Diabetes

Diabetic retinopathy is the leading cause of blindness in people under the age of 60 in the UK.

Visual loss has a devastating impact on individuals’ quality of life and the socio-economic cost is huge, estimated to be around £2 billion per year.

Overview

Diabetes is the commonest cause of blindness in young adults. The aim of the diabetes research theme is to protect people from loss of vision by improving the diagnosis and treatment of diabetic retinal disease. We have a broad strategy that integrates distinct but complementary programmes of research to translate progress in scientific research into effective new interventions. These research programmes include the development of highly sensitive diagnostic imaging techniques and powerful new therapies.

At Moorfields and the UCL Institute of Ophthalmology we are committed to addressing visual loss in diabetes in accordance with the St Vincent Declaration (a set of goals for the medical care of people with diabetes published following an international conference in 1989) to enable people with the condition to lead independent lives of high quality.

Objectives

Our objectives are:

  • to translate novel molecular anti-angiogenic therapies into safe and cost-effective clinical treatments for patients with established proliferative diabetic retinopathy in five years,
  • to develop functional imaging of the diabetic retina which, alongside laboratory work funded from other sources, will underlie the identification of a new intervention to prevent sight-threatening diabetic retinopathy in 5 to 10 years,
  • to advance surgical approaches in diabetes and to determine the feasibility of cell-based therapies to promote vascular regeneration in diabetic retinal ischaemia within 10 years.

Research Areas

Diagnostic imaging techniques

The retina can be studied in unique detail because it is accessible to optical imaging. We are using high-resolution cellular and molecular imaging techniques to study the effect of diabetes on the retina and the impact of therapeutic interventions. We are also working to develop imaging and psychophysical techniques to help us to understand the relationship between changes in retinal structure and function. As a ‘window’ to the brain, imaging of the retina enables us to study mechanisms of disease relevant to the central nervous system. Consequently, we are collaborating with neurologists to identify biomarkers of vascular disease in the retina that can be used as tools for the prevention of stroke.

Powerful new therapies

Recent scientific advances in our understanding of the mechanisms involved in diabetic retinal disease have led to the identification of new targets for treatment. The first results of an ongoing clinical trial demonstrate that intraocular delivery of a VEGF inhibitor (a substance that prevents the formation or growth of new blood vessels) can improve visual outcome in people with diabetes, benefiting five times more people than conventional laser treatment.

We are also working to understand the impact of diabetic retinal disease on people’s abilities to perform the essential activities of daily life. By offering hospital-based vision rehabilitation services to people with diabetes, we will investigate in detail the effect of diabetes on people’s sight. The results of this work will inform the future development of services to enable people with diabetes to make the most of their visual ability.

The Reading Centre

The Reading Centre provides vital objective evaluation of images for clinical epidemiological studies and clinical trials. It has a broad role within the BRC that includes teaching and training, research into the best methods of image analysis, and validation of new imaging techniques. For more information visit the Reading Centre Website