Mor Dickman strengthens Utrecht with innovative eye research

Could organoids be implanted to regenerate the eye? This is one of the questions Mor Dickman is working on. For just over a year, he has been part of Regenerative Medicine Utrecht as professor of ophthalmology and department chair at UMC Utrecht. He combines patient care, management and policy work with innovative research, ranging from large clinical studies to pioneering laboratory research. His goal is clear: better treatments for people with eye diseases, with a direct route from the lab to the patient.

At the end of 2024, Mor Dickman moved from Maastricht to Utrecht. He already collaborated with Utrecht researchers such as Hans Clevers (Hubrecht Institute) and Jeffrey Beekman (UMC Utrecht). Trained as an ophthalmologist and corneal specialist at Maastricht UMC+, he set up a research group with Vanessa LaPointe on regenerative treatments for the cornea. He continues this work in Utrecht together with Vanessa. “I really enjoy overseeing the whole process, from fundamental research to treating the patient.”

What makes the eye special?

“The eye may be just as complex as the brain, but it is much more manageable,” Mor says. “Many eye diseases affect only one cell layer, such as the endothelium or epithelium of the cornea, the transparent tissue at the front of the eye. That makes them much more accessible to study and treat.”

The eye is also very suitable for regenerative therapies. “In other organs you often have to replace the entire organ, but in the eye we can repair a single layer. That can make a huge difference: someone can see again. On top of that, the eye has a special immune privilege, so the risk of rejection is relatively low. All of this makes ophthalmology very special to me.”
 

What matters is whether the patient’s quality of life improves

What really works for the patient?

A large part of Mor’s research takes place in the clinic. Alongside his work as an ophthalmologist, he conducts studies that compare different treatments, for example in cataract surgery and corneal transplantation.

These studies focus not only on clinical outcomes, but also on how patients experience their treatment. “Sometimes doctors consider a treatment very successful, but the patient considers the benefits limited. In the end, what matters is whether the patient’s quality of life improves.” That is why his research pays a lot of attention to patient-reported outcomes, such as comfort and daily functioning.

Learning from big data

In addition to clinical research, Mor has a leading role in large national and European quality registries. These registries collect data from millions of patients who have undergone eye surgery, such as cataract surgery, corneal transplantation and refractive surgery. They show how treatments work in everyday practice, outside clinical trials.

“This helps us see how care really works in the real world and how patients experience it,” Mor explains. The results are used to improve the quality of care, both in the Netherlands and internationally.

For the first time, we are taking this research directly from the lab to the patient

Organoids as a treatment

The most innovative part of Mor’s research takes place in the lab. Here, he focuses on regenerative medicine for the front of the eye, such as the cornea. 

Together with researchers in Hans Clevers’ team, Mor develops eye organoids. These are small, lab-grown pieces of tissue that mimic parts of an organ. “Organoids help us understand diseases better and test treatments. Ultimately, we also want to use them as a treatment themselves.” This has never been done before.

The team has already created organoids from the conjunctiva, the lacrimal gland and the limbus. The limbus contains stem cells that renew the outer layer of the cornea. These organoids are made from a small tissue biopsy taken from the patient and grown in the lab.

A clinical study will soon start in which a conjunctival organoid is transplanted into patients. “For the first time, we are taking this research directly from the lab to the patient,” Mor says. It will also be the first time ever that an organoid is used as a medical treatment. In Utrecht, Mor will further expand this research with Jeffrey Beekman’s team and hopes to eventually transplant other types of eye organoids as well.

Cell therapy instead of transplantation

Another important research line focuses on the corneal endothelium. This is a vital cell layer that maintains fluid balance and clear vision. “Damage to these cells is the main reason for corneal transplants worldwide,” Mor explains.

Mor and his team are developing treatments in which cultured cells are injected into the eye. “Normally, endothelial cells cannot divide, but in the lab, we can make them grow,” he says. “This may allow us to replace damaged tissue and restore the cornea.”

As part of the Eye Moonshot within the Dutch-Flemish RegmedXB collaboration, Mor is also studying whether special stem cells, known as iPSCs, can mature into endothelial cells. This could allow even more patients to be treated in the future. “Our aim is to move from transplantation to cell therapy as a medicine. That could help many patients.”

Infrared light to strengthen eye tissue

Mor and his team are also researching new ways to strengthen eye tissue. In keratoconus, the cornea becomes progressively thinner. In severe myopia, the eye becomes elongated. “Myopia is not just a matter of needing glasses. It is a major cause of visual impairment in young people.”

Currently, keratoconus is treated with UV-A radiation, which strengthens the cornea by creating crosslinks in the tissue. However, this treatment cannot be used if the cornea is too thin. “The people who need it most often cannot receive it,” Mor explains. “UV-A also cannot be used for myopia, because it would damage the retina.”

“Infrared light is safe and already widely used in medical devices and can activate a unique drug we developed to safely crosslink the tissue. We have recently shown that this technique is also safe and effective in strengthening the sclera, the white outer layer of the eye. This is an important first step towards treating myopia.”

Genetic research into Fuchs dystrophy

Mor also works on better understanding Fuchs endothelial dystrophy, a common eye disease that often leads to corneal transplantation. It was long thought to be an age-related disease, but over the past decade it has become clear that it is mainly genetic.

In Fuchs dystrophy, so-called DNA repeats play an important role. These are parts of a gene that are repeated hundreds or even thousands of times. “What makes this disease unique is that similar repeat disorders are usually neurological, such as myotonic dystrophy, while Fuchs affects only one cell layer in the eye,” Mor explains.

“In the lab, we create models of Fuchs and use techniques such as CRISPR to understand how these repeats cause disease and to develop RNA-based therapies.” By understanding the disease process better, Mor and his team hope to detect the disease earlier and improve treatment.

Utrecht has a unique ecosystem. Within a small area, there is an enormous amount of expertise

A connector

Mor brings together many different fields. Alongside his work as a physician and researcher, both in the clinic and the lab and at population level, he has represented ophthalmology at the European Medicines Agency (EMA). There, he helped ensure that new treatments are applied safely and according to regulations. He is also chair of the cornea committee of the Dutch Transplantation Foundation (NTS).

“I enjoy connecting the dots and making sure research from the lab really reaches the patient,” he says. “I also believe that doing research makes you a better doctor, whether that research is in the clinic, with patient data, or in the lab, working on diseases you see every day.”

Utrecht is the ideal setting

Mor sees Utrecht as an ideal environment for his work because of the close collaboration between clinical care and fundamental research. “Utrecht has a unique ecosystem. Within a small area, there is an enormous amount of expertise. That makes it possible to take real steps towards new therapies.”

“My research was increasingly drawn to Utrecht because of the expertise and collaborations already present here. So, it was a logical step to continue my work here.” With his arrival, Mor Dickman strengthens regenerative medicine in Utrecht in many ways, from patient-focused care to innovative regenerative treatments, all aimed at helping people see better and improve their quality of life.