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Flinders University to trial SLT for high risk glaucoma patients in world first

Flinders University Professor of Ophthalmology Jamie Craig

In a world first, ophthalmology experts at Flinders University will trial early intervention treatment, selective laser trabeculoplasty (SLT), to prevent people at high risk of glaucoma from developing loss of sight from the disease.

Chief investigator Professor Jamie Craig, Matthew Flinders Distinguished Professor at the College of Medicine and Public Health, has been awarded over $1.7 million to explore the use of early intervention to prevent glaucoma related vision loss for those at risk.

The trial will use SLT that has been proven to slow disease progression by lowering intraocular pressure. The trial will determine the effectiveness and suitability of using SLT laser as an early intervention to prevent the onset of visual loss from glaucoma.

“We have developed a tool that can identify individuals who are deemed at high risk of losing their vision from glaucoma, however there is still a major gap between identifying them and how they may be safely treated,” Craig said.

He said early detection and treatment of those most at risk of vision loss is fundamental to reducing the disease burden for patients and the health care system.

“This clinical trial will generate high-quality evidence to determine the effectiveness of a more timely delivery of laser for high-risk individuals. If effective, this will reduce visual issues and blindness from glaucoma which will improve their quality of life, allow them to continue working and driving, reduce their risk of falls and lead to cost savings for the health system,” he said.

The $1.7 million research project will use a randomised controlled trial of 500 genetically at-risk glaucoma suspects to determine the effectiveness of early laser treatment in preventing loss of vision.

After receiving the laser treatment, participants will be monitored twice a year over a two-year period.

“Insights gained from this trial will have immediate implications for the monitoring and treatment of high-risk glaucoma patients, with the aim of preventing progressive vision loss and blindness both in Australia and internationally,” Craig said.

The new project also involves other researchers from Flinders University, University of Tasmania, Maquarie University, The University of Adelaide, The Garvan Institute of Medical Research, The Council of the Queensland Institute of Medical Research, University of New South Wales, and The George Institute for Global Health.

Craig has made important discoveries on the genetic basis of glaucoma using a pioneering International Registry of cases of vision loss. This approach led to genome-wide association studies identifying multiple genes associated with glaucoma susceptibility. These discoveries are now moving into the clinic as risk profiling for individuals becomes a reality.

This project follows on from previous research by Craig developing a glaucoma polygenic risk score (PRS) which effectively identifies individuals at high risk of becoming blind from glaucoma.

It found that PRS is highly predictive of future vision loss and that new monitoring and treatment strategies such as the pre-emptive laser treatment are required.

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