SIG Corner Editor: João Barbosa Breda

Chair: Gauti Jóhannesson Co-chairs: Esther Hoffmann, Francesco Oddone, Anthony Khawaja

What is the NGP?

The Next Generation Partnership (NGP) is a mentorship and networking program within the EGS for younger specialists in ophthalmology or established glaucoma researchers that are emerging, future leaders in glaucoma care delivery, education and research who are interested and able to support the goals of the EGS.

1) New Year’s message to the EGS NGPs

As we move into a new year, there are exciting NGP activities to look forward to in 2020. Among upcoming activities of the NGP-SIG are active participation in the EGS Residents’ course in Lisbon in March 2020 and the 3rd NGP day at the EGS Congress in Brussels in May 2020. There are many advantages of being an NGP (see NGP Manifesto - hyperlink “Manifesto” to https://www.eugs.org/data1/NGP-manifesto.pdf ) and we hope to see continuous fruitful discussions and participations of many NGPs at the NGP day in Brussels. With those words, the NGP-SIG would like to wish you all a wonderful and successful new year!

2) Update on NGP-SIG activities

One of the main activities of NGPs is the personal development and leadership programme held at the NGP days. The 2nd NGP day was held prior to the EGS Members Meeting in Bordeaux in August 2019 and its programme included lectures and workshops on a) projects and ideas involving NGPs in future activities of EGS, b) raising standards in education across Europe and finally c) presentation skills lead by professional facilitators.

The meeting was successful and attended by almost 50 NGPs. The participants were engaged in lively and fruitful discussions throughout the workshops which hopefully will give rise to many future projects within the EGS.

3) Choices of relevant papers to the NGPs

As we now have said farewell to the year 2019, we would like to highlight the papers the NGP-SIG has selected this past year. These are the following papers:

Genome-wide analyses identify 68 new loci associated with intraocular pressure and improve risk prediction for primary open-angle glaucoma (Khawaja et al. Nature Genetics 2018. This study represents a huge leap forward in the understanding of glaucoma genetics. Using data from the UK Biobank study, over 100 genetic loci have been identified that explain 17% of the variance of IOP. These genetic variants predicted POAG with 76% accuracy in the independent NEIGHBORHOOD study. This opens up the possibility of identifying people at high risk of glaucoma in populations on the basis of their genetic make-up alone, potentially enabling targeted screening. The genes identified point towards anatomical development and lymphangiogenic factors (supporting the lymphatic vessel nature of Schlemm's canal) as major determinants of adult IOP and risk of POAG.

Potential metabolic markers in glaucoma and their regulation in response to hypoxia (Vohra et al. Acta Ophthalmologica 2019.
In this novel study, normal-tension glaucoma (NTG) patients and healthy age-matched controls underwent normobaric hypoxia for two hours in order to assess potential differences in serum levels of glucose, lactate and amino acids. The study was led by NGP Miriam Kolko and their results showed significantly lower levels of lactate and amino acids in NTG patients at baseline. Furthermore, the results indicate a significant differential regulatory pattern of certain amino acids. The results suggest a link between systemic energy metabolites and NTG.

Prevalence of treatment with glaucoma medication in Scotland, 2010-2017 (Rotchford et al. Br J Ophthalmology 2019
This study, led by NGP Andrew Tatham, examined the changes in the prevalence of glaucoma treated by medication in Scotland between 2010 and 2017. There was a 27% increase in the numbers of patients treated with glaucoma medication in Scotland from 48,178 in 2010 to 61,249 in 2017. This increase was more than double that expected simply due to population ageing (12% based on census predictions). It remains uncertain what the underlying cause for this increase is, which may be due to a true increase in glaucoma prevalence, improved detection of glaucoma, a lower threshold for treatment, or over-treatment. Regardless, studies such as this help us to quantify the burden of glaucoma in our populations, the costs of treatment and the challenges that will face us in the future.

Intravenous Hypertonic Saline to Lower Intraocular Pressure in Ocular Hypertension and Primary Open-angle and Exfoliation Glaucoma (Inborr et al. Journal of Glaucoma 2018)
NGP Mika Harju and co-investigators examined the IOP-lowering effect of intravenous hypertonic saline (IVHTS) in patients with OHT, POAG and exfoliation glaucoma. They found effective and rapid IOP-lowering in all groups and suggest that IVHTS may be superior to other methods for rapid IOP-lowering such as mannitol, glycerol and acetazolamide.