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Gene Therapy Could Help Treat Glaucoma
Macquarie Medical School researchers have developed a technique for a gene therapy that could help treat the world's leading cause of irreversible blindness. The findings are published in the journal Molecular Therapy.
A treatment that ensures nerve cells in the eye continue to produce a vital protein that protects them from being broken down could help prevent the progression of glaucoma, researchers have found.
Glaucoma is the world's leading cause of irreversible blindness, affecting about 300,000 Australians and more than 70 million people globally. It is associated with gradual vison loss, initially in the periphery but then spreading centrally. The disease damages the optic nerve and the retinal ganglion cells, which are a type of neuron that carry visual information to the brain.
Glaucoma is often associated with increased pressure in the eye, and it can be detected during routine vision tests, by measuring the eye pressure or inspecting the optic nerve for damage with special scanners.
While any damage already sustained cannot be reversed, in many cases the progression of the disease can be slowed or stopped through treatment to lower the pressure.
However, many patients continue to worsen despite treatment, indicating there are other factors at play in addition to pressure.
Professor of Ophthalmology Stuart Graham from Macquarie Medical School is leading a team that is investigating the role of the protein neuroserpin in the disease.
Vision Neurobiologist Associate Professor Vivek Gupta says they have found that neuroserpin, which is produced in the connectors between nerve cells, is vital in protecting retinal ganglion cells.
"Other researchers have linked changes in neuroserpin to stroke and neurodegenerative disorders like Alzheimer's and Parkinson's diseases, but our work is the first to relate it to glaucoma," says Professor Gupta.
"Cells naturally break down and are recycled in the body, but when neuroserpin is absent, this process speeds up in the retina.
"Essentially, the body begins to eat away at the retinal ganglion cells and the optic nerve."
Oxidation is a common cause of molecular breakdown in nature. Iron rusting and a cut apple turning brown are both familiar examples.
The team has discovered that when neuroserpin oxidizes, it loses its protective ability, allowing accelerated cell breakdown.
They have also shown that when mice produce more neuroserpin, it has a protective effect, promoting the survival of the retinal ganglion cells and minimizing glaucoma damage.
Vision Scientist Dr. Nitin Chitranshi says in the latest work, detailed in an article in the latest edition of Molecular Therapy, the team has successfully manipulated a gene in mice to produce a version of neuroserpin that is resistant to oxidation.
"When we introduce this gene directly to the eye, it increases the production of neuroserpin in the retina," says Dr. Chitranshi.
"Currently, that involves injecting it into the eye, which is obviously quite confronting, but we are working on a way to introduce the gene using a synthetic virus that can be targeted to specific cells in the retina.
"The artificial virus would not have any effect on the body, but would act as a carrier for the therapy, allowing our specially developed nanoparticles to get inside the cells and tell them to produce our modified neuroserpin.
"We are also working on a way for the protein to give its instructions to produce neuroserpin only to the retinal ganglion cells and not to other neurons, so it can be perfectly targeted."
The team is now preparing for further testing of the enhanced gene and will commence new trials shortly.
Professor Graham says glaucoma is a complex disorder involving a number of mechanisms, not all of which are well understood. "For this reason, our gene therapy is unlikely to be a silver bullet for all glaucoma, but we have great hopes that it will become a valuable part of treatment for use in conjunction with other therapies, making the nerve cells more resistant to damage," he says.
More information: Nitin Chitranshi et al, Neuroserpin gene therapy inhibits retinal ganglion cell apoptosis and promotes functional preservation in glaucoma, Molecular Therapy (2023). DOI: 10.1016/j.Ymthe.2023.03.008
Citation: Gene therapy could help treat glaucoma (2023, June 27) retrieved 28 June 2023 from https://medicalxpress.Com/news/2023-06-gene-therapy-glaucoma.Html
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Glaucoma Classifications
There are several specific types of glaucoma. Some of these are:
Primary open angle glaucomaIn this type of glaucoma the optic nerve damage resulting from increased pressure in the eye is caused by trabecular blockage which is where the aqueous humor in the eye drains out. All patients with open angle glaucoma do not have eye pressure that is elevated beyond normal, but decreasing the eye pressure further has been shown to stop progression of loss of vision. Vision loss is a gradual process and peripheral vision is affected first, however, eventually the entire vision will be lost if not treated. Diagnosis is made by looking at changes in the optic nerve cup. Prostoglandin agonists like lataniprost and parasympathetic analogs like pilocarpine help by opening uveoscleral passageways for drainage. Beta blockers such as timolol and Alpha 2 agonists (brimonidine, apraclonidine), are also beneficial by decreasing aqueous formation. Similarly Carbonic anhydrase inhibitors like dorzolamide and acetazolamide help in decreasing bicarbonate formation from ciliary processes in the eye, thus decreasing formation of Aqueous humor.
Angle-closure glaucomaThis type of glaucoma occurs due to narrowing of the angle between the iris and trabecular meshwork, which in turn obstructs outflow of the aqueous humor from the eye. This narrowing damages the function of the meshwork until it fails to keep pace with aqueous production, and the pressure rises. In some cases, pressure may rapidly build up in the eye causing pain and redness. This is called acute angle closure glaucoma. In this situation the vision may become blurred, and halos may be seen around bright lights along with severe headache and vomiting. After initial treatment with medications definitive treatment is laser iridotomy. This may be performed using either Nd:YAG or argon lasers, or in some cases by conventional incisional surgery.
Normal tension glaucoma (low tension glaucoma)Glaucoma occurs in absence of a raised mean IOP on diurnal testing. There may be presence of optic nerve damage and an open angle between the iris and the cornea. Elderly and females are usually prone to this type of glaucoma. May be associated with the Raynaud's phenomenon, migraines, paraproteinaemia. Treatment is by reducing intraocular pressure as for open angle glaucoma. The aim is to reduce IOP by 30%. It is also recommended that systemic blood pressure be monitored over 24 hours, as normal tension glaucoma may be associated with nightly low blood pressure. There is often a delay in diagnosis, resulting in more advanced visual field defects. Patients with defects in one eye have a 40% chance of developing defects in the fellow eye over 5 years.
Secondary glaucomasThese are caused as a result of blockage of the aqueous outflow system due to other eye diseases. Types include:
This includes types like infantile glaucoma and glaucoma associated with hereditary of familial diseases.
Other types of glaucomaOphthalmology Lasers Market Size, Share, Demand, Future Growth, Challenges And Competitive Outlook Report
United States Ophthalmology Lasers Market are specialized medical devices that emit focused beams of light to treat various eye conditions. These lasers are commonly used in ophthalmology to perform various procedures, such as treating vision disorders, correcting refractive errors, and managing various eye diseases. The devices gained increased importance and adoption due …
New York United States - June 21, 2023 —
Ophthalmology Lasers Market are specialized medical devices that emit focused beams of light to treat various eye conditions. These lasers are commonly used in ophthalmology to perform various procedures, such as treating vision disorders, correcting refractive errors, and managing various eye diseases. The devices gained increased importance and adoption due to the high prevalence of several ophthalmic diseases, such as glaucoma, cataract, and other vision-related issues.
The global ophthalmology lasers market is expected to gain market growth in the forecast period of 2023 to 2030. Data Bridge Market Research analyses that the market is growing with a CAGR of 6.2% in the forecast period of 2023 to 2030 and is expected to reach USD 3,478.03 million by 2030 from USD 2,152.97 million in 2022.S
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Market Overview:
This ophthalmology lasers market report provides details of new recent developments, trade regulations, import-export analysis, production analysis, value chain optimization, market share, the impact of domestic and localized market players, analyses opportunities in terms of emerging revenue pockets, changes in market regulations, strategic market growth analysis, market size, category market growths, application niches and dominance, product approvals, product launches, geographic expansions, technological innovations in the market. To gain more info on the ophthalmology lasers market, contact Data Bridge Market Research for an Analyst Brief. Our team will help you take an informed market decision to achieve market growth.
Ophthalmology lasers are specialized medical devices that emit focused beams of light to treat various eye conditions. These lasers are commonly used in ophthalmology to perform various procedures, such as treating vision disorders, correcting refractive errors, and managing various eye diseases. The devices gained increased importance and adoption due to the high prevalence of several ophthalmic diseases, such as glaucoma, cataract, and other vision-related issues.
Drivers
Increasing incidences of chronic and communicable eye diseases
The field of ophthalmology has seen a rise in the incidence of both chronic and communicable eye diseases in recent years. Some of the major factors contributing to this trend include a growing global population, an aging population, increased urbanization, changing lifestyles, and increased exposure to environmental pollutants. One of the most common chronic eye diseases is Age-Related Macular Degeneration (AMD). AMD is a leading cause of blindness in people over the age of 60 and is caused by damage to the macula, a small part of the retina responsible for central vision. The prevalence of AMD is expected to increase with an aging global population. Another chronic eye disease that is becoming more prevalent is glaucoma. Glaucoma is a group of eye diseases that cause damage to the optic nerve and can lead to blindness. It is often asymptomatic until it reaches an advanced stage, making regular eye exams crucial for early detection and treatment.
In March 2023, according to an article by Indian Express, globally, glaucoma is the second leading cause of blindness after cataracts. It is estimated to cause blindness in 4.5 million people worldwide. Despite this, glaucoma is largely undiagnosed, with more than 90 percent of untreated cases. Thus, increasing incidences of chronic and communicable eye diseases are expected to drive the market's growth.
Increasing adoption of outpatient procedures
The field of ophthalmology has seen significant advancements in recent years with the advent of laser technology. With the increasing adoption of outpatient procedures, the global ophthalmology lasers market presents a significant opportunity for growth. Outpatient procedures are medical procedures that do not require an overnight stay in a hospital. These procedures can be performed in a medical office, ambulatory surgery center, or outpatient clinic. Thus, the increasing adoption of outpatient procedures is expected to drive the market's growth.
Market Development
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Major Players
Data Bridge Market Research recognizes the following companies as the market players in the global ophthalmology lasers market are NIDEK CO., LTD. (Japan) iVIS Technologies (Italy), SCHWIND eye-tech-solutions (Germany), ARC Laser GmbH (Germany), Calmar Laser (US), LENSAR, INC. (US), OD-OS (Germany), Quantel Medical (Subsidiary of Lumibird Medical) (France), Aurolab (India), Alcon (Switzerland), Ziemer Ophthalmic Systems AG (Switzerland), LIGHTMED (U.S.), Johnson & Johnson Inc. (U.S.), Bausch & Lomb Incorporated (Canada), MEDA Co., Ltd. (China), Topcon(Japan), Lumenis Be Ltd. (Israel), IRIDEX Corporation (U.S.), and Zeiss (Germany) among others.
Global Ophthalmology Lasers Market Scope
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Type
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End User
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