Project title: Scarring the vision: Unravelling fibrotic pathways after glaucoma filtration surgery

Supervisors: Dr Jennifer Fan Gaskin and Dr Elsa Chan

Email: fan.j@unimelb.edu.au

Suitable for: Honours and Masters

Glaucoma filtration surgery is the gold standard glaucoma operation but also the last option for treating glaucoma when other therapies such as medications or lasers are not sufficient. During the surgery, a new drainage pathway is created by which aqueous fluid inside the eye can escape, thereby lowering the intraocular pressure.

Scarring occurs as a result of a natural wound healing response, however, uncontrolled scarring can block this new drain. Chronic use of glaucoma eyedrops, which is common amongst glaucoma patients, can also predispose to scarring following glaucoma surgery.

Minimisation of scarring is currently treated through the application of cytotoxic agents such as Mitomycin C (MMC) during the surgery, nevertheless scarring remains a problem in some patients. Moreover, MMC is an anti-cancer drug that can lead to severe complications and even blindness. Due to these considerable risks, it is not uncommon to only perform trabeculectomy when patients have started to lose vision.

There is an urgent need to improve the long-term efficacy and safety of glaucoma surgeries. The CERA Ocular Fibrosis Research team explores the underlying fibrotic pathways with the aim of developing new strategies to improve current anti-scarring therapies.

The project aims to identify novel scarring markers by integrating both transcriptomic and proteomic data obtained from human Tenon’s fibroblasts biopsied from glaucomatous and non-glaucomatous eyes, and to evaluate the scarring response after inhibition of the identified scarring markers. Techniques include cell culture, bioinformatics, analysis of gene and protein expression.