# Health Equity and Access to Leverage Technology for Improved Diabetic Retinopathy Outcomes (HEAL-DR)

> **NIH NIH R01** · NORTHWESTERN UNIVERSITY · 2024 · $718,397

## Abstract

Project Summary/Abstract:
In the United States, diabetes (DM) impacts 37.3 million people (11.3% population) and 96 million people aged 18
years or older have prediabetes (38.0% of the adult US population). One in three of DM will develop diabetic
retinopathy (DR) in their lifetime, which is the leading cause of blindness in adults leading to permanent disability.
Ethnic minority groups are at greater risk for vision-threatening disease and disability from diabetes. Vision loss
can be the result of progression to proliferative DR (PDR) or from diabetic macular edema (DME). An eye exam
can detect these conditions and may include the technology of optical coherence tomography (OCT), fundus
photography (FP), and/or fluorescein angiography (FA). OCT measures central macular thickness (CMT) to detect
DME and can be used to guide treatment decisions, while FP and FA improve PDR detection. Subjects in many
DR clinical trials are disproportionately White and male compared to the population undergoing DR treatment.
Early evidence suggests that minoritized men with greater CMT are at risk for vision loss if left untreated. Given
that DM and DR are more prevalent in minorities and that 90% of DM-related vision loss is preventable, immediate
effort is needed to address this disparity and evaluate predictive capabilities of DR stage, CMT, clinical measures
(hemoglobin A1c, blood pressure, etc.), and social determinants of health (SDH) to improve screening and
treatment guidelines for high-risk groups. The proposed study, Health Equity and Access to Leverage Technology
for Improved DR Outcomes (HEAL-DR) fulfills a large gap in the current NIH ocular health disparities portfolio with
modelling (OCT machine data) to better identify minority people at greatest risk for both undetected and high-risk
disease using the Sight OUtcomes Research CollaborativE (SOURCE). SOURCE links electronic health record
data from 35 large academic medical centers to capture visual exam data and details typically found in clinical
trials. SOURCE overcomes major data barriers in ophthalmology health disparities work because it contains
robust, granular eye exam data for assessing treatment, quality, and outcomes, combined with key information on
race and ethnicity, gender, SDH measures, medications, HbA1c, Centers for Disease Control National Death
Index Data and others. Outputs from this research will enhance visual risk assessment with new modelling to
better identify minority people at greatest risk for vision loss from undetected and/or worsening disease (early
PDR, occult DME) on a population level. This study fulfills the target goals for National Eye Institute and Healthy
People 2030 and will lead to enhanced clinical guidelines for targeted outreach to those at greatest risk of DM
related visual impairment. This study: 1) is innovative, 2) is stakeholder-driven by both the American Medical
Association (AMA), Center for Health Equity and the American Academy of Ophthalmology (A...

## Key facts

- **NIH application ID:** 10928490
- **Project number:** 1R01EY036341-01
- **Recipient organization:** NORTHWESTERN UNIVERSITY
- **Principal Investigator:** DUSTIN D. FRENCH
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $718,397
- **Award type:** 1
- **Project period:** 2024-08-01 → 2029-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10928490

## Citation

> US National Institutes of Health, RePORTER application 10928490, Health Equity and Access to Leverage Technology for Improved Diabetic Retinopathy Outcomes (HEAL-DR) (1R01EY036341-01). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10928490. Licensed CC0.

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