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Global experts in Corneal Confocal Microscopy convene at WCM-Q conference

Dr. Rayaz Malik, professor of medicine, assistant dean for clinical investigations and a pioneer in the development of CCM.
Dr. Rayaz Malik, professor of medicine, assistant dean for clinical investigations and a pioneer in the development of CCM.

Experts in the pioneering diagnostic technique of Corneal Confocal Microscopy, which can detect major neurodegenerative disease by examining the small nerves of the eye, gathered at Weill Cornell Medicine-Qatar (WCM-Q) to discuss its use in clinical trials.

The two-day conference, which was supported by Qatar National Research Fund (QNRF) under grant number CWSP17-C-0902-19013, drew leading authorities in CCM from universities, research institutes and hospitals in Qatar, the UK, Italy, Germany, Australia, Singapore, China, Canada, the US and elsewhere to explore the applications of this rapid, ophthalmic test in the diagnosis and assessment of treatment effect in various neurodegenerative diseases.

CCM can accurately quantify nerve damage and repair in many central neurodegenerative diseases like Parkinson’s disease, dementia, multiple sclerosis, autism and schizophrenia as well as peripheral neuropathies in patients with diabetes, HIV, and chemotherapy for cancer. CCM can also used to investigate nerve damage in amyloid neuropathy (nerve damage caused by build-up of a rogue protein), Friedrich’s ataxia (an inherited degenerative condition), and idiopathic small fiber neuropathy (a genetic condition characterized by severe pain).

The expert speakers at the event discussed a wide variety of topics, beginning with a history of the development of CCM, and ranging through the use of CCM in clinical trials, the potential for using CCM in conjunction with AI, and the advantages and challenges of using CCM.

A major issue identified by most speakers was the lack of effective US Food and Drug Administration (FDA) and European Medicines Agency (EMA) approved therapies for neurodegenerative diseases, identifying inadequate end points as a major reason for multiple failed clinical trials. The main theme of the conference was whether CCM could be used as a ‘surrogate endpoint’ in clinical trials of new treatments for neurodegenerative diseases, enabling FDA approval.

WCM-Q speakers at the event included Dr. Rayaz Malik, professor of medicine, assistant dean for clinical investigations and a pioneer in the development of CCM; Dr. Ioannis Petropoulos, assistant professor of research in medicine; and Dr. Georgios Ponirakis, clinical researcher, and lab supervisor. Other speakers included Prof. Andrew Boulton, president of the International Diabetes Federation and professor of medicine at the University of Manchester, UK; Prof. Nathan Efron of Queensland University of Technology in Brisbane, Australia; Prof. Ashfaq Shuaib of the University of Alberta, Canada; Prof Giuseppe Lauria, Professor of Neurology, Milan and Prof. Roy Freeman, director of the Center for Autonomic and Peripheral Nerve Disorders at Harvard Medical School in Boston.

“The key advantages of CCM is that it is fast, non-invasive and reliably detects neurodegeneration. We need to make it more widely available and incorporate AI-based technology to diagnose different neurodegenerative diseases and to use it in multicenter trials of new therapies,” said Dr Malik.

The conference, which had the title Corneal Confocal Microscopy: A Surrogate Endpoint for Neurodegeneration in Clinical Trials, concluded with agreement on the issuance of a Doha CCM consensus statement - a document identifying the key challenges, opportunities, and actions for the wider adoption of CCM for the assessment of peripheral and central neurodegenerative disease, which is to be submitted for publication in the Journal of the Peripheral Nervous System. The participants also reached agreement on the establishment of a multi-center consortium to work collaboratively on studies utilizing CCM to investigate peripheral and central neurodegenerative diseases. The event was also supported by Proctor and Gamble and Heidelberg Engineering.

Experts from all over the world gathered at WCM-Q to discuss the potential uses for corneal confocal microscopy in clinical drug trials.