A close-up of a green eye ball.

We are supporting Dr Colin Chu in studying if immune responses measured in blood collected from birdshot chorioretinopathy (often called birdshot uveitis) patients could predict how they respond to treatment.

This timely study will run parallel with BIRD-SET, a large observational clinical study of birdshot patients at Moorfields.

The challenge

Birdshot chorioretinopathy (BCR) is an autoimmune condition that causes chronic eye inflammation and can lead to progressive vision loss.

More on birdshot chorioretinopathy

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  • BCR is a rare, chronic form of uveitis, an inflammatory condition of the eye that damages the retina, the light sensitive tissue at the back of the eye.
  • BCR is an autoimmune condition, which is when the body’s immune system mistakenly attacks its own, healthy cells.
  • The cause of BCR is unknown, but research has shown a strong genetic link to the immune molecule HLA-A29.
  • BCR is diagnosed by characteristic scattered pattern of orange to cream-coloured spots on the retina.
  • BCR can lead to progressive sight loss and the initial symptoms include floaters and/​or blurred vision.

Following a diagnosis of BCR, patients are prescribed medication to suppress their immune system. This is the main course of treatment for BCR.

60%

response rate with currently the most effective drug - adalimumab

There is a strong need to identify disease biomarkers and improve our understanding of how the immune status of BCR patients and their genes might impact their personalised response to treatment.

Finding a solution

Moorfields has one of the biggest BCR patient populations worldwide. 

Dr Chu and the team will conduct the Birdshot Dataset Study (BIRD-SET), an observational genetic study of BCR patients receiving standard care. 

More on the BIRD-SET study

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  • The plan is to recruit up to 180 BCR patients at Moorfields and Queen Elizabeth Hospital Birmingham and collect their clinical and genetic information for analysis.
  • Participants will be asked to provide a saliva sample for genetic sequencing, their medical history and eye imaging data, and blood samples to biobank for future research.
  • The study also aims to test a new non-invasive imaging technique to monitor the health and function of the retina.

A subset of patients will be selected to participate in the study funded by our charity. This study aims to measure immune responses in patients’ blood using TruCulture, an innovative and clinically validated method.

Whole blood samples will be routinely collected from BCR patients before starting adalimumab treatment. With the TrueCulture method, blood can be drawn directly into the experimental vial and stimulated with the medication. 

The research team can then measure how the immune system responds to the drug, which could predict if it will be effective in controlling the condition in patients. 

Dr Colin Chu, principal investigator at UCL Institute of Ophthalmology and honorary consultant ophthalmologist at Moorfields Eye Hospital

Dr Chu and team aim to determine whether this type of individual testing of patients’ blood could predict treatment success or failure before patients start on medication with potentially serious side effects.

The potential

This timely research could have an enhanced impact by combining immune responses data from the TruCulture system with the genome sequencing, clinical and imaging data that will be collected simultaneously in the BIRD-SET clinical study.

This will create a unique resource of information for clinicians and researchers, which could lead to new insights into BCR and other eye inflammatory diseases.

By using this integrated analysis, we have a high chance to identify blood signatures in BCR that could predict treatment success. Ultimately it will also allow us to make new discoveries to prime future research and provide insights to improve the care of BCR patients.

Dr Colin Chu

Importantly, these results could inform care of individual patients, allowing clinicians to select the most beneficial treatment tailored to the person. This could help avoid unnecessary, futile or possibly harmful interventions and shorten the time before disease is controlled thus preserving vision.

Dr Chu with Annie Folkard and Fiona Gee - members of Birdshot Uveitis Society

This project is supported by Moorfields Eye Charity, with thanks to supporters from the Birdshot Uveitis Society who raised funds.

Project Details

Funding scheme

Project grant

Grant holder

Dr Colin Chu

Area(s) of work

Uveitis

Award level

£49,648

Start date

February 2024

Grant reference

GR001642