Message from the CMO – Shaun Brierly M.D.
I’m pleased to share the first quarterly Provider Newsletter. With the broad clinical expertise we enjoy across practices in American Vision Partners, I’d like to communicate some capabilities and showcase a few topics of interest to practicing clinicians and surgeons.
The original intent for this communication was to internally share new provider hires and practice locations to assist with referral patterns and to facilitate local camaraderie. While that information will be included, a desire has also been expressed to communicate interesting endeavors occurring in our partner practices, as well as ideas and breakthroughs that providers feel are important.
In that spirit, Barnet Dulaney Perkins’ glaucoma specialist Dr. Andrew Rabinowitz, former CMO of AVP and Senior Advisor Emeritus to the Medical Executive Committee, shares information about the association between glaucoma and Alzheimer’s disease. We are also summarizing the current state of the Light Adjustable Lens roll-out across our practices. Future newsletters will include such topics as clinical research endeavors, practice and provider awards and recognitions, and new technologies and practice enhancement opportunities. Please share awards and accolades that you would like to showcase and your thoughts and ideas for future content.
While there are always challenges in medicine, business and life, there are also opportunities to grow and accomplishments to celebrate.
Thank you for the excellent work you do taking care of your patients and your communities.
UNDERSTANDING THE RELATIONSHIPS BETWEEN GLAUCOMA AND ALZHEIMER’S DISEASE – With Andrew Rabinowitz, M.D.
Alzheimer’s disease (AD) and glaucoma are two age-related neurodegenerative disorders that affect millions of people worldwide. AD primarily affects the brain. Glaucoma may also be viewed as a neurologic disorder. These two disorders have shared characteristics such as age-related progression, neurodegeneration, and potential genetic susceptibilities.
Several population-based studies have revealed a higher prevalence of glaucoma among patients with AD and vice versa. The Rotterdam Study revealed this comorbidity extends beyond mere age-related coincidence, suggesting other underlying interconnected factors. The most recently published, peer-reviewed study by Park et al1 found an increased risk of dementia in participants with newly diagnosed glaucoma. Over a 12-year period, the incidence of dementia was 1.9 times higher in participants with newly diagnosed glaucoma than in glaucoma-free individuals.
Scientific studies have revealed several pathophysiological correlations. Both disorders are noted to involve neurodegeneration. The hallmark pathological features of AD include the upregulation of amyloid precursor protein, as well as the accumulation of amyloid-beta plaques and tau neurofibrillary tangles. Interestingly, the upregulation of amyloid precursor protein and accumulation of amyloid-beta plaques have also been proposed to contribute to the retinal ganglion cell (RGC) apoptosis observed in glaucoma. Compelling evidence also surrounds the role of reduced cerebral blood flow, oxidative stress, and impaired axonal transport in both disorders. ONH cupping and RNFL thinning in glaucoma may be indicators of a generalized neurodegenerative process, and glaucoma may be associated with all types of dementia.
Genetic studies have illuminated potential shared genetic factors between AD and glaucoma. Genes like APOE, associated with lipid metabolism and previously implicated in AD, have surfaced in glaucoma studies hinting at common hereditary threads. Further investigation in APOE as well as other genes is warranted to gain further insight into the potential interrelationship between these diseases.
In conclusion, the associations between AD and glaucoma embody the frontier of contemporary neurodegenerative research. A holistic approach toward caring for these patients is vital so that neurology and ophthalmology can work together to further assess for correlations in the levels of amyloid-beta and tau tangles in the brain, CSF, aqueous humor, and vitreous samples. It is likely that in the coming half decade, we will identify the relationships and similarities between these two diseases.
- Park DY et al. Risk of Dementia in Newly Diagnosed Glaucoma: A Nationwide Cohort Study in Korea Journal of Ophthalmology 2023:684-691
NEWS FROM OUR DOCTORS
CONGRATULATIONS TO DR. JAVIER DE LA TORRE, M.D.
Please join us in congratulating Dr. Javier De La Torre, M.D. of Southwest Eye Institute for winning Best Laser Eye Surgeon by Best of El Paso!
DR. JORDAN GRAFF TO BE HONORED BY FOUNDATION FIGHTING BLINDNESS
Dr. Jordan Graff, MD, FACS from Barnet Dulaney Perkins Eye Center is being honored by the Foundation Fighting Blindness for his incredible contributions within the ophthalmology field and to the foundation.
Light Adjustable Lenses at AVP
Since we started offering the technology in March 2023, American Vision Partners surgeons have implanted 172 Light Adjustable Lenses. Drs. Aaron
Amacher, Ijeoma Asota, Michael Campion, Craig Cassidy, Scott Perkins and Deepti Saini, representing Barnet Dulaney Perkins, Southwestern Eye Center, and Moretsky Cassidy Vision Correction all now have experience implanting these lenses.
If you are interested in learning more about the new LAL technology, any metro surgeon can trial the lens and get training to do their own adjustments. You can also participate by having Dr. Anthony Nappi, OD perform follow-up adjustments.
Please connect with Lorna Ryhner at firstname.lastname@example.org at BDPEC Refractive N. Scottsdale to help facilitate post-op adjustments.