MSFHR is providing matching funds to support the research of Dr. David Maberley as part of Diabetes Action Canada, one of five national chronic disease networks established through the Canadian Institutes of Health Research’s (CIHR) Strategy for Patient-Oriented Research (SPOR) Networks in Chronic Disease, connecting researchers, health professionals, policy-makers, and patients across the country. MSFHR has committed funding over five years to support Diabetes Action Canada and the BC-based research activities of two other networks: Can-SOLVE CKD and CHILD-BRIGHT.
Diabetes is considered a global epidemic. By 2025, over 12 percent of the Canadian population will live with diabetes. Diabetes can damage the back of the eye (retina) causing swelling, bleeding and scarring which can lead to deterioration and loss of eyesight. Diabetic Retinopathy (DR) is a serious complication of diabetes and the leading cause of blindness in adults under 60 years of age. It is asymptomatic in the early stage, but can quickly progress to more advanced stages, and if left untreated, can lead to severe vision loss, and even blindness. Almost all people with Type-1 diabetes and more than 60 per cent of those with Type-2 develop some form of retinopathy in the first two decades after a diabetes diagnosis. In Canada, the rate of diabetic retinopathy is about 40 per cent higher in First Nations communities compared to the general population.
Early detection of DR, through regular screening of the retina, is an effective method of avoiding vision loss from diabetes. There are effective therapies that can prevent visual loss and slow the progression of the damage if detected early. Therefore, it is critical to screen all people living with diabetes for early or more advanced diabetic retinopathy.
Dr. David Maberley, head of the Department of Ophthalmology and Visual Sciences at the University of British Columbia (UBC), is co-leading a national retinopathy screening program for the early diagnosis and management of DR with Dr. Michael Brent from the University of Toronto. Maberley’s research is a component of Diabetes Action Canada – the first and only nation-wide collaborative network of clinicians, researchers, disease associations, industry and government in partnership with people living with diabetes – focused on the prevention of diabetes complications.
The focus of Maberley’s BC research is to evaluate a DR screening site in Vancouver’s Downtown East Side and in remote First Nation communities. These sites will provide a model for community-based screening to improve care for patients with diabetic retinopathy living in remote and under-served areas of BC. Diagnostic nodes will be established in several rural hospitals and equipped with optical coherence tomography (OCT) cameras using new software for automated retina image data capture, transfer and analysis to detect retinal degeneration before symptoms emerge. As well, two travelling screening cameras will serve remote communities. These advanced imaging procedures will allow for the segmentation of patients according to risk, for treatment and follow-up care. For patients, availability of DR screening closer to where they live means they only have to make trips to the larger centres when treatment is actually needed.
Maberley’s team will also explore the use of artificial intelligence (AI) to allow images from OCT cameras across the country to be analyzed instantly to determine the need for treatment at an advanced centre, and inform clinicians on the course of treatment. Another component is the development of an app to assist patients with managing their eye care.
New advancements in imaging technology will enhance the ability to identify the full spectrum of diabetes-related retinal disease and allow for detection and intervention at earlier stages in the disease process. Maberley’s research will support Diabetes Action Canada’s goal to develop a national DR assessment program and patient registry to facilitate clinical trials of new diagnostic methods and more effective treatments, accessible to all Canadians with diabetes, ultimately transforming health outcomes, with few people losing their vision as a result of their diabetes.