Researching new treatments for age-related blindness

There are two strands to Robert’s project. The first involves the transplantation of light sensitive cells called photoreceptors. “These are like the pixels on a digital camera,” Robert explains. “Most of the retinal diseases that we get act at the level of photoreceptor. We’re looking at ways to replace the cells that are damaged and destroyed in the end stages of macular degeneration, building on research we started a couple of years ago when we successfully transplanted photoreceptor cells. Until then no-one had shown convincingly that these cells could be transplanted into the correct layer of the retina with connections that restore sight.”

The other strand of the project is looking at replacing the lining of the back of the eye, called the retinal pigment epithelium, which is where macular degeneration starts. “If you imagine an old-style film camera, there’s a black bit at the back which sits in front of the negative and absorbs the light,” Robert explains. “The retinal pigment epithelium, which lines the back of the eye, works in the same way. It keeps the eye optically sharp by preventing stray light from bouncing around and keeps the photoreceptor cells healthy.”

As macular degeneration affects just the central ten degrees of the back of the eye, there is a lot of healthy retinal pigment epithelium around the edges of the eye which can be moved to the damaged area. “This involves transplanting a bit of tissue from the patient’s periphery, where it doesn’t have much optical use, to under the fovea, which is the central part of vision,” Robert says. “Three out of twelve patients on our study who underwent the treatment had a significant improvement in their vision. We’re now working to optimise the surgical technique for transplanting the tissue.”

In terms of its impact on patients, Robert believes that curing blindness is the second most important area of medical research after cancer. “If you stop someone in the street and ask them which conditions they fear, in general it will be cancer first and blindness second,” he comments.

The impact is even larger when you consider the elderly population, where blindness leads to significant additional health risks. “Having a fall is the most common cause of acute admissions for elderly people and if you think that half of those are due to poor eyesight, that gives you an idea of what we’re up against,” Robert comments.

As well as funding his early research, the support Robert has received from The Health Foundation has also helped him to attract additional grants. “As a result of my fellowship, I’m heading a clinical research team which has successfully applied for £3.6 million in funding from the National Institute of Medical Research and we have two project grants from the Medical Research Council totalling £2.5 million, enabling us to take our research even further.”

“That funding would not have been possible had it not been for The Health Foundation supporting me and putting me in a position where I could apply for further grants,” he continues. “The impact of The Health Foundation really cannot be underestimated because while most universities and hospitals tend to look at their staff budgets in the short term, the Foundation can take a much more strategic and long term view of where clinical research needs to go. Identifying the right people at an early stage is vital to that.”

In addition to his clinical research, Robert has been engaged in a wide range of activities to publicise his research and share the learning from it. “I’ve been on several television news channels talking about the impact of photoreceptor transplantation as a treatment for blindness,” he says. “I do regular interviews for a radio show for blind people called ‘Insight’, to explain the significance of new research to patients. Our lab work also features in a web exhibition for schools at the Science Museum.”

Although more work remains to be done, Robert’s fellowship has shown how a condition once considered incurable can in fact be treated. It holds out hope of a better quality of life for thousands of elderly people, along with their families and carers.