Vision Community Unites to Observe World Glaucoma Week on Capitol Hill

Christopher Girkin, M.D., M.S.P.H., speaks

On March 11, the Alliance for Eye and Vision Research’s (AEVR) Decade of Vision Initiative united the vision community in recognizing the first World Glaucoma Week (March 7-13), as well as the third World Glaucoma Day, held March 12, 2010. Glaucoma is a group of diseases that damage the optic nerve, so the transmission of visual information to the brain slowly decreases. It is the second leading cause of preventable vision loss in the United States, affecting 2.2 million Americans, and is the leading cause of permanent blindness worldwide, affecting 67 million individuals. African Americans have a three times greater risk of developing the disease than White Americans, and it is the leading cause of irreversible vision loss in African Americans and Hispanics.

Featured speaker Christopher Girkin, M.D., M.S.P.H., a tenured professor of Ophthalmology and director of the University of Alabama at Birmingham Glaucoma Service in the Department of Ophthalmology at Callahan Eye Foundation Hospital, described the National Eye Institute (NEI)-funded African Descent and Glaucoma Evaluation Study (ADAGES), which is designed to identify factors accounting for differences in glaucoma onset and rate of progression between individuals of African and European descent. Dr. Girkin is one of the lead investigators in this multi-center collaboration that began in 2002 and is gathering clinical information from 1,200 African American and White Americans to determine which clinical techniques can best detect damage to the optic nerve related to glaucoma. The other ADAGES clinical sites include the University of California at San Diego’s (UCSD) Hamilton Glaucoma Center, at which study Principal Investigators Pamela Sample, Ph.D. and Linda Zangwill, Ph.D. are located, and New York Eye and Ear Infirmary, with Jeff Liebmann, M.D.

Dr. Girkin stated that clinical observations demonstrate that Primary Open Angle Glaucoma (POAG), the most common form of the disease, appears ten years earlier in African Americans and progresses more rapidly. He noted that ethnicity is one of several risk factors for developing the disease, which include advancing age, a family history of glaucoma, long-term elevated ocular pressure, and access to healthcare—most importantly, regular eye exams. Chronic diseases, such a hypertension and diabetes, are likely to play a role as well, while the impact of environmental factors is not yet clearly understood.

Dr. Girkin explained that basic research is helping to understand the clinical observations, especially when using advanced imaging techniques, such as Optical Coherence Tomography (OCT), that can reveal damage to the optic nerve head, which is the delicate structure of ganglion cells at the very back of the optic globe. He predicted that developments in imaging will one day enable researchers to view individual cells in the eye and to determine physiological changes that could be associated with disease progression and visual impairment far earlier than currently possible. Dr. Girkin concluded by stating that, "However, for the new technologies to be useful to provide more efficient and high quality care to at-risk minority populations, it is critical that long-term studies using these devices continue in order to determine how best to detect progressive injury in this chronic blinding disease."

In closing comments, AEVR Executive Director James Jorkasky directed attendees to a March 3 statement issued by the NEI for World Glaucoma Week in which its Director Paul Sieving, M.D., Ph.D., noted that NEI currently funds 181 glaucoma research projects at a total of $82.6 million. In 2008, the NEI initiated its Glaucoma Human Genetics Collaboration (NEIGHBOR) to unite clinicians and geneticists engaged in glaucoma research, which includes 26 investigators from 12 institutions nationwide. These scientists will collect genetic and clinical data from more than 5,000 individuals, reflecting 2,500 individuals with POAG and 2,500 without. NEIGHBOR is the NEI’s Signature Project supported through the American Recovery and Reinvestment Act (ARRA) of 2009.

AEVR joined with the following co-sponsors to host this event: Congressional Vision Caucus (CVC), American Glaucoma Society (AGS), Association for Research in Vision and Ophthalmology (ARVO), Glaucoma Research Foundation (GRF), Optometric Glaucoma Society (OGS), Prevent Blindness America (PBA), and The Glaucoma Foundation (TGF).

Left to right: Michael Duenas, O.D. (American Optometric Association), Torrey Smitherman (Eye Sight Foundation of Alabama) and Dr. Girkin. The EyeSight Foundation, a private funding source and AEVR member, supports numerous basic and clinical research projects within the state, as well as prevention and educational activities.	Left and right: Cynthia Stuen, Ph.D. and Mark Ackermann (Lighthouse International) with Dr. Girkin. Lighthouse International is an AEVR member.
Several medical research advocacy colleagues attended the briefing, including (left) Martha Nolan (Society for Women’s Health Research) and (right) Renee Cruea (Coalition for Imaging and Bioengineering Research), with AEVR’s James Jorkasky	From Left: Marcia Knutson, from the office of Cong. James Moran (D-VA), an appropriator, with James Jorkaksky and NAEVR Advocacy Manager David Epstein
Throughout the day, Dr. Girkin and Ms. Smitherman joined James Jorkasky in visits with Alabama delegation offices. Left: Senator Jeff Sessions (R-AL) greeted them in the hallway prior to a visit with his staff. Right: With Graham Smith in the office of Senator Richard Shelby (R-AL).