A University of Utah ophthalmologist has been awarded $750,000 over five years to identify new genes and treatments for eye diseases related to diabetes. Dr. Kang Zhang is only the third ophthalmologist to receive a prestigious Burroughs Wellcome Fund Clinical Scientists Award in Translational Research.

The goal of the highly competitive awards — 13 presented this year — is to help scientists fund research that is immediately applicable to patients. Zhang will receive $150,000 a year for five years for the research.

An estimated 18 million Americans have diabetes, a number expected to double by 2030. The disease can lead to many complications, including microvascular complications in the eye, such as diabetic retinopathy, the leading cause of blindness in America's working-age population. Diabetes' other microvascular complications include kidney failure and neuropathy.

Zhang is associated with the department of ophthalmology and visual science and the program in human molecular biology and genetics at the U. The latter program's director, Dr. Guy Zimmerman, noted that "translational" in the award title means "that the investigator must be focused not just on making new discoveries but also on translating the new basic findings to bedside applications in patients. In addition, the awardee must have the potential to accomplish both of these goals and uncommon ability and a great track record to date."

Microvascular complications have interested Zhang for years. At Harvard, he noticed some diabetics had few or minor complications, even with poor sugar control. Others had "perfect sugar control, but are train wrecks. Why?" he said. The answer is likely that some are genetically inclined to microvascular complications, while others are not.

There's a "high concordance" between kidney and eye complications, he said. "I suspect genetic components drive the damage."

He hopes the funding will help his lab find the genes that "push people over the edge," using the latest genomic technology and understanding of genetic building blocks. Researchers can find markers that indicate areas to look for associations to specific complications, narrowing the search for the genes that are involved. Among other tools, Zhang's lab uses high-throughput arrays that help researchers look at many samples at a time in the search for responsible genes.

From a field of patients with diabetes, they will examine those 20 and older who have no complications, those with the most severe retinopathy and those with end-stage renal failure.

The current treatment for diabetic retinopathy involves using a laser on the scarred parts of the retina to preserve the precious macula. "To preserve that, we destroy the rest of the retina — about 90 percent." It amounts to man-made tunnel vision, because peripheral vision is lost. He is driven, he said, by the belief that eye tissue-preserving treatments will be possible.

He said the five-year funding serves as a "catalyst to take high risk in search of high reward."

Zhang was elected to the American Society of Clinical Investigation, only the second ophthalmologist to be granted membership.

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