Preventing Vision Loss by Predicting and Treating Exfoliation Syndrome Earlier in Patients

Karen Curtin, PhD
University of Utah (Salt Lake City, UT)

Co-Principal Investigators

Barbara M. Wirostko, MD
University of Utah (Salt Lake City, UT)
Year Awarded:
Grant Duration:
September 1, 2020 to August 31, 2022
Award Amount:
Grant Reference ID:
Award Type:
Award Region:
US Midwestern
Karen Curtin, PhD

Preventing Vision Loss by Predicting and Treating Exfoliation Syndrome Earlier in Patients


In patients with exfoliation syndrome, which is marked by abnormal threadlike white fibers in the front of the eye that accumulate over time. Can we correctly predict who will go on to develop a buildup of pressure in one or both eyes known as glaucoma, a leading cause of blindness worldwide? We believe the answer is ‘yes.’ From researching thousands of medical records of exfoliation patients to find the clinical conditions and personal characteristics that correlate with changes in the eyes of our exfoliation patients over time, we will help doctors who care for these patients prevent or delay loss of vision from glaucoma through earlier medical treatment.


Exfoliation syndrome, an ocular condition associated with other systemic medical conditions, is a common cause of rapid and debilitating glaucoma globally ─ yet we do not understand fully why certain individuals have asymmetric disease or rapid progression to vision loss, while others never develop glaucoma. We are not yet able to define risk factors that predict who is at risk for a more rapid progression with precision. Our objective is to improve outcomes for exfoliation patients by using innovative database resources to develop a targeted way to accurately predict more rapid progression to glaucoma. Using a statewide population resource containing millions of demographic and medical records linked to patient data, the Utah Population Database at the University of Utah, we will use a two-stage modeling approach. First, we will determine prognostic factors associated with progression to exfoliation glaucoma and progression-free survival using data spanning two decades of more than 3,000 exfoliation patients. Second, we will determine a smaller set of predictive markers that can accurately guide tailored therapy in exfoliation patients and validate these markers in an independent clinical data repository, the Sight Outcomes Research Collaborative (SOURCE) at the University of Michigan’s Kellogg Eye Center. At the end of the predictive modeling phase including validation, we will translate our set of prediction factors into a clinical prediction tool which will be designed targeting ease and practicality of use, meaningful results, and applicability to patients in a general or specialty ophthalmology practice. Our work will translate to earlier identification of exfoliation patients who are at risk for development of debilitating glaucoma by providing clinicians with an easy to administer prediction tool that can be used widely for patient assessment and referral and timing for interventions, such as medication or surgery to lower intraocular pressure. Our innovative project will fuel clarity into who with exfoliation progresses to glaucoma and why? and inform interventions in patients to help prevent vision loss.

About the Researcher

Karen Curtin, PhD and Principal Investigator, is an Associate Professor of Internal Medicine and adjunct Associate Professor in Ophthalmology at the University of Utah School of Medicine and the John A. Moran Eye Center. Dr. Curtin serves as Associate Director of the Utah Population Database (UPDB), a unique shared resource housed at the University of Utah. Her wide array of research interests and experience in research infrastructure and project development have resulted several in cross-disciplinary collaborations. Focused on preventive and translational research, she established ongoing and productive collaborations with renowned translational and clinical investigators in age-related macular degeneration and exfoliation syndrome/glaucoma and associated comorbidities. Dr. Curtin received her PhD in biomedical informatics with an emphasis in genetic epidemiology from the University of Utah, where she was awarded the John D. Morgan Fellowship Award in Biomedical Informatics. A prolific and extensively published researcher, Dr. Curtin is principal investigator of several internally and externally funded studies. She was invited to speak at the prestigious Lindberg Society Symposium at the 2018 World Ophthalmology Congress and recently received an award from the BrightFocus Foundation's National Glaucoma Research Program to study prognostic factors and predictive markers of progression to exfoliation glaucoma in exfoliation syndrome.

Dr. Barbara Wirostko, MD and Co-Principal Investigator, is a board-certified practicing glaucoma specialist holding a Clinical Adjunct Professor position at the University of Utah, in the department of Ophthalmology and Visual Sciences, Moran Eye Center where she established the Utah Project on Exfoliation Syndrome (UPEXS) research program. Her area of expertise has involved researching, publishing, and speaking globally on the associations between exfoliation glaucoma and systemic comorbidities. She is a serial entrepreneur and recently founded Qlaris Bio. Previously, she was the Chief Medical Officer of EyeGate Pharmaceuticals, following its acquisition of Jade Therapeutics where Dr. Wirostko was Co-Founder and Chief Scientific Officer spearheading the strategy and operations for the preclinical and clinical development of the unique hyaluronic acid (Ocular Bandage Gel) for human use. Prior to Jade, she held leadership positions in medical and clinical development at Pfizer in Ophthalmology, overseeing the global Xalatan franchise as Senior Medical Director. She sits on the prestigious editorial boards, Ophthalmology Glaucoma and Journal of Glaucoma, and has published hundreds of peer-reviewed papers, books, and holds a fellowship with The Association of Research in Vision and Ophthalmology. Dr. Wirostko received her MD and completed her residency at Columbia University, College of Physicians and Surgeons, New York and holds a B.A. with distinction in Microbiology from Cornell University.

Personal Story

As a member of a family extensively afflicted by ocular diseases including exfoliation glaucoma and a population health sciences researcher, I was very fortunate to have met Dr. Barbara Wirostko by chance nearly ten years ago when I was her patient at an Ophthalmology triage clinic visit. Her enthusiasm and spirit for making a difference in the lives of glaucoma patients, both as individuals and across a large population, aligned with and complimented my own interests and enthusiasm for epidemiological research. It is my belief that using resources available to us, including our established collaboration, we can and will make a difference in the quality of the lives of patients with exfoliation of the eye who are at risk for developing debilitating glaucoma. By identifying factors that can predict progression and developing a simple tool to assess these conditions early on, clinicians will be able to intervene much earlier to ameliorate future vision loss in the care of their patients. We are extremely grateful to have the opportunity that a BrightFocus award affords to assemble a top-notch research team and undertake the rigorous scientific investigation we propose, and express deep appreciation to BrightFocus donors for their enthusiastic and generous support of our objective and aims.

Dr. Curtin from the University of Utah expresses her gratitude for the research she was able to achieve thanks to the donors of BrightFocus Foundation.

View the video transcript.

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