New Study Links Epigenetic Aging to Glaucoma Progression Risks

In a groundbreaking study published in the journal *Ophthalmology*, Dr. Felipe Medeiros, a prominent researcher at the Bascom Palmer Eye Institute, has established a significant connection between epigenetic aging and the progression of glaucoma, a leading cause of irreversible blindness affecting over 100 million individuals globally. The research reveals that individuals experiencing accelerated biological aging are at an increased risk of rapid vision loss associated with glaucoma.

Glaucoma, characterized by damage to the optic nerve, often progresses even in patients with well-controlled intraocular pressure (IOP), which has long puzzled ophthalmologists. The study aimed to explore whether biological aging might be a crucial factor influencing the optic nerve's vulnerability to damage, particularly in patients who do not exhibit the typical high IOP profile. Dr. Medeiros stated, "We’ve long known that patients can lose vision from glaucoma even when intraocular pressure is well-controlled. That raises the fundamental question of what else is driving progression."

The study encompassed a cohort of 200 patients diagnosed with primary open-angle glaucoma, evenly divided between those exhibiting rapid and slow disease progression. Researchers employed four distinct epigenetic clocks—Horvath, Hannum, PhenoAge, and GrimAge—to evaluate biological age through blood samples. Patients were classified based on the rate of decline in their visual fields, measured via standard automated perimetry, and retinal nerve fiber layer thickness.

Key findings reveal that patients with faster glaucoma progression demonstrated significantly higher epigenetic age acceleration. Notably, the Horvath clock emerged as the most indicative, with each year of acceleration correlating to a 15% increase in the likelihood of rapid progression. Importantly, this association was even more pronounced in patients maintaining normal eye pressure, suggesting that biological aging could enhance the optic nerve's susceptibility to damage independent of IOP levels.

Dr. Medeiros remarked, "This is the first study to show that accelerated epigenetic aging is associated with faster glaucoma progression. It suggests that biological age, not just chronological age, could be an important predictor of disease trajectory, especially in patients who don’t fit the typical high eye pressure profile."

The implications of this research are profound, potentially paving the way for the development of blood-based biomarkers that could identify individuals at elevated risk for glaucoma progression. Dr. Medeiros envisions future studies focusing on how anti-aging therapies might mitigate glaucoma's impact. Early trials involving nicotinamide (vitamin B3) have shown promise in enhancing retinal function, indicating a path toward personalized glaucoma management that incorporates insights from epigenetic research.

As the research progresses, the Bascom Palmer Eye Institute aims to conduct prospective studies and deeper molecular analyses, ultimately striving to create effective interventions that could slow biological aging and preserve vision in glaucoma patients. The findings align with broader trends in neurodegenerative disease research, where accelerated epigenetic aging has been linked to increased risks and severity of conditions such as Alzheimer’s and Parkinson’s diseases.

This study not only contributes significantly to the understanding of glaucoma but also highlights the potential for innovative approaches in diagnosing and treating this debilitating condition, fundamentally changing the landscape of ophthalmological care.