Combining genetics and drug development to tackle glaucoma
Prof Sir Peng Khaw | GR000084
14 January 2020
Glaucoma is the leading cause of irreversible blindness and affects over 70 million people worldwide. We’re funding research into a new treatment that could help prevent scarring caused by glaucoma.
Glaucoma is a when damage to the optic nerve causes sight loss. It is usually caused by the pressure inside your eye rising too high.
Surgery can be effectively used to reduce eye pressure by opening up the drainage systems to allow the fluid within the eye to flow normally, however sometimes surgical interventions do not work.
A main reason why this happens is because of the natural human response to heal an area damaged by surgery can cause scarring. Scars in the area of the surgery block the drainage channels again so contributing to increasing eye pressure.
This project aims to develop a safe and effective treatment to prevent conjunctival fibrosis (scarring) in glaucoma.
What is glaucoma?
Glaucoma is an eye condition where damage to the optic nerve causes sight loss. It is usually caused by the pressure inside your eye rising too high.
Your eye is full of fluid, which helps it to keep its shape and function properly. If too much fluid builds up inside the eye, the pressure rises and squeezes the optic nerve at the back of the eye.
This can cause damage to your optic nerve - a bundle of over a million nerve fibres that carry signals between your eye and your brain.
Pressure might build up in your eye when:
- fluid is stopped from draining away
- extra fluid is produced after an eye injury or infection - this is called ‘secondary glaucoma’
- there is an abnormality in the shape of the eye in children - this is called ‘congenital glaucoma’
Glaucoma tends to develop slowly over many years. As there is currently no cure for glaucoma, treatment focuses on early diagnosis, careful monitoring and regular treatment to help prevent further sight loss.
9 in 10
people diagnosed with glaucoma today who get the treatment they need will retain useful sight for the rest of their lives
It is not currently possible to repair the optic nerve once it has been damaged, so any vision lost to glaucoma cannot be recovered. If left untreated, glaucoma can lead to blindness.
There are usually no symptoms of a rising pressure in the eye until sight loss occurs, so regular eye tests are the best way to help spot the condition early.
Finding a solution
Anti-cancer drugs are currently used to decrease scarring but can have harmful side effects and so new treatments would be welcomed.
In a previous study, Dr Cynthia Yu Wai Man and Professor Sir Peng Khaw have shown that there is an important group of genes that controls how badly the eye scars. Using this information and developing key collaborations with other experts, they are working to produce a targeted drug that can switch off this group of genes and thus stop scarring in the eye.
Once developed, the next steps involve checking if the drug is safe to use in the eye by doing tests in the laboratory and determining the best way of getting the drug into the eye of patients.
If the drug decreases scarring in the eye and does not have harmful side effects, the next goal will be to test if it works in humans in early clinical trials.
This work is a vital first step before drugs can be taken forward for testing in future clinical trials.
A safe and effective drug to prevent fibrosis in the conjunctiva will benefit millions of glaucoma patients worldwide by decreasing the risk of blinding side effects from current treatments and significantly improving their quality of life.
An effective anti-scarring treatment will also have an impact on policy makers and lead to significant NHS savings by decreasing the number of revision surgeries and patient follow-ups.
Research project grant
Prof Sir Peng Khaw