s impact in glaucoma and early disease detection, describing it as a game-changer in diagnostics and disease progression management.

Surgical Advances: Smaller, Safer, Smarter

Corneal and retinal surgeries have undergone profound changes, minimally invasive techniques have enhanced outcomes across subspecialties. Jennifer Lim, MD, cited innovations in vitrectomy, small-gauge instrumentation, and perfluorooctane use as game-changers in retinal detachment repair.

Christina Prescott, MD, traced the dramatic shift from full-thickness keratoplasty to DSEK, DMEK, and now cell-based therapies. “It’s been an evolution that became a revolution,” she said. “We’ve evolved from full-thickness keratoplasty to DSEK, DMEK, and now cell therapy. It’s a complete paradigm shift.”

Ellen Koo, MD, traced a similar arc in cataract surgery: “Phacoemulsification has revolutionized cataract management. Combined with premium IOLs, it represents one of the most important surgical innovations in ophthalmology.”

Phacoemulsification also received praise as a cornerstone development in cataract surgery. “It’s hard to overstate how transformative it was,” said Roger Goldberg, MD, MBA, noting the downstream impact on IOL implantation and refractive outcomes.

Gene Therapy and the Genomic Horizon

Several contributors underscored the early success and future potential of gene-based treatments. Dimitra Skondra, MD, PhD, acknowledged gene therapy’s proof of concept while urging the field to think beyond single-gene targets: “We need more inclusive, agnostic approaches that can be applied more broadly.”

C. Michael Sampson, MD, MBA, connected the dots: “Our comfort with intravitreal drug delivery has laid the groundwork for these therapies. Without that, gene therapy might still be theoretical.”

“Without intravitreal drug delivery experience, gene therapy wouldn’t be where it is today.” — C. Michael Sampson, MD, MBA

Artificial Intelligence and the Data Revolution

AI’s integration into ophthalmology is a frontier still unfolding. John Tan and Cameron Cummings praised AI’s potential in accelerating diagnosis, triage, and population-level screening, while Anisha Kasi noted its growing synergy with OCT.

“AI in ophthalmology will change screening and diagnostics just as it has in other fields.” — Cameron Cummings

Noemi Guemes-Villahoz, MD, PhD, offered a poignant reminder: “AI and tech matter, but people—physicians—are the real drivers of change. Our mission remains the same: to care for patients.”

Public Health and Global Access

Innovation’s true power lies in its reach. Jogin Desai cited the widespread accessibility of low-cost intraocular lenses as a prime example. “Innovation is not just invention—it’s making that invention accessible to millions.”

Mark Bullimore, MCOptom, PhD, offered a public health perspective on myopia management, once considered benign. “We now understand that myopia is a major cause of uncorrectable visual impairment,” he said. Interventions that slow axial elongation in children are now recognized as essential preventive strategies.

What Lies Ahead

Reflecting on the rapid pace of change, many ophthalmologists acknowledged that the next 50 years promise even more dramatic advances. From longer-acting therapeutics to real-time AI decision support, ophthalmology is poised to continue its trajectory as one of the most technologically advanced specialties in medicine.

Nitish Mehta, MD, concluded, “We’re on the cusp of another leap forward. Soon, we’ll treat chronic blinding diseases with fewer interventions and greater precision. It’s an exciting time to be in ophthalmology.”

“We must remember—the greatest innovation is us, the people who care for patients.” — Noemi Guemes-Villahoz, MD, PhD

As ophthalmology celebrates its half-century of progress, the message from its practitioners is clear: this is a field shaped not only by remarkable technology but also by the people who pioneer, adapt, and apply it to transform patients’ lives.

The incidence of uterine cancer among White and Black women is expected to increase exponentially over the next two decades, possibly a result of rising rates of obesity, lower rates of hysterectomy, and an aging population. The rates in Black women are expected to rise even more sharply, challenging clinicians to detect disease earlier in the absence of well-defined screening protocols.

These trends point to a need to develop recommendations for screening of uterine cancer, and even developing screening tests, along with coming up with better prevention strategies, said Jason Wright, MD, a gynecologic oncologist at Columbia University College of Physicians and Surgeons in New York City and lead author of a recently published natural model study that projected uterine cancer incidence out to 2050.

“Over the last several years what we’ve seen is both the incidence and mortality of uterine cancer has risen,” Wright said in an interview. “That’s particularly true in Black women who are seeing a much higher increase in the incidence and mortality of uterine cancer.” The study included both endometrial and nonendometrial cancers of the uterus.

The study also showed that disparities in the incidence of uterine cancer are widening, Wright said, and that mortality continues to increase “despite the fact that for most cancers mortality is declining.”

Disease Projections

The study cited CDC data that showed the incidence and death rates from uterine cancer increased dramatically over the past 30 years, and a 2025 National Cancer Institute report that showed the average annual rate of uterine cancer increased by 0.8% from 2014 to 2019, but that mortality increased more than twice that: 1.9% annually from 2015 to 2019, the highest for any malignancy in women.

Wright’s natural model study has projected a number of disturbing trends in uterine cancer in the period from 2020 to 2050, using 2018 as the baseline year. Among them: 

• In White women, the incidence is projected to increase from 57.7 cases per 100,000 to 74.2 cases, a 28% increase.
• In Black women, the rate is projected to increase from 56.8 cases to 86.9 cases per 100,000, a 53% increase.
• In White women, the incidence-based mortality will increase from 6.1 to 11.2 deaths per 100,000, an 83% increase.
• In Black women, the mortality rate will increase from 14.1 to 27.9 per 100,000, a 98% increase.

The study noted that White women will have “only a slight increase” in nonendometrioid tumors, but the incidence of these tumors will “increase substantially” in Black women. The study projected the rate of nonendometrial cancer would increase from 21.4 to 36.3 cases per 100,000 in Black women from 2018 to 2050 and from 8.4 to 10.8 cases per 100,000 in White women — a rate almost four times higher in Black women.

What’s Driving the Increase

The study identified two population trends that may be driving the increase in uterine cancers but did not define a causal relationship: the aging population and the increasing rate of overweight and obesity. But the study stated, these trends “likely only explain a part of the changing trends in uterine cancer incidence and mortality.”

Aging seems to be a major driver, Wright said. “The median age of uterine cancer in most studies is typically in the early to mid-60s.” 

Another factor may be declining hysterectomy rates, he added.

“What we’ve seen in last several years is that the rate of hysterectomy is declining in the United States, and that’s probably due to alternative treatments for other gynecologic disorders so that, overall, fewer women have their uteruses removed for benign or noncancerous conditions earlier in life,” Wright said.

“Almost by definition if you have a larger number of women that still have a uterus as they age, it does increase the absolute number of uterine cancer cases.” 

A systematic database search published in 2020 reported that hysterectomy rates peaked at 10.6 per 1000 women in 1975 and predicted that rates would fall to 3.9 per 1000 by 2035. Wright’s natural model study acknowledged a “substantial racial variation” in hysterectomy rates as a contributing factor for higher uterine cancer rates in Black women, the study stated.

But even adjusting for declining hysterectomy rates, rising rates of obesity and aging, the numbers of uterine cancers are still rising, Kemi Doll, MD, director of the Gynecologic Research and Cancer Equity Canter at the University of Washington in Seattle, said, in an interview.

“We need to think outside of the box to potential environmental exposures that may have affected the currently aging generation, and uterine cancer is a clue to find out what that is,” Doll said.

The Disordered State of Screening

“One of the problems for uterine cancers is there are no real widespread recommendations for either screening or prevention for uterine cancer in a majority of the population,” Wright said.

Indeed, the American College of Obstetricians and Gynecologists (ACOG) and the Society of Gynecologic Oncology, among other clinical organizations, concurred in 2015 guidance that no effective routine screening exists for endometrial cancer in women with no symptoms. The guidance suggests that abnormal postmenopausal bleeding is a trigger for immediate evaluation with biopsy, ultrasound or hysteroscopy-guided screening.

Another risk factor is Lynch syndrome, previously known as hereditary nonpolyposis colorectal cancer. Women with the condition are at a 13%-26% increased risk for endometrial cancer, according to the National Comprehensive Cancer Network. For them, ACOG recommends annual endometrial sampling starting at age 30-35.

Women who previously took tamoxifen for breast cancer may also have greater risk for endometrial cancer. Its use has long been associated with a heightened risk for endometrial cancer, with the risk increasing the longer a patient is on the drug. But, again, no routine screening is recommended for users with no symptoms, although ACOG has stated that pretreatment screening may have a role before starting tamoxifen therapy.

The lack of effective screening tests for uterine cancers and detecting predictors of uterine cancer complicates the outlook, Wright said. “Neither exist currently,” he said.

Endometrial thickness > 4 mm, as measured on transvaginal ultrasound, is a biomarker for endometrial cancer. Despite this, Doll and her coauthors recently found that transvaginal ultrasound may not be reliable for evaluating endometrial thickness in Black women.

“ This study underlines the importance of new strategies that do not rely on a patient to have a symptom or a provider to believe them,” Doll said.

What Clinicians Can Do

Despite the absence of routine screening protocols or preventive strategies for uterine cancers, clinicians must become more astute about warning signs and symptoms, Doll said. These include abnormal menstrual bleeding, which Wright said is a symptom most women diagnosed with uterine cancer have.

“Women that have abnormal bleeding should be evaluated in a timely manner and the clinician, the gynecologist, must recognize the importance of bleeding and rule out uterine cancer,” Wright said.

Doll called for primary care providers to actively screen for abnormal and postmenopausal bleeding and provider education about “the limits of ultrasound triage and the need for tissue biopsy with any concern for endometrial cancer.”

“We need to educate the public, especially those most at risk, about endometrial cancer symptoms and early detection,” she continued.

Disproportionate Rise in Black Women

Why uterine cancer rates in Black women are rising disproportionately compared with other groups is unclear, according to experts interviewed for this piece.

“Black women have been left behind in the world of uterine cancer research and it shows. Now that we have an increasing epidemic of nonendometrioid cancers — the histology that was always more common among Black women — we are faced with our major knowledge gaps in the etiology of these cancers and the fact our treatments are much less successful for them,” Doll said.

Timothy Rebbeck, PhD, a researcher specializing in cancer prevention at Dana-Farber Cancer Institute in Boston, pointed to some potential explanations.

Tumors in Black patients with prostate and colon cancers have unique molecular signatures compared with other ethnic groups, Rebbeck said. “We think it’s probably happening in uterine cancers as well.” 

Tumors in Black women may be more aggressive, he added.

Reproductive history may also come into play. The lack of screening for uterine cancer may also mean that Black women are diagnosed later in the disease course than other groups. It’s an area prime for more research, Rebbeck said.

The natural model study was supported by the National Cancer Institute. Wright reported receiving grant funding from Merck. Doll and Rebbeck had no relevant disclosures.

Richard Mark Kirkner is a medical journalist based in Philadelphia.