Non-invasive scan able to predict disease years before symptoms arise

Dr Wong Tien Yin can look deeply into your eyes and predict whether you are going to suffer from a range of diseases, including stroke, diabetes and high blood pressure.

The director of Singapore Eye Research Institute has pioneered a non-invasive scan of the blood vessels at the back of the eyeball, which can predict the risk of disease years before symptoms appear, or other diagnostic tests sound the alarm.

The senior consultant eye specialist at the Singapore National Eye Centre and the National University Health System, who always believed that the eye is a model for studying diseases, is focusing on dementia disorders such as Alzheimer’s to see if it is possible to monitor their progression through retinal imaging.

Dr Wong, 42, hopes that the eye will turn out to be “an inexpensive, precise, and non-invasive window to study Alzheimer’s”.

While brain scans can help to uncover changes in the brain’s structure that point to a patient having Alzheimer’s, the “gold standard” for diagnosing dementia comes when it is too late – during an autopsy.  “Dementia is such a mixed bag of diseases that need to be treated differently, so it would be useful to be able to split them up into, say vascular dementia or Alzheimer’s,” he explained.

His work hinges on the theory that Alzheimer’s sufferers lose nerves at the back of their eye.  In contrast, in vascular dementia, which is caused by reduced blood flow to the brain, he expects the vessels in the eye to be more affected than in Alzheimer’s.

Ten years ago, Dr Wong became the first to develop a suite of advanced computing imaging software and diagnostic platforms that assess a person’s disease risk simply by analyzing a retinal photograph.  His scanning technology can be used by optometrists, in the community by GPs, or as a specialized service in hospitals.  And it is already being used here and overseas to detect disease.

Over the last 10 years, the system has been tested on more than 25,000 individuals, creating a powerful image and diagnostic database.

He established the Singapore Advanced Imaging Laboratory for Ocular Research (Sailor) – the first translational clinical facility to take research to the bedside at the high-tech hub Fusionopolis in Buona Vista.  The centre is working with a number of other organizations to grade eye images for clinical trials being conducted in Asia, Britain, Australia and New Zealand. 

Dr Wong – who is among the world’s most prolific researchers in his field – has published more than 500 papers and received awards not only in ophthalmology, but also in the field of cardiovascular disease and diabetes.

This year, he scooped the nation’s premier scientific honour, the President’s Science Award.

His institute, which employs 160 people but is one of the few here with no core funding, gets 90 per cent of its $14 million annual budget from research grants.  His own research alone pulls in about one-third of the institute’s funding.

About half of the institute’s grant applications are successful, compared to the national average of about one in five, he said.  “Being an independent institute keeps everyone on their toes,”  said Dr Wong, a bundle of energy whose day starts at 5am answering e-mail and writing grants before his clinic starts at 9am.

He has high hopes for the centre, which he is grooming to be among the world’s top five research institutes within five years.

Right now, the centre is rushed off its feet with work.  “Our work has so many applications in the clinic and in industry that we’re getting more collaborations than we can handle,” he said.