Fight for Sight to Maximise Impact by Funding Solutions-Focused Research in Priority Eye Conditions
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25 YEARS IN OPHTHALMOLOGY Fight for Sight to maximise impact by funding solutions-focused research in priority eye conditions BY ROD MCNEIL Fight for Sight aims to stop sight loss by funding pioneering research. Rod McNeil takes a look at the Primer Fellowship Awards programme, which provides funding for up to £60,000 for individuals to undertake vision-related research for one year. mong the global population who were blind in 2015 (36.0 million [80% uncertainty interval A12·9 million to 65.4 million]), the leading causes of blindness (crude prevalence) among all ages was cataract, followed by uncorrected refractive error, glaucoma, age-related macular degeneration (AMD), corneal opacity, trachoma and diabetic retinopathy [1]. Figure 1 summarises prevalence estimates for blindness in 2015 by cause in Western Europe for adults aged 50 years and older. The main causes of blindness certifications in England and Wales in adults of working age (16-64 years) in 2009-2010 were inherited retinal diseases, diabetic retinopathy / maculopathy and optic atrophy [2]. These together accounted for almost half of all blindness certifications. Updated figures on causes of sight impairment in England and Wales for April 2012-March 2013 show that AMD remains Figure 1: Western Europe: projected prevalence of blindness (VA <3/60 in the better eye) by cause among adults ≥50 years [1]. the leading cause of certifications for sight of around £3-4 million each year, with impact that the research may have for impairment in England and Wales (both funding available through open competition patients and the scientific quality of severe sight impairment or blindness, and partial sight impairment) [3]. The three and peer review. The eye charity spent applications are the primary determinants. leading causes of severe sight impairment £16.5 million on research over the five In March 2017 the Board approved were degeneration of the macula and years to March 2017 and remains intensely a new Five Year Plan 2017 to 2022 and posterior pole, glaucoma and hereditary ambitious to increase its charitable the charity is now in the early stages of retinal disorders. spending. As of 31 March 2017, the charity’s implementation. The key development is a Currently over two million people in overall research commitments amounted heightened focus on outcomes, and a desire the UK are affected by sight loss, a figure to £7.9m for 159 research projects at 44 to enable a more flexible and proactive set to double by 2050. Fight for Sight’s different institutions across the UK. approach to the allocation of research ambition is to stop sight loss by funding Fight for Sight research has so far funding. It has determined its key areas of pioneering research and maximising the resulted in breakthroughs including the focus and identified where it believes the charity’s impact by providing information, identification of new genes responsible for real opportunities for maximising impact influencing opinion and shaping policy. To glaucoma, the world’s first clinical trial of lie. This builds on the insights gathered from ensure it delivers, it says its approach will a gene therapy for choroideremia and the patients about focusing on outcomes that be patient-centric, solutions-focused and design of a new test that can detect the really matter to them. This, coupled with evidence-based. early stages of sight loss in AMD. the development of an integrated on-going Fight for Sight provides research funding When awarding grants, the potential brand and fundraising campaign, will help Eye News | AUGUST/SEPTEMBER 2018 | VOL 25 NO 2 | www.eyenews.uk.com 25 YEARS IN OPHTHALMOLOGY raise the profile of the charity with the aim research outcomes established by the New vision research career route of generating greater awareness and income James Lind Alliance Sight Loss and Vision for young clinician scientists and over the next five years. Priority Setting Partnership for common ophthalmology trainees eye conditions are summarised in Table 1 The Primer Fellowship Awards programme Priority eye conditions [4]. has been established in partnership with Michele Acton, CEO of Fight for Sight, Michele Acton, said: “Fight for Sight’s The Royal College of Ophthalmologists explained that the charity’s new research vision is simple – we want to stop sight strategy is to focus funding largely on four loss. Our main way of achieving this is and The Royal Society of Medicine and key strategic areas to maximise the impact through funding medical research and provides funding for up to £60,000 for of the work it supports: AMD, glaucoma, finding innovative ways to treat eye individuals to undertake vision-related inherited eye diseases and sight loss related conditions. We look forward to supporting research for one year. The Fight for Sight / to other comorbidities, such as diabetes more researchers who between them hold Royal College of Ophthalmologists Primer or stroke. Open call funding will still apply the answers to creating a future where Fellowship Award is designed to fund for all eye conditions. The top ten priority everyone sees.” trainee ophthalmologists at an early stage Table 1: Top 10 research questions for AMD, glaucoma, inherited retinal diseases and retinal vascular diseases, from the Sight Loss and Vision Priority Setting Partnershipa. Priority Age-related macular Glaucoma Inherited retinal diseases Retinal vascular diseases degeneration 1. Can a treatment to stop What are the most effective Can a treatment to slow down What are the best methods to dry AMD progressing and / treatments for glaucoma progression or reverse sight loss prevent retinopathy of prematurity? or developing into the wet and how can treatment be in inherited retinal diseases be form be devised? improved? developed? 2. What is the cause of AMD? How can loss of vision be How can sight loss be prevented in How can sight loss from diabetic restored for people with an individual with inherited retinal retinal changes be prevented and glaucoma? disease? reduced? 3. How can AMD be How can glaucoma be Is a genetic (molecular) diagnosis What are the predictive factors prevented? stopped from progressing? possible for all inherited retinal for the progression to sight- diseases? threatening diabetic eye disease? 4. Are there ways of restoring What can be done to improve What factors affect the progression Is there a way to improve screening sight loss for people with early diagnosis of sight- of sight loss in inherited retinal of premature babies for retinopathy AMD? threatening glaucoma? diseases? of prematurity? 5. Can the development of What causes glaucoma? What causes sight loss in inherited Can an effective long lasting AMD be predicted? retinal diseases? treatment for diabetic macular oedema, both ischaemic and non- ischaemic, be developed? 6. What is the most effective What is the most effective What is the most effective way to Can a retinal vein occlusion be way to detect and monitor way of monitoring the support patients with inherited predicted and prevented? the progression of early progression of glaucoma? retinal disease? AMD? 7. What factors influence the How can glaucoma patients Can the diagnosis of inherited Can new non-invasive treatments progression of AMD? with a higher risk to progress retinal diseases be refined so that be developed to slow down the rapidly be detected? individuals can be given a clearer progression of diabetic retinopathy? idea about their specific condition and how it is likely to progress? 8. Can a non-invasive therapy Why is glaucoma more What is the relationship between What are the barriers that prevent be developed for wet aggressive in people of sight loss and mental health for diabetic patients having regular eye AMD? certain ethnic groups, such as people with inherited retinal checks? those of West African origin? diseases? 9. Can dietary factors, How can glaucoma be Would having a treatment for an What rehabilitation programmes nutritional supplements, prevented? inherited retinal disease preclude are best for the management complementary therapies a patient from having another of distorted vision from retinal or lifestyle changes prevent treatment? diseases? or slow the progression of AMD? 10. What are the best Is there a link between With regard to inherited retinal What is the efficacy and safety of enablement strategies for treatment adherence and diseases what is the role of prenatal anti-vascular endothelial growth people with AMD? glaucoma progression and and preimplantation diagnosis in factor (anti-VEGF) agents in the how can adherence be helping parents make informed treatment of retinopathy of improved? choices? prematurity? Abbreviations: age-related macular degeneration, AMD; anti-vascular endothelial growth factor, anti-VEGF. a Adapted from: Rowe F, Wormald R, Cable R, et al. [4] Eye News | AUGUST/SEPTEMBER 2018 | VOL 25 NO 2 | www.eyenews.uk.com 25 YEARS IN OPHTHALMOLOGY in their career in order to aid the successful applicant to produce a strong application Primer Fellowship Awards 2017-2018* for Clinical Research Training Fellowships in the future. The Fight for Sight / Royal Human hybrid antimicrobial peptides for ocular surface infection: from Society of Medicine Primer Fellowship conceptualisation to translation Award supports trainee ophthalmologists, Damage to the cornea can lead to permanent scarring with subsequent visual ophthalmic nursing or allied health impairment or blindness. Corneal blindness represents the fourth leading cause professional graduates (including of blindness (5.1%) globally. Dr Darren Shu Jeng Ting aims to create and develop optometrists and orthoptists) to undertake novel human-derived hybrid AMPs for a range of ocular surface infections. Different vision research. combinations of human-derived hybrid peptides will be designed and tested The aim is to attract the brightest minds for antimicrobial efficacy and toxicity to host tissue. Developing a new class of amongst eye health professionals to efficacious and broad-spectrum antimicrobial agent could potentially improve the ophthalmic and vision research.