1.2 The VR surgical teams have continued to investigate new applications of VR techniques. In the last year a pilot study on the use of vitrectomy in diabetic macular oedema has been concluded. No improvements in visual outcome were seen in this study, but retinal thickness was improved and it is anticipated that further development of this novel application of vitrectomy will be investigated. An ongoing prospective randomised study of the potential use of vitrectomy in uveitis continues to recruit patients. Recruitment will be completed this year and will provide valuable data on this application of vitrectomy. Pilot studies on the use of VR surgical techniques for the treatment of a) branch and b) central retinal venous occlusion have been initiated. To date medical retinal treatments for these conditions have been unsuccessful and it is anticipated that these pilot studies will eventually lead to prospective randomised studies on the surgical management of retinal vascular disease.

1.3 The VR unit continues to collaborate with laboratory scientists on the investigation of VR disease. The unit's central project involves collaboration with the team of Professor Fisher, University of California on further investigation of an experimental model of retinal detachment. We have now successfully induced proliferative vitreoretinopathy into this model which has led to considerable interest in the similarities between our experimental findings and laboratory analyses of human retina with PVR. These studies have been supported by the MRC and will be developed further in the future. Collaboration with Dr Limb, at the Institute of Ophthalmology on the retinal response of injury is funded by the Wellcome Trust. This work builds on previous collaborations on the pathology of retinal detachment and VR disease. Collaborations with the Institute of Ophthalmology have investigated mechanisms of neovascularisation in retinal degeneration and the response of retinal pigment epithelial cells to retinal injury.

1.4 Investigations have been initiated into the correlation between the morphological recovery of the retina and visual function. These have initially focused on proliferative vitreoretinopathy. A prospective randomised trial in prevention of inflammatory cystoid macular oedema following retinal detachment has been established. This study is in collaboration with the anaesthetic department at St Bartholomew's hospital who will investigate secondary the pain relief. Novel optical imaging techniques using optical coherence tomography and retinal thickness analysis will be employed for this study to determine whether this medication also influences macular changes following retinal detachment.

1.5 The potential in vitreoretinal surgery for age-related macular degeneration is a priority of the vitreoretinal unit and to enable work on this area to progress a joint research/clinical job which will also involve medical retina work is to be established. This will allow a closer collaboration with the medical retinal research team in the investigation of age-related macular degeneration.

1.6 The VR unit is part of a multi-centre study investigating the potential for staining with Trypan Blue dye to enhance visualisation of epiretinal membranes during vitreoretinal surgery. Trypan Blue dye additionally has the potential to improve visualisation of the inner limiting membrane and allow easier peeling of this during macular hole surgery.