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| Dr. Petty and Dr. Elner review data suggesting early signs of diabetes. |
"Snapshots" of the eyes may give early warning of diabetes and related eye disease
A new vision screening device could give physicians and patients a head start on treating diabetes and its vision complications. The instrument, invented by two Kellogg scientists, captures images of the eye that show metabolic stress and the tissue damage that occur before the first symptoms of disease are evident. The camera-like instrument can detect this damage earlier than any current clinical method.
For people with diabetes — diagnosed or not — the new device could offer potentially significant advantages over blood glucose testing, the “gold standard” for diabetes detection. It is non-invasive and takes about five minutes to scan both eyes. Used as a firstline screening test, the device would indicate whether a patient should proceed with additional testing.
In the July issue of Archives of Ophthalmology (read the report), Victor M. Elner, M.D., Ph.D., and Howard R. Petty, Ph.D., report on the potential of the new instrument to screen for diabetes.
“Technology that can detect the earliest signs of diabetes gives us a new way to tackle a growing public health concern,” says Dr. Elner. “Early detection and treatment are critical in controlling the disease and its many complications.” He points out that 24 million Americans have diabetes and an additional 57 million have abnormal blood sugar levels that qualify as prediabetes. Some of these individuals will develop diabetic retinopathy, an eye disease that affects 4.1 million people and can cause blindness.
The instrument can detect metabolic stress, and therefore disease, by measuring the intensity of cellular fluorescence in retinal tissue. This is the second study in which Drs. Petty and Elner reported that high levels of flavoprotein autofluorescence (FA) are reliable indicators of eye disease.
Dr. Petty, a biophysicist and imaging expert, explains that hyperglycemia — or high blood sugar — is known to induce cell death in diabetic tissue soon after the onset of disease but before symptoms can be detected clinically. “Increased FA activity is the earliest indicator that cell death has occurred and tissue is beginning to break down,” says Dr. Petty.
People with diabetes might take better care of themselves once they receive results from this kind of testing, suggests Dr. Petty. “A patient who understands that body tissue is being destroyed may be newly motivated to step up efforts to manage the disease,” he says.
In the study, Drs. Elner and Petty measured FA levels of 21 individuals with diabetes and compared the results to age-matched healthy controls. The Kellogg scientists found that FA activity was significantly higher for those with diabetes, regardless of severity, compared to those who did not have the disease. Similarly, individuals with diabetic retinopathy had much higher FA activity compared to diabetic patients without any visible eye disease.
The study also suggests that FA levels can be used to monitor the severity of the disease and the ability of treatments to stem tissue damage. Dr. Elner is a Research to Prevent Blindness Senior Scientific Investigator. The researchers have formed a company, OcuSciences, Inc., to commercialize the metabolic imaging instrument.
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