A Moorfields project published in the British Journal of Ophthalmology demonstrates the effectiveness of a widely-used eye injection to manage the previously untreatable rare condition, hypotony.
This condition is characterised by abnormally low eye pressure, which alters the eye’s normal shape and internal structure. Over time, this can lead to progressive and permanent vision loss, often taking several years to result in blindness. Hypotony may develop as a result of underlying eye conditions that damage the part of the eye responsible for producing the fluid that maintains normal eye pressure.
Until now, the standard treatment for eyes losing vision from low pressure has been to fill them with silicone oil. This has many benefits but is not ideal as it can be toxic to eye structures over long periods of time and is difficult to see through.
The data published today indicates that ocular injections containing HPMC (hydroxypropyl methylcellulose) – a low-cost gel used in most eye surgery – can be safely used to increase the volume of eyes with hypotony, increasing both their size and pressure.
Remarkably, in addition to restoring the eye’s anatomy, patients also regained sight. Seven of the eight patients who received the treatment experienced improvements in vision, eye pressure and length restoration after a twelve-month course of treatment. These all came from the world’s first dedicated hypotony clinic, enabled by funding from Moorfields Eye Charity.
Moorfields consultant ophthalmologist Harry Petrushkin said: “We are excited that this simple treatment has proved so effective for patients with this rare condition. This is the start of a process of understanding more about the balance of fluid inside the eye, leading to improved care for our patients.”
The Moorfields clinic integrates structured clinical assessment and collaboration with bioengineers at UCL to understand the drivers of chronic low intraocular pressure. This preliminary data is already informing thinking on standardised hypotony treatment nationally.
It provides a foundation for future, larger-scale formal clinical trials to evaluate the potential of this highly promising approach.
This project could not have taken place without the funding from Moorfields Eye Charity.
