Overview
Diabetes is a major cause of blindness amongst working-age people. Almost 3 million people in the UK have diabetes and it can lead to diabetic retinopathy. But the risk of diabetic retinopathy may be different in the UK compared to other countries with different public health systems and lifestyles.
Over half a million people aged 40-69 had physical examinations, gave blood, urine and saliva samples together with details of health and lifestyle as part of a project called UK Biobank. More than 68 thousand participants also had digital pictures taken of the retina in both eyes.
In this study the team is going through the images and marking them as either 1) healthy, 2) showing signs of bad eye health or 3) impossible to say. They want to find out how often diabetic retinopathy turns up and what it looks like in the images from known diabetics who took part. They’re also looking for any links between diabetic retinopathy in these images and health, lifestyle, background and situation.
Results from the study will help us understand the relationship between known and new risk factors for diabetic retinopathy in the UK population. They may help to shape healthcare policy for preventing and managing the condition in the UK. The study will also build a major new resource for UK eye and vision research.
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Scientific summary
Quantifying and characterising the impact of diabetic retinopathy in the UK Biobank Cohort
Diabetic retinopathy (DR) is the most common complication of diabetes. A recent study suggests there are 93 million people with DR, and 28M with vision threatening DR worldwide. DR is the leading cause of vision loss in working age people in the UK. Direct healthcare costs of complications of diabetes exceed £10 billion/annum, while lost productivity costs the UK >£15 billion/annum 13. None of the above 3 (Diabetes UK). These figures highlight the substantial public health burden of DR, and the importance of identifying modifiable risk factors that my reduce this burden. Longer diabetes duration and poorer glycemic- and blood pressure control are strongly associated with DR. Pooled global data cannot be reliably applied to the UK, where preventive medicine strategies are more robust, and implemented more widely.
The team is studying diabetic retinopathy in the UK using a unique resource with unparalleled scientific power – UKBiobank - which contains colour digital photographs and simultaneous spectral domain OCT images of the macula for both eyes of 68,151 participants aged 40-69. Physical activity, cardiovascular health (exercise ECG), blood pressure, medication usage, anthropometry, adiposity and relevant biomarkers (glucose, HBA1c, lipid profile, renal and liver function) are available for this cohort from the baseline examination, allowing an extensive analysis of the cross-sectional relationship between risk factors and prevalent disease. They are performing a disease/no disease grading of all photographic images, and grading diabetic retinopathy in all known diabetics. The availability of OCT images allows the first detailed description of the anatomical characteristics of diabetic maculopathy in a large, community-living cohort.