New thinking: improving clinical trial endpoints in glaucoma neuroprotection 10 More frequent testing to minimize visual field variability Greater sensitivity for detecting retinal ganglion cell (RGC) losses Early activity biomarkers 1. Wu & Medeiros. Scientific reports (2018) 8:4889 2. Transl Vis Sci Technol. 2024 Jun 3;13(6):14. 3. Proc Natl Acad Sci U S A. 2017 Nov 28;114(48):12803 - 12808 4. Transl Vis Sci Technol. 2025 Feb 3;14(2):24 5. IOVS June 2025, Vol.66, 4005 Sample size can be reduced by 40% with a cluster testing paradigm 1,2 Enable direct visualization of RGC at a cellular level 3 Neurofilament light chain (NFL), a neurodegeneration biomarker, is elevated in glaucoma patients’ aqueous humor and could potentially indicate early neuroprotective drug activity 4,5