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Research spotlight – diabetic retinopathy

Retinopathy is one of the most devastating complications of diabetes, and it's essential that people with diabetes have regular eye checks to ensure that the early signs of eye damage are spotted quickly.

Diabetes UK supported research that led to the current national eye screening programme and today we support studies that aim to make it even more effective.

What is retinopathy?

Diabetic retinopathy involves changes in the tiny blood vessels that nourish the retina at the back of the eye, which, if left untreated, can lead to serious vision problems. Within 20 years of diagnosis, nearly everyone with Type 1 diabetes and almost two thirds of people with Type 2 diabetes will have some degree of retinopathy.

Early screening is vital

In 1986 Diabetes UK supported a trial at Newcastle University to see if a retinal camera could be used to screen the eyes of people with diabetes for retinopathy. To make screening more accessible, the camera was set up in the back of an ambulance, which could visit diabetes clinics and screen up to 48 people a day.

The trial was incredibly successful. It helped lead to a national eye screening programme and, thanks to this, retinopathy is no longer the leading cause of blindness among the UK’s working age population.

Current projects

We are currently funding a range of research projects that aim to both understand and treat the eye damage caused by diabetes.

Earlier detection of diabetic retinopathy using non-invasive imaging

Dr Ruth Hogg at Queen’s University Belfast

In recent years, new ways to image the blood vessels in the eye have been developed. OCT-A (optical coherence tomography angiography) is a new, quick, and non-invasive method that can be used to see very small blood vessels at the back of the eye. Currently, big blood vessels at the back of the eye are assessed in retinopathy tests – but the smaller blood vessels may be more vulnerable to damage.

Dr Hogg is investigating whether it is possible to detect retinopathy early on by looking at the very small retinal vessels using OCT-A. If successful, this method could transform the way retinopathy is currently detected by offering earlier diagnosis and treatment.

Banking on retinopathy research

Dr Marcus Fruttiger at University College London

Retinopathy is thought to arise because high levels of glucose in the blood damage the blood vessels in the eye. However, our understanding of how the condition progresses is incomplete. Dr Fruttiger has developed methods to study retinopathy in human eyes donated by patients after their death.

A large number of samples are needed to better understand retinopathy, so Dr Fruttiger is creating a tissue bank of donated eyes. The samples in the tissue bank will then be studied by looking at microscopic images of the cells in the eye to understand how retinopathy affects different eye regions. The tissue bank will be a valuable resource for further retinopathy studies, and understanding how the condition develops creates potential for new treatments.

Limiting damage in diabetic eyes

Dr Heping Xu at Queen’s University Belfast

Diabetic macular oedema (DMO) is a major cause of vision loss during diabetic retinopathy. DMO is caused by leakage of fluid from damaged blood vessels into the macula, a specific area in the retina at the back of the eye. A therapy that blocks a protein called VEGF is currently used as a treatment for DMO. However, this protein is also important for cell survival and function in the retina.

Dr Xu is concerned that long-term treatment of DMO might damage patient’s eyes. He is currently investigating the safety of the anti-VEGF therapy to understand which cells suffer the most damage from the therapy, and if the damage can be reversed by stopping the treatment. The results from this study will help to improve the long-term management of retinopathy.

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