Studies are beginning to demonstrate the longitudinal success of an interventional glaucoma treatment approach rooted in micro-invasive glaucoma surgery (MIGS).
Scientists are translating bench discoveries about the pathophysiology of the disease into potential neuroprotective therapies.
Low-resource care paradigms and devices that have decreased the global burden of cataracts are models for what can be done with glaucoma.
New virtual reality-based visual field testing and surgical simulation technologies are coming of age.
These collective advances show the timing could not be better for a quantum leap forward in glaucoma treatment and care, says Ike Ahmed, MD, FRCSC, director of the Moran Eye Center’s new Alan S. Crandall Center for Glaucoma Innovation.
“I truly believe we can create a radically different future for glaucoma patients,” says Ahmed. “The Crandall Center is aimed at supercharging our efforts in a way that hasn’t been done before.”
Four Crandall Center initiatives bring to bear unique resources and talent.
Glaucoma Therapeutics
Director: Ike Ahmed, MD, FRCSC
Goal: Develop safer and more effective surgical therapeutics.
Method: Assist companies with device development, testing, and research by conducting independent preclinical, clinical, complications-related, and comparative studies. Ahmed draws upon his unique expertise as a consultant to over 50 medical companies. He is principal investigator for numerous research studies and clinical trials, including the recent HORIZON randomized trial for a Schlemm’s Canal microstent in combination cataract and glaucoma surgery. The initiative is modeled after Moran’s renowned Intermountain Ocular Research Center, which vets new intraocular lens technology and complications.
Neuroprotection-Based Therapies
Director: David Krizaj, PhD
Goal: Develop new therapies to restore or regenerate the optic nerve, damaged by high intraocular pressure associated with glaucoma.
Method: Bring together top neuroprotective researchers and investors to fund their work. Studying how the trabecular meshwork senses pressure to regulate the flow of aqueous humor, Krizaj has targeted Transient Receptor Potential Vanilloid 4 (TRPV4), an ion channel that can sense tiny changes in pressure and translate them into cellular responses. He has developed a potential eye drop therapy that inhibits TRPV4 to increase outflow. The treatment also appears to be neuroprotective. Fiona McDonnell, PhD, joined the Crandall Center in October to work with this initiative, studying meshwork exosomes and their potential for use in new therapies and as disease biomarkers.
Translational Research
Director: Gregory S. Hageman, PhD
Goal: Understand the biology and genetics of glaucoma to develop new treatments.
Method: Use Moran’s Sharon Eccles Steele Center for Translational Medicine’s (SCTM) model of establishing partnerships among academia, philanthropists, and private industry to fast-track drug development. Researchers can use a collection of nearly 10,000 donor eyes and glaucoma patients already enrolled in an SCTM macular degeneration clinical study that collects genotype, phenotype, and retinal images. They also can cross-reference data with the Utah Population Database, which contains genealogical, public health, medical, and environmental exposure records for more than 20 million people. Moran’s Utah Retinal Reading Center, directed by SCTM scientist Steffen Schmitz-Valckenberg, MD, will analyze disease progression and the best time to administer new therapies.
Global Care
Director: Craig J. Chaya, MD
Goal: Change the trajectory of glaucoma in low-resource nations where the rates of detection and treatment are low.
Method: Leverage Moran Global Outreach Division partnerships with providers worldwide to find new ways to detect glaucoma earlier, create systems where local health care workers can screen for glaucoma, and develop affordable surgical devices to preserve vision. Working in more than 20 countries, the division builds sustainable access to high-quality eye care through teaching and training doctors, nurses, and medical personnel. It is a North American academic partner of India’s Aravind Eye Care System, renowned for its unique ability to manufacture safe, effective, low-cost surgical devices.