Researchers at UCL and Moorfields Eye Hospital have identified specific markers in the blood that can predict if glaucoma patients are at a higher risk of ongoing vision loss despite receiving traditional treatment.
Glaucoma affects over 700,000 individuals in the UK and is the primary cause of irreversible blindness globally. It occurs when the retinal ganglion cells in the eye, responsible for vision, start to deteriorate.
The major risk factors for glaucoma include elevated eye pressure and advancing age.
Presently, all approved treatments aim to reduce eye pressure, also known as intraocular pressure. However, some patients still experience vision loss even after treatment.
A recent study published in Nature Medicine explored whether mitochondrial function in white blood cells could help predict vision loss in glaucoma patients compared to individuals without glaucoma.
Mitochondria act as the energy source for cells, particularly crucial in the energy-intensive cells of the eye.
The research involved 139 participants already undergoing treatment to lower intraocular pressure and 50 healthy individuals for comparison. They examined oxygen utilization in blood cells, vision loss progression, and nicotinamide adenine dinucleotide (NAD) levels.
NAD, derived from vitamin B3 in the diet, is essential for cellular energy production.
The study unveiled that blood cells, specifically peripheral blood mononuclear cells, exhibited different oxygen utilization patterns in individuals with glaucoma.
Those with lower oxygen utilization tended to experience faster vision loss, regardless of the intraocular pressure-lowering treatment. This variance accounted for 13% of the differences in vision loss speed among patients.
Furthermore, individuals with glaucoma showed reduced NAD levels in their blood cells compared to those without the condition, with these lower NAD levels correlating with diminished oxygen utilization in the blood cells.
Professor David (Ted) Garway-Heath from UCL Institute of Ophthalmology and Moorfields Eye Hospital stated, “Introducing white blood cell mitochondrial function and NAD levels as clinical tests could help clinicians predict which patients are more likely to experience continuous vision loss, enabling them to prioritize these individuals for closer monitoring and specialized treatment.”
He added, “If subsequent research confirms that low mitochondrial function or NAD levels contribute to glaucoma, it could lead to novel treatment approaches.”
UCL and Moorfields Eye Hospital are currently overseeing a significant clinical trial, funded by various organizations, to assess whether high-dose vitamin B3 can enhance mitochondrial function and reduce vision loss in glaucoma patients.
This research aims to explore alternative treatment avenues for glaucoma patients beyond traditional eye pressure reduction.
The study received support from various organizations, including Santen SenSyT, Fight for Sight, Glaucoma UK, and the National Institute for Health and Care Research.
