Massimo A. Fazio, PhD, assistant professor in the University of Alabama at Birmingham Department of Ophthalmology, and Christopher A. Girkin, MD, have received a 4-year, $2.55 million R01 grant from the National Eye Institute to explore how visual field loss developed with glaucoma is associated with individual-specific biomechanics of the eye.
This new study will explore the role of biomechanical differences in the optic nerve that may explain why individuals of African descent are at greatest risk of developing glaucoma. It applies Dr. Fazio’s novel computational approaches to a large multicenter cohort of patients followed in the African Descent and Glaucoma Evaluation Study (ADAGES). Prior studies of this cohort have defined racial difference in progression of glaucoma along (ADAGES 1 and 2) with genetic factors (ADAGES 3).
“The scope of the work aims to uncover how the morphology and biomechanics of the optic nerve head is associated with glaucoma onset and progression,” Dr. Fazio said in a university news release. “Our ultimate goal is to discover a biomarker to help physicians detect glaucoma before the visual field deteriorates, or to identify which individuals are more likely to progress too fast.”
Dr. Fazio uses a laser-based technique called optical coherence tomography, or OCT, that allows researchers to capture 3-D images of the optic nerve head. This data shows researchers the structural damage in each eye. He has developed new methods to reveal and quantify structures deep within the optic nerve that are critical in the development of glaucoma.
“The imaging protocols developed for this study in collaboration with the OCT manufacturer Heidelberg Engineering allows us to uncover 3-D structural and biomechanical parameters as none has ever done before,” Dr. Fazio said. “This has generated a wealth of knowledge and has created a large body of data that show there are indeed racial differences in the mechanical behavior of the optic nerve that may put individuals of African descent at greater risk for blindness from glaucoma.”
This study will define these structural and biomechanical differences in the optic nerve that exist between people of European and African descents and how these differences increase the rate of glaucoma progression and disease susceptibility within this at-risk minority group. Dr. Fazio says the collagen structure and biomechanics are different between the two groups and are therefore correlated with a different rate of damage.
Dr. Fazio has a multidisciplinary background in machine design, experimental mechanics and biomechanical characterization of soft tissue, and he is a mechanical engineer. He has dedicated his career to developing customized methods of noncontact optical techniques to measure deformations in loaded materials to gain a deeper understanding of the biomechanical properties of ocular tissues. Dr. Fazio holds a primary joint appointment in the Department of Biomedical Engineering.
This grant is a multiprimary investigator study lead at UAB, involving several premier universities throughout the country. Dr. Fazio leads the investigation at UAB, together with Dr. Girkin; EyeSight Foundation of Alabama Chair of the Department of Ophthalmology Linda M. Zangwill, PhD, co-director of Clinical Research at the Shiley Eye Institute at The University of California San Diego; and Jeffrey M. Liebmann, MD, vice chair and director of Glaucoma Services at Columbia University.