Diabetic retinopathy remains one of the commonest causes of blindness, one of the most feared complications of diabetes. 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.
Fenofibrate is a well-known cholesterol-lowering medicine that has been used for more than twenty 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 is needed.
The LENS (Lowering Events in Non-proliferative retinopathy in Scotland) trial is testing whether taking fenofibrate tablets on a regular basis for at least 3 years will slow the progression of retinopathy compared to placebo. LENS will recruit over a thousand patients with diabetes and observable retinopathy from across mainland Scotland. This streamlined trial is funded by the National Institute for Health Research. LENS is being sponsored and co-ordinated by the University of Oxford and run in close partnership with the Universities of Glasgow, Aberdeen, Dundee and Edinburgh, and with NHS Scotland’s Retinal Screening Service.