November Spotlights Breakthroughs in Diabetic Retinopathy Research
Each November, Diabetic Retinopathy Awareness Month calls attention to one of the leading causes of preventable blindness. At the WashU Medicine John F. Hardesty, MD Department of Ophthalmology & Visual Sciences, researchers are taking the conversation a step further shifting the focus from awareness to innovation, discovery, and early intervention.
Rather than waiting until diabetic retinopathy threatens vision, WashU scientists are building the tools to detect it sooner, understand it more deeply, and ultimately prevent its most damaging effects.
Why Diabetic Retinopathy Matters
Diabetic retinopathy develops when prolonged high blood sugar damages the retina’s delicate blood vessels. Because the disease often progresses without symptoms, many patients do not seek care until significant damage has already occurred. This silent progression underscores why early detection and accurate screening tools are essential.
According to Rithwick Rajagopal, MD, PhD, a leader in diabetic retinal disease research at WashU:
“Diabetic retinopathy is the fifth most common cause of blindness worldwide, but whereas blindness from all other causes has been steadily decreasing over the past 30 years, blindness from diabetic retinopathy has greatly increased during the same time. Such worrisome epidemiological data highlight a pressing need for better screening, prevention, and treatment strategies for diabetic retinopathy.”
This increasing burden reinforces the importance of WashU’s multidisciplinary approach, combining imaging science, AI, metabolism research, and clinical trials.
Innovations Shaping the Future of Diabetic Retinopathy Care
Next-Generation Retinal Imaging
WashU research teams are working with engineering collaborators to develop ultrafast, wide-field OCT imaging that captures more of the retina at higher resolution and in far less time than traditional systems. These tools could detect early vascular changes that are not visible using current methods.
AI-Driven Tools for Earlier Diagnosis
In partnership with Chao Zhou, PhD in Biomedical Engineering, were early adopters of artificial intelligence for diabetic retinopathy screening. Their work showed that point-of-care AI screening improves patient follow-up and identifies disease earlier.
Current projects use AI algorithms to detect earliest vascular changes, broadening access to screening, particularly in primary care and community settings.
Understanding the Earliest Disease Triggers
Rajagopal’s lab has made key discoveries about how photoreceptor metabolism contributes to vascular damage in diabetic retinopathy.
High glucose disrupts metabolic pathways in photoreceptors, triggering inflammation and vascular injury. In experimental models, correcting these metabolic abnormalities significantly reduced disease severity, opening new avenues for targeted therapies.
Therapeutic and Preventive Strategies Under Study
The department is exploring a range of interventions, including:
- Time-restricted eating and ketogenic diet patterns, which show potential in reducing early retinal stress
- Participation in a nationwide Phase 3 clinical trial evaluating fenofibrate, a lipid-lowering drug that may slow progression in both Type 1 and Type 2 diabetes
Complementary basic science studies are examining how fenofibrate protects retinal blood vessels at the cellular and molecular levels.
Looking Toward Curative Possibilities
Rajagopal emphasizes the long-term potential of this research:
“New tools to correct abnormal photoreceptor metabolic signatures in diabetes could be curative for blinding disease. Our lab is deeply involved in this transformative research.”
These advances suggest that the future of diabetic retinopathy care may shift from managing late-stage complications to preventing disease at its earliest stages.
The Importance of Screening and Awareness
Because diabetic retinopathy can progress without symptoms, regular eye exams remain critical. Emerging tools, including wide-field imaging, AI-driven diagnostics, and portable ERG, are expanding access and improving diagnostic accuracy.
WashU Medicine encourages individuals with diabetes to prioritize routine screenings and stay informed about innovations that can help protect their vision.
About WashU Medicine
WashU Medicine is a global leader in academic medicine, including biomedical research, patient care and educational programs with 2,900 faculty. Its National Institutes of Health (NIH) research funding portfolio is the second largest among U.S. medical schools and has grown 56% in the last seven years. Together with institutional investment, WashU Medicine commits well over $1 billion annually to basic and clinical research innovation and training. Its faculty practice is consistently within the top five in the country, with more than 1,900 faculty physicians practicing at 130 locations and who are also the medical staffs of Barnes-Jewish and St. Louis Children’s hospitals of BJC HealthCare. WashU Medicine has a storied history in MD/PhD training, recently dedicated $100 million to scholarships and curriculum renewal for its medical students, and is home to top-notch training programs in every medical subspecialty as well as physical therapy, occupational therapy, and audiology and communications sciences.