18 November 2019
Source: Fight for Sight
Fight for Sight is funding a project to create the UK’s first large-scale glaucoma biobank, a new tool that will help personalise glaucoma treatment and identify patients most at risk of sight loss.
Fight for Sight-funded researcher Dr Anthony Khawaja and his team will establish a data resource to allow better genetic prediction of which glaucoma patients are likely to worsen and therefore require the most intensive treatment. They will be linking data from glaucoma patients at Moorfields Eye Hospital and a national genetics study (the National Institute for Health Research BioResource).
The biobank, called the Moorfields Glaucoma BioResource, will be the first of its kind for glaucoma and comes in response to a recent study part-supported by Fight for Sight  undertaken by Dr Khawaja which identified over 100 genetic factors that are associated with intraocular pressure (IOP) and the risk of developing glaucoma.
Finding the right treatment for individual glaucoma patients is complex. It is difficult to predict on diagnosis which patients will require the most intensive form of treatment, and difficult to determine which care will be most effective for individuals. A ‘trial and error’ approach is therefore used, where several treatments are tried in succession until an effective one is found. Some patients worsen despite treatment , while it is thought some patients are over-treated, which is why this research will be so vital.
If this resource is successful, it is hoped that prediction models can be developed so that patients at high risk of losing their sight will be identified from the point of diagnosis, enabling earlier intensive treatment to prevent vision loss. Conversely, patients at low risk of blindness may be saved the costs of unnecessary treatment.
Lead researcher on the project, Dr Anthony Khawaja, said:
“With the global glaucoma burden set to increase dramatically due to an ageing population, there is an urgent need to innovate our glaucoma management strategy. If we’re able to successfully develop this resource and establish a genetic prediction model, we hope to better detect the most serious cases of glaucoma to prevent sight loss, and to identify low-risk glaucoma patients to reduce over-treatment and resource misuse.”
Fight for Sight’s Head of Research and Policy, Dr Rubina Ahmed, said:
“Research is desperately needed to enable ophthalmologists to determine early on which patients are at high risk of sight loss and require the most intensive care. A biobank for glaucoma is a much-needed step towards personalising care and improving the efficacy of treatment for this devastating condition. This will reduce the burden on both patients and the NHS.”
The project is funded through the Fight for Sight Small Grant Award, which will support the establishment of the Moorfields Glaucoma BioResource, data collection processes, database and the first year of recruitment. It is anticipated this will provide a springboard for further funding to continue recruitment beyond the initial 12-month period, to contribute to the UKGGC (UK Glaucoma Genetics Consortium), and to undertake analyses. It is expected that the initial 1,000 participant recruitment to the Moorfields Glaucoma BioResource will be completed in 24 months.
Glaucoma is the name given to a group of conditions that cause damage to the optic nerve, often linked to a build-up of pressure in the eye. It is the second most common cause of blindness, affecting roughly 60 million people are currently living with glaucoma and the number of patients with the condition is on the rise due to an ageing population.
Given its incurable nature, glaucoma usually requires life-long treatment and is a considerable burden for the NHS. There are over a million NHS attendances per year for glaucoma alone. Indeed, last week The Times reported that 15 glaucoma patients at University Hospital Southampton were found to have been left blind or with severe sight loss as a result of delayed appointments  – suggesting that the prevalence of the condition outstrips the provision of care available to tackle it.
 Khawaja AP et al. Genome-wide analyses identify 68 new loci associated with intraocular pressure and improve risk prediction for primary open-angle glaucoma. Nature Genetics 2018;50:778.
 Garway-Heath DF et al. Latanoprost for open-angle glaucoma (UKGTS): a randomised, multicentre, placebo-controlled trial. Lancet (London, England) 2015;385:1295