Develop new detection and monitoring techniques of early-to-late changes in diabetic and other retinal vascular disorders, and treatments to improve quality of life for patients with these conditions.
Vascular diseases of the retina are a major and growing contributor to blindness globally. There are more than 40 million people worldwide with type 1 diabetes, and Australia has one of the highest incidence rates at 7.4 per cent. Of affected Australians, 15 per cent have diabetic retinopathy. Among our Indigenous people, the incidence is at least double that of non-Indigenous Australians, with much greater rates of diabetic retinopathy, and much higher rates of blindness. Diabetes is the leading cause of preventable blindness in Australia.
Another common retinal vascular disorder is retinal vein occlusion, which has 1.6 per cent prevalence in Australians over the age of 50. Additionally, retinopathy of prematurity (ROP), a blinding disorder, commonly affects premature newborn infants and causes abnormal retinal vessel development.
Our work, our achievements
The Lions Eye Institute has an extensive experimental and clinical track record of retinal vascular disorders study. We have:
- Built experimental models for measuring vital parameters of induced vascular disorders.
- Studied modulation of retinal arterioles and veins and tested more than 50 vasoactive compounds in collaborations with Novartis, Alcon and Pharmaxis, and were the first to demonstrate drug-induced changes in retinal vein diameter. This work positioned us at the forefront of techniques for imaging the earliest retinal vascular changes.
- Studied retinal capillary perfusion and characterised the spatial and temporal heterogeneity of retinal blood flow. Quantitative assessments of such spatial and temporal heterogeneity (coefficient of variation) have been developed. This work has been highly recognised internationally.
- Studied retinal metabolism, particularly intraretinal oxygen distribution and consumption in more than 10 disease models. This work is important for understanding the pathogenesis of retinal vascular diseases, including diabetic retinopathy and other retinal ischemic diseases.
- Developed microperfusion and labelling techniques for human donor eyes, obtaining valuable information from normal and varying diseased eyes. Data gained has assisted linking our experimental and clinical studies.
- Developed a special technique to assess the retinal vein pulsation from experimental studies to clinical application. This technique is valuable for retinal vascular disease and glaucoma, but also for brain studies.
- Developed an effective treatment for managing retinal vein occlusion, using laser-induced retinal to choroidal vein anastomosis. This has been successfully translated from laboratory studies to routine clinical application.
The three common retinal vascular disorders – diabetic retinopathy, retinal venous occlusion (both branch and central) and retinopathy of prematurity – have many common causal linkages, and hence, many potential common treatment avenues which we are uniquely placed to explore.
Our work has great potential for identifying at-risk patients with systemic vascular diseases, as the retina is the only part of the body in which the vessels are easily visualised.
