Belfast
Dr Heping Xu
Queen’s University Belfast
£227,051 Project Grant
Inflammation in diabetic retinopathy: how is it influenced by cataract surgery?
August 2011 - August 2014
Project Summary
People with diabetes can be prone to developing cataracts and although surgery is effective at restoring vision, it can increase the risk of later development of retinopathy. By studying mice, Dr Xu aims to determine why and how the later development of retinopathy
occurs with the aim of offering insight to determine the best course of action for people with diabetes and cataracts and to develop anti-inflammatory treatment options for the future.
Background to project:
Diabetic retinopathy is a devastating complication of diabetes and remains the major cause of blindness in the UK’s working age population. People with diabetes are also prone to developing cataracts, where the lens of the eye becomes clouded by damaged proteins. Although cataract surgery is highly effective at restoring vision, it has been shown to increase the risk of people with diabetes going on to develop retinopathy. The underlying reasons for this are unknown, but Dr Heping Xu of Queen's University Belfast has shown that cataract surgery can lead to inflammation in the retina. This finding is interesting, because it is already known that diabetes causes chronic inflammation of the retina (leading to nerve and blood vessel damage), which could be exacerbated by cateract surgery.
Project aims
Dr Xu will study the specific processes involved in the development and progression of diabetic retinopathy after cataract surgery. Specifically his team will perform cataract surgery on mice either before or after they develop diabetic retinopathy and then closely monitor the effects of surgery on their eyes using a variety of imaging techniques (including microscopy, electroretinography and scanning laser ophthalmoscopy) and studies of the genes present in eye cells. In addition, they will test whether anti-inflammatory drugs can prevent or reduce the impact of diabetic retinopathy after cataract surgery.
Potential benefit to people with diabetes
Understanding the specific processes involved in the development and progression of retinopathy after cataract surgery could help healthcare professionals establish the best ways to treat people with diabetes and cataracts. In addition, if this research shows that anti-inflammatory drugs can help to protect against retinopathy, this could lead to the development of new treatment options within a relatively short period of time.
Summary of progress
The researchers’ first aim in the past year was to understand whether cataract surgery causes a more aggressive inflammatory response in the eyes of mice with diabetes compared to the eyes of mice without diabetes. Their results suggest that this is indeed the case. Although cataract surgery induces inflammation in both diabetic and non-diabetic eyes, the level of inflammation is generally higher in the eyes of mice with diabetes compared to those without. Their on-going investigations now aim to identify the key inflammatory pathways involved in this process.
The second aim of this project over the past year has been to understand whether cataract surgery worsens diabetic retinopathy. There are two components of retinopathy: retinal neuronal damage (referred as diabetic retinal neuropathy) and retinal blood vessel damage (referred as diabetic retinal vasculopathy). The researchers have found that retinal neuronal damage is increased in diabetic eyes 40-50 days after cataract surgery. Ongoing investigations now aim to understand which retinal neuronal cells are damaged in diabetic eyes and how. The researchers are also investigating whether retinal blood vessel damage is affected by cataract surgery in diabetic eyes.