Dr. Gardiner has been working for almost two decades to improve clinical diagnostic tools for glaucoma. This consists of assessing current techniques, developing new techniques for making measurements, and improving methods of analyzing the results. The aims are to detect the presence of disease, and accurately measure its rate of change, so that appropriate treatment can be assigned.
He has gained a growing international reputation for this work, leading to invited talks and a place on the editorial board of the premiere ophthalmology research journal, IOVS.
His background is in medical statistics, and he uses this expertise to help other researchers with their studies, not just within Discoveries in Sight but also throughout Legacy Health and elsewhere, both nationally and internationally.
Detection of Functional Change Using Cluster Trend Analysis in Glaucoma.
Gardiner SK, Mansberger SL, Demirel S. Invest Ophthalmol Vis Sci. 2017 May 1;58(6):BIO180-BIO190.
Localized Changes in Retinal Nerve Fiber Layer Thickness as a Predictor of Localized Functional Change in Glaucoma.
Gardiner SK, Fortune B, Demirel S.
Am J Ophthalmol 2016; 170: 75-82.
Assessment of the reliability of standard automated perimetry in regions of glaucomatous damage.
Gardiner SK, Swanson WH, Goren D, Mansberger SL, Demirel S.
Ophthalmology 2014; 121: 1359-69.
A method to estimate the amount of neuroretinal rim tissue in glaucoma: comparison with current methods for measuring rim area.
Gardiner SK, Ren R, Yang H, Fortune B, Burgoyne CF, Demirel S.
Am J Ophthalmol 2014; 157 (3): 540-549.
The main focus of Dr. Gardiner’s research is on improving diagnostic techniques for glaucoma.
Currently, when patients visit the glaucoma clinic, they may undergo one or more different tests. Functional testing, called “perimetry”, typically consists of looking at a white screen, and pressing a button when a brighter light appears. The aim is to measure how bright this light has to be for it to be visible, at different locations, in order to produce a map showing how much damage there has been across the eye. These tests are long and frustrating for the patient, and the results can vary from day to day, especially in eyes with glaucoma. Dr. Gardiner is working to improve this testing, making it more accurate and reliable. This will provide better quality information to the doctors, while also improving the experience for the patient.
Structural testing consists of taking images of structures at the back of the eye. Of particular interest is OCT (optical coherence tomography), which can be used to measure the thickness of different layers as much as 2mm deep within the retina. These structures change in glaucoma, as cells are damaged and vision is lost. Dr. Gardiner is working with others, including Drs. Burgoyne and Fortune within Legacy Health, to improve the understanding and interpretation of these measurements.
With all diagnostic testing, the doctor needs to be able to see not only how much damage there has been, but also how quickly it is getting worse. A rapidly progressing eye needs to be treated aggressively to prevent or delay severe vision loss, and so it is essential to identify those eyes as early as possible. Dr. Gardiner is working with others to improve methods for determining the rate of change, and to predict the likely subsequent rate of change based on testing that can be performed now.
Dr. Gardiner also uses his experience and training to help other researchers around Legacy Health with designing and analyzing experiments. This has encompassed a diverse range of medical fields, including studies in breast cancer, neonatal intensive care, trauma, and mental health.