Diabetic retinopathy (DR) is currently the leading cause of vision loss in working-aged adults. With theanticipated growth of the diabetic population, the number of visually impaired diabetic people who cannot workor care for themselves will continue to be a major public health concern. Diabetes is known to cause alterationsin the retinal microvasculature and tissue that can progressively lead to visual impairment. Currently,prevention of vision loss due to DR requires early diagnosis, regular monitoring, and timely therapeuticintervention. However, a key impediment is distinguishing diabetic individuals who will develop retinopathy andprogress to vision-threatening diabetic macular edema or proliferative DR. Furthermore, it is not known whyanti-vascular endothelium growth factor treatment of diabetic macular edema is effective in improving vision ofonly some individuals. Since multiple concomitant factors likely contribute to the pathophysiology of DR, singlebiomarkers of retinal structure have had limited success in predicting DR progression and treatment outcome.The current research proposal will overcome this limitation by an innovative approach of comprehensive andcomparative characterization of both anatomical and physiological ocular biomarkers.
The specific aims are toidentify ocular biomarkers of microvascular, neural, and metabolic function that are predictive of development,progression, and treatment outcome of DR. These ocular biomarkers will be obtained by non-invasivemultimodal optical imaging technologies. The findings will also provide insight into how microvascular, neuraland metabolic biomarkers interact synergistically in contributing to the development of DR and other diabetescomplications. Future incorporation of the identified ocular biomarkers into clinical practice will aid in preventionof visual impairment, thereby significantly impacting the quality of life of diabetic people.
Diabetic retinopathy is a major and common cause of vision loss in working age adults. The potential for earlydiagnosis and better monitoring of treatment based on non-invasive ocular biomarkers could significantlyimpact diabetic health care by improving the quality of life and reducing the cost of health care.
