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Tuesday / June 25.
HomemifeatureFRB! Research: So Much More Than Number Crunching

FRB! Research: So Much More Than Number Crunching

Involvement in the Fight Retinal Blindness! research has fuelled Dr Adrian Hunt’s passion for science, informed the management of his patients as a retinal specialist, and helped him establish a professional network of peers interested in doing the same.

The research is also contributing to the way healthcare experts around the world treat and advocate for treatments of patients with a retinal disease.

“The research complements my clinical work, there is plenty of variety each week,” said Dr Hunt, who works from his private practice in Miranda in the southern suburbs of Sydney, and consults at Eye Associates in Macquarie Street, and at Westmead Public Hospital.

“I have been fortunate to be part of the VEGF revolution as a clinician and researcher,” he said. “Pivotal clinical trials established VEGF inhibitors as first-line therapy; the exciting challenge is to help patients achieve equivalent outcomes in the real-world setting.”

JOINING THE FRB! PROJECT

Dr Hunt, who has contributed data as a retinal specialist to the FRB! project since its inception, told mivision that his interest in research is motivated by a desire to better help patients.

The first research paper Dr Hunt contributed to in the FRB! project was published in the leading international journal Ophthalmology. 1 He enrolled in a PhD at the University of Sydney, supervised by Professor Mark Gillies, focussing on the retinal vein occlusion (RVO) module. “It was a big challenge, but I found it very rewarding. It is invaluable being a clinician with skills in statistical computing when analysing big research datasets.

“The web-based registry provides a graphical display outlining the individual treatment journey of my patients, compared with other patients in the global database,” he explained.

FRB! AND REAL-WORLD EVIDENCE

The FRB! registries collect real-world data for a growing variety of eye diseases from treating ophthalmologists in Australia and around the world. Dr Hunt said his work has unearthed some important insights regarding patient outcomes using available VEGF inhibitors for three subtypes of RVO: central (CRVO), branch (BRVO), and hemi (HRVO).

“The three main VEGF inhibitors were studied, revealing that aflibercept was generally superior to ranibizumab and bevacizumab in RVO. The RVO subtypes were compared, revealing that HRVO has the greatest improvements.2-5 We have also studied longer term outcomes,6 providing patients with a clearer understanding of what to expect through the first three years of treatment,” he said.

“By analysing FRB! data we can look at outcomes from hundreds of patients globally. That means when a patient starting injections for RVO asks about what to expect, I can say, ‘we did a study on this and in three years, one third of patients have good vision, one third poor vision and around half still require treatment’. That gives them a light at the end of the tunnel,” Dr Hunt said.

PERSONAL AND PROFESSIONAL REWARDS

“For me, research is an injection of energy as I am part of the excitement of scientific discovery. It makes me feel like I am at the forefront of the latest developments. And, by collaborating on these projects with ophthalmologists from around the world, it means that I’ve made a lot of new international friendships, which is really nice,” he said. “I think the main thing though, is I feel like I’ve contributed in some way, and that is rewarding.”

Dr Hunt has found it particularly rewarding to be mentored by Prof Gillies at the Save Sight Institute, University of Sydney, to be supported by the University to learn a new coding language (‘R’ for data science programming) and to collaborate with leading researchers from Australia, New Zealand, Asia, Europe, and the USA.

The research outputs have included multiple publications in leading journals, and presentations at the Association for Research in Vision and Ophthalmology, the Macula Society, American Academy of Ophthalmology, the European Society of Retina Specialists, and the American Society of Retina Specialists, as well as nationally at the RANZCO Congress.

References

  1. Nguyen, V., Daien, V., Guymer, R., et al., Projection of Long-term visual acuity outcomes based on initial treatment response in neovascular age-related macular degeneration. Ophthalmology 2019;126(1):64–74.
  2. Hunt, A.R., Nguyen, V., Creuzot-Garcher, C..P, et al., Twelve-month outcomes of ranibizumab versus aflibercept for macular oedema in branch retinal vein occlusion: data from the FRB! registry. Br J Ophthalmol 2022;106(8):1178–84.
  3. Niedzwiecki, M., Hunt, A., Nguyen, V., et al., 12-month outcomes of ranibizumab versus aflibercept for macular oedema in central retinal vein occlusion: data from the FRB! registry. Acta Ophthalmol 2022;100(4):e920-e7.
  4. Wang, N., Hunt, A., Nguyen, V., et al., One-year real-world outcomes of bevacizumab for the treatment of macular oedema secondary to retinal vein occlusion. Clin Exp Ophthalmol 2022;50(9):1038–46.
  5. Hunt. A.R., Nguyen, V., Arnold, J.J., et al., Hemiretinal vein occlusion 12-month outcomes are unique with vascular endothelial growth factor inhibitors: data from the Fight Retinal Blindness! registry. Br J Ophthalmol 2023;107(6):842–8.
  6. Hunt, A., Nguyen, V., Bhandari, S., et al., Central retinal vein occlusion 36-month outcomes with anti-VEGF: the Fight Retinal Blindness! registry. Ophthalmol Retina 2022.