AVENUE-PDR
Research type
Research Study
Full title
Assessing the viability of non-medical practitioners conducting photocoagulation for PDR (AVENUE-PDR): A feasibility trial
IRAS ID
347120
Contact name
Stephen Bain
Contact email
Sponsor organisation
Swansea Bay University Health Board
Duration of Study in the UK
1 years, 5 months, 30 days
Research summary
Aims: To investigate whether it is possible to train experienced people (eye care practitioners (ECPs)), who are not doctors, to performing laser treatment for advanced eye disease caused by diabetes and whether it is acceptable to people with diabetes. We will measure the potential impact on service levels and determine the potential for a larger trial comparing trained ECPs with ophthalmologists (eye doctors) in performing laser treatment.
Background: People with diabetes are at risk of advanced eye disease (known as proliferative diabetic retinopathy or PDR) which can cause sight loss as there are no symptoms until the late stages. The most serious complication of PDR is new blood vessels growing in the eye, which can bleed leading to scarring and sight loss. An important treatment for new blood vessels is laser delivered to the back of the eye, which causes them to shrink, preventing bleeding. Laser treatment is done by trained doctors (ophthalmologists), but there is a shortage of ophthalmologists, meaning people are waiting longer for treatment and are at risk of losing their vision.
What we hope to discover:
• whether suitably trained and experience people who are ECPs giving laser treatment for PDR is acceptable to people living with diabetes and healthcare professionals,
• if there are enough ECPs willing to undertake training to deliver laser treatment,
• the potential for a larger trial, with appropriate data collection, to assess outcomes for patients,How have public research partners been included:
Two people with diabetes who have undergone laser treatment for PDR have reviewed the lay summary; one is included as a PPI co-applicant. Both saw the need for new ways to reduce waiting times, the number of cancelled clinics and stopping people losing vision, with one thinking this could be ‘game-changing’. In addition, questionnaires were distributed to people undergoing laser treatment to gain further views on ECPs performing laser. These will be used to inform the study design, and the materials produced for study participants.
How will the findings make a difference?
Increased demand for hospital eye services has outstripped capacity due to new treatments requiring more intensive follow-up and an ophthalmology workforce shortage particularly affecting Wales. Without innovative ways of working. people living with diabetes will continue to lose eyesight whilst waiting for treatment.
If feasibility and acceptability of ECPs delivering laser treatment for PDR, with suitable outcomes, and patient and professional participation is determined, we will apply for funding to conduct a full trial. This will include cost-effectiveness analysis and service evaluation, comparing laser treatment performed by trained ECPs to medical practitioners. This has the potential to increase capacity, reduce waiting times and subsequently reduce sight-loss.
REC name
Wales REC 4
REC reference
25/WA/0284
Date of REC Opinion
21 Nov 2025
REC opinion
Further Information Favourable Opinion