TAckling & Reducing Glaucoma Blindness with Emerging Technologies (TARGET)

Overview

Glaucoma is the leading cause of irreversible blindness worldwide and is a major cause of visual impairment and blindness. The number of people with glaucoma globally is projected to increase to a staggering 111.8 million by 2040, with the majority of afflicted patients residing in Asia. Approximately 10% of Singapore’s population is affected by glaucoma of which 50% of glaucoma patients are undiagnosed. The healthcare burden for managing glaucoma in Singapore is several billions of dollars annually; this will rise further due to ageing and increased life expectancy.

Despite the significant progress made in glaucoma research over the past decades, there remain outstanding clinical and research gaps that result in many people going blind from glaucoma. The $25 million 5-year programme TAckling & Reducing Glaucoma Blindness with Emerging Technologies (TARGET), helmed by the Singapore Eye Research Institute (SERI) and supported by the National Research Foundation Singapore under its Open Fund - Large Collaborative Grant, aims to address unmet clinical needs through a broad-based, interlinked, multi-disciplinary “bench-to-bedside” approach, utilising precision medicine approach to glaucoma management. Led by Professor Aung Tin, Chief Executive Officer of the Singapore National Eye Centre (SNEC), the TARGET programme brings together some of the world’s leading glaucoma researchers and clinicians to develop innovative methods and technologies to identify and more effectively treat individuals who are most at risk of vision loss from glaucoma.

Our Vision

To reduce avoidable vision loss from glaucoma globally and glaucoma blindness in Singapore.

Aims

The TARGET programme will tackle the five major reasons why blindness still occurs amongst patients with glaucoma via thematic approach to each of these key challenges. The programme proposes to develop improved, technology-driven approaches, to identify earlier and more effectively treat individuals most at risk of vision loss from glaucoma and this promotes a precision medicine approach to glaucoma management.

Team Members

The TARGET programme is a broad multi-institution and multi-disciplinary programme that brings together many of the leading glaucoma researchers in Singapore and worldwide to tackle the issue of glaucoma blindness. Collaborating institutions include the major eye departments in Singapore, with leading universities/academic centres.

Clinical Competencies & Expertise

The spectrum of glaucoma in Asia differs from the West, with primary angle closure glaucoma and normal tension glaucoma being more prominent in Asia. This makes Singapore an ideal place to advance research into Asian glaucoma. The multi-centre collaborative research proposed in TARGET to reduce glaucoma blindness is thus important as the findings will have implications for the many millions of glaucoma patients in Asia and globally. Singapore is one of the leading centres for research in the field of glaucoma. Under the website Expertscape (www.expertscape.com), SNEC/SERI ranks second amongst all institutions in the world for the field of glaucoma, and the lead PI, Aung Tin is listed as second amongst all glaucoma experts in the world.

Theme 1: Co-Theme PI Professor Aung Tin [Aung Tin (snec.com.sg)] is the Chief Executive Officer of the Singapore National Eye Centre (SNEC) and Lead Principal Investigator of this TARGET programme. Together with Co-Theme PI Adjunct Professor Chiea Chuen Khor [Chiea Chuen Khor (a-star.edu.sg)], the team has established a world-leading glaucoma genetics program that have identified major genes for POAG, PACG and exfoliation glaucoma. These findings have been reported multiple times in prestigious research journals such as Nature Genetics, and weekly clinical journals such as JAMA.

Theme 2: Co-Theme PI Professor Cheng Ching-Yu [Cheng Ching-Yu (duke-nus.edu.sg)] has developed a world-class translational research programme in population eye health. As the Director of the Singapore Epidemiology of Eye Diseases (SEED) programme and Head of the SERI Ocular Epidemiology Research Group, he has built up one of the largest epidemiological databases and biobanks (n >10,000) for eye diseases globally. Co-Theme PI Dr Rachel Chong [Rachel Chong (snec.com.sg)] is a clinician scientist with joint appointment as a glaucoma consultant at the Singapore National Eye Centre, and as Assistant Professor at the Duke-NUS Medical School. Dr Chong’s area of research involves developing robust models to study neuronal and related vascular contributions to glaucoma pathogenesis more precisely.

Theme 3: Co-Theme PI Professor Leopold Schmetterer [Leopold Schmetterer (ntu.edu.sg)] is the Head of the Ocular Imaging Research Group and Scientific Director at SERI, and Professor at the Nanyang Technological University. His interests span a wide range of imaging from development of novel technology towards applications in preclinical research and clinics. He has published more than 390 peer reviewed publications, was invited for more than 200 lectures; including more than 15 key note lectures and been awarded more than 30 million Euro in research grant funding. Co-Theme PI Associate Professor Michael Girard [Michael Girard (snec.com.sg)] heads the Ophthalmic Engineering & Innovation Laboratory (OEIL; https://www.ophthalmic.engineering) and the Bioengineering & Devices Research Group at SERI. He has strong expertise in Ophthalmic Engineering with a focus on Artificial Intelligence, Biomedical Imaging, Ocular Biomechanics, and Ophthalmic Devices. Associate Professor Girard has authored more than 120 papers in top Ophthalmology and Engineering journals with many of these papers have presented novel findings in ocular biomechanics and the use of deep learning/artificial intelligence to better our understanding of glaucoma disease.

Theme 4: Co-Theme PI Professor Tina Wong [Tina Wong (snec.com.sg)] is Head and Senior Consultant of the Glaucoma Department at SNEC. Her research interests lie in the development of new ophthalmic therapies, nanomedicine and the innovative application of drug delivery systems to improve on the current medical and surgical treatments in glaucoma and other ophthalmic diseases. Professor Wong has published widely in these areas and has nationally funded research grants amounting to $8 million. She holds many patents to her name and is the co-founder of 2 spin-off biotech companies that spawned from her research. Co-Theme PI Associate Professor Shamira Perera [Shamira Perera (snec.com.sg)] is a Senior Consultant of the Glaucoma Department at SNEC and Deputy Director of the Medical Technology office at SingHealth with an interest in novel surgical devices, biomechanics and imaging. Supported by competitive research grants totalling over $2 million as PI, his core work has yielded 8 patents and commercialised two devices for cataract surgery.

Theme 5: Co-Theme PI Clinical Associate Professor Rahat Husain [Rahat Husain (snec.com.sg)] is the current Director of Regional and Community Eye Care for SingHealth and a Senior Consultant of the Glaucoma Department at SNEC. He has more than 20 years of experience in clinical research and has authored or co-authored nearly 70 peer-reviewed articles, the vast majority of the subject of glaucoma. Co-Theme PI Associate Professor Victor Koh [Victor Koh (nuh.com.sg)] is currently the Head for Department of Ophthalmology at the National University Hospital (NUH) and National University of Singapore (NUS) Yong Loo Lin School of Medicine. Together with our overseas collaborator Professor Jonathan Crowston, Professor of Ophthalmology at the University of Sydney and Save Sight Institute, the team will conduct a multi-centre randomised placebo-controlled trial to investigate the effect of nicotinamide as a neuroprotective treatment for patients with glaucoma.

Our Local and International Collaborators

National University Hospital System (NUHS), Singapore

Tan Tock Seng Hospital (TTSH), Singapore

Changi General Hospital (CGH), Singapore

Duke-NUS Medical School (Duke-NUS), Singapore

Nanyang Technological University (NTU), Singapore

National University of Singapore (NUS), Singapore

Agency for Science, Technology and Research (A*STAR), Singapore

Vietnam National Eye Hospital, Vietnam

Kyoto Prefectural University of Medicine, Japan

Ozaki Eye Hospital, Japan

Duke University Medical Centre, USA

Chinese University of Hong Kong, Hong Kong

Aravind Eye Hospital, India

Harvard Medical School, USA

University of Alabama, USA

Utrecht University, Netherlands

Tel Aviv University, Israel

Royal Adelaide Hospital, Australia

University of Melbourne, Australia

University of Sydney, Australia

Karolinska Institute, Sweden

We are keen to discuss and develop new industry partnerships, and research and development collaborations.

You may contact us here.

Publications

Theme 2

From 2 Dimensions to 3rd Dimension: Quantitative Prediction of Anterior Chamber Depth from Anterior Segment Photographs via Deep-learning. Soh ZD, Jiang Y, S/O Ganesan SS, Zhou M, Nongiur M, Majithia S, Tham YC, Rim TH, Qian C, Koh V, Aung T, Wong TY, Xu X, Liu Y, Cheng CY. PLOS Digital Health. 2023 Feb.

Theme 3

Evaluation of Generative Adversarial Networks for High-Resolution Synthetic Image Generation of Circumpapillary Optical Coherence Tomography Images for Glaucoma. Sreejith Kumar AJ, Chong RS, Crowston JG, Chua J, Bujor I, Husain R, Vithana EN, Girard MJA, Ting DSW, Cheng CY, Aung T, Popa-Cherecheanu A, Schmetterer L, Wong D. JAMA Ophthalmology. 2022 Oct.
Differing Associations between Optic Nerve Head Strains and Visual Field Loss in Patients with Normal- and High-Tension Glaucoma. Chuangsuwanich T, Tun TA, Braeu FA, Wang X, Chin ZY, Panda SK, Buist M, Strouthidis N, Perera S, Nongpiur M, Aung T, Girard MJA. Ophthalmology. 2023 Jan.
Discriminating Between Papilledema and Optic Disc Drusen Using 3D Structural Analysis of the Optic Nerve Head. Girard MJA, Panda S, Tun TA, Wibroe EA, Najjar RP, Aung T, Thiéry AH, Hamann S, Fraser C, Milea D. Neurology. 2023 Jan.
Geometric Deep Learning to Identify the Critical 3D Structural Features of the Optic Nerve Head for Glaucoma Diagnosis. Braeu FA, Thiéry AH, Tun TA, Kadziauskiene A, Barbastathis G, Aung T, Girard MJA. American Journal of Ophthalmology. 2023 Jun.
How Myopia and Glaucoma Influence the Biomechanical Susceptibility of the Optic Nerve Head. Chuangsuwanich T, Tun TA, Braeu FA, Yeoh CHY, Chong RS, Wang X, Aung T, Hoang QV, Girard MJA. Investigative Ophthalmology & Visual Science. 2023 Aug.
Posterior Scleral Birefringence Measured by Triple-input Polarization-Sensitive Imaging as a Biomarker of Myopia Progression. Liu X, Jiang L, Ke M, Sigal IA, Chua J, Hoang QV, Chia AW, Najjar RP, Tan B, Cheong J, Bellemo V, Chong RS, Girard MJA, Ang M, Liu M, Garhöfer G, Barathi VA, Saw SM, Villiger M, Schmetterer L. Nature Biomedical Engineering. 2023 Aug.
Three-Dimensional Structural Phenotype of the Optic Nerve Head as a Function of Glaucoma Severity. Braeu FA, Chuangsuwanich T, Tun TA, Perera SA, Husain R, Kadziauskiene A, Schmetterer L, Thiéry AH, Barbastathis G, Aung T, Girard MJA. JAMA Ophthalmology. 2023 Sep.
The Structural Layers of the Porcine Iris Exhibit Inherently Different Biomechanical Properties. Tan RKY, Panda SK, Braeu FA, Muralidharan AR, Nongpiur ME, Chan ASY, Aung T, Najjar RP, Girard MJA. Investigative Ophthalmology & Visual Science. 2023 Oct.

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