3.3 Research Priorities

  3.3.1 Epidemiological and Service Issues

· Evaluation of novel treatments and improvement of existing treatments in AMD, diabetic retinopathy and vein occlusion including:
o Photodynamic therapy
o External beam radiation, proton beam irradiation
o Transpupillary thermotherapy
o Chorioretinal anastomosis (surgical and laser)
o Intraocular administration of tissue plasminogen activator, other clot-lysis agents and anti-angiogenic, anti-scarring agents
· Assessment of most efficient delivery of diabetic screening and ophthalmic management in the UK diabetic population.
· Clinical trials of new immunosuppressive agents to control intraocular inflammation

  3.3.2 Clinical and Laboratory Issues

· Elucidation of novel genes and chromosomal loci causing monogenic retinal disease.
· Elucidation of population genetic polymorphisms influencing the susceptibility to age-related macular degeneration and diabetic retinopathy.
· Evaluation of gene function, protein structure, chemistry and interaction in cell systems and animal models.
· Elucidation of novel therapies including gene replacement therapy, modulation of retinal cell apoptosis, catalysis of harmful gene mutations in vivo (ribozymes) and retinal cell transplantation.
· Characterisation of molecules involved in neovascularisation occurring in AMD, diabetic retinopathy and vein occlusion (e.g. vascular endothelial growth factor).
· Identification of cytokine profiles of the infiltrating cells from ocular fluids
· Devising strategies to switch off particular cytokines by these cells using other downregulatory cytokines
· Identification of cytokine and other genetic polymorphisms that might influence disease outcome
· Phenotype-genotype characterisation of monogenic retinal disorders
· Characterisation of phenotype of AMD genetic polymorphisms (eg ApoE4).
· Elucidation of genes conferring susceptibility of diabetics to sight-threatening retinopathy.
· Phenotype-genotype characterisation of ocular inflammatory disorders
· Development of RPE transplantation strategies in AMD
· Development of drugs to use in intraocular devices to control intraocular inflammation

   3.2 Research Potential