Glaucoma is the most common cause of permanent vision loss worldwide, currently affecting over 80 million people. Glaucoma is an irreversible disease; therefore, early detection and treatment of patients at high risk for glaucoma is the only reliable method to decrease its burden on patients and healthcare systems. Established risk factors for glaucoma, such as age and intraocular pressure (IOP), that are routinely evaluated in the clinic are only moderately predictive of disease outcomes. This creates an urgent need for novel diagnostic tools that can more precisely identify patients at risk for glaucomatous vision loss who would benefit from early sight-saving treatment. Recent studies suggest that biomechanical properties of ocular tissues, including the stiffness of the lamina cribosa and iris, are associated with glaucoma status and severity. However, there is currently no diagnostic tool to measure these tissue properties in vivo for routine clinical care. High-resolution USE is a non-invasive imaging technology that provides in vivo measurements of biomechanical properties of ocular tissues.

The Xu and Zhou labs collaborated to develop a novel USE system capable of simultaneous imaging and assessment of biomechanical properties of the whole eye. Therefore, we propose imaging human eyes with this system to: 1) assess the role of scleral and iris tissue stiffness for predicting presence and severity of primary open angle glaucoma (POAG) and primary angle closure glaucoma (PACG);2) elucidate fundamental relationships between ocular tissue stiffness and IOP, the only modifiable risk factor for glaucoma. Our hypothesis is that ocular tissue stiffness measurements are associated with glaucoma severity and may serve as novel clinical biomarkers to improve prediction of disease outcomes. The overall objective of the current study is to demonstrate the potential clinical application of USE imaging of human ocular tissues for glaucoma care, specifically predicting disease status and severity.

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