Glaucoma: Advances in detection and treatment

Glaucoma: Advances in detection and treatment

Affecting more than 60 million people, glaucoma is a neurodegenerative disorder that causes vision loss by damaging the optic nerve, which carries signals from the eye to the brain. In fact, it is the second most common cause of blindness.

While older people are at more risk from the disease, babies and young children are also vulnerable to glaucoma. It is a particular threat to those with existing neurological disorders.

In a study published this month, in the Proceedings of the National Academy of Sciences journal, a research team from the Kennedy Krieger Institute made a significant breakthrough.

Working with four affiliated institutions, the scientists identified a new and unexpected biological pathway, which appears to contribute to the development of glaucoma and its resulting vision loss.

Previous findings had revealed that the optic nerve head, the point at which signals to the brain first leave the eye, play a role in glaucoma.

In the new study, researchers noted a series of findings which provide novel insights into mechanisms operating at the optic nerve head at a molecular level.

Most importantly, they discovered that at a specific location within the optic nerve head, there is a unique class of cells called astrocytes, which demonstrate qualities that could make them a critical factor in glaucoma-induced blindness.

"These findings are very exciting because they give us several novel targets for future interventions," said Dr Nicholas Marsh-Armstrong, senior study author and a research scientist at Kennedy Krieger Institute.

"I believe these findings put us on the cusp of discovering a treatment for glaucoma that may also have relevance for a number of other neurodegenerative diseases," he added.

Future investigations will examine this pathway and molecular mechanism to determine more precisely what steps go awry in glaucoma – and what can be controlled with medicines to slow the disease's progression.

Meanwhile, in a separate project, an engineer at the University of Arizona has this month completed the development of a new device, which could make trips to the ophthalmologist for glaucoma tests a thing of the past.

The self-test instrument, which could one day be used in people's homes, was designed in Eniko Enikov's laboratory at the institution's College of Engineering.

Removing the need for eye drops and a sterilised sensor, the tool comprises an easy-to-use probe, which gently rubs the eyelid.

"You simply close your eye and rub the eyelid like you might casually rub your eye. The instrument detects the stiffness and, therefore, infers the intraocular pressure," explained Professor Enikov, who specialises in aerospace and mechanical engineering.

The professor started work on the probe four years ago, in collaboration with Dr Gholan Peyman, an ophthalmologist from Phoenix.

Funded by the National Science Foundation, the work could soon see the two experts seeking investment to help complete its development and bring it to market.

"The innovation with our device is that it's non-invasive, simpler to use and applies to a variety of situations that are either difficult to address or impossible to test using the current procedures," added Professor Enikov.

He concluded: "That's why we're so excited about this probe. It has great potential to improve medical care, and significant commercial possibilities as well."

by Adrian Galbreth

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