Revitalise: Precise Robotic Delivery of Retinal Intravascular Therapies

Retinal vascular diseases such as Diabetic Retinopathy (DR) and Retinal Vein Occlusion (RVO) affect more than 200 million people worldwide and are a leading cause of irreversible blindness. Current standard of care requires 6–8 intravitreal anti-VEGF injections per year, at a cost of £6,000–£8,000 per patient, yet this only slow disease progression and does not reverse retinal ischemia or vision loss. By 2045, almost 45 million people will be affected by vision-threatening DR, and RVO already causes severe sight loss in 3 million cases globally. There is thus an urgent unmet clinical and economic need for therapies that restore rather than only preserve vision. Emerging approaches, including regenerative cell therapies for DR and thrombolytic delivery for RVO, have shown vision restoration in early trials. For example, intravascular injection of tissue plasminogen activator (t-PA), already licensed for ischemic stroke, improved vision in patients with RVO. However, these interventions remain impractical: retinal veins are ~150 ?m wide, at the limits of human manual precision, and surgery is compromised by tremor, tool–tissue perception limits, and patient heard drift and motion. Clinicians and patients alike highlight that robotic delivery is essential to translate these promising therapies into routine care. We address this challenge with a new class of vitreoretinal surgical robot that departs from conventional straight instruments. Our platform, based on flexible continuum “elephant-trunk” robotics, enables controlled approach to retinal vessels from multiple orientations, unlocking procedures impossible with manual tools. Unlike competing research systems, our device is developed to be sensorised, ISO-compliant, and aiming for clinical translation within the NHS. Following a decade of development, we now propose to advance our minimum viable product (MVP)—a flexible robotic endo-illuminator—into first-in-patient evaluation and expand its capabilities for intravascular therapy. The project has three aims: 1. Clinical validation: Conduct a first-in-patient Clinical Investigation in five participants under general anaesthesia to quantify safety, usability, and performance, thereby establishing a platform for future therapeutic trials. 2. Technology development: Design and validate a suite of six-degree-of-freedom, sensorised instruments for safe retinal vein cannulation and localised drug delivery in tissue phantoms. 3. Regulatory preparation: Compile externally verified technical documentation to support robotic t-PA delivery for RVO. Our programme has been shaped by clinicians, patients, and commercial stakeholders. Surveys show >90% of patients would consider robotic eye surgery if it offered permanent treatment results. Clinicians have confirmed the urgent need for intravascular precision robotics, while commercial input underpins a robust strategy to spin out a company, Revitalise, to deliver the technology to the NHS and beyond. By de-risking our platform through ISO certification, clinical evaluation, and regulatory readiness, this project will bring robotic, disease-reversing interventions closer to reality. The result will be a transformative step toward restoring vision for millions worldwide while delivering substantial savings for health systems.