New Dynamometric Techniques for Predicting Glaucoma Progression

青光眼是我们社区失明的主要原因。青光眼的最大危险因素是眼压升高。然而，这种疾病的确切病因仍不清楚。通过我们在动物身上的基础科学研究，我们发现视盘血管血流的变化可能参与了疾病的过程。在最近的临床试验中，我们发现视网膜视网膜静脉是否有搏动是青光眼严重程度和进展的一个指标。这是一项重大突破，因为没有其他方法可以预测青光眼患者视力丧失的发展速度最快。这些信息将非常有助于决定哪些患者应该接受最积极的治疗以恢复正常的眼压。该项目旨在开发一种新的商业设备，使任何临床眼科医生都能轻松进行这种检查。该设备允许医生检查盘上的血管，同时对眼睛施加轻微压力以暂时提高眼压。当医生看到血管搏动时，就按下脚开关。所需的力由笔记本电脑记录下来，数据与患者的详细信息一起存储。现在我们已经证实了这种测量方法能够预测青光眼的视野丧失率，这种测量方法将在临床眼科中得到更广泛的应用，为这种仪器提供了新的、大规模的机会。我们的设备操作简单，对患者来说更舒适，将在全球青光眼诊所具有重要的诊断价值。

Glaucoma is a major cause of blindness in our community. The biggest risk factor for glaucoma is raised intraocular pressure. However, the exact cause of the disease remains unknown. Through our basic science studies in animals we have discovered that changes in blood flow in the vessels at the optic disk may be involved in the disease process. In recent clinical trials we discovered that the presence or absence of pulsations in the retinal veins at the disk was both an indicator of severity and progression of glaucoma. This is a major breakthrough because there is no other means of predicting in which glaucoma patients vision loss will develop most rapidly. This information will be very helpful in deciding which patients should have the most agressive treatment to restore normal intraocular pressure. This project seeks to develop a new commercial device to make such an examination easy for any clinical ophthalmologist. The device allows the doctor to examine the vessels at the disk whilst applying slight pressure to the eye to temporarily raise intraocular pressure. A footswitch is pressed when the doctor sees the vessels pulsate. The required force is recorded by a laptop computer and the data stored along with the patients details. Now we have confirmed the ability of such a measurement to predict the rate of visual field loss in glaucoma, such a measurement will become much more widespread in clinical ophthalmology, offering a new and large scale opportunity for such instrumentation. Our device will be easy to operate, more comfortable for the patient, and will be of major diagnostic value in glaucoma clinics worldwide.