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Earlier detection of diabetic retinopathy using non-invasive imaging

Project summary

Improved phenotyping of microvascular changes in diabetic retinopathy with multi-level data

Dr Ruth Hogg and her team will develop new software to assess high resolution images of the blood vessels in the retina, produced using a new non-invasive imaging method called OCT-A. The study will increase our understanding of the earlier stages of diabetic retinopathy and how blood vessels in the retina change, allowing for earlier diagnosis of diabetic retinopathy. 

Background to research

Retinopathy is the term used to describe damage to the retina (the light sensitive area at the back of the eye). It can affect people with diabetes and is the most common cause of blindness among people of working age in the UK. Researchers have increased our understanding of diabetic retinopathy, but there are still many questions regarding the development and pattern of the condition, specifically in the earliest stages, which remain unanswered.  Until now, imaging vessels in the retina has required the use of fluorescent dyes, which are injected into the bloodstream to allow the blood vessels in the back of the eye to be photographed (known as fluorescein angiography). However, these methods are invasive and can't be used with everyone who might be at risk of developing retinopathy, such as women with gestational diabetes.   In recent years, substantial progress has been made with newer types of imaging that enable very small retinal vessels to be imaged. OCT-A (optical coherence tomography angiography) is a new quick and non-invasive method of producing high-resolution detailed images. Dr Hogg and her colleagues believe that these vessels are likely to be most vulnerable early on, and therefore may be better at providing an earlier indication of retinopathy than the large vessels that are currently used for assessment. 

Research aims

The team will study whether it's possible to detect diabetic retinopathy earlier on using OCT-A.  Using information from participants in the NICOLA study – Northern Ireland’s largest public health study – they will first compare the retinal vessels in people with various stages of diabetic retinopathy, using standard clinical imaging and OCT-A.   They will then develop software to analyse the OCT-A images, to determine the differences in the vessels between people with diabetes, without, and at different stages of diabetic retinopathy.   Finally, Dr Hogg and her colleagues will use computer modelling to combine different types images with information about the individual and their lifestyle, to determine the most effective way of diagnosing diabetic retinopathy and monitoring its progression. 

Potential benefit to people with diabetes

If successful, OCT-A has the potential to transform the way people are assessed, by offering earlier diagnosis and treatment of diabetic retinopathy in a safer and timelier manner than currently possible. It will also enable researchers to study the subtle changes in the early stages of diabetic retinopathy, when the use of fluorescein angiography isn't possible. 

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