A marker for asymptomatic glaucoma

Glaucoma, characterised by cupping of the optic nerve head and irreversible loss of retinal ganglion cells, affects roughly 70 million people worldwide and is the leading cause of irreversible blindness. But glaucoma is often asymptomatic for an extended time period, and therefore fewer than 50% of affected subjects are aware of their disease. Diagnostic markers are urgently needed and in March Nature Medicine, researchers at Tufts University School of Medicine, Boston, report the finding of the first such marker.

Nan Wang and colleagues examined the main outflow pathway for aqueous fluid in eyes from the cadavers of glaucomatous and normal people. They found that endothelial leukocyte adhesion molecule-1 (ELAM-1), the earliest marker for the atherosclerotic plaque in the vasculature, was consistently present on trabecular meshwork cells in the outflow pathways of eyes with glaucomas of diverse etiology (Nature Med 2001, 7:304-309).

Expression of ELAM-1 is controlled...