A Singaporean scientist and his team of researchers dazzle the world with a web-based system of retinal vascular imaging to predict diabetic retinopathy, glaucoma and heart disease.
Dr Wong Tien Yin, Director of the Singapore Eye Research Institute and Senior Consultant of the Singapore National Eye Centre says, “The biggest advantage is that screening will be non-invasive and allows for repeatable tests”. A patient’s eyes are digitally photographed in a few seconds and sent to trained readers. The digital image will then be assessed for any narrowing or ballooning of the retinal arterioles, which will show if there is any damage due to diseases like diabetes or heart disease.
“The early stages of these diseases often affect the blood vessels of the eyes and since the front of the eye [the cornea and lens] is transparent, the retina is the only part in the body that allows doctors to have a direct look into the vessels,” Dr Wong says.
Recently, Dr Wong and his team discovered the relationship between retinal microvasculature signs and cerebral small vessel stroke. Changes like narrowed arterioles, enhanced arteriolar light reflect and smaller arteriolar-to-venular diameter ratio (AVR), which quantifies the severity of retinal-arteriole narrowing, help predict the pathology of a small vessel stroke.
Dr Wong says “the idea of predicting illnesses through the eyes has been around for more than a century, but real scientific evidence only came about in the last two decades”. However, he adds that some doctors and patients have found the concept “unbelievable”, which is why his team needs to convince them with more data and evidence.
He revealed to Reader’s Digest, “We are now looking at predicting diseases such as dementia and cognitive decline, rheumatoid arthritis and heart rhythm disorders using eye imaging technology.”
Vaccines: The Next Generation
A shot against cancer After 30 years of disappointing starts, “vaccines” against lymphoma, prostate cancer, melanoma and neuroblastoma are finally making headway.
Last year, a trial of patients with late-stage melanoma found 22 per-cent responded favourably to a vaccine combined with the immunotherapy drug interleukin-2 (IL-2), compared to 9.7 percent of patients receiving conventional treatments. Says Dr Patrick Hwu, melanoma chief at the University of Texas M.D. Anderson Cancer Centre, “If we can use the body’s own defence system to attack tumour cells, we can rid the body of cancer without destroying healthy tissue.”
Only 50 percent of people with melanoma can be given the vaccine as it has to match the patient’s tissue type. “Studies are trying to identify which patients will respond,” says Hwu. ≫ 2-5 years
Q & A
Professor Wong Tien Yin .jpg)
Prof Wong Tien Yin’s eye imaging technique revolutionised the way diseases are detected and diagnosed.
The most exciting medical breakthrough of the past 12-18 months?
The discovery that eye imaging may help refine how we predict stroke. We’ve found that damage to small vessels in the eye are linked to “small vessel” stroke in the brain. The new knowledge eye imaging provides could improve treatment for stroke sufferers by providing an accurate diagnosis tool, similar to the MRI scan and, with more research, lead to preventative screening.
The medical discovery you wish you had thought of?
That “small vessel” or “micro-vessel” disease is a major cause of heart disease, stroke, diabetes and hypertension.
Our greatest medical achievement by 2060?
Reduction in cardiovascular disease and its major risk factors-diabetes and hypertension.
Your dream discovery?
A new, safe and effective treatment for diabetic retinopathy.
Professor Ian Frazer
Immunologist, University of Queensland. Dr Frazer has led research into the human papillomavirus and a cervical cancer vaccine.
The most exciting medical breakthrough of the past 12-18 months?
The sequencing of the human genome. If we can build a map explaining why some people respond to therapies and others don’t, we have a much greater chance of tackling disease.
The medical discovery you wish you has thought of?
All the vaccines I haven’t already been involved with! Vaccines are the most important health defence we have.
Our greatest medical achievement by 2060?
Getting the message out that what we do impacts on our risk of disease. If people don’t smoke, don’t go in the sun, don’t get overweight, they won’t die at 50 or 60, they’ll die at 80 or 90.
Your dream discovery?
A therapy that delays the onset of the chronic diseases of ageing, particularly dementia.
Area of health most in need of a breakthrough?
Mental health. If you sum the burden of disability, it’s at the top of the list.
Professor Judith Whitworth
Professor Judith Whitworth 
Expert in hypertension. She is chair of the WHO Global Advisory Committee on Health Research (2004-2007) and a member of the Global Forum for Health Research.
The most exciting medical breakthrough of the past 12-18 months?
The British government has worked with the food industry to reduce salt in processed food and reduced cardiovascular disease. If we can reduce salt intake substantially around the globe, we will prevent many millions of deaths (as well as disability).
The medical discovery you wish you had thought of?
The revolution in bioinformatics, which is transforming biology and medical care through the ability to link and manipulate data of all types.
Your dream discovery?
To understand the brain and mind as well as we understand the body. To link knowledge of how single nerve cells work with supercomputing to understand the networks of billions of nerves in our brains, which will revolutionise every aspect of our lives and reduce the burden of dementia and mental illness.