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Broad overview published on strategies to protect neurons in glaucoma

12 July 2023

James Tribble, Assistant Professor at Karolinska Institutet and St. Erik Eye Hospital, has written an overview article with colleagues in Australia and Canada on how research into new glaucoma treatments is progressing.

James Tribble, Assistant Professor at Karolinska Institutet and St. Erik Eye Hospital, has made a broad overview of strategies to protect nerve cells in glaucoma.

You and colleagues in Australia and Canada have written a review article on the progress of research into new glaucoma treatments. How is that?

– Current treatments only attempt to control pressure in the eye; while for many patients this can be effective, unfortunately, for many this does not prevent the loss of vision, says James Tribble. What we need are treatments that work in other ways to prevent the loss of nerve cells in the eye and prevent people from losing their sight.

There has been a great advance in our understanding of glaucoma in the last few decades, in particular, what is happening to these nerve cells and their environment and how we may be able to target these processes for protection. We have written a comprehensive review article highlighting this progress. We hope that this article will be an excellent starting point for scientists and clinicians entering the research field as well as an important resource for those wishing to learn more about where the future of glaucoma management may lie.

What does the state of research in terms of neuroprotective strategies look like in the world?

– We know that glaucoma is a very complex disease, there are many processes that become dysfunctional, and the combination of these is what has made the search for a universal treatment so difficult. We outline a number of the most important of these processes, including controlling inflammation, how cells die, how they move around their resources, and their metabolism. The research community has developed a good understanding of these processes now and many of these we can treat in animals to completely prevent glaucoma. While many of these processes are not so easy to turn in to therapies for patients, what we have learnt adds to our knowledge about glaucoma and how we could treat it in the future. Some of these may well become future treatments. 

Which research fields have come the farthest and is the most interesting, in your opinion?

– We have made rapid advancements in understanding metabolic dysfunction in the retina and optic nerve in glaucoma. I think this is where we are most likely to see new treatment for glaucoma because it is so heavily linked to all of these different processes and can be modified so much more easily than other processes. Nicotinamide in particular is showing a lot of promise and is currently in clinical trials here in Sweden and with collaborators across the world.

What research area do you work in yourself?

– I’m particularly interested in both metabolism and inflammation, and my current research is looking at ways in which these processes become dysfunctional in glaucoma and how we may target them with the hope of identifying new treatments for glaucoma.