26 September 2026
Researchers at Imperial College London and Imperial College Healthcare are developing a new imaging technology that detects cells undergoing programmed cell death – known as apoptosis – before signs of disease appear on optical coherence tomography (OCT) scans.
Research published in Expert Review of Ophthalmology, found that Detection of Apoptosing Retinal Cells (DARC) technology could predict the precise location of future retinal atrophy more than three years in advance.
Imperial College London Professor Francesca Cordeiro has been working on DARC for the past two decades.
She told OT that her experience as a clinician has influenced her approach as a researcher.
“As a glaucoma consultant, it was really quite devastating to see a small but significant number of people continue to lose their vision, despite treatment,” Cordeiro said.
Cordeiro added that one of the reasons for this was that the disease was detected too late.
“People have already lost vision by the time they see you for the first time. At that stage, it’s much more difficult for treatments to reverse the damage that has been done,” Cordeiro highlighted.
During her PhD, Cordeiro started exploring whether techniques regularly used in cell biology could be used to differentiate between healthy and dying cells in the eye.
“The idea of using the eye as a petri dish came about,” the ophthalmologist highlighted.
“In cell biology, there are these assays that are routinely used to differentiate between healthy, apoptosing and dead cells. We wanted to see if, by identifying cell stress, we could detect diseases earlier,” Cordeiro explained.
My ultimate vision is that it would be used as a non-invasive screening test
The technology that Cordeiro and colleagues has developed works by using a fluorescent marker, ANX776, which binds to dying retinal cells. The cells can then be visualised using retinal imaging equipment.
DARC has been used in more than 400 patients to assess the effectiveness of treatments under development in clinical trials.
While the fluorescent marker is currently delivered as an intravenous injection, Cordeiro envisions that one day it could be self-administered by patients as a nasal spray ahead of an optometry appointment.
“My ultimate vision is that it would be used as a non-invasive screening test,” she said.
Cordeiro said that images captured by an optometrist could then be uploaded and analysed by an artificial intelligence algorithm for signs of disease.
The clinician scientist noted that DARC can reveal changes in single cells, while OCT identifies changes in retinal tissue.
“Tissue shrinkage due to cell loss occurs a lot later than single cell change,” she said.
Cordeiro added that rather than replacing OCT, DARC would serve as a complementary technology.
“Until we had enough data to show that we no longer required OCT, we would be using it for confirmation and validation purposes,” she said.
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