Detecting large intraocular pressure (IOP) fluctuations remains a critical challenge in treating patients with glaucoma. This IOP variation and the peak measurement of IOP predict who will have glaucoma damage and related vision loss. Sayoko Moroi, MD, PhD, along with team members at Kellogg, the Mayo Clinic, the University of Nebraska, and Case Western Reserve University have worked to integrate these tools toward personalizing IOP treatment for glaucoma. Funded by the National Eye Institute and other agencies, Dr. Moroi and her team have characterized the “inflow”, “outflow” and blood vessel factors that influence IOP changes over time.
In the next study phase, Dr. Moroi and her team will measure IOPs at home to gain real world data outside of clinic hours. Preliminary home IOP data have identified patients with high home IOPs that were measured as normal during clinic visits. By understanding the factors responsible for IOP variation, Dr. Moroi hopes to target those with the greatest fluctuation or highest IOPs for more intensive care.
A related translational project is to map the eye fluid drainage pathways, which is recently funded by the National Science Foundation with UM Engineer Dr. Alan Argento. Characterizing a patient’s eye fluid drainage map will help us understand the variable IOP outcomes patients experience with the new “microinvasive glaucoma surgeries” or MIGS. The results will advance our understanding of the complex biology of IOP and lead toward a personalized IOP-based treatment for patients.