Expertscape is pleased to speak with Robert Weinreb, MD, an Expertscape World Expert in numerous ophthalmology topics, and specifically in glaucoma. Dr. Weinreb is the Director of the Shiley Eye Institute and also Chair & Distinguished Professor of Ophthalmology at the University of California San Diego School of Medicine.

In this “Ask The Expert” interview, we discuss the latest advances in glaucoma research and treatment and what we can expect in the future.

Expertscape: First, congratulations on your sheer productivity. Over 300 papers in the last decade. And with that background, what do you see next for glaucoma?

Dr. Weinreb: My research focuses on a variety of areas relating to personalized glaucoma care, as we have arrived at an inflection point for glaucoma diagnosis and management. The introduction into clinical practice of several technologies in the near future will enable improved glaucoma outcomes. With artificial intelligence and deep learning, the precision and accuracy of glaucoma diagnosis/monitoring soon will be improved. Genetic testing will enable clinicians to better distinguish subtypes of disease for more specific therapies. Wearable technologies will be implemented for improving adherence with topical ocular hypotensive medications, and sustained release medications that are placed within the eye should reduce ocular surface disease and issues with adherence. The use of implantable sensors to monitor intraocular pressure already is providing a plethora of data that enhance our knowledge of glaucoma and provide insights for improved management.

Expertscape: Does all this progress also translate into improved surgical procedures, as well?

Dr. Weinreb: It does. Glaucoma surgery will be more effective and safer as it continues to improve with targeted placement within the outflow pathways. In the meantime, the role of the microcirculation and perfusion in glaucoma pathophysiology will be elucidated. Finally, the potential for neuroprotective therapies to protect the optic nerve, particularly when complementary to ocular hypotensive therapy, remains a daunting challenge. However, this too will reach fruition with improved testing and clinical trial designs, novel drug therapies, as well as implementation of cell and genetic therapy.

Expertscape: And when it comes to research, what advancements are needed to better understand glaucoma and facilitate further therapy improvements?

Dr. Weinreb: Improved animal models and other relevant experimental paradigms, as well as new tools for monitoring and controlling cellular and optic nerve responses to various perturbations, are needed to enhance understanding of the biologic bases of glaucoma. And the development of centralized databanks to facilitate resource and data sharing will facilitate what is perhaps the most daunting challenge, namely translating laboratory discoveries to the glaucoma patient.

Expertscape: Shifting gears a little, you’ve made a very significant commitment to the research side of medicine. That said, is it feasible today to pursue a career as a clinician-scientist?

Dr. Weinreb: It is. For ophthalmologists with an unwavering scientific curiosity and also an interest in improving patient care, there should be no hesitation in pursing such a career. As the complexity of science continues to grow, it is essential to seek excellence in research training. And to enhance the likelihood of success, one also should seek out the best possible clinical training, enlist the guidance of an accomplished and nurturing mentor, and also be involved in a highly supportive academic community. At the Shiley Eye Institute - UC San Diego, we endeavor to create a home for the clinician-scientist, as they have a pivotal position in translating research discoveries into clinical practice.

Expertscape: Indeed. Thank you for your time and dedication, Dr. Weinreb. And we wish you continued success.

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