As a practising optometrist, Associate Professor Zhichao Wu realised there was a big problem diagnosing glaucoma. Glaucoma is a leading cause of irreversible vision loss that is projected to cost Australia $4.3 billion per annum by 2025.
One in 2 people with glaucoma doesn’t know they have it. And, shockingly, half of these people have had an eye test in the past year. Yet good 3-dimensional scanning technology, already used by many optometrists today, can show the initial warning signs of damage to the neurons in the retina.
The dire statistics didn’t make sense to Associate Professor Wu. ‘I kept thinking: How is it possible, in the 21st century, when we're living with such incredible technology, that we still can't stop people from going blind? Why can’t we diagnose glaucoma early?’
This story is part of our 10 of the Best -Fifteenth edition. 10 of the Best is an annual NHMRC publication, showcasing 10 NHMRC-funded health and medical research projects. See more 10 of the Best.
After completing his PhD tackling another leading cause of irreversible vision loss—age-related macular degeneration— Associate Professor Wu received an NHMRC Early Career Fellowship to pursue his project: ‘Novel Clinical Biomarkers of Glaucoma Management’.
As part of this Fellowship, he travelled to the University of California San Diego and Columbia University in the USA in 2016–17. He set out to overcome the major challenges in preventing vision loss from glaucoma, including early diagnosis and detection of disease progression.
‘How do we take the shocking diagnosis problem from half of people being missed to nearly no one being missed? Then how do we shorten the timeframe of detecting the worsening of the disease from 6 years to 6 months, before significant vision loss has occurred?’ he questioned.
‘I want to substantially reduce the health and economic impact of this condition. Early diagnosis, rapid detection of disease worsening, and better treatment options means we won’t miss the window of opportunity to intervene more aggressively before vision is irreversibly lost,’ he said.
Associate Professor Wu and his colleagues have already developed an approach to near-perfectly detect glaucoma through expert evaluation of 3-dimensional eye imaging.
Buoyed by the wonderful mentorship gained through the Fellowship and his ongoing research, Associate Professor Wu and his team at the Centre for Eye Research Australia are now creating technology to make detecting glaucoma and its progression faster and more accurate.
‘We’ve taken human expertise, novel computational methods, superb eye imaging and put them all together. We're developing artificial intelligence models to replicate that approach so it can be applied widely in the clinic with patients,’ said Associate Professor Wu.
‘The patients involved in our research are excited because most of them, being older, tend to think of future generations. They’re incredibly generous people who are eager to participate so that they can make a global impact on those with glaucoma,’ he said.
Next steps
Associate Professor Wu had developed new clinical trial approaches to improve the scalability and reduce costs. This has included changing how to analyse results, optimise timelines of study visits, and leverage new imaging technology.
‘We can reduce the sample size needed for trials by about 20 times,’ said Associate Professor Wu.
The medical and pharmaceutical industry are now taking advantage of this knowledge when exploring new treatments such as gene therapies.
Associate Professor Wu’s team is also developing new imaging technologies to better identify individuals with glaucoma at high risk of vision loss to target for trials and to better evaluate new treatments.
CIA
Associate Professor Zhichao Wu
Institution
Centre for Eye Research Australia
Research title
Novel Clinical Biomarkers of Glaucoma Management