编者按：科技跨越和无穷的求学欲为眼科鸿沟的发展提供了源源络续的能源。在芝加哥遍及召开的2024年好意思国眼科学会年会（AAO2024）上，繁密学者共享了眼科鸿沟的前沿有计划效果，展示了多样新发现、新视点和新冲破，照亮了眼科改日发展之路。《海外眼科时讯》有幸在会议本领邀请到海外著名眼科大家、威尔斯眼科病院的Joel S. Schuman训导进行专访，注重先容保管或复原视网膜神经元功能的身手、小梁网干细胞再生有计划和东谈主工智能（AI）在眼科的期骗等热门履行，并测度了眼科鸿沟精彩的改日。 《海外眼科时讯》影响视网膜和视神经的神经退行性疾病导致大众数亿东谈主不可逆转的倡导丧失，领导当今是否有一些有长进的身手不错保管或复原视网膜神经元的功能？Joel S. Schuman训导: 青光眼是最常见的不可逆性致盲疾病。到咫尺为止，咱们的诊治所有勾通在缩短眼压上，这是至关进击的，但并非诊治的全部。多样药物已被有计划用于神经保护、神经增强或神经再生，可是咫尺尚无一种药物在好意思国获取FDA批准用于以上筹办。有笔据标明烟酰胺和丙酮酸具有神经保护作用，将与眼内压缩短诊治扫数使用。另一项在哥伦比亚大学进行的有计划正在探索用于神经保护的补充剂的组合。其他药物如胞磷胆碱、姜黄（姜黄素）和白藜芦醇（在葡萄酒中发现）已被有计划发现具有神经保护作用。但即便这些药物自满出诊治后劲，但与眼压缩短疗法比拟，撑合手其疗效的笔据力度不及，其中烟酰胺和丙酮酸的笔据基础最强。当今还有几种药物正被有计划其神经保护方面的作用，举例神经助长因子（NGF）可能会提供神经保护以致神经增强作用，以改善现存思经元的功能而非再生新的神经元。好意思国眼科学会的有计划也出于相似筹办探索了睫状神规画养因子（CNTF）。此外，正在建树的一种分子阻断内皮素-1A，可能改善青光眼患者的眼部结构和功能截至，这属于神经增强的规模，其他有长进的药物也在有计划经过中。
Glaucoma is the most common irreversible blinding condition. To date, our treatments have focused entirely on lowering intraocular pressure, which is crucial but likely not the full story. Various compounds have been tested for neuroprotection, neuroenhancement, or neuroregeneration, though none are currently FDA-approved in the U.S. for these purposes. Evidence suggests that nicotinamide and pyruvate can be neuroprotective. These would be used alongside intraocular pressure-lowering treatments. A second study, likely conducted at Columbia University, is examining the combination of these supplements for neuroprotection. Other agents like citicoline, turmeric (curcumin), and resveratrol(found in wine) have been investigated for neuroprotective properties. While they show potential, the evidence supporting their efficacy is less robust compared to intraocular pressure-lowering therapies. Among these, nicotinamide and pyruvate have the strongest evidence base.Several drugs are under investigation for neuroprotection. For instance, Nerve Growth Factor (NGF) might provide neuroprotection or even neuroenhancement—improving the function of existing neurons without regenerating new ones. Studies presented at the American Academy of Ophthalmology have explored CNTF (Ciliary Neurotrophic Factor) for similar purposes. Additionally, a molecule being developed blocks endothelin-1A, potentially improving structural and functional outcomes in glaucoma patients. This falls under the category of neuroenhancement. Other promising agents are also in the research pipeline. 《海外眼科时讯》您仍是共享了几种保管视网膜神经元功能的机制和身手，这些身手是否已进行临床覆按？Joel S. Schuman训导：是的，烟酰胺和丙酮酸不错减少炎症并景仰细胞健康，其他抗氧化剂，如白藜芦醇，以及胞磷胆碱和姜黄等神经增强药物也得到了有计划。NGF和CNTF可促进神经元健康，而内皮素-1拮抗剂则通过所有不同的机制发达作用，内皮素是东谈主体最灵验的血管收缩剂，阻断其不错加多视网膜血流，加多的血流量可更好地提供养分，断根废料，改善视觉功能，正如波及玻璃体内给药的II期有计划所评释的那样。天然这些药物不行再生神经元，AG百家乐怎么稳赢但它们增强了现存思经元的功能，其他具有不同机制的药物也在建树中，咫尺尚处于早期阶段。
Yes, I mentioned nicotinamide (vitamin B3) and pyruvate, which are believed to reduce inflammation and support cell health. Other antioxidants, such as resveratrol, and nerve-enhancing drugs like citicoline and turmeric, have also been studied. NGF and CNTF promote neuron health, while endothelin-1 antagonists work through a completely different mechanism. Endothelin is the body’s most potent vasoconstrictor, and blocking it enhances blood flow to the retina. This increased blood flow provides better nutrition, removes waste, and appears to improve visual function, as demonstrated in phase II studies involving intravitreal administration. While these agents do not regenerate neurons, they enhance the functionality of existing ones. Other drugs with varying mechanisms are also in development, though at earlier stages in the pipeline. 《海外眼科时讯》可否请您谈谈小梁网干细胞再生有计划的临床有趣有趣？Joel S. Schuman训导: 这项有计划侧重于再生，由Yi Chin、Du Dan Stamer、Ross Ether和我构成的团队在Progress in Retinal and Eye Research上发表了一篇对于这一主题的论文。咱们将多样类型的干细胞（脂肪着手、胚胎和多颖慧细胞）打针到激光招引青光眼小鼠的前房中，这些细胞告捷地重建了小梁网，复原了其结构和功能。咱们不雅察到，干细胞似乎通过趋化信号或流体能源学靶向小梁网。有趣有趣的是，当使用成纤维细胞时，它们会当场散播，而非靶向小梁网。咫尺尚不明晰干细胞是转机为小梁网细胞如故开释增强现存细胞功能的因子，干细胞在体内的其他用途也存在相似的不投诚性。咱们的有计划仍是由小鼠发展到猪这么的大型动物，可是东谈主体覆按需要大皆的资源和监管部门的批准来确保安全性，咱们正在勤勉为下一步活动争取必要的撑合手。
This research focuses on regeneration. Our consortium, including Yi Chin, Du Dan Stamer, Ross Ether, and myself, published a paper in *Progress in Retinal and Eye Research* on this topic. We have used various stem cell types—adipose-derived, embryonic, and pluripotent—injecting them into the anterior chamber of mice with laser-induced glaucoma. These cells successfully rebuilt the trabecular meshwork, restoring both its structure and function. We’ve observed that stem cells seem to target the trabecular meshwork, possibly through chemotactic signals or due to fluid dynamics. Interestingly, when fibroblasts are used instead, they distribute randomly rather than targeting the trabecular meshwork. It's unclear whether stem cells transform into trabecular meshwork cells or release factors that enhance the function of existing cells. Similar uncertainties exist with other uses of stem cells in the body. Our experiments have progressed from mice to larger animals like pigs. Human trials, however, require significant resources and regulatory approvals to ensure safety. We are working to secure the necessary support for these next steps. 《海外眼科时讯》青光眼鸿沟流流露了好多翻新的诊治身手，您合计青光眼鸿沟改日的有计划热门可能有哪些？Joel S. Schuman训导: 我刚才提到的履行等于热门话题，需要连接深刻有计划。AI亦然热门话题之一，卓绝是它在成像分析和医疗数据中的期骗备受督察。思象一下，患者初诊查验时拍摄眼底像片，需要投诚患者是否健康或是否患有青光眼、糖尿病视网膜病变或黄斑变性等疾病。AI不错显赫增强筛查才智，卓绝是在获取督察契机有限的地区发达的作用更大。AI还不错监测疾病进展并预测其轨迹，助力眼科医生为患者量身制定督察权谋，举例AI不错指令患者是否需要在一个月或两年内进行随访，这将松开患者和医疗系统的背负。通过整合眼底图像、OCT、视线和医疗纪录的数据，AI有可能提供更精准的会诊。大型讲话模子和其他AI算法处于这一鸿沟的前沿，我对该鸿沟颠倒感兴味。
The areas I’ve mentioned remain hot topics and require further investigation. One area I haven’t discussed is artificial intelligence (AI), particularly its application to imaging analytics and medical data. Imagine examining a patient for the first time, taking a fundus photo, and determining with high certainty whether they are healthy or have a condition like glaucoma, diabetic retinopathy, or macular degeneration. AI could significantly enhance screening, especially in areas with limited access to care. AI could also monitor disease progression and predict its trajectory, helping physicians tailor care. For example, it could indicate whether a patient needs follow-up in one month or two years. This would reduce the burden on both patients and healthcare systems. By incorporating data from fundus images, OCT, visual fields, and medical records, AI has the potential to provide even more precise diagnostics. Large language models and other AI algorithms are at the forefront of this field, which I find incredibly exciting. 《海外眼科时讯》您奈何看待AI在会诊中的作用？您信托AI的会诊截至，如故更繁荣信托我方的会诊？Joel S. Schuman训导: 咫尺，AI算法输出存在好多不投诚性，大多数医生更繁荣我方审查数据。确保AI的论断可被意会并相宜逻辑，这少许至关进击，也等于说，咱们仍是在使用自动AI进行糖尿病视网膜病变筛查，青光眼的相似期骗也行将出现。跟着时辰的推移，我信托改日医生们会越来越信任AI，会宽心性将其颓靡用于疾病的会诊。
Currently百家乐AG真人, there’s enough uncertainty around algorithm outputs that most physicians would prefer to review the data themselves. It’s essential to ensure that the AI’s conclusions are understandable and logical. That said, we are already using autonomous AI for diabetic retinopathy screening, and similar applications for referable glaucoma are on the horizon. Over time, I believe we will grow to trust AI more and use it independently for diagnostics.