Studies of Glaucoma Damage and Glaucoma Surgery

The research proposed by Drs. Quigley and Jampel addresses two important problems remaining before the amount of blindness caused by glaucoma can be reduced. The first problem is how to better detect and monitor glaucoma damage. The second is how to improve the treatment of glaucoma once it has been diagnosed. The investigators hypothesize that the detection and monitoring of glaucoma damage can be improved with the use of a computerized camera called an image analyzer. The image analyzer appears to be better at detecting small changes in the optic disc, the structure damaged in glaucoma, that signify worsening glaucoma damage. The investigators propose to use the image analyzer to study changes in the optic disc that occur after short- and long-term changes in eye pressure. A second hypothesis that Drs. Quigley and Jampel will test is whether cells of the retina are damaged by glaucoma. Dr. Quigley has been instrumental in demonstrating that glaucoma damages the nerve fibers in the optic nerve. He now proposes to examine whether glaucoma affects other cells in the eye, specifically cells of the retina, which is the tissue that perceives light. The number and types of cells in the retinas of normal eyes and eyes with glaucoma will be compared. If certain retinal cells are damaged in glaucoma, this might lead to the development of better tests for the detection of glaucoma. Glaucoma surgery is an important treatment of glaucoma. When the surgery is unsuccessful, it is usually due to undesired scarring. The investigators hypothesize that a cell derived from the blood, called a macrophage, and the products it produces, play a critical role in determining if undesired scarring, and surgical failure will occur. Tissue sections from glaucoma operations will be examined with antibodies to determine the role of these cells and their products after glaucoma surgery. Accomplishment of Drs. Quigley and Jampel’s objectives will hopefully enhance the ability to prevent blindness from glaucoma through both improved methods of detection and treatment.