Health: University project into ageing helps keep an eye on the welfare of over 50s

Dr Ruth Hogg is leading the eye component of the research
Dr Ruth Hogg is leading the eye component of the research

One of the researchers involved in the study, Dr Ruth Hogg, reveals more about the project and how its findings will benefit us all in the future

According to the old saying, the eyes are windows into the soul, revealing deep emotions that we might otherwise want to hide.

But technological advances mean that they are rapidly becoming windows to our hearts, arteries, brain and nerves, too.

The picture (below) is of the back of my eye.

It was taken at the Northern Ireland Clinical Research Facility at Belfast City Hospital using state-of-the-art non-invasive eye-imaging equipment not available elsewhere in Northern Ireland.

Like me, more than 2,000 people from the Province, have attended the facility as participants in Northern Ireland’s largest ever public health research project.

Entitled ‘NICOLA’ – the Northern Ireland Cohort for the Longitudinal Study of Ageing – it is hoped it will provide the basis for future government policy by following the lives of 8,500 over 50s as they grow older.

The Queen’s University-led project, supported by groups such as the Public Health Agency and the Commissioner for Older People of Northern Ireland, randomly selected people from across the Province to take part in the study.

NICOLA consists of three stages, an interview conducted in the home, a questionnaire and a health assessment which takes place at the Northern Ireland Clinical Research Facility at Belfast City Hospital.

The assessments, completed by registered nurses, include blood pressure readings, brain function (thinking) tests, blood sample collection and a detailed eye examination.

Follow-up interviews will be conducted every two years.

Dr Ruth Hogg, who is leading the eye component of the research, said the study could help revolutionise early detection of a range of illnesses, as the eye can reveal health issues not directly related to sight, such as dementia, cognitive decline, MS, stroke, diabetes, etc.

She said the long term hope is that early diagnosis of these conditions can be made through ocular imaging – it could be done very quickly, would save the NHS a fortune and would help catch diseases early.

The out-workings of this could be in GP surgeries within a decade.

Dr Hogg said: ‘‘We are probably the first large scale systemic study in the world to include state-of-the art imaging of the eye. We are using ultra wide field retinal imaging, a technique that reveals almost the entire retina with a single photo; and OCT (Optical Coherence Tomography), which allows us to see all the different layers of the retina. This was impossible even a few years ago. This type of imaging allows us to see the retina in exquisite detail and detect the earliest signs of conditions like diabetes.’’

Dr Hogg said the NICOLA study will shed light on how the most common eye conditions develop and what the risk factors are for these conditions.

‘‘We want to find out how frequently macular degeneration, diabetes and glaucoma occur in our population. We also have the opportunity now to detect the conditions at a very early stage and thus take action to prevent their progression.

‘‘In particular by looking at the optic nerve using OCT can reveal very early signs of glaucoma. We know from the type of patients who are referred to us in the hospital that only about 50 per cent of people that have glaucoma, know about it, so we expect that there will be a number who will be diagnosed as a result of their participation in the NICOLA study and this might be the first time they know that they have an eye condition.’’

At the moment around 7,000 people have taken part in the home interview stage and some 2,200 have attended the health assessment.

When a participant goes forward for retinal imaging, the first part of the assessment is a visual acuity test with a letter chart, an eye pressure check, then drops are placed in the eyes to dilate the pupils and very detailed images are then taken of the back of the eye.

I had these images taken of my eyes and thankfully everything looked fine. However, so detailed are the images, that Dr Hogg was able to see that I have had problems with eye inflammation in the past.

In addition to eye diseases, the researchers are also interested in ocular markers of systemic disease, including cardiovascular disease, diabetes and vascular dementia.

‘‘The eye is probably the easiest organ in the body to image non-invasively,’’ said Dr Hogg.

‘‘There is a huge amount of excitement and interest worldwide in using the eye as a much easier marker for systemic disease.’’

Dr Hogg said from the findings they will assess risk factors for eye diseases, looking at diet and lifestyle and social circumstances and therefore establish who is at most risk of diseases in Northern Ireland.

It is hoped the study findings will leave a lasting legacy for society by enabling policy makers to base Government strategy upon research.

Those who have completed the home questionnaire and have been invited to attend a health assessment are encouraged to do so, as it will not only give a more detailed insight into their own health, but will provide society with a treasure trove of data for future generations.