DIABETIC RETINOPATHY

Diabetes can affect the small blood vessels at the back of the eye, a condition called diabetic retinopathy. Diabetic retinopathy remains one of the commonest causes of blindness in adults of working age.

While control of glucose and blood pressure is important, many patients with diabetes still develop progressive retinopathy and this may require interventions such as retinal laser, vitrectomy and courses of intravitreal injections to preserve sight. However, these treatments are only given when the condition is already advanced. Therefore, treatments which can substantially reduce the progression of retinopathy to a serious level are urgently required.

the lens trial

Fenofibrate is a well-known cholesterol-lowering medicine that has been used for more than 20 years. Two major trials conducted in patients with diabetes suggested that taking fenofibrate may slow down the progression of retinopathy by 30% to 40%. However, conclusive information was needed.

The LENS (Lowering Events in Non-proliferative retinopathy in Scotland) trial tested whether taking fenofibrate tablets on a regular basis for about four years would slow the progression of retinopathy compared to placebo.

LENS recruited over a thousand participants with diabetes and early retinopathy from across mainland Scotland. We found that people who received fenofibrate had a 27% lower risk of diabetic eye disease compared with people who were assigned to receive placebo. Treatment with fenofibrate also reduced the development of macular oedema (swelling at the back of the eye).

LENS is coordinated by the University of Oxford and was run in close partnership with the Universities of Glasgow, Aberdeen, Dundee and Edinburgh, and with NHS Scotland’s Diabetic Eye Screening Service. The University of Oxford sponsors the trial which was funded by the National Institute of Health and Care Research.