A research team at the University of Missouri has made a discovery that could transform how glaucoma is detected and treated. Glaucoma, a major cause of irreversible blindness in older adults, often goes undiagnosed until significant vision loss has already occurred. Scientists are now closer to identifying a biomarker that may allow doctors to detect the disease much earlier and develop new ways to protect the eye.
Glaucoma occurs when retinal ganglion cells (RGCs) and their axons become damaged. These delicate nerve cells, located at the back of the eye, carry visual information to the brain. Once they deteriorate, vision loss begins. Current therapies mainly reduce pressure inside the eye, but none effectively protect RGCs from harm. This gap in treatment highlights the urgent need for neuroprotective strategies that can preserve these critical nerve cells.
Searching for Biomarkers and Protective Treatments
Pawan Singh, a researcher at Mizzou's School of Medicine, is dedicated to finding both biomarkers that reveal glaucoma early and therapies that safeguard the optic nerve. His team recently discovered that glaucoma patients have lower levels of two naturally occurring molecules, agmatine and thiamine, in the clear fluid at the front of the eye compared with individuals without the disease. These small molecules, known as metabolites, may serve as early indicators that can be detected through testing.
"In several cases, people do not find out they have glaucoma until they are older and their eye pressure is elevated," Singh explained. "Our long-term goal is to see if doctors could one day do a simple blood test to check for these biomarkers. If they can, hopefully they will be able to catch the disease much earlier, before vision loss occurs, so patients can receive treatment sooner."
Promising Clues for Future Treatments
Beyond diagnosis, the discovery offers hope for new therapies. Singh's pre-clinical research suggests that agmatine and thiamine may help protect RGCs and maintain visual function, offering neuroprotective potential. These molecules could eventually be developed into treatments, possibly in the form of eye drops or supplements, that slow or prevent vision loss from glaucoma.
"Mizzou's impressive research infrastructure and our collaborative team help make this research possible," Singh said. "While more work needs to be done, the eye doctors I have spoken to here at Mizzou are very excited about this research, so I am proud and hopeful for the future."
The findings were published in Investigative Ophthalmology and Visual Science under the title "Metabolomic profiling of aqueous humor from glaucoma patients identifies metabolites with anti-inflammatory and neuroprotective potential in mice."
