Building a UK Glaucoma Bioresource: a disease-specific biobank for advancing translational research in glaucoma

Abstract

Purpose : To set up a glaucoma specific biobank and describe the design, characterisation and results of the UK Glaucoma BioResource as an important database to support molecular and translational studies.

Methods : Prospective multicentre longitudinal study across seven tertiary hospitals in the UK. Eligible participants were scheduled to undergo glaucoma, cataract or strabismus surgery, and their data were entered onto an electronic database between October 2019 to December 2022. Sample tubes and standardised protocols for tissue collection were provided to surgeons, transferred to the laboratory and stored according to International Society for Biological and Environmental Repositories guidelines. Main outcome measures were tissue specimen types, detailed phenotyping (demographics, clinical examination, medical, laser and surgical treatments), bleb grading, visual fields, OCT imaging of the disc and macula, and quality-of-life measurements.

Results : 2430 tissue samples were collected, of which 2319 were from primary open angle glaucoma (POAG) (aqueous, conjunctiva, tenon, iris, blood DNA, blood serum) and 111 from non-POAG control participants (aqueous, conjunctiva, tenon). Mean (± SEM) age was 67.3 ± 0.8 years and 66.3 ± 1.3 years in POAG and non-POAG eyes, respectively (p=0.56). 55% of POAG and 53% of non-POAG participants were male (p=0.73). Most POAG and non-POAG patients were Caucasian (41.5% vs 51.0%) or African-Caribbean (45.2% vs 33.0%). Pre-operative mean intraocular pressure (mmHg) was 22.3 ± 0.4 (range 9-52) in POAG and 14.2 ± 0.5 (range 8-24) in non-POAG cases (p=0.0001). Mean cup-to-disc ratio was 0.86 (range 0.4-1.0) in POAG and 0.32 (range 0.3-0.5) in non-POAG participants (p=0.0001). 96.5% and 26.5% of POAG patients were on topical and oral anti-glaucoma drugs, respectively; 49.2% had previous glaucoma lasers; 43.8% were pseudophakic, and 12.4% had conjunctival sparing minimally invasive glaucoma surgery (MIGS). 79.6% of POAG patients had moderate to severe glaucoma (MD>-6 dB in 20.4%, MD -6 to -12 dB in 26.4%, MD<-12 dB in 53.2%). Mean OCT disc RNFL thickness was 56.8 ± 1.2 µm and OCT macula mean ganglion cell and inner plexiform layer thickness was 53.3 ± 0.6 µm.

Conclusions : A glaucoma specific bioresource provides a platform for the advancement of translational research and will support future development of novel diagnostic tests and targeted therapeutics.

This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.