Centre for Eye Research Ireland

Myopia (short-sightedness) is the most common eye problem in Ireland and is growing all over the world.  It now affects 90% of young adults in Asia and up to 50% in Western countries, and is the leading cause of blindness among working age people in Europe.  As well as the costs and the frustrations of not being able to see well without glasses, myopia is also bad for the health of our eyes.  It imposes major challenges and costs for refractive correction, and the treatment of associated pathological complications.

  • It is estimated that 5 billion people will be myopic by 2050, with 1 billion people expected to be at significant risk of blindness.
  • Myopia is a leading cause of permanent blindness among working age people in Europe.

Currently there are no established treatments to stop people becoming short-sighted, and no treatments to stop them getting worse if they do.  The CERI team is working to find a means to control and prevent myopia in children under the collective SHIELD initiative, and umbrella of research, technology development and translational projects designed to address the global myopic pandemic.

 

‌In the first study of the SHIELD initiative Prof. Loughman and Prof. Flitcroft are leading a €3.1 million European clinical trial to control the development of myopia.

MOSAIC is the first study to explore the efficacy and safety of atropine for myopia prevention in a Caucasian population.  The study is funded by the Health Research Board, Medical Charities Research Group and Fighting Blindness in Ireland.  Additionally, CERI will lead an independent patient data meta-analysis of pooled data from the international arms of the MOSAIC trial, MOSAIC UK and MOAIC AUS, which will launch in 2017-18.

On completion, MOSAIC will provide definitive evidence pertaining to the capacity of atropine to control myopia in Caucasian children, as well as advancing our understanding of myopia and our ability to predict those at risk.

Given the inconvenience to people, the costs associated with lifelong care and the untreatable blindness it causes, the research could lead to dramatic and important public health benefits to communities and families in Ireland and across the world.

 
Glaucoma
, which is a neurodegenerative disease, is the most common cause of irreversible blindness worldwide.  It is a progressive lifelong condition that requires ongoing medical therapy and significantly impacts the quality of life if not carefully controlled. 

 

The only current therapy available for glaucoma is to reduce the pressure in the eye using eye drops or surgery.  Very often, the condition continues to progress, however, and some glaucoma patients become blind dispute treatment.

Three dietary carotenoids, lutein (L), zeaxanthin (Z) and meso- zeaxanthin (MZ), selectively accumulate at the macula, located at the centre of the back of the eye.  L, Z and MZ are collectively referred to as macular pigment (MP).  Leafy green vegetables, corn, yellow peppers and eggs are good sources of these carotenoids.  However, the modern diet is very deficient in many nutrients essential for optimal eye health, including macular carotenoids.

MP is responsible for maintaining eye health and contributing to good vision including minimising glare.  Glaucoma patients commonly suffer from disability glare and the cause for this is poorly understood.

A previous study by Prof. Loughman’s team has revealed that MP levels are low in glaucoma subjects, and that the lack thereof is associated with more severe visual loss and structural damage particularly affecting central vision.

To further investigate the relationship between macular carotenoids and glaucoma, CERI is now launching the European Nutrition in Glaucoma Management trial (ENIGMA).

The ENIGMA trial comprises a 2-year double-masked, randomised and placebo-controlled clinical trial to determine the potential benefits of MP supplementation for one of the leading causes of blindness in Ireland and globally.

It is well recognised that vision impairment from glaucoma is a major contributing factor to falls and motor vehicle collisions.  The ENIGMA trial will determine the impact of MP supplementation on vision and quality of life including symptoms and glare among glaucoma subjects.  If successful, ENIGMA will lead to development of a novel adjunct therapy for the management of glaucoma.  This might create lifestyle benefits for glaucoma patients and perhaps give some people back the freedom to drive safely at night.

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