New Dynamometric Techniques For Predicting Glaucoma Progression
Funder
National Health and Medical Research Council
Funding Amount
$171,825.00
Summary
Glaucoma is a major cause of blindness in our community. The biggest risk factor for glaucoma is raised intraocular pressure. However, the exact cause of the disease remains unknown. Through our basic science studies in animals we have discovered that changes in blood flow in the vessels at the optic disk may be involved in the disease process. In recent clinical trials we discovered that the presence or absence of pulsations in the retinal veins at the disk was both an indicator of severity and ....Glaucoma is a major cause of blindness in our community. The biggest risk factor for glaucoma is raised intraocular pressure. However, the exact cause of the disease remains unknown. Through our basic science studies in animals we have discovered that changes in blood flow in the vessels at the optic disk may be involved in the disease process. In recent clinical trials we discovered that the presence or absence of pulsations in the retinal veins at the disk was both an indicator of severity and progression of glaucoma. This is a major breakthrough because there is no other means of predicting in which glaucoma patients vision loss will develop most rapidly. This information will be very helpful in deciding which patients should have the most agressive treatment to restore normal intraocular pressure. This project seeks to develop a new commercial device to make such an examination easy for any clinical ophthalmologist. The device allows the doctor to examine the vessels at the disk whilst applying slight pressure to the eye to temporarily raise intraocular pressure. A footswitch is pressed when the doctor sees the vessels pulsate. The required force is recorded by a laptop computer and the data stored along with the patients details. Now we have confirmed the ability of such a measurement to predict the rate of visual field loss in glaucoma, such a measurement will become much more widespread in clinical ophthalmology, offering a new and large scale opportunity for such instrumentation. Our device will be easy to operate, more comfortable for the patient, and will be of major diagnostic value in glaucoma clinics worldwide.Read moreRead less
Advanced New Therapeutics And Diagnostics In Retinal Diseases And Glaucoma
Funder
National Health and Medical Research Council
Funding Amount
$3,550,944.00
Summary
This program proposal targets the most common blinding diseases in clinical ophthalmology. The applicant team includes research and clinical ophthalmologists and basic scientists. The team have an internationally established reputation in bringing basic science discoveries to the point where they can impact directly on clinical diagnosis and therapy. The proposed research includes new treatment therapies for diabetic retinopathy, age related macular degeneration, and retinal vascular diseases. A ....This program proposal targets the most common blinding diseases in clinical ophthalmology. The applicant team includes research and clinical ophthalmologists and basic scientists. The team have an internationally established reputation in bringing basic science discoveries to the point where they can impact directly on clinical diagnosis and therapy. The proposed research includes new treatment therapies for diabetic retinopathy, age related macular degeneration, and retinal vascular diseases. A new diagnostic technique for glaucoma and new instrumentation for detecting areas of poor blood flow and oxygen supply in the eye are also to be developed. Past successes in our current program grant make us confident that we can produce clinically useful outcomes from this new proposal.Read moreRead less
Retinal Vascular Signs As Predictors Of Systemic Disease Outcomes: 10-year Evolution In A Population-based Cohort
Funder
National Health and Medical Research Council
Funding Amount
$389,575.00
Summary
Recent U.S. data from two population-based studies have highlighted retinal microvascular signs as being predictive of systemic vascular and other important health outcomes in middle-aged or older individuals, particularly stroke and heart attack and mortality, independent of traditional vascular risk factors. The present application proposes to evaluate the 10-year development and progression of retinal microvascular signs and their relations to the development of stroke and other important sys ....Recent U.S. data from two population-based studies have highlighted retinal microvascular signs as being predictive of systemic vascular and other important health outcomes in middle-aged or older individuals, particularly stroke and heart attack and mortality, independent of traditional vascular risk factors. The present application proposes to evaluate the 10-year development and progression of retinal microvascular signs and their relations to the development of stroke and other important systemic health outcomes in the population-based cohort of residents attending the Blue Mountains Eye Study (BMES. Two types of retinal signs will be evaluated: firstly, the presence of specific clinical signs, such as focal narrowing of small retinal vessels (arterioles), nicking of retinal veins as arterioles cross them or presence of retinopathy (haemorrhages and other signs) secondly, measures of generalized retinal vessel calibre (narrowing) using a computer-assisted method developed for the U.S. studies. We will also develop new grading methods for two other signs. Late and will compare computer-assisted grading from 35mm slides to automated grading of vessels using a scanning device (being developed) to screen the eyes of older persons. This project builds upon our current 3-year NHMRC grant (ID153948; 2001-2003) Retinal vascular signs as risk markers for incident stroke or cerebrovascular death: A population-based assessment . In the last 2 years, this has explored different aspects of measurement and grading of these signs, has documented their relation to blood pressure and has begun to assess whether these features predict vascular events and other systemic outcomes in older Australians. The new project will assess the evolution of retinal microvascular signs over a 10-year period, using data and retinal photographs from the 10-year examinations of the BMES cohort, currently being collected, in a further current NHMRC grant (ID211069; 2002-2004).Read moreRead less
OCULAR PERFUSION PRESSURE: A MODIFIABLE RISK FACTOR FOR GLAUCOMA?
Funder
National Health and Medical Research Council
Funding Amount
$327,560.00
Summary
This project aims to study the mechanisms underlying glaucoma, the second leading cause of vision loss. Specifically it will provide proof for the idea that a person can develop vision loss without having high eye pressure, if their blood pressure cannot provide enough supply to the eye. It will achieve this by combining expertise from several disciplines; physiology, blood pressure control, anatomy and biochemistry. This project will help to improve glaucoma detection, monitoring and treatment.
The Blood-Retinal Barrier - Modelling Mechanisms For Maintenance, Breakdown And Repair
Funder
National Health and Medical Research Council
Funding Amount
$394,310.00
Summary
We believe that breakdown of the barrier that separates the delicate nervous tissue of the eye from the bloodstream, the blood-retinal barrier, may be an early event in the development of age-related macular degeneration (AMD), now overall the commonest cause of blindness in Australia. We have recently demonstrated with the first scientific clinical trials to be conducted in the world that an injection of steroid into the jelly of the eye, or vitreous , of the steroid triamcinolone slows the gro ....We believe that breakdown of the barrier that separates the delicate nervous tissue of the eye from the bloodstream, the blood-retinal barrier, may be an early event in the development of age-related macular degeneration (AMD), now overall the commonest cause of blindness in Australia. We have recently demonstrated with the first scientific clinical trials to be conducted in the world that an injection of steroid into the jelly of the eye, or vitreous , of the steroid triamcinolone slows the growth of abnormal blood vessels in patients with wet AMD. In the current project, Prof Nick King, a cell biologist and viral immunologist, will collaborate with Dr Michelle Madigan, A-Prof Jan Provis, both experts in experimetnal AMD, and A-Prof Mark Gillies, a clinician-scientist specialising in AMD, to study how the treatment works using established animal and laboratory models of a damaged blood retinal barrier. We will be particularly interested in processes which are thought to critical in the development these diseases. We will also study newly described processes by which the junctions that seal the cells of the barrier together come apart. We will be interested not just in the cells that make the barrier, but also the effect of nearby cells that are thought to contribute to it. These studies will provide a solid foundation for the rationalisation of steroid treatment for AMD which can be expected to result in improved outcomes for our patients. The studies may also provide insights into how other barriers malfunction, such as the blood brain barrier which breaks down in Alzheimer s disease and multiple sclerosis.Read moreRead less