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Articles  |   May 2012
Overarching Themes
Author Affiliations & Notes
  • Gerald J. Chader
    From the Doheny Retina Institute, University of Southern California School of Medicine, Los Angeles, California.
  • Corresponding author: Gerald J. Chader, Doheny Retina Institute, 1355 San Pablo St DVRC-107, Los Angeles, CA 90033; gchader@doheny.org
Investigative Ophthalmology & Visual Science May 2012, Vol.53, 2461. doi:10.1167/iovs.12-9483b
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      Gerald J. Chader; Overarching Themes. Invest. Ophthalmol. Vis. Sci. 2012;53(5):2461. doi: 10.1167/iovs.12-9483b.

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The following themes emerged from the symposium. These are general, overarching themes that give a framework for the more specific recommendations in subsequent sections. 
Scientific
  1.  
    We need better and earlier diagnosis of glaucoma. Since it is a “silent” disease at its early stages, it is often diagnosed too late for effective treatmen t.
  2.  
    We should take advantage of new opportunities to slow or stop vision loss in all glaucoma patients through manipulation of inflow and outflow channels within the eye, alone or in combination with other therapies that focus on the posterior segment, specifically ganglion cells and the optic nerve.
  3.  
    We must better understand the underlying causes of glaucoma through more basic research by establishing and funding consortia that can better, more efficiently, and more rapidly advance our knowledge as to the causes of glaucoma and its treatment.
  4.  
    We should consider and treat all aspects of glaucoma. These aspects include changes in the ganglion cell body and axon, nerve head, brain, and anterior segment changes related to intraocular pressure.
  5.  
    We ought to take advantage of advances made in parallel fields on other neurodegenerative diseases. Neuroprotective and antioxidative agents, for example, have gone to clinical trial in retinitis pigmentosa for photoreceptor cell protection; some have been shown to be effective and safe in glaucoma animal models. Clinical trials should be planned.
  6.  
    Although more basic research on stem cells is still needed, we can aggressively explore the possibility that precursor stem cells have the potential of replenishing trabecular meshwork and ganglion cells.
Personnel and Administrative
  1.  
    We need more strategic planning for the glaucoma field. The strategists should include experts working in other neurodegenerative diseases and other diseases of cellular aging to take advantage of their knowledge.
  2.  
    We should pair selected investigators from different disciplines with incentives to collaborate on a promising treatment strategy.
  3.  
    We need more consortia and vehicles for distant, interlaboratory opportunities, interactions, and communication with more “face time” to design and execute experiments.
  4.  
    There should be a greater number of focused, catalytic meetings of a smaller scale and scope, to complement larger, often impersonal meetings. General strategies can be mapped out at these, and the opportunity for one-on-one talks at such meeting can lead to fruitful collaborations.
  5.  
    We need to find better ways to involve physicians in basic research extending beyond initial clinical residency/fellowship training. A better incentive is needed.
Harnessing Academia, Government, and Industry
  1.  
    We need the increased involvement of pharmaceutical industries (large and small) to test risky, but promising, modalities for controlling intraocular pressure.
  2.  
    We ought to have more meetings among leaders in academic research in glaucoma and industry decision makers to rapidly translate advances at the laboratory bench into clinical testing for a new treatment.
  3.  
    We need government to catalyze meetings and information sharing between academic research leaders and key industry personnel to demonstrate preclinical safety and efficacy to companies so that clinical trials will be planned.
  4.  
    Government and foundations should develop and fund “university incubators” where a potential new treatment can be taken from initial concept through all phases of preclinical testing for safety and efficacy such that a company can confidently take it to clinical trial. This funding should be sustained and relatively long term.
Footnotes
 Disclosure: G.J. Chader, None
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