Advancing early detection, risk modification, and neuroprotection
Four connected areas of investigation guide GRO’s current scientific priorities.
Although intraocular pressure reduction remains central to glaucoma management, glaucomatous injury can occur or progress despite statistically normal intraocular pressure. GRO investigates early neuronal dysfunction and risk factors that may influence susceptibility.
1. Normal-Tension Glaucoma
Understanding glaucomatous injury beyond intraocular pressure
Our research investigates normal-tension glaucoma (NTG), emphasizing factors associated with retinal ganglion cell dysfunction in individuals without elevated intraocular pressure. We seek to improve identification of at-risk individuals and understanding of disease development and progression.
2. Early Retinal Ganglion Cell Dysfunction
Detecting neuronal stress before established damage
GRO investigates objective functional measures, particularly pattern electroretinography (PERG), to characterize retinal ganglion cell dysfunction that may precede detectable structural damage or established visual-field loss. We study the potential clinical significance of this early functional stage for glaucoma risk assessment and monitoring.
3. Modifiable Non-IOP Risk Factors
Investigating systemic contributors to glaucomatous injury
Our work examines potentially modifiable risk factors beyond intraocular pressure, with particular attention to obstructive sleep apnea (OSA). Prospective investigations explore relationships among OSA, treatment exposure, and retinal ganglion cell function.
Preliminary findings suggest that OSA treatment may be associated with improved electrophysiological function; larger longitudinal studies are needed to establish clinical significance and durability.
4. Neuroprotection and Functional Recovery
Exploring opportunities to preserve vulnerable retinal neurons
We investigate whether early retinal ganglion cell dysfunction represents a potentially recoverable phase of neuronal stress. Our long-term objective is to inform research on interventions that may preserve neuronal function before irreversible injury.
Our research integrates steady-state PERG, optical coherence tomography, visual-field testing, intraocular pressure assessment, and systemic clinical information to examine early glaucomatous vulnerability.
From early dysfunction to longitudinal understanding
GRO studies whether functional changes can help characterize vulnerable retinal ganglion cells, and how clinical and systemic risk factors relate to their subsequent course.
Early RGC dysfunction
Study PERG signals alongside OCT and visual-field findings, including eyes without established structural loss.
Potentially modifiable risks
Examine OSA and treatment exposure alongside intraocular pressure and other clinical factors.
Function and structure
Assess longitudinal functional and structural trajectories to inform future neuroprotection research.
Research hypothesis, not a proven clinical pathway. PERG and OCT are complementary measures; their abnormalities do not follow a universal sequence. Whether OSA treatment changes glaucoma outcomes remains to be determined.