UK researchers pinpoint markers in blood that predict response to glaucoma treatment

Researchers from Moorfields Eye Hospital and University College London (UCL) have identified markers in the blood that predict whether an individual is likely to continue losing vision despite treatment that aims to lower intraocular pressure.

Writing in Nature Medicine, scientists described a trial involving 139 patients with glaucoma and 50 healthy individuals who acted as a control group.

The researchers tracked how efficiently cells in the blood use oxygen, how much vision was lost over time and levels of a molecule that help cells produce energy – nicotinamide adenine dinucleotide (NAD).

The scientists found that the oxygen consumption rate of peripheral blood mononuclear cells was linked to how fast glaucoma patients lost peripheral vision – even if they were being treated to lower intraocular pressure.

Those with a lower oxygen consumption rate in these cells experienced faster visual field loss.

People with glaucoma were found to have lower levels of NAD in their blood cells compared to people without glaucoma.

Professor David ‘Ted’ Garway-Heath, of UCL’s Institute of Ophthalmology and Moorfields Eye Hospital, shared: “White blood cell mitochondrial function and NAD levels, if introduced as a clinical test, would enable clinicians to predict which patients are at higher risk of continued vision loss, allowing them to be prioritised for more intensive monitoring and treatment.”

UCL and Moorfields are currently leading a clinical trial to establish whether high-dose vitamin B3 can boost mitochondrial function and reduce vision loss in glaucoma.

“We hope that this will open a new avenue for treatment of glaucoma patients which does not depend on lowering the eye pressure,” Garway-Heath explained.