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Speaker: Glaucoma on the cusp of personalized medicine
ANAHEIM, Calif. – “It used to be that patients learned about their health from their doctors, from us, but this is changing. Thanks to mobile health gadgets, apps and services, it's going to continue to change, and the changes are going to be transformative and cataclysmic,” Robert N. Weinreb, MD, professor and chair of ophthalmology at the University of California, San Diego, said during the annual meeting of the Optometric Glaucoma Society, held prior to the American Academy of Optometry meeting.
He discussed the new paradigm.
“The idea where the patients felt lucky to have you as their doctor is ending,” Weinreb said.
He showed a video on the SkinVision app, which allows a patient to take photos of their questionable moles, compare the change over time and share the images with a doctor.
“Think about that. A simple dermatologic application. Say you have a skin lesion, and instead of making an appointment and maybe waiting a month, you have an app,” he said.
“What’s going to be increasingly different is that medical data are available to each of us and our patients through biosensors, images, laboratory testing and genomic sequences. It’s accessible, analyzable and transferable,” Weinreb said.
He said that every patient is now an expert in their own chosen field, namely themselves and their own life.
He spoke about actress Angelina Jolie, who, through blood testing, learned she was susceptible to a certain type of breast cancer and proactively decided on a double mastectomy to mitigate the risk.
“Medicine today is reactive, it’s population based and one-size fits all,” Weinreb said. “We are entering the era of personalized medicine ... personalizing surgery that is predictive, patient-centric, allowing us to identify the right patient, with the right test and do it with the right frequency, instead of doing the same test at the same frequency for all of our patients.”
Personalized medicine allows for targeting the right drug and the right dose to the right patient, Weinreb explained.
“We are on the cusp of a revolution in glaucoma; we are beginning to identify new genes, but we still cannot link the genes to the disease,” he said.
The gene SIX6 has been found to increase the expression of a substance that damages retinal ganglion cells. The Shiley Eye Institute has begun biobanking and analyzing thousands of DNA specimens and full genome sequences, he said.
“It means that for every one of our glaucoma patients, we have terabytes of data,” he said.
Patient practices such as diet, exercise, supplements and nutraceuticals should all be on a doctor’s radar, “because we are beginning to collect the data we need for evidence-based application for each of these,” he said.
Health care access issues, such as those in the third world will be alleviated with smartphone technologies.
“Where there are profound access issues, today there can be medicine on demand,” he added.
“There is no doubt that the future of glaucoma will not be what it used to be.” Weinreb concluded. – by Abigail Sutton
Reference:
Weinreb RN. Personalized medicine and glaucoma. Presented at: Optometric Glaucoma Society annual meeting. Anaheim, Calif. Nov. 7-9, 2016.
Disclosures: Weinreb is a consultant for Abbvie, Aciex, Aerie, Alcon, Allergan, Amakem, Ametek, Amira, Aquesys, Bausch + Lomb, EyeTech Care, Eyenovia, ForSight Vision5, Genentech, Glaxo, Implandata, National Eye Institute, Novartis, Sensimed, Solx and Unity. He is a speaker for Carl Zeiss-Meditec, Genentech, Heidelberg Engineering, Lumenis, National Eye Institute, Optovue, Optos, Paradigm, Quark and Topcon.