Patient stratification in clinical glaucoma trials using the individual tear proteome

Area of Science:

• Ophthalmology
• Proteomics
• Biochemistry

Background:

• Glaucoma patients frequently experience ocular surface disease.
• Preserved eye drops can exacerbate these conditions.
• Switching to preservative-free formulations may improve symptoms.

Purpose of the Study:

• To investigate changes in tear proteome and ocular surface health in glaucoma patients switching from preserved to preservative-free latanoprost.
• To stratify patients based on tear protein profiles to identify recovery patterns.
• To correlate baseline protein levels with treatment response.

Main Methods:

• Sequential Window Acquisition of All Theoretical Mass Spectrometry (SWATH-MS) for quantitative tear proteomics.
• Clinical evaluation of ocular surface health at baseline and four follow-up visits over 12 months.
• Stratification of 28 glaucoma patients into distinct groups based on protein expression.

Main Results:

• Quantification of 785 proteins per tear sample.
• Identification of three distinct patient groups based on tear protein profiles.
• Patients with higher baseline pro-inflammatory and lower protective proteins showed the most benefit from the medication switch.

Conclusions:

• Patient stratification using SWATH-MS is a valuable tool for understanding treatment responses in glaucoma.
• The study identified specific tear protein profiles associated with better outcomes after switching to preservative-free tafluprost.
• Targeting pro-inflammatory pathways may be beneficial for glaucoma patients with ocular surface disease.