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We show for the first time that lower systemic mitochondrial function (as measured in peripheral blood) is strongly linked to faster glaucoma progression. This is an exciting development in the field of glaucoma and our findings have practical implications for clinical decision making. Low mitochondrial function may identify patients at risk of faster glaucoma worsening and inform personalised treatment strategies, offering the potential for future mitochondria-targeted therapies.

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A prestigious £2.0 million grant has been awarded to a team of researchers, led by Professor Ted Garway-Heath at the UCL Institute of Ophthalmology/Moorfields Eye Hospital and Mr Gerassimos Lascaratos at King’s College Hospital, to conduct a novel neuroprotection trial to treat glaucoma. The grant, awarded by the National Institute for Health Research (NIHR) and the Medical Research Council’s EME programme, could potentially benefit 300,000 people in the UK living with glaucoma, the leading cause of irreversible blindness worldwide.

The trial will look at whether nicotinamide tablets, a form of vitamin B3, can improve mitochondrial function (energy production) and delay sight loss in people with primary open angle glaucoma (POAG), the most common type of glaucoma. Mr Lascaratos and Professor Garway-Heath will be using mitochondrial function in peripheral blood (blood that flows through the veins and arteries) as a biological marker of glaucoma and to monitor response to treatment, in the hope to offer more personalised treatment to patients. This is the first time such a study has been carried out for this condition in the world. The team will be recruiting patients from seven UK sites, including King’s College Hospital, and the trial will finish in November 2026.

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Have you been told that your eye pressure is high or that you may suffer from glaucoma? Have you been tested for glaucoma? Glaucoma is the most common cause of irreversible blindness worldwide. Yet, as it doesn’t usually give any symptoms, about half of all patients with glaucoma in the UK are not even aware they have it. In this article, Mr Gerassimos Lascaratos, answers your frequently asked questions on Glaucoma.

https://www.spirehealthcare.com/spire-london-east-hospital/patient-information/news-and-events/the-silent-thief-of-sight

Mr Lascaratos is delighted to be using the new InnFocusMicroshunt at King’s College Hospital. This new minimally invasive glaucoma surgery device appears to achieve a significant eye pressure lowering effect,while maintaining an improved safety profile compared to traditional approaches. The Microshunt is similar to a trabeculectomy in that it creates a subconjunctival bleb, but the procedure is considerably less invasive and requires much less postoperative interventions and clinic visits. It has a flow restrictor 70um lumen and is made from SIBS,a highly biocompatible,biostable material that has been shown to result in reduced inflammation and minimal scar tissue formation.

Happy to be invited to speak about the role of mitochondrial biogenesis in glaucoma at the International Society for Eye Research (ISER) conference in Belfast and honoured to be part of such an esteemed faculty. Congratulations to Prof Colm O’Brien and Mr Patrick Yu-Wai-Man for organising an excellent session.

It was a great pleasure and honour to be invited to speak at the Moorfields Alumni meeting at the Royal Society of Medicine on ‘Mitochondrial efficiency: the Holy Grail of glaucoma resistance?’ The study presented was kindly funded by Fight for Sight, Allergan Europe and the International Glaucoma Association.

Excited to see our paper published in the Neurobiology of Disease. We show for the first time that some patients with high eye pressure who haven’t developed glaucoma have very healthy mitochondria in their blood. Mitochondria are the batteries of cells – they produce the energy the cells need to survive. This study suggests that systemic mitochondrial efficiency is associated with resistance to developing glaucoma and raises the possibility that new treatments that make energy production more efficient may protect against glaucoma.

Representative electron microscopy images of lymphocytes from the study participants (glaucoma left, ocular hypertension right). The mitochondria are highlighted with black arrows and are more elongated and healthier in individuals with ocular hypertension as compared to patients with glaucoma.

New landmark trial in glaucoma co-authored by Mr Lascaratos is published in The Lancet. The United Kingdom Glaucoma Treatment Study (UKGTS) is the first randomised, triple-masked, placebo-controlled trial to assess the benefit of topical medical treatment (eye drops) for reduction of loss of vision in patients with open angle glaucoma. Our findings provide strong evidence for the vision-preserving benefit of lowering of intraocular pressure, supporting evidence from previous randomised trials that were not masked or placebo controlled. The study also provides evidence of the vision preserving benefits of topical prostaglandin analogues. Congratulations to Prof David Garway-Heath for leading this landmark study in glaucoma the results of which are likely to influence clinical decision making in this field for many years to come.

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