Medical Student Research Fellowship for Summer 2011

Mentor: Karanjit S Kooner MD                 
Department: Ophthalmology       
Room number; E5-406.
Mail Code:     9057  
Phone number: 214-648-4733
E-mail: Karanjit.Kooner@UTSouthwestern.edu           
Project title: Racial Influences on Medical Therapy in Glaucoma
           

Human subjects IRB approved project number (where applicable): 102004-073

Animal subjects IRB approved project number (where applicable):  N/A

Project Type (patient-based research, animal-based research, or basic research; this characterization is only to permit a general classification for grouping similar types of projects): Patient based research.

Brief Description of Project:
Glaucoma is one of the leading causes of blindness affecting approximately 66.8 million people worldwide. Glaucoma is a slowly progressive optic neuropathy characterized by enlarging optic disc cupping and visual field loss. There is a strong racial disparity in the prevalence of glaucoma. The prevalence of primary open-angle glaucoma (POAG) among blacks is estimated to be up to six times as high in certain age groups compared with whites. In addition, POAG is more likely to result in irreversible blindness, appear earlier and progress more rapidly in blacks than in whites. The Baltimore Eye Survey suggested that blacks who have POAG may not be as responsive as whites to some drugs used to control intraocular pressure.
The study is designed to retrospectively evaluate racial influences on drug response for the treatment of primary open-angle glaucoma and ocular hypertension. Outcome variables are (1) need for surgery for uncontrolled intraocular pressure or (2) intraocular pressure reduction equal to or greater than 20% over two consecutive visits. The working hypothesis is that 50% of black individuals will require surgery to control intraocular pressure compared to 30% of white individuals. To test this hypothesis a sample size of 500 patients in each group will give a power of 84% with alpha at 0.05. Intraocular pressure readings will be recorded pre-treatment and followed at 1 month, 3 month, and 6 months after treatment initiation and every 6 months thereafter. The type and number of anti-glaucoma medications used will also be recorded along with cup-disc ratios and visual field analysis.

Role of students:    1. The first few days will be spent in getting familiarized with clinical activates in ophthalmology. The students will spend time with us in clinics and operating rooms. They will observe how we interview patients, check vision, intraocular pressure, central corneal thickness, gonioscopy, fundoscopy and slit lamp examination. They will watch our technicians perform visual fields, ocular coherent tomography and fundus photos. In the OR, they will observe common eye surgeries including various glaucoma and cataract procedures.

2. They will study the data collection form and understand how information is extracted from charts. We will show them how to read visual fields and optic disk features.

3. Each student will be given a separate project from our main area of research and will be supervised regularly. We expect them to prepare an abstract for submission at a national eye meeting.

Previous Research Activities or Publications with Medical Students:

1. Lieu P, Kooner KS et al: Symptoms of Autonomic Dysfunction in Primary Open-Angle Glaucoma (POAG). Presented at the Association of Research in Vision and Ophthalmology, Fort Lauderdale, FL, May 2008.
2. Brooks, PA, Kooner KS et al: The Effect of Nocturnal Blood Pressure and Intraocular pressure on the progression of Primary Open-angle Glaucoma (POAG). Presented at the annual scientific meeting and exposition of the       American Society of Hypertension. New Orleans, LA. May 2008.
3. Coleman M,  Lubahn JG, Chitkara P, Aronowicz J, Brooks P, AlBdoor M, Lieu P,                             Butsch R, Adams-Huet B, Nesbitt SD,. Kooner KS. Circadian Intraocular Pressure                               and Blood Pressure Fluctuation in Primary Open Angle Glaucoma. National Medical                          Association Annual Convention and Scientific Assembly in Atlanta, GA. July 2008.
4. Shar A, Joseph A, Huet B and Kooner KS .Glaucoma Suspect Results from the  Dallas Glaucoma Registry. Presented at the American Glaucoma Society Meeting, San Diego. CA. March, 2009.
5. Joseph A, Shar A, Huet B and Kooner KS. Is Secondary Glaucoma a Surgical         Disease? Results from the Dallas Glaucoma Registry. Presented at the American    Glaucoma Society Meeting, San Diego. CA. March, 2009.
6. Kamath P, Harrison M, Zohra P, Marquardt F, and Kooner KS: Glaucoma in United States Veterans: an overlooked group?  Presented at ASCRS meeting, Boston, MA April 7-9, 2010.
7. Harrison M, Zohra P, Kamath P, Marquardt F, and Kooner KS: Glaucoma Suspects in Children. Presented at annual meeting of American Glaucoma Society meeting in Naples, FL. March 4-7, 2010.
8. Zohra P, Harrison M, Kamath P, Marquardt F, and Kooner KS: Is Childhood Glaucoma a Surgical Disease? An Analysis of 231 Ethnically Diverse Patients. Presented at the annual Medical Student Research Forum, UTSWMC, Dallas, January, 2010.
9. Roensch MA, Kooner KS, Prala Z, Harrison M, JT Whitson: Characteristics of Childhood Glaucoma. Presented at annual meeting of American Academy Ophthalmology, Chicago.IL October 17 2010.