Lawson Spring 2015 IRF: Spotlight on Richard Ryan Filek


Sealing the leaks: Short-term gain for long-term demise?

Diabetic Macular Edema (DME) affects approximately 2.5 per cent of the nearly 2.4 million Canadians with diabetes, or approximately 60,000 people, making it a major cause of adult-onset vision loss. It occurs when blood vessels in the retina of diabetic patients become leaky, resulting in unwanted fluid accumulation in the centre of vision known as the macula. This can lead to blindness if untreated.

Originally used in the treatment of age-related macular degeneration (AMD), anti-VEGF drugs are now being used to control the leakage and abnormal growth of retinal blood vessels. This treatment requires repeated and frequent injections. 

“Numerous questions have now emerged related to potential structural and functional changes to the retina caused by the therapy, as well as influences on intraocular pressure and overall retinal perfusion,” explains Richard Filek, PhD candidate.

Filek is a successful applicant of Lawson’s Spring 2015 Internal Research Fund (IRF) for the studentship “Structural and Functional Changes to the Retina Following Anti-VEGF Treatments in Diabetic Retinopathy.”

“The study uses a ‘bench to bedside’ strategy to investigate the influence of anti-VEGF therapy at the cellular, tissue and organ level by using cell and animal models, as well as state-of-the-art diagnostic testing in patients with diabetic retinopathy.”

Anti-VEGFs are being increasingly used as the first line of treatment in numerous types of conditions. Research to substantiate the safety and efficacy of this treatment for patients is greatly needed.

“Studying the anatomy, physiology and diseases of the eye has always been a research interest of mine, as was the pursuit of a truly ‘bench to beside’ project,” says Filek. “During my PhD studies with Dr. Subrata Chakrabarti, who is an expert on the pathology of chronic diabetic complications, and a collaborative team at the Ivey Eye Institute, we developed this novel and unique translational research project that utilizes both basic science at the bench top and clinical work at the bedside.”

Filek graduated with a Bachelor of Medical Science with Honours from Western University in 2012. During his studies in the Master of Science graduate program in the Department of Pathology and Laboratory Medicine, he was increasingly interested in the study of structural and functional changes in cells, tissues and organs of the body that cause, or are caused by, disease. Now, as a PhD candidate, his main area of research is diabetes, diabetic ocular complications, macular diseases and glaucoma.

According to Filek, Lawson’s IRF program is extremely valuable for students. “By eliminating funding worries, students can focus on their research and making it leading edge. I am deeply honoured to be named a recipient.” Filek is grateful to continue his research this year, answering a very important clinical question and working with patients. Results have already shown that changes are happening to the retinal structure and function at the first treatment follow-up. Cell and animal studies are currently being done to verify the clinical results. The next research questions would be to determine why this is happening, the mechanisms involved, and how frequently treatment should be recommended.

The potential impact on clinical care may be to provide a cautionary note to carefully monitor the retina, optic nerve status and intraocular pressure in patients undergoing frequent anti-VEGF injections as part of their care. The risk/benefit ratio may need to be reconsidered for frequent and/or extended treatment.

Filek would like to thank his supervisor Dr. Subrata Chakrabarti, co-supervisor Dr. Cindy Hutnik, and the entire research team (Dr. Philip Hooper, Dr. Tom Sheidow, Dr. John Gonder, Dr. William Hodge and Dr. Hanif Ladak) for their mentorship. He would also like to recognize the Department of Pathology and Laboratory Medicine, the Chakrabarti lab at Western University, Hong Liu and the ophthalmology lab at Lawson, and all of the administrative staff and technicians in the Ivey Eye Institute for their assistance, teaching and guidance.

The IRF is designed to provide Lawson scientists the opportunity to obtain start-up funds for new projects with the potential to obtain larger funding, be published in a high-impact journal, or provide a clinical benefit to patients. Funding is provided by the clinical departments of London Health Sciences Centre and St. Joseph’s Health Care London, as well as the hospital foundations (London Health Sciences Foundation and St. Joseph's Health Care Foundation).