Could imaging the eye help us to monitor kidney and cardiovascular health?
Dr Gavin Chapman from the University of Edinburgh has received a training fellowship grant of £250,000 to investigate whether new techniques in eye imaging can give us reliable information on kidney and cardiovascular health.
The problem
People with chronic kidney disease (CKD) have an increased risk of cardiovascular disease (CVD), a group of conditions affecting the heart or blood vessels. Improving heart and vessel health is very important for patients with CKD, who are more likely to die of cardiovascular disease than develop kidney failure.
Identifying patients with CKD earlier is crucial to improve outcomes. However, current methods for diagnosing CKD are not very precise and do not provide accurate information on each individual's risk of disease progression or their likelihood of developing cardiovascular disease such as a heart attack, stroke or heart failure.
The solution
Gavin will use a technology known as Optical Coherence Tomography (OCT); this is a special type of eye imaging. Gavin’s project builds on previous Kidney Research UK-Stoneygate funded work at the University of Edinburgh published in Nature Communications. This research, using OCT scans, showed that patients with CKD have thinner retinas and choroid layers – structures at the back of the eye. This thinning worsened as kidney function declined.
“One of our first grants for researching the use of OCT scans in kidney disease was from Kidney Research UK; this kickstarted the work. These scans are accessible, and our initial results show that they could be a quick and non-invasive way of assessing kidney health. In the future, OCT imaging might reduce the number of biopsies patients need which can be painful and unpleasant and come with some risk.” Professor Neeraj Dhaun (Bean), a supervisor for this project.
Optical coherence tomography
Optical Coherence Tomography (OCT) is an imaging technology which creates a detailed map of the eye’s layers.
These are widely used to assess eye health in ophthalmology, the field of medicine which focuses on diseases of the eye and visual system, and OCT scanners are present in most high-street opticians.
Recent research has shown that changes seen on OCT scans can be used to predict certain diseases.
Analysing patient scans
Using a database of OCT scans collected from patients with CKD, alongside their medical data, Gavin will look at whether changes to the layers at the back of the eye predict the likelihood of CKD progression, and cardiovascular disease. OCT scans will also be done in CKD patients taking recently available medicines called SGLT2 inhibitors, which have been shown to slow progression to kidney failure, to see if the layers at the back of the eye change in response to treatment.
Gavin and the team will also scan individuals with inflammation of the blood vessels, seen in some kidney diseases such as vasculitis, to identify whether any changes are visible on OCT.
What could this mean for kidney patients?
OCT scans are a quick and non-invasive imaging technique. They could be a kinder way to monitor kidney and cardiovascular health, and treatment response, in patients with CKD which in the future could reduce the number of biopsies a patient needs and support earlier diagnosis and treatment.
Meet the researcher
Gavin is a doctor in southeast Scotland and is training to specialise in kidney medicine. He has had kidney disease since he was 12 and received a transplant from his brother in law in 2020 at the age of 27.
“It is under recognised that kidney disease and heart disease are closely linked. We hope OCT scans may allow an individual to track their kidney and cardiovascular health over time. I am delighted to be working on this project, which I feel has huge potential to benefit many patients living with CKD.” Dr Gavin Chapman
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