21st century glaucoma care

Quigley, Harry A.

doi:10.1038/s41433-018-0227-8

Cited by 66 publications

(53 citation statements)

References 36 publications

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“…This adverse effect was not unique to Eyecatcher, and the participant reported similar reactions following conventional SAP. However, this highlights that it may be helpful to tailor the use and frequency of home-monitoring to the needs and abilities of individual patients, in contrast to the current "one size fits all" approach to VF monitoring 12 , 56 , 57 . A full qualitative analysis of participants’ views on the benefits and challenges of home-monitoring is in preparation, and will be reported elsewhere.…”

Section: Discussionmentioning

confidence: 99%

“…Thus, it may be best to concentrate home-monitoring resources on those patients whose age 11 or condition 17 , 18 , 19 makes them most likely to experience debilitating vision loss within their lifetime. It may also be worth considering the potential secondary benefits of home-monitoring, such as improved patient satisfaction and retention 56 , 64 , or better treatment adherence. Thus, it is well established many glaucoma patients find hospital visits stressful and inconvenient 56 , 65 , and home-monitoring might be welcomed as a way of saving time, travel, and money.…”

Section: Discussionmentioning

confidence: 99%

“…It may also be worth considering the potential secondary benefits of home-monitoring, such as improved patient satisfaction and retention 56 , 64 , or better treatment adherence. Thus, it is well established many glaucoma patients find hospital visits stressful and inconvenient 56 , 65 , and home-monitoring might be welcomed as a way of saving time, travel, and money. Treatment adherence is known to increase markedly prior to a hospital appointment 66 (“white-coat adherence”), or when patients receive automated reminders 67 , 68 , and it is conceivable that the anticipation of regular home monitoring could provide a similar impetus.…”

Section: Discussionmentioning

confidence: 99%

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Glaucoma Home Monitoring Using a Tablet-Based Visual Field Test (Eyecatcher): An Assessment of Accuracy and Adherence Over 6 Months

Jones

Campbell

Callaghan

et al. 2021

American Journal of Ophthalmology

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Purpose To assess accuracy and adherence of visual field (VF) home-monitoring in a pilot sample of glaucoma patients. Design Prospective longitudinal feasibility and reliability study. Methods Twenty adults (median 71 years) with an established diagnosis of glaucoma were issued a tablet-perimeter (Eyecatcher), and were asked to perform one VF home-assessment per eye, per month, for 6 months (12 tests total). Before and after home-monitoring, two VF assessments were performed in-clinic using Standard Automated Perimetry (SAP; 4 tests total, per eye). Results All 20 participants could perform monthly home-monitoring, though one participant stopped after 4 months (Adherence: 98%). There was good concordance between VFs measured at home and in the clinic ( r = 0.94, P < 0.001). In 21 of 236 tests (9%) Mean Deviation deviated by more than ±3 dB from the median. Many of these anomalous tests could be identified by applying machine learning techniques to recordings from the tablets’ front-facing camera (Area Under the ROC Curve = 0.78). Adding home-monitoring data to 2 SAP tests made 6 months apart reduced measurement error (between-test measurement variability) in 97% of eyes, with mean absolute error more than halving in 90% of eyes. Median test duration was 4.5 mins ( Quartiles : 3.9 – 5.2 mins). Substantial variations in ambient illumination had no observable effect on VF measurements ( r = 0.07, P = 0.320). Conclusions Home-monitoring of VFs is viable for some patients, and may provide clinically useful data.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Glaucoma Home Monitoring Using a Tablet-Based Visual Field Test (Eyecatcher): An Assessment of Accuracy and Adherence Over 6 Months

Jones

Campbell

Callaghan

et al. 2021

American Journal of Ophthalmology

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“…Elevated intraocular pressure (IOP) is strongly associated with glaucoma, and reduction of IOP is the only therapeutic mechanism available to slow disease progression. However, glaucoma can continue to progress even in patients who achieve normal IOPs following medical and/or surgical treatments ( Quigley, 2019 ). Therefore, new therapies are urgently needed to prevent vision loss in patients with glaucoma.…”

Section: Introductionmentioning

confidence: 99%

GLP-1 Receptor Agonist NLY01 Reduces Retinal Inflammation and Neuron Death Secondary to Ocular Hypertension

et al. 2020

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SUMMARY Glaucoma is the leading cause of irreversible blindness and is characterized by the death of retinal ganglion cells (RGCs). Recent studies have implicated pro-inflammatory microglia, macrophages, and A1 astrocytes in the pathogenesis of neurodegenerative diseases. The role of pro-inflammatory, neurotoxic A1 astrocytes in glaucoma is just beginning to be explored. Using a mouse model of glaucoma, we demonstrate that ocular hypertension is sufficient to trigger production of C1q, interleukin-1α (IL-1α), and tumor necrosis factor α (TNF-α), three cytokines necessary and sufficient to drive the formation of A1 astrocytes. Upregulation of these cytokines occurs first in CD11b + CD11c + cells followed by CD11b + CD11c − cells. Ablation of this pathway, by either genetic deletions of C1qa, IL-1α, and TNF-α, or treatment with glucagon-like peptide-1 receptor agonist NLY01, reduces A1 astrocyte transformation and RGC death. Together, these results highlight a neuroinflammatory mechanism of glaucomatous neurodegeneration that can be therapeutically targeted by NLY01 administration.

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“…Elevated intraocular pressure (IOP) is strongly associated with glaucoma, and reduction of IOP is the only therapeutic mechanism available to slow disease progression. However, glaucoma can continue to progress even in patients who achieve normal IOPs following medical and/or surgical treatments (Quigley, 2018). New therapies are urgently needed to prevent vision loss in patients suffering from glaucoma.…”

Section: Introductionmentioning

confidence: 99%

GLP-1R agonist NLY01 reduces retinal inflammation, astrocyte reactivity, and retinal ganglion cell death secondary to ocular hypertension

Sterling

Adetunji

Guttha

et al. 2020

Preprint

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Glaucoma is the leading cause of irreversible blindness worldwide and is characterized by the death of retinal ganglion cells. Reduction of intraocular pressure (IOP) is the only therapeutic mechanism available to slow disease progression. However, glaucoma can continue to progress despite normalization of IOP. New treatments are needed to reduce vision loss and improve outcomes for patients who have exhausted existing therapeutic avenues. Recent studies have implicated neuroinflammation in the pathogenesis of neurodegenerative diseases of both the retina and the brain, including glaucoma and Parkinson's disease. Pro-inflammatory A1 astrocytes contribute to neuronal cell death in multiple disease processes and have been targeted therapeutically in mouse models of Parkinson's disease. Microglial release of pro-inflammatory cytokines C1q, IL-1α, and TNF-α is sufficient to drive the formation of A1 astrocytes. The role of A1 astrocytes in glaucoma pathogenesis has not been explored. Using a mouse model of glaucoma, we demonstrated that IOP elevation was sufficient to trigger production of C1q, IL-1α, and TNF-α by infiltrating macrophages followed by resident microglia. These three cytokines drove the formation of A1 astrocytes in the retina. Furthermore, cytokine production and A1 astrocyte transformation persisted following IOP normalization. Ablation of this pathway, by either genetic deletions of C1q, IL-1α, and TNF-α, or treatment with glucagon-like peptide-1 receptor agonist NLY01, reduced A1 astrocyte transformation and RGC death. Together, these results highlight a new neuroinflammatory mechanism behind glaucomatous neurodegeneration that can be therapeutically targeted by NLY01 administration.

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21st century glaucoma care

Cited by 66 publications

References 36 publications

Glaucoma Home Monitoring Using a Tablet-Based Visual Field Test (Eyecatcher): An Assessment of Accuracy and Adherence Over 6 Months

Glaucoma Home Monitoring Using a Tablet-Based Visual Field Test (Eyecatcher): An Assessment of Accuracy and Adherence Over 6 Months

GLP-1 Receptor Agonist NLY01 Reduces Retinal Inflammation and Neuron Death Secondary to Ocular Hypertension

GLP-1R agonist NLY01 reduces retinal inflammation, astrocyte reactivity, and retinal ganglion cell death secondary to ocular hypertension

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