Over 3M people in the UK have diabetes. Diabetic macular oedema (DMO) is the most common cause of visual impairment in people with diabetes. This condition is characterised by swelling in the centre of the retina. 240,000 people with diabetes in the UK have DMO. When DMO affects the central few degrees of vision, it causes visual impairment. All patients with early DMO are referred from screening centres into hospital eye service to be monitored more closely for progression of DMO. However, there is no treatment in this early stage of DMO. Once the disease progresses, patients are treated with laser or by injecting drugs that block a compound called VEGF into the eyeball. These treatments are used in many retinal diseases that cause fluid to accumulate in the central retina such as age related macular degneration. However, these treatments are not always successful and are expensive and invasive. We propose to carry out a clinical study to find out if and how sleeping in dim light reverses or slows down the progression of early DMO. Given that VEGF is the main factor that causes the retinal swelling, any procedure that reduces the excess VEGF in the eye would help prevent DMO. The most important cause of elevation of VEGF is reduced oxygen, which occurs in diabetes, especially in the retina because the cells absorbing light (rods) demand so much. The extra demand only occurs in darkness. Therefore by sleeping in dim light, retinal demand for oxygen would decrease and hence DMO might be reduced. Two small, short, clinical trials support this view. We need a robust clinical study to investigate whether sleeping with a light-mask at night will reduce the swelling in the retina. So we will perform a clinical study at 10 centres. 300 patients with early DMO will be randomised into 2 groups. One half will use ‘light masks’ which illuminate the closed eyelids with dim light during sleep. The other half will use masks without light (dummy masks) so that the light level will be zero, as a control. The masks have been subject to stringent safety checks but we will report all adverse effects and the effect on sleep will be evaluated. The patients will have standard tests to monitor the progression of DMO for 24 months: the changes in vision and the structure of the retina will be monitored at regular time-points. 30 patients will also undergo further tests to evaluate the scientific basis of oxygen demand and dim light on the retina. The team assembled has vast experience of such trials and we have linked clinicians, scientists, statistician and members of an accredited Clinical Trials Unit to provide expert help with analysis of the results. The numbers of staff and resources requested are the minimum needed to ensure that this project and the associated scientific studies are conducted to the very highest international standards. Finally, this is a major study that has the potential to identify a new and non-invasive treatment in early DMO and prevent progression to the centre.

Abstracts are not currently available in GtR for all funded research. This is normally because the abstract was not required at the time of proposal submission, but may be because it included sensitive information such as personal details.

Abstracts are not currently available in GtR for all funded research. This is normally because the abstract was not required at the time of proposal submission, but may be because it included sensitive information such as personal details.

Abstracts are not currently available in GtR for all funded research. This is normally because the abstract was not required at the time of proposal submission, but may be because it included sensitive information such as personal details.

Glaucoma is a condition that affects the human eye and is an umbrella term for a family of related eye conditions. A common trait of these conditions is a functional abnormality of the retina and optic nerve, leading to loss of visual field. This vision loss is usually only part of the visual field, although, untreated, glaucoma often leads to blindness. It is thought that by 2010, there will be over 60 million people worldwide suffering from the various forms of Glaucoma. Visual field tests are crucial to the diagnosis and management of all types of glaucoma. Such tests require the level of retinal sensitivity to light to be sampled at a number of points typically between 50 and 100, depending on the type of test; the eye is then assigned a numerical value in the range 'no perception' (lowest) to 'perfect perception' (highest). A specialised machine is used to conduct these tests - a typical clinical test can take between six and seven minutes per eye. Once diagnosed with glaucoma or suspected glaucoma, a patient is monitored and recommended to undergo the same tests every six months (or more frequently in some cases). However due to the psychophysical nature of the glaucoma test, the results can therefore vary in quality dramatically. For example, they can be affected by patient fatigue (as the test can last for long periods) and attention span deficits (particularly in the elderly and children).This proposal aims to use data quality metrics (such as false positive and negative rates) to incorporate uncertainty into computational models that will also take into account the spatial and temporal nature of visual field data. The proposed research will use probabilistic Cellular Automata (CA) with an appropriate rule learning approach as the technique to model the visualfield deterioration of glaucoma sufferes. The aim is to accurately model visual field progression and to provide an aid to the clinical practitioners.This project is in collaboration with Moorfields Eye Hospital, London, UK.