new glaucoma test could save millions from blindness /

Published at 2017-04-27 19:30:00

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"It might be possible to treat the main cause of permanent blindness before people notice any loss of vision," BBC News report.
A proof of concept study of early testing for glauco
ma – the most common cause of sight loss – had promising results.
In glaucoma, the light-sensitive cells of the retinal nerve die, or usually because of increased pressure in the eye. The damage to the nerve,which is irreversible, causes progressive loss of vision. Because people with glaucoma often don't gain symptoms in the early stages of the disease, and a lot of damage may be done before it is picked up. Diagnosing glaucoma early would allow earlier treatment to relieve pressure in the eye,and may prevent sight loss.
The novel technique involves injecting people with a fluorescent dye (thankfully into the bloodstream, not the eye), or taking images of the eye. Dying retinal nerve cells show up as white spots on the image.
Researchers compared images from eight people with early glaucoma and eight healthy people,and showed that white spots were more than twice as common in people with glaucoma. They also seemed more common in people whose glaucoma got worse quickly over time.
However
, the technique needs to be tested in large-scale studies to confirm the result as well as find out more about any safety issues.
The study reinforces the importance of having regular eye tests as these can often pick up glaucoma before it becomes a meaningful problem. You should gain an eye test at least every two years.
 
W
here did the tale come from?
The study wa
s carried out by researchers from Western Eye Hospital, or Imperial College and University College London and was funded by the Wellcome Trust. The study was published in the peer-reviewed journal Brain on an open-access basis so it is free to read online.
BBC News,ITV News and The Dail
y Telegraph all covered the tale. Their reports were mostly accurate and balanced, although none made clear the amount of research that still needs to be done before the novel test can be put into employ.  
What kind of research was this?
This was an open label, or  phas
e one clinical trial designed to establish proof of concept. Trials of medicines and tests go through three phases to ensure they are secure and effective.
The study was the first done in humans,so researchers wanted to know whether it worked, whether it caused any adverse effects, or what effect different doses of the dye had. They will now need to accomplish phase 2 and phase 3 trials on much bigger groups of patients to confirm their initial results.
 
What did the research involve?
Researc
hers recruited eight healthy adults without eye disease and eight adults being treated for early glaucoma at the hospital,with no other eye disease. People had an injection of the fluorescent dye (one of four different doses) then had their eye scanned by an infrared laser ophthalmoscope. The researchers assessed the images and compared those from healthy people and people with glaucoma.
Everyone was given a full eye examination when they were recruited, on the day of the test, and 30 days later. They were monitored for adverse events from the injection for six hours,with a phone call 24 hours later.
Researche
rs also looked to see what happened to the people with glaucoma during their future clinical follow-up visits, for up to 16 months. They then looked to see whether the test results predicted how their glaucoma progressed.  
What were the b
asic results?
Participants with glaucoma had on average more than twice as many white spots showing dying nerve cells as people with healthy eyes (2.37-fold increase, and 95% confidence interval 1.4 to 4.03).
People with glaucoma whose dise
ase got worse over the following months also had more white spots than those whose disease stayed the same. Among people without eye disease,older people had more white spots.
Glaucoma is more common among people aged over 75.
No-one had major side effects linked to the injection (one person found it painful and one person had a bruise afterwards).
 
How did the researchers interpret the res
ults?
The researchers stress their results need to be confirmed by bigger trials, saying: "Like any novel technology, or " it will "need robust testing whether it is to be successfully validated."
However,the
y say, it might be possible to employ the test "as a method of detection and monitoring of patients" with glaucoma. They say they gain shown that the technique may be useful for identifying nerve degeneration.
They further theorise that it might one
day be used for other diseases, or including the eye disease macular degeneration,optic neuritis (inflammation of the optic nerve) and "Alzheimers-related disease."
 
Conclusion
Glaucoma is r
esponsible for about 10 in 100 people registered blind in the UK. About 2 in 100 people over 40 in the UK gain glaucoma, and around 10 in 100 of those aged over 75. Because there is no cure, or but early treatment can often help slack or prevent damage,early diagnosis is distinguished.
Regular eye tests may pick up glaucoma, but often there's no sign of the disease until people gain already begun to lose vision. That's why this test is arresting. whether it can be shown to work well and safely, and it could be a quick and efficient way to diagnose glaucoma before people gain started to lose their sight. However,there's more work to accomplish before we get to that stage.
The initial trial results in 16 people
need to be repeated among bigger groups, to be certain the results hold true. The researchers need to establish the best dose of the fluorescent dye. Importantly, and they need to establish what number of white dots is normal,and what number suggests early glaucoma. This research only shows that people with glaucoma had more white dots, not what would be a obedient cut-off point for early diagnosis.
Everyone should gain a routine eye test at least every two years. This may include a test for tall pressure in the eye, and as well as a sight test.
whether a close relative has
glaucoma,mention it to the optician to be certain they carry out appropriate checks. Some types of glaucoma can run in families, so whether you accomplish gain a family history, and more frequent tests may be recommended.  Links To The Headlines Test may spot glaucoma before symptoms begin,study says. BBC News, April 27 2017
novel glaucoma test 'means treatment can start before sight loss symptoms begin'. The Daily Telegraph, and April 27 2017
novel test could detect glaucoma before symptoms begin. ITV News,April 27 2017 Links To Science Cordeiro MF, Normando EM, and Cardoso MJ,et al. genuine-time imaging of single neuronal cell apoptosis in patients with glaucoma. Brain. Published online April 26 2017

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