Early Detection Poses Challenge

Glaucoma may strike individuals of any age, but it is most prevalent in people over the age of 60. For Black Americans, the rate of prevalence ticks up much earlier, at about 40 years of age, and people with diabetes or a family history of the condition are also more susceptible. Because glaucoma is asymptomatic in initial stages, early diagnosis is challenging.

The disease occurs when the optic nerve and the retinal ganglion cells — which relay visual inputs to the central nervous system — are damaged; elevated pressure in the eye, or intraocular pressure, is the main culprit. When fluid accumulates in the eye, such as from overproduction or improper drainage, it increases intraocular pressure and also the risk of developing glaucoma. Symptoms appear slowly, with changes in peripheral vision occurring before forward-facing vision becomes compromised.

Comprehensive eye exams can catch glaucoma in earlier stages, as these screenings involve optic nerve examination, intraocular pressure measurement, visual field testing and risk factor assessment. Patients must be proactive about regular screenings because once vision is lost, it cannot be repaired or restored. Available therapies can stop glaucoma’s progression and generally focus on alleviating intraocular pressure, but early diagnosis remains key.

Building on Existing Diagnostic Tools

Advances in diagnostic tools can give clinicians more and better information for treating glaucoma. Optical coherence tomography (OCT), for instance, uses light-wave imaging to help assess the optic nerve’s structural integrity. More recently, OCT angiography (OCTA) has been adopted to consider the optic nerve’s support system, such as blood supply. Functional imaging may be the next wave, as it should enable clinicians to identify cells under oxidative stress and take corrective action before irreversible damage is done.

Understanding a patient’s visual field is critical to identifying ocular diseases, and virtual reality goggles are emerging as a user-friendly, portable device. Doheny Eye Institute, dedicated to vision science, is investigating VR to enhance existing field vision testing and foresees future assessments that could bypass patient response. With its predictive powers, AI should also have a diagnostic role; AI may identify factors that clinicians could overlook when determining the risk of disease, progression, and aggressiveness so that patients can be treated early and accordingly.

Treatment Options Keep Evolving

Patients have various treatment options for glaucoma and generally take one of three paths: medication, laser or surgery. In the past five years, two new medications have surfaced, each with a novel mechanism of action that is additive to clinicians’ arsenals. The rho kinase inhibitor works to lower intraocular pressure, while a nitric oxide medication has dual action, reducing pressure and improving blood flow and oxygen to the optic nerve head. Research organizations like Doheny Eye Institute are also investing in the drug delivery arena, seeking ways to reduce patient error in medication administration and improve outcomes.

Laser treatment is nothing new in treating glaucoma, but techniques and instruments are constantly being refined. Laser trabeculoplasty has gained more acceptance, and as a minimally invasive procedure, it provides relief by reducing intraocular pressure. A more recent introduction, micropulse transscleral laser therapy also relieves intraocular pressure but by delivering energy in short pulses, which appears to minimize collateral tissue damage.

Should patients be beyond medication or non-invasive procedures, incisional surgery remains an option to improve natural drainage of the eye or insert an implant to create an accessory drainage pathway. Advances in surgical procedures, implants and devices continue to be sought after in research circles.

The Future Lies in Neuroprotection

Glaucoma research is a dynamic field, and an emergent focus is neuroprotection, where treatment extends beyond decreasing intraocular pressure to intervention in the chemical pathways that lead to the death of retinal ganglion cells. This exciting area considers protective effects, such as a drug therapy that could prevent cells from dying. It also explores how cells could be resuscitated, or what interventions could return damaged cells to their full functionality. Ultimately, this field of study is working toward neuro regeneration, where neural pathways may be fully restored so that lost vision may be regained.

With continued advances in glaucoma-related research and development across the board — from diagnostics and devices to pharmaceuticals and drug delivery to laser and surgical procedures — the future for patients is looking brighter. Maintaining momentum will be key for researchers to achieve the ultimate goal and find a cure for existing and future glaucoma patients.

The post Envisioning a Future with Reversal of Glaucoma-Related Vision Loss appeared first on Medika Life.

This May, the 2024 Annual Meeting was held in Seattle, and after taking some time to absorb the whirlwind of activity and insights, three elements stand out:

1. ARVO is back!

The pandemic changed the face of many conferences and meetings, and ARVO was no exception. This year, the annual meeting returned to pre-pandemic levels of attendance and participation, and the energy and enthusiasm were palpable. The number of abstract presentations and scientific research presentations rebounded, and I was very proud of the large showing by my colleagues and fellow vision scientists from Doheny Eye Institute and UCLA; Doheny contributed 67 papers and posters among a total of 155 from UCLA.

In addition to the many new learning opportunities, there were a number of opportunities for forging collaborations and networking. Growing connections within the scientific community is essential to expanding our thinking and considering new methods of achieving outcomes to benefit all.

2. Tech innovations are driving progress.

Artificial intelligence has been a hot topic in almost every industry in recent years. In vision science, we’re seeing many developments in AI that have the potential to enhance assessments and diagnoses, as well as to quantify disease features precisely, something previously thought not possible.

Additionally, incredible gains are being made in genetic science and gene-based therapies. The recent groundbreaking FDA approval for a gene-editing approach to addressing sickle cell anemia, which can affect the eye, opens the door to other patient trials and new gene-based therapeutics.

In parallel with these advances in genetic and molecular therapies, significant progress is happening in high-resolution diagnostic technologies. For example, my colleagues at Doheny and UCLA demonstrated, for the first time, visualization of metabolic processes in individual retinal cells in the living eye.

Exciting innovation in the tech space inspires the ARVO 2025 Annual Meeting, which has the theme of “i3: Imagining Innovation and Intelligence in Vision Science.”

3. We need to communicate.

The closing keynote speech focused on a topic that some don’t readily associate with the scientific community: communication. The vision science community is producing incredible work and results, and while we are adept at sharing technical information with vision science colleagues, we cannot necessarily take the same approach with other audiences.

Communication needs to be tailored to reach various stakeholder groups, from the general public to policymakers to government and philanthropic organizations that hold the keys to funding. Advocacy is one of the pillars of ARVO’s five-year strategic plan, developed in 2023. We can only grow advocacy for our cause if we can clearly communicate its impact and importance.

Start planning for 2025.

ARVO 2025 Annual Meeting will be held in Salt Lake City, Utah, May 4-8, and as the newly appointed president of ARVO, I am already deep into the planning stages. If the 2024 meeting is anything to go by, our 2025 gathering will offer compelling content and unparalleled opportunities for collaboration and engagement. I invite all members of the vision science community to join me!

The post Key Takeaways from the ARVO 2024 Annual Meeting – the Vision Science Community Gathers appeared first on Medika Life.