Glaucomics: A Call for Systems Diagnostics for 21^stCentury Ophthalmology and Personalized Visual Health

Abstract

This article analyzes and theorizes the current knowledge silos at the intersection of omics science, ophthalmology, personalized medicine, and global visual health. Visual disorders represent one of the largest health care expenditures in the United States, costing $139 billion per year. In middle-income and industrialized countries, glaucoma is a World Health Organization priority category eye disease, known for difficulties in its early diagnosis, chronic progressive nature, and large person-to-person differences in drug efficacy and safety. A complex disease, glaucoma is best conceptualized as a syndrome displaying an ostensibly common clinical end-point, but with vastly heterogeneous molecular underpinnings and host-environment interactions. About 12% of all global blindness is attributable to glaucoma. Glaucomics is a term that we coin here so as to introduce omics science and systems diagnostics to ophthalmology, a field that can benefit enormously from personalized medicine, and which has sadly lagged behind in systems diagnostics compared to fields such as oncology. We define glaucomics as the integrated use of multi-omics and systems science approaches towards rational discovery, development, and tandem applications of diagnostics and therapeutics, for glaucoma specifically, and for personalized visual health, more broadly. We propose that glaucoma is one of the neglected lowest hanging fruits and actionable targets for omics and systems diagnostics in 21(st) century ophthalmology for the salient reasons we describe here. Additionally, we offer an analysis on two of the most pertinent neglected tropical diseases (NTDs), trachoma and river blindness, which continue to plague visual health in developing countries. We conclude with a call for research on omics applications in glaucoma and personalized visual health.

Metabolomics in Glaucoma: A Systematic Review

“…Application of metabolomics on glaucoma is a field that can benefit enormously from personalized medicine. 1 However, the development of glaucoma metabolomics has sadly lagged behind compared to other fields such as oncology. More studies, especially longitudinal cohort metabolomics and clinical intervention metabolomics studies, should be carried out to explore novel biomarkers of glaucoma and determine target metabolic pathways for prevention and treatment.…”

“…Glaucoma is a main cause of irreversible blindness, contributing to about 12% of all global blindness. 1 It is estimated that the global prevalence of glaucoma in adults aged 40 to 80 years is 3.54%. 2 The number of people with glaucoma worldwide is projected to increase to 111.8 million in 2040, disproportionally affecting Asians and Africans.…”

A Data Mining Metabolomics Exploration of Glaucoma

“…It is the leading cause of irreversible blindness worldwide, with an incidence increasing due to population aging [1,2]. It is the World Health Organization's priority in eye disease, known for the difficulties in providing an early diagnosis, its chronic evolution, and its large person-to-person difference in drug efficacy [3]. Glaucoma remains a poorly understood disease, with a range of therapeutic options targeting the main risk factor, the increased intra-ocular pressure, while there is currently no treatment to protect the retinal ganglion cells.…”

Organizational Silos: A Scoping Review Informed by a Behavioral Perspective on Systems and Networks

“…Lastly, functional silos [93] are particularly interesting for the aims of this study, insofar as they are defined as a hierarchical management style [94], rather than the structure of exchanges underlying the management or leadership practices. For example, this view is in contrast with other views of organizational silos: data silos [95,96] and knowledge silos [97,98], according to which the boundaries lie in the content and are not just formal or arbitrary ones.…”