DREAM Project

Diabetes can damage the small blood vessels of the eye, causing leakage of fluid at the macular - the part of the eye where you get the most detailed vision from.

The global increasing prevalence of diabetes has meant that diabetic retinopathy (DR) and diabetic macular oedema (DMO) have become increasingly important causes of vision impairment. Trends show an increase in diabetes-related blindness over two decades except for in high-income regions such as Australia.

For Australia’s Indigenous people the story is inconsistent with these high-income trends, in that the prevalence of DR appears to have doubled over the same period. Diabetes-related vision loss is estimated to be approximately five times higher among Indigenous Australian people when compared to other Australians. So far, we do not understand why this is and what factors are driving this.

These inequalities in disease burden have persisted despite national health investments and initiatives. Much of the research effort in relation to DR/DMO among Aboriginal Australians has focused on “surveying” ocular outcomes as standalone measures and lacks comprehensive and systematic investigation into the underlying drivers of diabetes-related blindness.

The DREAM Project will utilise a population-based biomedical cohort with baseline assessments and forthcoming longitudinal data with the aim of better understanding the underlying social, psychological, environmental, behavioural, clinical, biological and metabolomic risk factors of DR/DMO among Aboriginal people. This will allow for characterisation of baseline phenotypes in individuals with and without DR/DMO and investigating the cross-sectional/temporal risk factors that contribute to DR/DMO progression.

Ultimately, these findings of new factors and their ability to tell us who will do well, and who will do poorly, is important to initiate steps in reducing the human and societal costs of blindness.

This project is funded by the Macular Disease Foundation Australia