December 08, 2022 Keeping an eye on diabetic retinopathy

Who:

Dr. Valeria Rac, program director, Health System and Technology Evaluation, Ted Rogers Centre for Heart Research at Peter Munk Cardiac Centre, Toronto General Hospital Research Institute; associate professor, Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto

Research highlights/discoveries:

• Using provincial healthcare data to create a Canadian diabetic retinopathy screening program that will help prevent or delay sight loss and other eye complications in people at risk

Dr. Valeria Rac at a glance:

• Received a Diabetes Canada and CIHR Team research grant for Preventing Sight Loss from Diabetic Retinopathy (2022)

• Appointed associate professor with the Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto (2022)

• Appointed program director for the Health System and Technology Evaluation and lead for health technology assessment, Ted Rogers Centre for Heart Research at Peter Munk Cardiac Centre, Toronto General Hospital Research Institute (2020)

• Received a scientist appointment at Toronto General Hospital Research Institute (2017) 

• Received a post-doctorate fellowship at St. Michael’s Hospital, Toronto (2012)

• Completed PhD at the Institute of Medical Science, University of Toronto (2007)

• Completed Doctor of Medicine (MD) degree from the University of Sarajevo, Bosnia and Herzegovina (1999)

How did you get interested in diabetes research?

My father was a researcher, and when I was a child he would take me to his lab on Sundays, where I developed an early appreciation for science and research. Eventually I went to medical school and then had an opportunity to join several research projects focused on diabetes, [which] sparked my interest further. I also have a personal connection to the disease, as my father-in-law has been managing his diabetes for a long time now.

Why the interest in diabetes-related sight loss, or retinopathy?

Retinopathy is a serious complication of diabetes that can develop in anyone with type 1 or type 2 diabetes—and it impacts about three million Canadians living with [the disease]. Often there are no symptoms, or only mild ones at the onset. Early detection through regular screening is a very effective tool in avoiding or delaying sight loss and other eye issues because it allows for treatment in a timelier fashion.

How will your research help to achieve this?

Even though many optometrists and ophthalmologists are equipped to screen for diabetic retinopathy, screening rates are still well below Diabetes Canada Clinical Practice Guidelines, which recommend annual or biannual screenings. COVID-19 has made things worse with so many missed healthcare appointments.

Thanks to support from Diabetes Canada, my research team and I are using the provincial and local data provided through community health centres in Ontario to help identify people who may be at risk of developing diabetic retinopathy and have not been screened so they can be called in for retinopathy screening. Many of these people are already systematically marginalized, meaning they don’t have adequate access to regular health care. We are also planning to adopt this approach in other provinces, starting with Alberta, followed by British Columbia and Newfoundland and Labrador.

What is your ultimate goal?

The goal is to develop an organized approach for diabetic retinopathy screening in Canada, like we do for cervical and colon cancer screenings. By offering screenings to Canadians at risk, we can help them receive treatment to prevent severe diabetic retinopathy and sight loss.

Eventually, we could follow this same approach and use healthcare data to guide us in identifying people at risk of developing diabetic foot ulcers, too.

The last word

“One in three people with diabetes has diabetic retinopathy [DR] and, unfortunately, many do not get screened for DR, either due to not being able to access an eye care professional or not being aware of the importance of screening,” says Laura Syron, president and CEO of Diabetes Canada. “That’s why Dr. Rac’s screening program, identifying those at risk, has the potential to make a significant difference in the lives of many people who live with diabetes.”

FYI

Having too much sugar in your blood can cause the blood vessels to swell and leak into the retina of your eye, which causes blurred sight or blind spots. If the high blood sugar levels are left untreated, this condition can eventually cause permanent sight damage. Tune into the webinar Diabetic Retinopathy & Sight Loss, in which Dr. Rac and Ryan Hooey, who has experienced full sight loss, talk about this topic.

Did you know?

Diabetes is a leading cause of sight loss in Canada. That’s why we need to act now. We can all play a role in helping to ending diabetes. Help us fund research like that of Dr. Rac, which has the power to change lives. Donate now.  #LetsEndDiabetes