Vision problems in young children can impact on educational attainment, employment opportunities and quality of life. Although severe eye disease is recognised shortly after birth, there are no Australian population-based data on the magnitude, frequency and risk factors for conditions causing moderate or milder levels of visual impairment in one or both eyes, particularly refractive error, amblyopia and strabismus. There is widespread evidence that mild or unilateral visual impairment in young ....Vision problems in young children can impact on educational attainment, employment opportunities and quality of life. Although severe eye disease is recognised shortly after birth, there are no Australian population-based data on the magnitude, frequency and risk factors for conditions causing moderate or milder levels of visual impairment in one or both eyes, particularly refractive error, amblyopia and strabismus. There is widespread evidence that mild or unilateral visual impairment in young children is frequently unrecognised and that this can sometimes lead to important adverse health outcomes. While recent data suggests that early detection and treatment could reduce development of permanent and more severe disability in the long-term, there is no consensus that screening is cost effective. The proposed study will estimate the frequency and examine risk factors and impacts from a number of childhood vision conditions in over 4,000 children, aged 6 months to under 6 years. The population sample will be derived by performing door-to-door counts of children in a random cluster sample of census districts in the Sydney region, following letter box and media publicity. Based on similar surveys we have conducted, we expect to examine at least 75% of eligible children. They will have detailed vision and eye tests using standardised methods. We will align these to methods used in a large sister US study. The project will have sufficient power to provide accurate and reliable information about conditions affecting vision in young children. These data will inform debate and assist in designing interventions to reduce disability in children from visual impairments. The multidisciplinary team has expertise in epidemiology, paediatric eye disease and in conducting vision assessments, plus a strong track record in population-based research.Read moreRead less
DISSECTING THE GENETICS OF GLAUCOMA AND ITS RISK FACTORS USING A TWIN STUDY.
Funder
National Health and Medical Research Council
Funding Amount
$682,850.00
Summary
Glaucoma is one of the leading causes of blindness both in Australia (affecting 2-3% of the population) and worldwide. Glaucoma is often asymptomatic until it causes permanent loss of peripheral vision that precludes 10% of individuals with the condition from holding a driver's license. Around 50% of people with glaucoma are unaware that they have the condition; therefore better screening strategies are required. Genetic factors have been shown to contribute to glaucoma and our work has revealed ....Glaucoma is one of the leading causes of blindness both in Australia (affecting 2-3% of the population) and worldwide. Glaucoma is often asymptomatic until it causes permanent loss of peripheral vision that precludes 10% of individuals with the condition from holding a driver's license. Around 50% of people with glaucoma are unaware that they have the condition; therefore better screening strategies are required. Genetic factors have been shown to contribute to glaucoma and our work has revealed that 50% of people with glaucoma have a family history of the condition. Raised intraocular pressure (IOP) is a major contributing factor in glaucoma. Although there are some genes associated with high-pressure glaucoma, little is known about the heritability of IOP itself. Optic disc cupping is another important sign in the diagnosis and management of glaucoma, but again little is known of the inheritance of this feature. Twin studies, (comparing sets of identical twins with non-identical twins); allow us to estimate the relative contribution of genetic and environmental factors to disease states or physiological measurements. Although there have been small studies involving twins with glaucoma, it is unknown to what degree the basic parameters of glaucoma diagnosis such as IOP and optic disc characteristics are heritable. This project aims to conduct a large twin study into glaucoma and its associated ocular risk factors, including refractive error. We aim to identify genes that predispose to glaucoma, which will facilitate better screening for glaucoma in family members, and the general population, and ultimately leading to improved treatment.Read moreRead less
Characterising The Changes In Regulation Of Visual Contrast Sensitivity In Glaucoma.
Funder
National Health and Medical Research Council
Funding Amount
$337,600.00
Summary
Glaucoma is the second leading cause of blindness in developed nations. A recent study estimated the number of Australian's that will need regular visual examination in 2030 either because they have glaucoma or glaucomatous risk factors to be at least 800,000. As the ultimate aim of glaucoma treatment is to maintain vision, visual functional assessment is of paramount importance to glaucoma management . The current standard measure for the assessment of visual loss due to glaucoma is visual fiel ....Glaucoma is the second leading cause of blindness in developed nations. A recent study estimated the number of Australian's that will need regular visual examination in 2030 either because they have glaucoma or glaucomatous risk factors to be at least 800,000. As the ultimate aim of glaucoma treatment is to maintain vision, visual functional assessment is of paramount importance to glaucoma management . The current standard measure for the assessment of visual loss due to glaucoma is visual field testing. Regrettably, substantial damage to retinal ganglion cells (the primary neurons affected by glaucoma) is often present prior to the discovery of visual field loss using standard measures. Indeed studies have demonstrated that even 30-50% retinal ganglion cell loss may only manifest as a mild visual field deficit using current standard testing. This project will use novel techniques for exploring sight impairment in glaucoma, enabling a better understanding of the underlying neural damage. Our pilot work demonstrates that these methods can detect loss of sight in areas diagnosed as normal using standard visual field testing. The study will provide new technologies for the assessment of early vision loss due to glaucoma that may enable the detection of malfunction of retinal ganglion cells prior to their death. Such measures of neural malfunction are essential to establishing the efficacy of new pharmacological therapies (known as neuroprotective agents) for glaucoma aimed at keeping retinal ganglion cells alive and functioning. This project also has the potential to identify visual measures that have better capability for monitoring the progression of vision loss due to glaucoma. Early detection of glaucoma and its progression is essential so that treatment can be initiated or altered, slowing the progression of vision loss and its toll on both the individual and the community.Read moreRead less
A Functional Predictive Test For Age-related Macular Degeneration
Funder
National Health and Medical Research Council
Funding Amount
$532,500.00
Summary
Age-related macular degeneration (AMD) is the leading cause of blindness in our community. It is a progressive, late onset disease affecting central vision. Signs of disease are present in 15% of the population over 50 years with severe visual loss affecting increasing numbers in each subsequent decade. By 90 years 25% of people will have lost significant vision. There is no prevention, and treatment options are limited and have little impact on the rates of blindness. AMD causes enormous person ....Age-related macular degeneration (AMD) is the leading cause of blindness in our community. It is a progressive, late onset disease affecting central vision. Signs of disease are present in 15% of the population over 50 years with severe visual loss affecting increasing numbers in each subsequent decade. By 90 years 25% of people will have lost significant vision. There is no prevention, and treatment options are limited and have little impact on the rates of blindness. AMD causes enormous personal costs and places a massive burden on health resources. The high prevalence, anticipated increase in the ageing population and the limited treatment options, highlight the urgency with which research is required. The early clinical signs of AMD are yellow deposits called drusen, in the central retina (macula) and alteration in retinal pigmentation. As AMD progresses the macula is damaged either through atrophy (holes) or by growth of blood vessels. Currently, clinically accessible information about drusen and pigmentary changes are used to grade the severity of disease and predict the risk of progression to vision loss. This at risk group is recruited into prevention and intervention studies looking for new interventions. Such scoring of clinical characteristics currently underpins all clinical trials and epidemiological research in AMD. However this scheme is not without limitations, and results in an inexact correlation between clinical appearance and risk of blindness. We believe that a test of retinal function, (ability to see in the dark, to detect a faint light), will provide a better correlation for identifying patients at high risk of vision loss. We aim to test various aspects of retinal function (in both the light and dark and for moving and stationary objects) in subjects with early clinical signs of AMD, to identify parameters that will be more sensitive and specific predictors of risk of progression to visually devastating complications of AMD.Read moreRead less
Heritable Influences In Experimental Retinopathy Of Prematurity
Funder
National Health and Medical Research Council
Funding Amount
$272,591.00
Summary
Retinopathy of prematurity is an eye disease of very premature infants who require neonatal intensive care. It is a major cause of childhood blindness world-wide. Disease is caused by the growth of abnormal blood vessels in the retina, at the back of the eye. Currently, management involves the repeated examination of premature infants by an eye doctor. The babies are anaesthetized for this examination. If early disease is detected, then the affected eyes are treated with a medical laser, to burn ....Retinopathy of prematurity is an eye disease of very premature infants who require neonatal intensive care. It is a major cause of childhood blindness world-wide. Disease is caused by the growth of abnormal blood vessels in the retina, at the back of the eye. Currently, management involves the repeated examination of premature infants by an eye doctor. The babies are anaesthetized for this examination. If early disease is detected, then the affected eyes are treated with a medical laser, to burn the abnormal blood vessels. This stops the growth of these vessels and can prevent the child from going blind. However, the laser treatment itself can damage the eye. Left untreated, early retinopathy of prematurity will disappear of its own accord in some babies, but because they cannot currently be distinguished from those who will develop severe disease, all babies with signs of disease are treated. Not every premature infant develops retinopathy of prematurity: an as-yet unknown genetic factor controls susceptibility to disease. We plan to investigate this genetic basis using laboratory rats. Raised under the same conditions that are used in intensive care nurseries, baby rats develop eye disease that is similar to retinopathy of prematurity. However, as with human babies, not every baby rat develops this eye disease. We have shown a heritable tendency to retinopathy in different strains of rat. We identify the genes and proteins that differ amongst rats with or without the eye disease. We predict that identification of the inherited factors for retinopathy of prematurity in rats will provide strong clues to similar factors in humans. Our ultimate goal is to develop a test which will identify those human babies who are at risk of developing blinding retinopathy of prematurity, so that treatment is not given unnecessarily. We also expect to discover new targets for treatment.Read moreRead less
The mechanism for defocus-driven ocular growth. 30 per cent of the Australian young adult population (with much higher percentages in Asia) suffer from myopia, and while we know the retina senses defocus, we do not know how. The knowledge gained through this project will help the development of pharmaceuticals to control myopia and of developmental practices that minimise the chances of children becoming myopic.
Dynamic ocular imaging: New tools to study neurodegenerative disease. Neurovascular uncoupling occurs when blood supply and energy production is no longer responsive to the metabolic of nervous tissue. Neurovascular uncoupling is thought to be a key mechanism in the development of debilitating neurodegenerative diseases such as Alzheimer’s disease and glaucoma. This project will be the first study to develop, validate and employ a comprehensive suite to simultaneously image blood flow, oxygen sa ....Dynamic ocular imaging: New tools to study neurodegenerative disease. Neurovascular uncoupling occurs when blood supply and energy production is no longer responsive to the metabolic of nervous tissue. Neurovascular uncoupling is thought to be a key mechanism in the development of debilitating neurodegenerative diseases such as Alzheimer’s disease and glaucoma. This project will be the first study to develop, validate and employ a comprehensive suite to simultaneously image blood flow, oxygen saturation, metabolic activity and retinal function to understand neurovascular uncoupling in aging and age-related neurodegeneration. Read moreRead less
Design and Analysis of Optimal Algorithms for Automated Perimetry. Australian demographic studies reveal that visual impairment contributes significantly to disability in the elderly. Glaucoma, the second leading cause of blindness in developed nations, may be slowed if detected early, however recent studies estimate 50% of Australians with glaucoma are undiagnosed. Automated perimetry is used to detect and track such vision loss, but perimetry algorithms perform poorly. This project will design ....Design and Analysis of Optimal Algorithms for Automated Perimetry. Australian demographic studies reveal that visual impairment contributes significantly to disability in the elderly. Glaucoma, the second leading cause of blindness in developed nations, may be slowed if detected early, however recent studies estimate 50% of Australians with glaucoma are undiagnosed. Automated perimetry is used to detect and track such vision loss, but perimetry algorithms perform poorly. This project will design and analyse new algorithms with superior accuracy and efficiency, improving detection and monitoring of vision loss. Enhanced tools for community vision screening will also result, crucial for the ARC's priority goals of ?ageing well, ageing productively? and ?preventative healthcare?Read moreRead less