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The Catalyst for a Cure Biomarker scientists, funded by Glaucoma Research Foundation, are now evaluating their novel biomarkers in glaucoma patients. The newly identified markers of glaucoma can be detected with unique imaging devices and diagnostic tests developed by the team.
This video was first shown at the Glaucoma 360 Annual Gala on January 31, 2019 in San Francisco.
Dr. Goldberg: Seven years ago, the Glaucoma Research Foundation put together four of us to achieve an ambitious goal of figuring out how we can better measure glaucoma, make new biomarkers so that we can better diagnose disease, and better determine whether patients are progressing or getting worse.
It’s been an amazing seven years. We’ve made advances in the basic science of understanding glaucoma and, importantly, we’ve made advances in engineering new ways to measure the disease in our patients.
Dr. Srinivasan: Right now, we are in the midst of clinical studies to validate these biomarkers and to see how well they predict changes in glaucoma. This Catalyst for a Cure team early on discovered that the inputs of the ganglion cells, the dendrites of the ganglion cells have very early changes in glaucoma and pinpointed a specific layer or specific type of ganglion cell that has the earliest changes.
Dr. Huberman: We’ve identified mitochondrial signatures that are indicative of ganglion cell dysfunction that hold the potential to be imaged in vivo as well as cell types within the retina, specific types of retinal ganglion cells, that are particularly vulnerable to early phases of glaucoma at stages when typical diagnoses within the clinic wouldn’t pick up on those.
Dr. Dubra: We’ve been focusing on imaging biomarkers because they are noninvasive, and they can be in principle deployed to existing clinical settings with minimal effort. So, we’ve developed a new family of imaging techniques that show contrast in a way that you don’t have to inject anything in the eye. It reveals transparent structures like, for example, the finest capillaries in the retina and the ganglion cells. We’re thinking that if we perfect this technique to the point it can be applied in a clinical setting, we’re going to be able to help clinicians adjust the treatment very rapidly to the point that they can hopefully prevent progression of the disease altogether.
Dr. Goldberg: I’m particularly excited this year about three new biomarkers that we’ve been testing in earnest this year in our glaucoma patients, one using adaptive optics. We’re seeing retinal ganglion cells and their fibers, and even the spaces between retinal ganglion cells with unprecedented resolution, and we think that this is giving us new hints into whose disease is worse, whose disease is progressing.
I’m also very excited about the use of visible light, OCT. This is a way of imaging the retina and seeing layers of the retina degenerating that previously no one was able to visualize.
Finally, we’re measuring the different pathways of vision and finding differences in glaucoma patients versus control.
Any of these new biomarkers might be critical to moving the field forward and, for the first time, we’re seeing that data come to fruition. I believe that over this next year or two, as we test these in formal clinical trials, we will really understand which ones, or multiple of them, will really be important for the future of glaucoma diagnosis and determining treatments.
Dr. Huberman: The 2018 goals for Catalyst for a Cure were severalfold, but one of the ones that I am particularly most excited about was a collaboration between Jeff Goldberg and I, which is a clinical trial currently running using visual stimulation delivered through a virtual reality device to try and encourage survival of ganglion cells that are injured and might otherwise be lost, as well as regeneration of existing cells within the retina, as well as plasticity within the brain in order to restore vision. We can’t report any of the results of that trial right now, but we’re very excited about the fact that the trial is taking place, and that work could not have happened without the support of GRF and other people that are involved in supporting the research on the whole.
Dr. Goldberg: The progress from this Catalyst for a Cure biomarker initiative is going to be critical to bringing a cure forward to glaucoma patients. The reason is we don’t have great ways of measuring glaucoma, and particularly glaucoma progression in the clinic, and if we can’t measure whether a drug is preventing that progression or even restoring function, it’s very hard to get through a clinical trial in a reasonable period of time. These new biomarkers that have come from this program over the last seven years are already now being used in early clinical trials for new, potentially vision-restoring therapies in glaucoma. Now, with the new vision restoration team starting, the idea that we will generate exciting new candidate therapies for glaucoma and test them using these biomarkers in the clinic, in patients, this will be the culmination of a fantastic, visionary program.
Last reviewed on March 15, 2019