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eye to eye newsFebruary, 2021The Glaucoma Foundation | Page OneJoin us on Saturday Feb 27continued on back pagePlease join us on ZOOM on Saturday, February 27, 2021 from 10 am to noon Eastern Daylight Time for “Bringing the Latest gLaucoma science DirectLy to the Patient.” Four experts will discuss issues of importance to glaucoma patients, clinicians and researchers. We’ll learn about advances in glaucoma diagnosis and treatment and the role of articial intelligence, the importance of the patient-physician relationship, and possibilities in optic nerve regeneration. Two glaucoma patients will give their perspectives and there will be live Q&A sessions with the panel.TO REGISTER:Use this QR code or go toglaucomafoundation.org/events-3/MESSAGE FROM THE PRESIDENTThank you to each of you who helped us to keep our momentum over these past, often difcult, months. We hope that you are safe and well. While we expect that life will remain in ux for some time, we are condent that the new year will bring further, meaningful advancements in glaucoma research and treatment.Dr. Audrey Bernstein, Associate Professor at SUNY Upstate Medical University and a member of our Scientic Advisory Board has been awarded a $1.7 million grant from the National Eye Institute (NEI) and a $1 million VA Merit Award grant to continue research into exfoliation syndrome (XFS), an age-related disease involving deposits of material on the outside of certain cells of the eye. Her initial research for these grants began several years ago and was supported in part with seed money from TGF. In November, Dr. Deborah Wallace and her team at University College in Dublin published their research
The Glaucoma Foundation | Page TwoDoctor, I Have A QuestionWhat is the status of in-home tonometry?Answered by Louis Pasquale, MD, FARVOSite Chair, Department of Ophthalmology, Mount Sinai Hospital Vice Chair, Translational Ophthalmology Research,Mount Sinai Healthcare SystemScientic Advisory Board, The Glaucoma FoundationThe pandemic exposed a glaring deciency in remote glaucoma care – it is not easy to measure IOP outside the ophthalmologist’s ofce. The iCare HOME tonometer meets many criteria for accurate self-measurement of IOP: the device is portable, it is accurate, no anesthesia is needed, the skill can be transferred to the patient, and there are anecdotal reports of how home tonometry can provide real insights into glaucoma management. Patients with moderate-to-advanced disease and rapid visual eld progression despite normal IOP in the ofce would be logical candidates for its use. There is no other viable tool for remote IOP monitoring that meets the criteria that the iCare HOME tonometer meets. For example, the Tonopen is portable and accurate but requires anesthetic drops and cannot be used for self-tonometry. Currently, the FDA has approved the iCare tonometer to be prescribed to patients and CMS can reimburse doctors for the analysis of long-term (longer than 1 month) IOP measurements. This is good news for patients who can afford to purchase the iCare tonometer outright but it is not feasible for patients who cannot afford the several thousand dollar cost to purchase it.eye to eye news
The Glaucoma Foundation | Page Threeeye to eye newsYou can now rent the iCare HOME through MyEYES, LLC.IOP can vary throughout the dayand night. Icare HOME offers a quick and easy way to take multiple readings at home while conducting your normal activities. When you return your tonometer, your doctor will review all the measurements and evaluate IOP levels and uctuations to help safeguard the health of your eyes.We invite you to learn more about MyEYES and iCare on March 9 via ZOOM.Visit TGF’s website to register www.glaucomafoundation.orgthank you for your supportYour donation matters.Since it’s founding in 1984, The Glaucoma Foundation has never wavered from its principle mission: to fund cutting edge glaucoma research and to educate the public about glaucoma, its diagnosis, and its treatment. The support of individuals like you has provided us with the resources to deliver on this mission. Please give online or with the enclosed envelope.
The Glaucoma Foundation | Page FourTwo New Classes of Eye Drops: How Do They Work?eye to eye news Until late 2017, the glaucoma medication toolbox lacked a treatment that directly targeted the trabecular meshwork, the diseased tissue in glaucoma. Most other eye drops have targeted only the secondary drainage system, the uveoscleral pathway, or have reduced aqueous production. In 2018 two new drugs that represent entirely new classes of glaucoma medication were introduced -- Vyzulta™ (latanoprostene bunod ophthalmic solution 0.024%, from Bausch & Lomb) and Rhopressa® (netarsudil ophthalmic solution 0.02%, from Aerie Pharmaceuticals). Each have mechanisms of action different from those of the drugs that were previously available. Vyzulta, the rst new class, increases outow through both the trabecular network, the primary outow pathway, and the smaller uveoscleral pathway. Latanoprost works to lower intraocular pressure by opening the uveoscleral pathway much like other prostaglandin analogs.(e.g. Xalatan). But another component of the drug is related to nitric oxide, which is thought to relax the trabecular meshwork and increase aqueous humor outow.Rhopressa, represents another novel class of medications called ROCK inhibitors. These inhibit Rho kinases, enzymes that control cellular structures involved in cell shape and movement. Rhopressa reduces IOP specically by improving outow of the trabecular meshwork, a pathway from which most of the aqueous humor drains. Aerie launched Rhopressa in the United States in 2018 and in 2019 launched Rocklatan. Rocklatan is a once-daily eye drop that is a combination of latanoprost, the most widely-prescribed prostaglandin analog, and netarsudil, the active ingredient in Rhopressa which targets the trabecular meshwork. The diseased trabecular meshwork is considered to be the main cause of elevated IOP in open-angle glaucoma and ocular hypertension.
The Glaucoma Foundation | Page FiveLow vision rehabilitation can enhance your visual function and improve your quality of life. A low vision therapist can teach you a variety of techniques to help you when low vision is interfering with your daily activities.A low vision exam looks carefully at your medical and ocular history, and at how you deal with activities of daily living – can you read your mail, cook without burning yourself, take public transportation? Are you anxious or depressed? Could an occupational therapist help you? The goal is to determine the best prescription for your particular needs. You might benet from one or more low vision devices like a hand-held or standing magnier with adjustable magnication and contrast levels for prolonged reading. Optivisor is a hands-free headband magnier; there are glasses with a telescope attached, and hand-held monoculars for spot reading and spot tasks. The OrCam MyEye uses a scanner on the side of your eyeglasses to read text out loud. It could scan product labels for you at the market. Although Medicare will typically cover a low vision exam, it won’t reimburse for low vision devices. If you want a hi-tech resource like the Orcam, you should expect it to be pricey. But others are low or no-cost. For instance, there are built-in magniers on IOS smartphones that can change contrast and font size. VoiceOver is a built-in screen reader on iPhones. Seeing AI is a free iPhone app that uses articial intelligence to read text out loud.Low vision specialists are licensed doctors of optometry who are trained in the examination and management of patients with visual impairments. A few of them are ophthalmologists with additional training in low vision care. In New York State, these specialists are certied and there is a website that lists providers – www.primarycareopt.comTGF offers a list of resources on our website:https://glaucomafoundation.org/about-tgf/patient-resource-center/and we recommend watching our online seminar, “An Overview of Low Vision Rehabilitation” with Delaram Shirazian, OD.https://glaucomafoundation.org/events-3/Low Vision erapyeye to eye news
The Glaucoma Foundation | Page Six eye to eye newsCLINICAL GLAUCOMA TRIALSNearly all treatments, including drugs and medical devices, require clinical trials and approval by the government’s Food and Drug Administration (FDA). A clinical trial is a research study using human volunteers, referred to as participants, to answer specic health questions. In general, clinical studies are designed to add to medical knowledge related to the treatment, diagnosis, and prevention of diseases or conditions. These studies are conducted to evaluate whether the new treatment, procedure, or device is safe and effective. Clinical trials can be sponsored by the government, by academic institutions, and by industry, and usually involve at least three phases.Phase 1 clinical trials evaluate the safety and dosage of a drug or treatment to determine how well it works. This testing normally takes place with a small group of healthy volunteers. If the trial meets the primary outcomes, as proposed in the application to the FDA, then the FDA permits the trial to proceed to Phase 2.Phase 2 clinical trials test the efcacy and side effects in treating a particular disease, with several hundred participants with the disease.Phase 3 clinical trials are the ultimate test of whether a treatment is safe and effective for a wide variety of people, and typically involve a much larger group of volunteers for a longer period of time than Phase 1 and 2 trials. Just like Phase 2 trials, the plan normally involves assigning participants to treatment or control groups.
Would you like to receive newsletters by email? Please call us (212) 285-0080 Or write to info@glaucomafoundation.orgThe Glaucoma Foundation | Page Seven eye to eye newsChoosing to participate in a clinical trial is an important personal decision. If you or someone you know is interested in learning more, it is important to talk to your doctor and family members. All clinical trials have guidelines about who can participate. Each has its own protocol or set of guidelines, and volunteers must meet certain criteria to qualify for inclusion. Because small groups and select doctors are involved with trials, don’t expect your doctor to have specic details on each study. Be sure to understand that expressing trial interest does not guarantee involvement nor does it guarantee that you will be included in the treatment group. If you want to learn more, try these resources:www.nih.gov/health-information/nih-clinical-research-trials-you/basicsA resource for people who want to learn more about clinical trials. www.clinicaltrials.govGlaucoma-related trials globally are accessible in one section – with such details as location, sponsor, and status (completed, active, recruiting, etc.).www.CenterWatch.comOffers a clinical trial database with currently enrolling trials, information on the trials process, and on drugs and new medical therapies.www.researchmatch.orgA free and secure registry that brings together people who are trying to nd research studies and researchers who are looking for people to participate in their studies.
This issue is made possible with support from New York Community Trust.Eisenberg Fellowships in Glaucoma. We are honored that RPB is joining us in support of these young doctors. Our two organizations will also jointly grant an annual $150,000 TGF/RPB Advancement Award in Glaucoma Research to assist early-career ophthalmic scientists in pursuit of ongoing research of unusual signicance and promise. This award will focus on the degeneration of human retinal ganglion cells with openness to connectomic, genetic, imaging, epidemiologic, and regeneration approaches. It will be available to assistant professors who have already received their rst NIH R01 grant, a group identied by RPB’s Scientic Advisory Panel as representing a critical gap in the funding pipeline. Funding here will be important both for the eld of vision research at large and for advancing the research and careers of individual vision scientists. Thank you for being a TGF newsletter reader. If there are topics you would like us to explore in upcoming issues, please write to us at info@glaucomafoundation.orgWishing you all the best,Elena SturmanPresident & CEOeye to eye newson pseudoexfoliation glaucoma, funded in part by a 2015 grant from TGF. Dr. Simon John of Columbia University, a former member of our Scientic Advisory Board and for many years an active participant in our Scientic Think Tank, is a world-renowned glaucoma researcher. He was honored last month with the prestigious Sanford and Susan Greenberg Visionary Prize to End Blindness. The award will support him and his team as they focus on diseases that damage the retinal cells connecting the eye to the brain and develop approaches to regrow their connections.The Foundation has just entered into a signicant new partnership with Research to Prevent Blindness (RPB), a major funder to 35 leading scientic institutions in the U.S. working on a diverse range of disease-oriented research. Together, we will be co-funding ve new $10,000 supplemental fellowships targeted to under-represented minorities, as dened by the NIH, who are fellows in Departments of Ophthalmology engaged in substantive glaucoma research. TGF fellowships were rst founded in 2020 by board member Patricia Hill as the Patricia Hill-Dr. Sanford MESSAGE FROM THE PRESIDENTcontinued from page 1