New glaucoma therapy targets neurodegeneration of retinal nerve cells. New diagnostic test is Detection of Apoptosing Retinal Cells [DARC]. It uses Optical Coherence Tomography [OCT] to find dying nerve cells in the eye. DARC helps to evaluate neuroprotection drug candidates faster. Leading glaucoma and neurodegeneration expert.
A clinical trial of Brimonidine (or Alphagan) to provide neuroprotection in glaucoma, was better designed. It was randomized and large. The clinical trial office was in America. Clinicians in Chicago led this clinical trial. They used a medication Brimonidine, or Alphagan. This is a medication that is alpha agonist. Dr. Francesca Cordeiro, MD. Medication has been around for many years for lowering the pressure in the eye. But they found that brimonidine had some neuroprotective effects in glaucoma. That clinical trial compared Brimonidine to beta-blocker eye drops called Timolol. It did show that there was much less visual field progression [constriction of visual fields] in the eyes. Patients were treated with Brimonidine compared to the eyes treated with Timolol. Dr. Anton Titov, MD. So, there was a nice difference in glaucoma treatment results. But the problem was the design of the clinical trial. There were quite a few patients who dropped out. There was a controversy as to whether Brimonidine (Alphagan) conical trial really reflected something that could be taken as a proof of efficacy. We still don’t know if we should change our therapy of glaucoma patients. To be perfectly honest I say this. The patients who probably would benefit most from the neuroprotection in glaucoma are those who are already on glaucoma treatments. But they still continue to lose their vision. So, in all probability in our clinics, most of these patients would already be on something like Brimonidine. But there is no medication currently that is approved as a neuroprotective agent in glaucoma. Hopefully, that will change. Dr. Francesca Cordeiro, MD. I have tried to emphasize is our ability to understand how to perform a clinical trial in this difficult eye disease, glaucoma. Our ability has have improved. For example, you can use the latest methods. I've mentioned the OCT, Optical Coherence Tomography. There is also the visual field testing. You can look at the level of progression or the rate of progression of vision decline. It helps you decide as to whether there is actually a response to treatment. So, these tools that are coming through are very exciting and then, of course there are biomarkers that are coming through. One of the topics we are very keen on putting forward is a brand new marker for glaucoma. This diagnostic marker looks at apoptosis of retinal ganglion cells. We will see whether or not this new diagnostic marker for glaucoma could be used as a measure of eye disease activity. Dr. Francesca Cordeiro, MD. What we are hoping is this. It is a technology called the Detection of Apoptosing Retinal Cells, so that's DARC. This is actually the clinical trial that was performed in this very department at the end of last year. We finished the phase one and we're starting phase two. This clinical trial will determine if this new glaucoma diagnostic marker is safe and tolerable. Dr. Anton Titov, MD. Are we able to diagnose active glaucoma eye disease compared to stable glaucoma eye disease? Or compared with healthy patients. I can't reveal the results of that clinical trial because the scientific paper hasn't been published yet. So, you've talked about glaucoma and the effects of neurodegeneration. This is a significant pathology in glaucoma.