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UK ISSUES NEW drop instillation and the number of hospital visits.
GUIDELINES The American Academy of Ophthalmology’s Preferred Practice
FOR GLAUCOMA Pattern and the European Glaucoma Society has also decided to
issue updated guidelines due to the LiGHT Study results.
TREATMENT
ANTABUSE TO TREAT BLINDING
DISORDERS
The UK’s National Institute
for Health and Care Excellence Researchers at the University of California, Berkeley, have found
(NICE) has changed the primary that Antabuse, an FDA-approved drug erstwhile used to wean
intervention from instillation people off alcohol, may help to improve sight in mice with retinal
of eye drops, the long-time degeneration.
standard of care, to selective
laser trabeculoplasty (SLT) for A group of scientists led by Richard Kramer, UC Berkeley professor
glaucoma. Prior to this, SLT had of molecular and cell biology, informed that the drug may revive
been the second treatment sight in humans with the inherited disease retinitis pigmentosa (RP),
choice when drop instillation and possibly in other vision disorders such as age-related macular
proved problematic for some degeneration.
patients. In new experiments, Kramer and collaborator Michael Goard, who
The new guidelines were directs a lab at UC Santa Barbara (UCSB), discovered that treatment
formed due to the findings of the with disulfiram – also called Antabuse – decreased the production of
multicenter Laser in Glaucoma retinoic acid and made nearly-blind mice much better at detecting
and Ocular Hypertension (LiGHT) images displayed on a computer screen.
study, led by Ophthalmology The experiment involved suppressing the sensory noise in the
Consultant and Chief inner retina caused by dying photoreceptors brought on by the
Investigator Gus Gazzard from progression of outer retinal degeneration (like AMD and RP), where
Moorfields Eye Hospital, and the light-sensing cells (photoreceptors) slowly disappear over the
professor of Glaucoma Studies course of years.
at the University College London
Institute of Ophthalmology, The team noted that disulfiram can target that sensory noise,
London. which in turn allows the surviving photoreceptors in the outer retina
to complete the signal to the brain − in turn, restoring vision.
The LiGHT study, which took
a close look at the effects of “There may be a long window of opportunity in which suppressing
laser therapy, compared the retinoic acid with drugs like disulfiram could substantially improve
quality of life and visual acuity in low vision and make a real difference in people’s quality of life,”
two patient groups: those who said Kramer, the CH and Annie Li Chair in Molecular Biology of
started glaucoma treatment Diseases at UC Berkeley and a member of the campus’s Helen Wills
with drops and those who were Neuroscience Institute.
treated first with SLT and then “If a vision impaired human were given disulfiram, and their vision
later were prescribed drops as got better, even a little bit, that would be a great outcome in itself. But
needed. Earlier, no study patients it would also strongly implicate the retinoic acid pathway in vision
were treated for glaucoma. loss,” Kramer said. “And that would be an important proof of concept
The findings of the LiGHT that could drive new drug development and a whole new strategy for
Study reiterated the fact that helping to improve vision.”
laser treatment was indeed safer The researchers are planning to partner with ophthalmologists to
and more cost effective over conduct a clinical trial of disulfiram on patients with RP. The trial will
the long term because laser initially be carried out on a small set of people with advanced, but not
application reduced the need for yet complete, retinal degeneration.
22 THE INDIAN OPTICIAN MAY-JUNE 2022 OPHTHALMIC NEWS
