Detecting eye disease before blindness sets in.
This research was completed on 31 October 2009
Published on 6 October 2007
Two of the leading causes of registered blindness in the UK are age-related macular degeneration and diabetic retinopathy1 They both result from progressive damage to the eye, but this often goes unnoticed until sufferers start to lose their vision. Researchers are developing a highly sophisticated new way of imaging the eye. They hope to enable much earlier and better diagnosis, which could help save people’s sight.
What's the problem and who does it affect?
Vision loss devastates lives
It goes without saying that losing your eyesight would be truly devastating – typically causing panic, fear and frustration. Two of the leading causes of blindness – age-related macular degeneration (AMD) and diabetic retinopathy – normally start to cause vision loss in mid to later life. They both affect vast numbers of people: up to 300,000 people in the UK are blind or partially sighted because of AMD. 2 Diabetic retinopathy affects nearly everyone with Type I diabetes and up to 60% of those with Type II.3
People with advanced AMD and diabetic retinopathy can’t read, watch television or see the faces of loved ones. They can’t drive, have problems going out alone for their shopping and often have to give up long-standing hobbies. Many worry about losing their independence and they are susceptible to depression.
Fortunately, the last few years have seen the launch of some promising new treatments, with many more in the pipeline. While it’s still not possible to cure AMD or diabetic retinopathy, or restore lost vision, several treatments seem to delay vision loss. But the success of these new treatments depends crucially on early diagnosis, so we urgently need new ways to detect damage to the eyes well before it causes blindness.
What is the project trying to achieve?
Sophisticated new imaging of damage to the eye
The project team is developing a new approach to taking images of the retina – the light-sensitive area at the back of the eye that is damaged in AMD, diabetic retinopathy and several other types of blindness. They are using a technique called optical coherence tomography (OCT), which is similar to ultrasound except that it uses low-power, laser light, instead of sound, achieving up to 100-times higher resolution.
Though it’s already proved useful in some areas of medicine, current OCT equipment cannot provide sufficiently detailed images to allow early enough detection of damage to the retina in AMD and diabetic retinopathy. So researchers are making highly technical modifications – which involve changing the wavelength of the laser light and the imaging speed, for example.
They are testing the new equipment on 30 people with diabetic retinopathy, 30 with AMD and 30 with cataracts. They hope to provide three-dimensional images of the retina of vastly improved quality.
What are the researchers' credentials?
|Project Leader||Professor W Drexler MS PhD|
|Location||Department of Optometry and Vision Sciences,Cardiff University|
|Grant awarded||6 July 2007|
|Start date||1 November 2007|
|End date||31 October 2009|
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The Project Leader, Professor Wolfgang Drexler, has an outstanding track record. His research group has played a leading role in the pioneering development of OCT, an important new diagnostic tool that provides high-resolution, non-invasive three-dimensional medical images. The technique has already proved valuable in several illnesses, helping diagnose problems in the eye, skin, gut and the nervous system.
The group has state-of-the art facilities at their disposal after moving in 2007 to a purpose-built, new building. Indeed, the School of Optometry and Vision Sciences is now the biggest research-intensive school of its kind in the country, with a top, 5-star rating in a recent government assessment.
The project will involve an important collaboration with Professor Rachel North, an internationally acclaimed expert in taking images of the eye, who has a reputation for clinical excellence. Professor North will supervise the recruitment of patients.
Who stands to benefit from this research and how?
The priceless gift of sight
Researchers are hoping to achieve a ‘quantum leap’ in our ability to image the eye’s light-sensitive retina, so providing diagnostic information of unprecedented quality. They are aiming for three-dimensional images with improved resolution, giving previously unobtainable information about the structures within and behind the retina. This pain-free and non-invasive technique takes only a few seconds.
Such images might dramatically improve the diagnosis of all forms of vision loss that result from damage to the retina, allowing much earlier diagnosis. Everyone with the early stages of AMD or diabetic retinopathy stands to benefit.
Early diagnosis is essential if we are to take full advantage of promising new treatments that can delay or even prevent vision loss. The success of these therapies depends crucially on timing – people who start their treatment at the very early stages of disease benefit most.
Detailed images of the retina would also help in the effort to develop even better treatments, by providing an accurate way to measure their benefits. The ability to save more people’s sight, so helping them retain their independence, would bring considerable cost benefits to society. The advantages to the individuals concerned would be priceless.
1. Bunce C, Wormald R. Leading causes of certification for blindness and partial sight in England and Wales. BMC Public Health 2006 Mar 8;6:58. 2. Fletcher A, Donoghue M, Owen C. Low vision services for people with age-related macular degeneration in the UK: a review of services needed and provision. Denbigh: Macular Disease Society, 2001. 3. L. M. Aiello, Principles and practice of ophthalmology: clinical practice, (Eds. D. M. Albert and F. A. Jakobiec, Saunders, Philadelphia, PA, 1994).