Are scientists on track for a glaucoma cure?

Are scientists on track for a glaucoma cure?

Two separate studies recently looked at the molecular level for rhyme or reason to glaucoma's cause, and turned up not only a more rounded picture of the disease, but also a theory for curing it.

"[These studies offer] the basic science behind understanding why glaucoma may develop in some people and may allow additional therapies to treat the condition."

Published earlier this month, the pair of studies—both originating from Northwestern University—scrutinized the dysfunctional cells and chemical pathways that restrict fluid drainage from the anterior chamber of the eye.

The first study identified "a new culprit" for glaucoma—the consequence of mechanical dysfunction of endothelial cells in the trabecular meshwork. In glaucomatous eyes, this cell layer acts stiffer than in healthy eyes, resulting in an inability to allow the aqueous humor to drain into Schlemm's canal.

Researchers concluded that therapeutic strategies to alter these endothelial cells potentially could lead to an abatement or cure for the disease.

The second study took a different approach, using an animal model to identify the molecular building blocks needed for drainage vessels.

The study identifies the chemical equivalent of a "lock and key" signaling pathway—the growth factor, angiopoietin, and the receptor, Tie2—for healthy functioning and growth of Schlemm's canals. If either factor was missing in mice, glaucoma developed.

The chemical pathway is theorized to be involved in human glaucoma, and researchers hope to develop a nanofiber eye drop that could reopen vessels to lower intraocular pressure (IOP).

Research could move glaucoma care forward
Glaucoma, the second-leading cause of blindness in the United States, cannot currently be prevented or cured, making such research in the field promising for the estimated 2.2 million Americans and 60 million worldwide diagnosed with the disease.

Murray Fingeret, O.D., an AOA member involved in multiple glaucoma-related organizations and roles, says the research out of Northwestern University proves interesting and could set the stage for future research or therapeutic avenues to treat glaucoma.

"The study examining the building blocks could be a real advance because it provides the chemicals that could lead to medications being developed to lower the IOP in new and novel ways, but that's many, many years away," Dr. Fingeret says.

Nonetheless, both studies offer "the basic science behind understanding why glaucoma may develop in some people and may allow additional therapies to treat the condition," Dr. Fingeret says.

Optometrists are often among the first health care practitioners to detect glaucoma. Members can find tools and resources related to glaucoma care, including clinical practice guidelines, educational modules at AOA EyeLearn, and patient education and practice materials, at AOA Marketplace.

September 24, 2014

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