“Social justice is at the foundation of why I pursued medicine,” Mian said. “I believe that health care is a human right and that people of all cultures and backgrounds deserve to be treated with equitable, high-quality care.”

This belief has motivated her throughout medical school and inspired her to apply for a master’s degree in public eye care in order to directly impact the health care conditions of impoverished populations locally and abroad. Mian realized her passion for ophthalmology when she shadowed a doctor who provided free eye surgeries and training. Inspired by how a simple surgery to cure blindness could empower someone to get an education, live independently without a disability and pursue their dreams, Mian was dedicated to becoming an ophthalmologist.

In May, Mian was awarded a $50,000 Rotary Global Grant Scholarship to attend the London School of Hygiene and Tropical Medicine. The scholarship is designed for students pursuing a career in an area of great humanitarian need and have a long-term commitment to measurable and sustainable change. Students must be sponsored by a local Rotary club in their place of permanent residence or full-time study.

“The rotary club has a long history of service and humanitarian work, and I found that I shared similar goals with the organization,” Mian said. “As a public eye care master’s candidate, I believe I can gain valuable knowledge and experience to be a successful social justice leader, physician, and policy maker.”

As a future ophthalmologist, Mian hopes to create an equitable health care system for diverse populations. She believes her experience at the London School of Hygiene and Tropical Medicine will widen her cultural competence and knowledge in research and epidemiology and allow the opportunity to work intensely in preventing detrimental ocular disease.

Mian attributes her award to the support of her faculty mentors at the School of Medicine, Bethany Smith and Susan Sawning, as well as her community involvement during her first years of medical school. During her time as a medical student, she has been extensively involved with the American Medical Association creating health policy. She is the co-founder of Grow502, a professional student-led nonprofit organization aiming to address health care disparities in the Louisville community, and also the co-founder of Physicians for Human Rights. These experiences have led her to live a life of service.

The research, conducted by Kaplan, chair of the Department of Ophthalmology and Visual Sciences, Douglas Dean, PhD, and Wei Wang, PhD, and published in December in , could lead to therapies for preserving or recovering central vision in patients with RP. Kaplan will present the research findings at five conferences in the United States and abroad beginning this month.

Retinitis Pigmentosa is an inherited disease in which the photoreceptor cells in the retina – rods and cones – deteriorate over time. Photoreceptors absorb and convert light into electrical signals, which are sent through the optic nerve to the brain. Rods, located in the outer regions of the retina, allow peripheral and low-light vision. Cones, located mostly in the central part of the retina, allow perception of color and visual detail.

In RP, rods deteriorate first, causing the peripheral and low light vision loss typically associated with the disease. In later stages, the cones also deteriorate. Without cone function, RP patients lose the high-resolution daylight vision necessary for reading, facial recognition and driving. As a result, this stage of RP vision loss is more debilitating than the loss of nighttime or peripheral vision. RP affects 1 in 4,000 people globally.

Recent research has shown that as the rods deteriorate, the cones are no longer able to access glucose, which becomes trapped in the retinal pigment epithelium (RPE). As a result of glucose starvation, the cones go dormant and eventually die.

The UofL researchers found that the cones remain dormant for a period of time before they are completely lost, and if the glucose supply can be replenished during dormancy, the cones can be regenerated. The researchers were able to successfully restore cone access to glucose in either of two procedures. First, by transplanting rod-specific induced pluripotent stem cells beneath the retina, and second by injecting glucose directly into the subretinal space.

“Following rod stem cell transplant, we observed reassembly of the cone inner segments, regeneration of cone outer segments and increased electrophysiologic function within 1,000 microns from the transplant margin for at least three months after the transplantation in all directions,” Kaplan said. “However, the recognition that glucose starvation of cones occurred because of the trapping of glucose in the RPE provides multiple new possible treatments to restore lost central vision including drug therapy, gene editing and regenerative medicine.”

Kaplan will present these findings at the 6^th China Ocular Microcirculation Society Annual Meeting – International Ophthalmology Conference, Beijing, China, and the American Society of Retina Specialists, Boston, this month, at the Indiana Academy of Ophthalmology, Carmel, in September, the Retina Society, Boston, in October, and the 5th World Integrative Medicine Congress, Guangzhou, China in December.

This research has the potential to lead to therapies that preserve or restore central vision for individuals with RP.

“If therapy can prevent or reverse the onset of cone degeneration within the macula, most patients would be immeasurably helped and able to live a normal life despite the loss of peripheral vision and decreased dark adaptation,” Kaplan said.