Clinical and Molecular Studies in Families With Glaucoma and Related Diseases



Status:Completed
Conditions:Ocular
Therapuetic Areas:Ophthalmology
Healthy:No
Age Range:4 - Any
Updated:3/13/2019
Start Date:December 29, 2005
End Date:July 29, 2016

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This study will document the clinical and genetic features of glaucoma and related diseases,
including normal tension glaucoma (NTG). Researchers would like to define genetic influences
and eventually isolate the genes causing those diseases.

Glaucoma is an important cause of vision loss in the United States and worldwide. The disease
is marked by a wearing down of the retina and optic nerve, often associated with increased
pressure in the eye. It is often an inherited trait. This study will involve between 250 and
2,000 patients over a 5-year period. It will examine the natural history of the genotype, or
genetic makeup, of a person and the phenotype, that is, visible situations produced by the
interaction of the genotype and one's environment.

Patients 4 and older who have glaucoma or related diseases or whose family members have those
diseases may be eligible for this study. They will complete a medical history for the doctors
to verify the diagnosis, inquire about medical problems and surgical operations, and gather
data about vision problems in a patient's family (by drawing a family tree). The complete eye
examination may take several hours. Eye drops will be used to dilate, or enlarge, the pupils
of patients' eyes, and the pupils will stay dilated for 4 to 6 hours. There may be some
temporary glare in brightly lit areas, which can be reduced by wearing of sunglasses.
Patients may experience some blurring of vision. There may be a localized allergic reaction
to the medication used or an increase of pressure inside the eye. If that occurs, medication
to control the reaction will be given. In addition, photographs of the retina and perhaps
even the lens will be taken. For that procedure, eye drops will dilate the pupils of the
eyes. The light that is involved with the specialized photography may cause some mild
discomfort. Patients will undergo eye tests regarding color vision, field of vision, and
ability to see the dark. Also, there will be a measurement of pressure in the eye and
thickness of the cornea.

To study patients' DNA, the researchers will obtain a blood sample of about 4 teaspoons from
patients 10 years or older. A smaller amount of about 1 teaspoon for each 5 lb. of body
weight will be collected from younger patients. Those DNA samples will be used only for
research in the genetic disorder in a patient's family. No other testing or research will be
conducted on the blood samples without patients' separate permission. Also, the DNA will be
stored by codes that the researchers define and contained in a secured building.

In this study, researchers will not provide information about a patient's health to patient
family members or to other people. They will not discuss information such as adoption or
biological fatherhood unless it has medical implications for the patient or the patient's
family members.

If information obtained from this study may be important to patients' health, they will be
informed when it is available. There are no plans to give patients the results of any medical
tests, evaluations, or other research data. Further research may be needed before such
results become meaningful.

Objective: This project, Clinical and Molecular Studies in Families with Glaucoma and Related
Diseases, will study the inheritance of glaucoma in families of many nationalities and ethnic
backgrounds in order to identify the genes that, when mutated, cause glaucoma, elevated
intraocular pressure, or similar diseases and the pathophysiology through which they act.

Study Population: The number of subjects to be enrolled has no logical upper limit, but will
be at least 250 and not more than 2000 during the next 5 years.

Design: The study consists of ascertaining individuals and especially families with multiple
individuals, affected by glaucoma or related retinal and anterior chamber diseases. These
patients and their families will undergo detailed ophthalmological examinations and, where
indicated, additional non-investigational examinations to characterize disease in their
families and determine their affectation status. A blood sample will be collected from each
individual for isolation of DNA and in some individuals biochemical testing or for
lymphoblastoid transformation to establish a renewable source of DNA. Linkage analysis,
physical mapping, SNP and microsatellite analysis for association studies, and mutational
screening will be carried out to identify the specific the gene and the mutations in it that
are associated with glaucoma in this family. If necessary, the gene product or blood sample
will be characterized biochemically. The study will enroll subjects at the NEI and at
collaborating institutions.

Outcome Measures: Linkage will be determined using the lod score method and mutations in
specific genes will be assessed using a combination of residue conservation, blosum score,
and molecular modeling. Biochemical, metabolic, and physiological effects will be
individualized to the specific assay.

- INCLUSION CRITERIA:

Subjects with the following will be recruited:

1. Individuals or family members of individuals with glaucoma, either congenital,
childhood, or age related.

2. Adults must be capable of providing their own consent.

3. All subjects must be able to cooperate with study examination and phlebotomy.

4. Older than 4 years of age.

EXCLUSION CRITERIA:

1. Diseases, infections, or trauma that mimic primary glaucoma.

2. Children requiring sedation for study procedures.
We found this trial at
4
sites
Durham, North Carolina 27710
(919) 684-8111
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201 Presidents Circle
Salt Lake City, Utah 84108
801) 581-7200
University of Utah Research is a major component in the life of the U benefiting...
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9000 Rockville Pike
Bethesda, Maryland 20892
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Guangzhou,
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