Research Title: Integrating Novel CLINical markers into Eye care models (INCLINE) to improve management of diabetic complications
Metabolic syndrome and type 2 diabetes mellitus (DM) are multifactorial conditions with similar risk factors and overlapping complications, including retinopathy, neuropathy, and chronic kidney disease. Due to this, patients require multidisciplinary care. Consequently, patient management is complex and disease progression difficult to anticipate.
Individuals with DM require regular eye assessments to assess for DR, yet 22% of non-Indigenous and 47% of Indigenous Australians fail to do so. The Eye Clinic at The Sutherland Hospital (TSH), a collaborative effort between Centre of Eye Health and TSH Department of Ophthalmology, was established to provide assessments for patients with DM who were not receiving regular eye care. In this model, triaging low-risk patients to CFEH can reduce the burden on ophthalmologists. Best possible care and management for patients, however, requires improved risk assessment for the development of diabetic complications and more efficient interprofessional collaboration.
Changes to the neurosensory retina, retinal vasculature, and cornea nerves have been observed prior to clinically evident diabetic neuropathy (DN) and diabetic retinopathy (DR). Optical coherence tomography (OCT) has demonstrated reduction in RNFL thickness. OCT angiography has revealed increases in the foveal avascular zone and reduced vessel density. Corneal confocal microscopy has established changes in corneal nerve fibre length, branch density, and fibre density. These markers have not been assessed in patients with nephropathy. An understanding of these changes will foster the development of more sensitive ocular markers to predict diabetic complications and guide multidisciplinary care delivery.
This project aims to:
• evaluate the efficiency, satisfaction and costs of clinical assessment for DR by ophthalmologists and optometrists through current eye health care delivery models at TSH Eye Clinic for patients with DM.
• develop new ocular markers in a cohort of individuals with CKD, and contrast these findings with patients with or at risk of developing DM, DN, and DR.
• implement new ocular markers into current eye health care delivery models in order to determine if these markers can predict complications, and better direct patient management.
Vincent graduated with a combined Bachelor of Optometry with Honours and Bachelor of Science from UNSW in 2014. He then spent three years in Nowra, NSW working in corporate practice. Here, he developed a special interest in ocular pathology. During those three years he has supervised optometry students under the UNSW Preceptorship Program and Deakin University Clinical Residential Placements. He has also been invited to lecture medical students from the Graduate School of Medicine, University of Wollongong. He became a Fellow of the American Academy of Optometry in 2017.
2014 BOptom(Hons)/BSc – UNSW Sydney
Reports and Book Chapters
- Khou V, Katalinic P, Zangerl B. Should optometrists recommend fenofibrate? Pharma. 2018 Sep;15-20.
AFFILIATIONS AND MEMBERSHIPS
Fellow of the American Academy of Optometry