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eye to eye newsCONTINUED ON BACK PAGECONTINUED ON PAGE 4MESSAGE FROM THE PRESIDENTDear Readers,I extend our best wishes for a healthy and good new year. Here at the Foundaon, we are ringing in 2025 with a special project to highlight the observance of Glaucoma Awareness Month. Each day this month, TGF is posng a new message on social media to shine a spotlight on paents and others who are tackling this disease. How are they struggling? How are they thriving? Our aim is to raise awareness about the importance of early detecon and the need for ongoing research. The campaign is sponsored by Bausch + Lomb. It has been a busy end of the year. Aer earlier webinars ranging from what to do if you have just been diagnosed, to how far we’ve come toward making eye transplantaon a reality, the nal webinar this year focused on intervenonal glaucoma, which is shiing treatment protocols to intervene earlier. You can read about it in this issue.A new year of webinars begins on January JANUARY IS GLAUCOMAAWARENESS MONTHJanuary 2025DOCTOR, I HAVE A QUESTION.What are some recent advances in the treatment of glaucoma?Queson answered by:Gregory K. Harmon, MDBoard Chairman, The Glaucoma FoundaonWhile there is sll no cure for glaucoma, the past year has seen advances in several aspects of the disease – for example, sustained-release glaucoma medicaons that can improve compliance and treatment eciency, devices that help clinicians treat glaucoma, and encouraging research results. It is esmated that almost half of glaucoma paents do not take their eyedrop medicaons as prescribed. Adherence and compliance have long been problemac. But recently, two drug delivery systems that are designed to provide connuous drug therapy directly inside the eye have been added to the toolbox for treang open-angle glaucoma and ocular hypertension.The rst was Durysta (AbbVie), an FDA-approved biodegradable implant that dissolves aer six months – although some paents have reported a longer me frame.
The Glaucoma Foundation | Page TwoTGF’s Grant-in-Aid Program has awarded millions of dollars in seed money for cung-edge research projects. Preliminary data from these projects have frequently been used to support proposals for larger grants from such enes as the Naonal Instutes of Health.“We are pleased that we have now broadened the scope and increased funding for our grant program so our eorts can have a sll greater impact on our goal of eliminang blindness from glaucoma,” said Elena Sturman, President and CEO of the Foundaon. In June, three researchers were funded under new guidelines. Five addional researchers were just awarded new one-year grants of $75,000 for projects to be researched during 2025.Bryce Chiang, MD, PhD Wilmer Eye Instute,Johns Hopkins Hospital “Targeted Delivery of Enzymes to Modulate Opc Nerve Head Biomechanics.” All FDA-approved glaucoma treatments lower eye pressure but do not address other important aspects of the disease. More eecve therapies are needed to prevent neuronal loss. The goal of this project is to develop treatment strategies in a laboratory model that modulate the biomechanics of the eye. This could suggest new strategies for glaucoma and other opc neuropathies. Wendy Liu, MD, PhD Stanford University, Center for Vision Research“Mechanotransducon Pathways for Neuroprotecon in Glaucoma.” Intraocular pressure (IOP) is the most signicant risk factor for glaucoma, yet the mechanisms of how the eye senses pressure remain largely unknown. This project will invesgate the role of a mechanosensive ion channel in glaucoma, and how modulang the acvity of this channel may protect renal ganglion cells from dying in glaucoma.eye to eye newsTGF AWARDS FIVE NEW RESEARCH GRANTS
The Glaucoma Foundation | Page Threeeye to eye newsLev Prasov, MD, PhDUniversity of Michigan “Dening Novel Genes and Syndromic Associaons in Childhood Glaucoma.”This project leverages data from over 150 families whose DNA has undergone whole genome sequencing. Its goal is to dene genes that are associated with childhood glaucoma and to idenfy and validate new types of genec variants in exisng genes, such as variants that impact the expression of a gene. These studies will have direct implicaons by assessing glaucoma risk.Pete A. Williams, PhD Docent, St. Erik Eye Hospital, Karolinska Instutet “Dual Targeng in Neuroprotecon and Neuroregeneraon in Glaucoma.”Niconamide is an ideal candidate for treang glaucoma paents. Using the knowledge gained from niconamide pre-clinical and clinical work, as well as experse in regenerave mechanisms, this project addresses the queson: can we simultaneously target neuroprotecon and axon regeneraon to develop a comprehensive intraocular therapy for glaucoma and opc neuropathy?Guan Xu, PhDUniversity of Michigan “Understanding the contribuon of the distal aqueous oulow to intraocular pressure regulaon.”Currently, glaucoma surgeons do not have a sucient understanding of the mechanism of the uid oulow in the eye. This study establishes an experiment plaorm – including a clinically relevant model with donor human eyes and an advanced imaging system to observe the uid oulow – to ll this long exisng gap in knowledge and to test the hypothesis that paents with s scleral ssue are likely to have high pressure in their eyes.
The Glaucoma Foundation | Page Foureye to eye news eye to eye newscell therapies to regenerate and transplant opc nerve cells in individuals with renal degenerave diseases, AI algorithms to improve early diagnosis, and research to idenfy addional genes associated with an increased risk for developing glaucoma.OUR FINAL WEBINAR OF 2024What is intervenonal glaucoma and what does it mean for paent care and quality of life? That was the core queson Dr. Nathan Radclie addressed in his November TGF webinar. Dr. Radclie is Aending Physician at New York Eye Surgery Associates, PLLC, and Clinical Assistant Professor of Ophthalmology at the Icahn School of Medicine at Mount Sinai. The webinar was sponsored by Glaukos.Intervenonal glaucoma is a treatment philosophy, Dr. Radclie explained. It is a shi away from the way glaucoma was treated years ago, which typically began with Durysta slowly releases prostaglandin analog that increases the amount of uid drained from the eye.Most recently, the FDA approved the iDose® TR (travoprost intracameral implant), manufactured by Glaukos, which is designed to provide up to three years of therapy directly into the eye. Selecve Laser Trabeculoplasty (SLT) has been an important procedure in the treatment of glaucoma and is increasingly being used as an eecve early step in treatment. SLT lowers the eye pressure by applying laser energy to the eye’s drainage ssue. It smulates the trabecular meshwork, the eye’s natural drain, to increase drainage. A year ago, Belkin Vision’s “Eagle” device, intended for use in performing selecve laser trabeculoplasty (SLT), was cleared by the FDA. The device is the rst contactless laser for glaucoma, providing an automated and non-invasive procedure. The laser energy is delivered in a non-contact procedure directly to the trabecular meshwork via the cornea without the use of a gonioscopy lens. In addion, the device automacally denes the target locaon, then applies the laser treatment sequence while the eye tracker compensates for any eye movement. Alcon, Inc. bought Belkin Vision in July. There also has been encouraging progress in vital research. Of note have been invesgaons into such areas as gene therapies and stem Advances in treatmentCONTINUED FROM PAGE 1
The Glaucoma Foundation | Page Fiveeye to eye newsTWO NEW FELLOWSHIPS SUPPORT GLAUCOMA RESEARCHERS Beginning in 2021, TGF and Research to Prevent Blindness (RPB) partnered to provide fellowships to increase diversity in glaucoma research. The TGF (sponsored by Patricia Hill) / RPB Fellowships in Glaucoma provide one-year, $10,000 supplemental fellowships targeted to under-represented racial and ethnic minories, as dened by the NIH, who are fellows in departments of ophthalmology engaged in substanve glaucoma research. Two new awardees, both ophthalmic epidemiologists, were selected in December. Epidemiology is the study of the distribuon paerns and determinants of diseases in a dened populaon.Patrice Marie Hicks, PhD., MPHDr. Patrice Marie Hicks is an ophthalmic epidemiologist in the Department of Ophthalmology and Visual Sciences at the University of Michigan Medical School. The long-term goal of her research is to develop an independent and interdisciplinary research program to understand how social determinants of health aect vision outcomes, ulmately informing policy and intervenon. Her research porolio includes several studies on glaucoma. She is currently eyedrops and only progressed to surgery at the middle or end of the disease progression.Intervenonal glaucoma involves intervening earlier in the disease and somemes being more aggressive, understanding that there is a window of opportunity to treang glaucoma.It’s about being a lile more proacve rather than waing for things to get worse, he said, and then reacng to that worsening. It involves using applicaons such as lasers, the emerging eld of sustained drug delivery and minimally invasive surgeries (MIGS). That window of opportunity is important, said Dr. Radclie. We are learning that intervening early and aggressively in glaucoma is the best me to make a big impact on the disease and that some of these early intervenons that work well at the beginning of the disease don’t work as well when done at the middle or end of the disease.“We are really trying to get ahead of glaucoma because we know that glaucoma progresses, so why wait unl you lose vision before taking steps to stop the disease? We also want to address adherence and risk.“What this is really all about is preserving the best possible quality of life for our paents,” Dr. Radclie said. “That Includes prevenng blindness and also trying to avoid riskier glaucoma surgeries if that’s wise and possible to do.” It isn’t always, Dr. Radclie noted. TGF WEBINARS CAN BE VIEWED ON YOUTUBECONTINUED ON BACK PAGE
The Glaucoma Foundation | Page SixLIVING WITH GLAUCOMAMeet Mitch HillJanuary 2, 2025 marked the ocial rerement date for 65-year-old Mitch Hill as Chief Financial Ocer for Inari Medical, Inc., a California-based medical device company with a mission to treat paents suering from venous thromboembolism and other diseases. Mr. Hill served as CFO since 2019, and prior to that in various senior nancial roles spanning over four decades. His glaucoma journey began in 2017, when he was living in Dallas and noced his peripheral vision was changing. “I went to be tested,” he says, “and then I was diagnosed with low tension glaucoma, and also with dry macular degeneraon. That all happened about seven years ago – I’m like a science project for eye diseases.”“My father was a pilot during WW II but later in life he had a lot of eye problems. For example, he had early-onset cataracts -- I had cataracts when I was only 49. “My view is that I’m happy to share my story as broadly as possible to make people aware of the importance of talking to your parents to nd out if they have ever had glaucoma. My Dad didn’t tell me – I wish he had been more open about it; I wish I had known earlier. “I’m the father of ve grown children, with nine grandchildren spread around the country. When my family gets together around the holidays, I’m planning a family meeng to inform my children as in, ‘here’s what you need to do on an annual basis to make sure that you’re monitoring your eye health. You are all suscepble to hereditary glaucoma.’ “I have found my glaucoma journey to be very disconcerng. Nobody really knows what to do about low-tension glaucoma because you have normal intraocular eye pressure and yet your vision is deteriorang. I try to keep my eye pressure as low as possible by using several dierent eye drops mulple mes per day. Right now, my physicians from The Glaucoma Care Center in Newport Beach, believe my glaucoma is stable / not progressing. That’s great news. Having said that, I have lost signicant peripheral vision in both eyes and I’ve actually lost central vision in my le eye. I really funcon with my right eye in terms of reading, working, driving and things like that. I’m working hard, and also praying that I can retain my remaining vision through the rest of my natural life. “I’m obviously hopeful about some of the research that’s going on – whether it’s stem
cells or neurogenerave medicaons, which in some cases are causing the regeneraon of opc nerve cells. It’s excing to think that maybe someme in the next 3, 5, or 10 years there will actually be a way to reverse the course of glaucoma. “My whole life I’ve been imagining the things I’d be doing when I rere and guess what, I’ve had to start to re-imagine that because of my compromised vision. As one example, my wife likes pickleball and I would enjoy it also except I can’t see the ball coming at me. We may be moving to Utah to see if I can increase my ski me. I can sll ski just ne, but can’t see the contour of the mountain the way I used to. As a rered person I’m also hoping to stay involved in the business world, perhaps by joining a few corporate boards.“I need to make the most of the next ve to 10 years so I’ve been asking myself how can I reinvent myself in 2025 as a rered person? I’m looking forward to that opportunity. I try to be grateful every day for the vision I sll have. I have nothing to complain about when I learn about others who have experienced glaucoma (and other eye diseases) from an early age. As menoned, I’m going to make sure my kids – in their 20s to late 30s -- get comprehensive eye exams and eld of vision tests and monitor their peripheral vision which is usually to rst signal that something is wrong. “My advice to paents whose glaucoma is progressing? Personally, I would always get a second opinion. I’d seek another point of view to see if there’s anything that can be done dierently to stop the progression of the disease.” The Glaucoma Foundation | Page Seven
eye to eye newsMESSAGE FROM THE PRESIDENTconnued from page 128th, when Dr. Poonam Misra will dispel some myths about glaucoma surgery.In this newsleer you can also read about ve new research grants we just funded, and the selecon of two new Fellows. Looking ahead, we hope you’ll save the date of April 3, when TGF will hold its annual Gala at New York’s Mandarin Oriental. We’d love to welcome you there!We start this new year so grateful for the ongoing support of our friends and readers. In the year ahead, we look forward to addressing issues and answering quesons that are important to you. If there are subjects you’d like us to explore in future issues, let us know at info@glaucomafoundaon.org. With your support, we look forward to what lies ahead.Thank you,Elena SturmanThe Glaucoma Foundation | Page Eightfocused on idenfying facilitators and barriers to glaucoma medicaon adherence. One of her ongoing studies is evaluang the inclusion and accuracy of sex and gender, as well as race and ethnicity, in arcial intelligence applicaons in ophthalmology.Bushra Usmani, MDDr. Bushra Usmani is a member of the Department of Ophthalmology at the University of Pittsburgh School of Medicine. Her research explores the epidemiology of ophthalmic diseases. She is parcularly interested in exploring preventable blindness, or high morbidity ophthalmic condions. Dr. Usmani’s approach is to idenfy the disease, explore the epidemiology, and idenfy risk factors, costs, resources utilized for care, and disparies in the aected populaons over a 10-year period to idenfy trends. The goal has been to idenfy ways to protect and prevent these preventable causes of blindness. NEW FELLOWSHIP RECIPIENTSconnued from page 5Thank you for supporng the work of The Glaucoma Foundaon.Your contribuons help us to improve life for people with glaucoma by raising awareness, funding cung-edge research, encouraging diversity in medicine, and educang physicians, paents, and the public.