Glaucoma is a progressive optic nerve degenerative disease that often leads to blindness. Local inflammatory responses in the retina and optic nerve are implicated in the pathology of glaucoma. In addition, microbial populations in other parts of the body have been linked to glaucoma. To explore the relationship between oral health and glaucoma we queried the FinnGen database (Risteys 10.0) to assess whether poor oral health carries an increased risk of subsequently developing primary open angle glaucoma (POAG). In a separate study, we also collected mouthwash samples and administered a questionnaire relating to oral health status to a cohort of participants enrolled in Diagnostic Innovations in Glaucoma Study (DIGS) that included 107 participants with glaucoma and 19 healthy non-glaucomatous controls. 16S sequencing was performed to characterize the number of bacteria species and total bacteria count of the samples. A significant association between having dental conditions affecting the teeth, gingiva, or periodontium and developing glaucoma after 1 year, 1-5 years, 5-15 years and cumulatively was detected in the FinnGen data, a population of 429,209 with at least 153,661 having a dental condition and 10,687 having POAG. Among the cohort of the DIGS ancillary study, the total bacterial count of the glaucoma group was significantly higher compared to that of controls (Mean ± SD: 1.7 ± 1.4 and 0.9 ± 0.6, respectively, p < 0.03, two-sample t-test), while the species richness was significantly lower in glaucoma subjects compared to controls (p < 0.0005, Wilcoxon rank sum test). While the top taxa ordered by total abundance were similar between the two groups, mostly organisms associated with the commensal oral microbiome, there were some taxa linked with periodontal disease that were associated with glaucoma cases. However, the study was underpowered for the differences in top taxa between the glaucoma and non-glaucomatous control groups to achieve statistical significance (< 0.05) after adjusting for multiple comparison testing. A different bacterial abundance profile was detected between cases and controls by stepwise linear discriminant analysis. Inclusion of sleep apnea and the presence of cardiovascular disease as covariates in the analysis models did not significantly affect the results. Answers to the questionnaire about oral health and oral/dental history did not show a statistically significant difference between the two groups. The above findings suggest a potential link between oral health and glaucoma that may warrant further investigation.

Primary open angle glaucoma (POAG) is one of the leading causes of irreversible blindness and is associated with dysfunction of the trabecular meshwork (TM), a three-dimensional (3D) structure that regulates aqueous humor outflow and, consequently, intraocular pressure (IOP). IOP is the only modifiable factor for glaucoma. Outflow facility is the inverse of aqueous humor outflow resistance caused by the presence of the TM and adjacent tissues, and reflects the TM's central role in IOP control, representing the most physiologically relevant measure of human trabecular meshwork (HTM) function. Therefore, development of ex vivo systems to study outflow facility and IOP regulation is critical for advancing glaucoma research. We present a comprehensive review of bioengineering approaches to generation of 3D HTM models using synthetic, natural, and hybrid hydrogels, micro- and nanofabricated synthetic substrates or porous scaffolds, and microfluidic devices. These 3D HTM systems have been designed to capture key features such as topography, stiffness, and fluid flow in the conventional outflow pathway. In particular, we highlight HTM models that recapitulate IOP regulation and allow measurement of outflow facility, which directly reflect pressure-dependent outflow resistance in dynamic HTM physiology and glaucoma pathophysiology. By integrating these bioengineering approaches with emerging stem cell technologies, this review offers an evidence-based landscape overview and framework for designing next-generation 3D human-relevant TM models for outflow physiological studies and IOP-modulating drug discovery.

PURPOSE. Proteomes of lens nuclei from young (4 years old) and old (15-16 years old) rhesus macaques (Macaca mulatta) were analyzed to determine similarity of the proteomic profile to that of human lenses, age-related differences in protein solubility, and association of various post-translational modifications with age and protein solubility. METHODS. Lens core proteins were separated into water-soluble and water-insoluble fractions using aqueous buffer and centrifugation. The water-insoluble fraction was solubilized using sodium dodecyl sulfate (SDS). Proteins were processed using S-trap columns, and peptide digests were analyzed using high-resolution, label-free datadependent acquisition (DDA) proteomics. Open modification searches were performed using MSFragger to identify possible post-translational modifications (PTMs). The number of modified peptide tandem mass spectra confidently assigned to samples by age or solubility were compared to find PTMs with statistically significant count differences. RESULTS. The overall proteomic profile of rhesus macaque lenses was very similar to human lenses, consisting of 80.2% crystallins, 1.1% beaded filament proteins, and 18.7% other proteins. The crystallin fraction consisted of 27% alpha crystallins, 67.6% beta/gamma crystallins, and 5.4% taxon-specific psi crystallin. Glycolytic enzymes, beta/gamma crystallins, and a few glutathione-related enzymes were found to have agerelated shifts to the water-insoluble fraction. There were significant differences in deamidation, dioxidation, carbamylation, carboxymethylation, and trioxidation based on age and/or solubility of proteins. CONCLUSIONS. These data indicate a high level of conformity between rhesus macaque and human lens proteomes, and a few key differences. We identified several age-related differences in protein solubility and PTM that may contribute to lens pathology.

The ocular surface microbiota (OSM) is important for eye health, and variations in OSM composition have been associated with multiple diseases in humans. Studies of OSM-disease dynamics in humans are confounded by lifestyle factors. Animal models provide a complementary approach to understanding biological systems, free from many confounds of human studies. Here, we provide the first study of the OSM of rhesus macaques, a premier animal model for eye health and disease. We describe the taxonomy of the rhesus macaque OSM, and explore compositional correlations with age, sex, and living condition. We analyzed eyelid and conjunctival microbiota swabs from 132 individual rhesus macaques (Macaca mulatta) (57 males, 75 females, 1–26 years old) from one captive and one free-ranging group using 16 S rRNA V3/V4 MiSeq sequencing. We investigated alpha diversity, beta diversity, and differential abundance. We found several similarities between the top Phyla and Genera of the rhesus macaque OSM and those reported in human literature. Significantly higher alpha diversity, which may reflect age-related ocular surface mucous membrane integrity and immune function, was present in younger individuals compared to older ones. Higher alpha diversity was also present in free-ranging rhesus macaques compared to ones in captivity, possibly related to differences in diet, exercise, and medical exposures between macaques in different living conditions. Beta diversity was most strongly influenced by individual identity, followed by living conditions. Sex did not correlate with any OSM variation. In this study we describe the taxonomic composition of the rhesus macaque OSM, and identify significant differences in alpha and beta diversity according to individual nonhuman primate host variables and the surrounding environment. Our findings suggest composition of the nonhuman primate OSM is shaped by age-related physiology, individual identity, and external living conditions. Our results offer novel insights into an underexplored region of the primate microbiome and highlight the utility of rhesus macaques as a model system for investigating the links between the OSM, ocular health, and disease.

Purpose:The lamina cribrosa (LC) is hypothesized to be the site of initial axonal damage in glaucoma with the circumpapillary retinal nerve fiber layer thickness (RNFL-T) widely used as a standard metric for quantifying the glaucomatous damage. The purpose of this study was to determine in vivo, 3-dimensional (3D) differences in the microstructure of the LC in eyes of nonhuman primates (NHPs) with naturally occurring glaucoma. Methods:Spectral-domain optical coherence tomography (OCT) scans (Leica, Chicago, IL, USA) of the optic nerve head were acquired from a colony of 50 adult rhesus monkeys suspected of having high prevalence of glaucoma. The RNFL-T was analyzed globally and in quadrants using a semi-automated segmentation software. From a set of 100 eyes, 18 eyes with the thinnest global RNFL-T were selected as the study group and 18 eyes with RNFL-T values around the 50th percentile were used as controls. A previously described automated segmentation algorithm was used for LC microstructure analysis. Parameters included beam thickness, pore diameter and their ratio (beam-to-pore ratio [BPR]), pore area and shape parameters, beam and pore volume, and connective tissue volume fraction (CTVF; beam volume/total volume). The LC microstructure was analyzed globally and in the following volumetric sectors: quadrants, central and peripheral lamina, and three depth slabs (anterior, middle, and posterior). Results:Although no significant difference was detected between groups for age, weight, or disc size, the study group had significantly thinner RNFL than the control group (P < 0.01). The study group had significantly smaller global and sectoral pore diameter and larger BPR compared with the control group. Across eyes, the global RNFL-T was associated positively with pore diameter globally. BPR and CTVF were significantly and negatively associated with the corresponding RNFL-T in the superior quadrant. Conclusions:Global and sectoral microstructural differences were detected when comparing thin and normal RNFL-T eyes. Whether these LC differences are the cause of RNFL damage or the result of remodeling of the LC requires further investigation. Translational Relevance:Our findings indicate structural alterations in the LC of NHP exhibiting natural thinning of the RNFL, a common characteristic of glaucomatous damage.

Purpose of review To provide the latest advances on the future use of gene therapy for the treatment of glaucoma. Recent findings In preclinical studies, a number of genes have been shown to be able to reduce elevated intraocular pressure (IOP), and to exert neuroprotection of the retinal ganglion cells. These genes target various mechanisms of action and include among others: MMP3 , PLAT, IκB, GLIS, SIRT, Tie-2, AQP1. Some of these as well as some previously identified genes ( MMP3, PLAT, BDNF, C3, TGFβ, MYOC, ANGPTL7 ) are starting to move onto drug development. At the same time, progress has been made in the methods to deliver and control gene therapeutics (advances in these areas are not covered in this review). Summary While preclinical efforts continue in several laboratories, an increasing number of start-up and large pharmaceutical companies are working on developing gene therapeutics for glaucoma ( Sylentis, Quetera/Astellas, Exhaura, Ikarovec, Genentech, Regeneron, Isarna, Diorasis Therapeutics ). Despite the presence of generic medications to treat glaucoma, given the size of the potential world-wide market (∼$7B), it is likely that the number of companies developing glaucoma gene therapies will increase further in the near future.