The Changes Within the Cells of the Drainage System of the Eye in Patients With Glaucoma

Study Overview
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Brief Summary
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The purpose of this study is to try to identify the cause of damage to the drainage system of the eye (the trabecular meshwork). Damage to this system may cause elevation in the pressure within the eye and thereby damage to the optic nerve and the vision.

Detailed Description
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During a routine trabeculectomy surgery, a corneo-scleral block that includes TM tissue will be collected at the operating room. This tissue is routinely removed during every trabeculectomy surgery. The tissue will be stored immediately in normal saline at 4 degrees Celsius, and walked directly to the Jefferson Center for Translational Medicine at Thomas Jefferson University by the Wills eye glaucoma research fellow. TM tissue will be identified using light microscope base on TM cell pigmentation. The ocular tissue will be fixed and placed in pre-cooled fixative on ice for 1 hour. The lengths of mitochondrial cross sections at the longest extent will be measured under electron microscopy (EM) in order to identify the mitochondrial dynamics. Quantitative Polymerase Chain Reaction (qPCR) will be done to identify proteins responsible for mitochondrial fusion.

Official Title
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The Changes of Mitochondrial Dynamics and the Molecular Mechanisms in the Trabecular Meshwork of Patients With Glaucoma

Conditions
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Glaucoma

Intervention / Treatment
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* Other: Collection of trabecular meshwork tissue during surgery


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Minimum 2-year diagnosis of POAG Moderate to advanced stage of the disease DDLS stages 5 through 10 with visual field loss Age between 21 and 80 years Planned trabeculectomy with or without concomitant cataract surgery Exclusion Criteria: Age ≤ 20 years old Any other type of glaucoma other than POAG Patients who had undergone selective laser trabeculoplasty (SLT) or argon laser trabeculoplasty (ALT) Patients with history of ocular trauma Patients with previous eye surgery will be excluded both from the study and the control groups

Ages Eligible for Study
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Minimum Age: 21 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Basic Science
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Glaucoma subjects<br>During glaucoma surgery, collection of trabecular meshwork tissue during surgery that is not needed is cut away from the surgical site. The physician will keep this tissue for analysis by the researchers at Wills Eye Hospital and Thomas Jefferson University Center for Translational Medicine. | Other: Collection of trabecular meshwork tissue during surgery<br>* Tissue is collected during surgery at Wills Eye and then processed at thomas jefferson to identify the trabecular meshwork using light microscope. The ocular tissue will be fixed and the mitochondrial cross sections at the longest extent will be measured under electron microscopy (EM) in order to identify the mitochondrial dynamics. Quantitative Polymerase Chain Reaction (qPCR) will be done to identify proteins responsible for mitochondrial fusion.<br>|
| Active Comparator: Control cadaver eyes<br>control cadaver eye are ordered and the collection of trabecular meshwork tissue during surgery and is processed at Thomas Jefferson University | Other: Collection of trabecular meshwork tissue during surgery<br>* Tissue is collected during surgery at Wills Eye and then processed at thomas jefferson to identify the trabecular meshwork using light microscope. The ocular tissue will be fixed and the mitochondrial cross sections at the longest extent will be measured under electron microscopy (EM) in order to identify the mitochondrial dynamics. Quantitative Polymerase Chain Reaction (qPCR) will be done to identify proteins responsible for mitochondrial fusion.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| 3-D EM tomography for mitochondria obtained from sample tissue |  | 1 year | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Gene expression of Drp1 |  | 1 year | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Mitochondria, trabeculectomy, trabecular meshwork, Glaucoma surgery