Our themes

  • Inflammation and Immunotherapy

     

    Overview

    All of the leading causes of blindness are influenced by the immune system. Our ambition is to understand and rebalance the immune system to restore eye health. To do this, we first need to characterise how the immune system is changed in disease.

    Key activities

    Alongside our international partners, we are increasing our understanding of the human immune response and how this relates to the eye, including genetic control of inflammation.  

    We are harnessing treatment developments in the wider field of human immunology for application to the eye. In addition, we are seeking to modulate the immune response to augment the benefits from gene and cell therapies for the eye. 

    Advances in imaging now enable us to see single cells in the retina. We seek to utilise this ultimate precision medicine tool to understand and guide treatments for immune-related disease of the eye.

    Objectives

    • Discover the causes of abnormal immune responses in patients with eye disease (Deep immune phenotyping)
    • Design targeted therapies to reverse sight loss (Immune therapeutics)
    • Directly visualise the immune system through imaging (Immune imaging)
  • Gene Therapy

     

    Overview

    We are developing gene therapies for a wide range of ocular conditions.

    Key activities

    We have developed a pipeline of therapies to treat inherited retinal dystrophies and have established three on-going clinical trials: LCA 2 due to defects in RPE65; achromatopsia due to defects in CNGB3 and X-linked RP due to defects in RPGR. We are now preparing additional trials for other inherited retinal dystrophies.   

    We have established proof-of-concept for the treatment AMD and corneal disorders using gene therapy and are now developing pathways to clinical trials.

    Objectives

    • Our centre has identified more inherited retinal dystrophies than any other centre worldwide and we are now building a comprehensive gene therapy programme to treat many of these disorders
    • To develop gene therapy for age-related macular degeneration (AMD) and corneal disorders
  • Genomic Medicine and Informatics

     

    Overview

    Ophthalmology generally, and particularly our centre, is prominent in the field of clinical genetics and the leading causes of blindness such as age-related macular degeneration and retinal dystrophies are more completely understood in terms of the underlying causative genes than in most other systems. A recent step change in genetic sequencing technology occurring over the past ten years has given us the opportunity to leverage this understanding and acquire more genomic and clinical data to improve diagnosis, counselling and clinical care going forwards.

    Key activities

    Although single gene causes of blindness are rare, together they affect 5 per cent of the population These eye diseases, however, are a huge burden on the patient, families, carers and society as they cause lifelong, untreatable and permanent blindness. We have recruited extensively to five large studies which will look overall at gene discovery, deep phenotyping, trial recruitment and treatment. These studies as a resource will increase our understanding of the link between gene mutation and eye disease and therefore the counselling and management for patients and families living with these diseases. The studies include NIHR-Bioresource BRIDGE-SPEED study (720 families), the Genomics England Pilot study (220 families), Genomics England (>2100 participants), UK Retinal Disease Consortium (500 families) and the NIHR Translational Research Consortium for Rare Disease (over 700 probands).

    We have identified that the majority of genetic risk factors in AMD act early in the disease process. We plan to identify the highest and lowest risk individuals in the population and undertake deep phenotyping to determine structural and functional changes that may occur before patients have started to have symptoms. Diabetic eye disease is a variable and potentially blinding disorder in which unknown genes confer increased susceptibility in some patients. Finding these will increase our understanding of the disorder and improve management. We have the opportunity to collect data from 3000 patients prospectively (ORNATE study – Prof Sivaprasad) to address this important medical challenge.

    We are working on using the development of retinal tissue from patient-derived stem cells to provide us with the tools to develop and validate our precision medicine approach for blinding eye diseases. Already, one cause of severe blindness in children has found to be tractable to treatment with specific molecules aimed at the molecular defect (Prof Cheetham) and we intend to expand this approach to understand, and test treatments on such cells from those with other blinding disorders.

    Objectives

    • Develop precise diagnosis, novel treatments and improved patient care for single gene causes of blindness
    • Define mechanisms, improve treatments and prevent blindness for common multi-factorial blinding conditions
    • Implement Precision Medicine through cellular models of specific blinding diseases
  • Regenerative Medicine and Pharmaceutics

     

    Overview

    We are targeting common disorders such as age-related macular degeneration (AMD), glaucoma, and cataract, but also rarer devastating conditions, including thyroid eye disease, corneal diseases and inherited retinal diseases. 

    The treatments that have and might emerge in the future from our research in these areas have the ability to improve the lives of millions in the UK and globally.

    Key activities

    We are developing cell-based technologies and diagnostics in these areas:

    Age-related Macular Degeneration (AMD) and other retinal diseases:

    1. 1. AMD is the single most common cause of blindness in the UK and accounts for blind or partial sight registration in almost 300,000 people, more than all other eye conditions combined. Globally, about 20 to 25 million people are affected with prevalence expected to rise threefold over the next 25 years with increased life expectancy worldwide.
    2. 2. Our stem cell research and drug delivery initiatives in AMD and other retinal diseases could reduce the frequency of treatment as well as improve patient outcomes. 

    Glaucomatous optic neuropathy:

    1. 1. Glaucoma affects 70 million people globally of which 7 million are blind. Our research suggests that repair and regeneration approaches could work faster than re-growing the entire optic nerve. Our next step is multiple proof-of-principle studies in this area, including the use of stem cells.

    Inherited retinal diseases:

    1. 1. Inherited disorders of the retina are one of the leading causes of childhood blindness and, for the most part, there are no effective treatments. Loss of vision in these conditions is usually caused by the gradual loss of function and eventual death of the light-sensitive cells in the retina.

    We are working on controlling and improving repair scarring and restoring function with biodevices and new technology in the following areas:

    1. 1. Glaucoma surgery - we are developing treatments to reduce the effects of scarring when performing glaucoma surgery in conjunction with surgery and microdevices. We are continuing to work towards our ’10-10-10 Target’ (induce an intraocular pressure of 10 mmHg, lasting 10 years, and surgically achieved in 10 minutes) by changing and improving how glaucoma is successfully treated with surgical and therapeutic methods. 
    2. 2. Trachoma 
    3. 3. Ocular surface disease – corneal disease
    4. 4. Orbital scarring in thyroid disease
    5. 5. Retinal degeneration and scarring
    6. 6. Devices and techniques for eye disease - we are developing multiple projects including the development of a device using implanted magnets to control abnormal ocular movements (nystagmus).

    We continue to strive towards improved therapeutics and drug therapy in areas such as:

    1. 1. Novel pharmacokinetic models
    2. 2. Reformation and repurposing of existing treatments for ocular disease
    3. 3. New therapeutic molecules
    4.  

    Objectives

    • Continue to develop cell-based therapies and diagnostics
    • Control repair (scarring) and restore function with biodevices and new technology
    • Improve therapeutics and drug delivery
  • Visual Assessment and Imaging

     

    Overview

    The ability to assess structure and function of the eye in astonishing detail via medical imaging has been at the centre of much of our innovation. Increasingly, we seek to exploit this potential not just for ocular disease but also many other central nervous system (CNS) and systemic disorders. 

    Our research in assessment and imaging aims to improve diagnostics, provide new treatments and tools to evaluate treatment effectiveness for sight loss and neurodegenerative conditions. We are striving to reduce the burden of disease on patients and on society. 

    Key activities

    We are striving to reduce the burden of eye and neurodegenerative disease through innovations in imaging, vision science and engineering. We are establishing new visual assessment tests for infants and children (using eye movement responses) as well as other novel assessment techniques in adults. 

    We are developing new tools to improve the diagnosis of eye and neurodegenerative diseases. Rapid advances in the technology we are developing alongside the revolution in mobile communications is providing us with a path to change the way that care is delivered. 

    We are working with our partners to address statistical testing in image and genomic data. Our approach, including primary care and epidemiologic data will give unparalleled insight into lifestyle and genetic determinants of ocular, cardiovascular and neurologic disease. We are also working on projects to discover relationships between AMD and cardiovascular disease.

    Objectives

    • Develop new visual assessment tests proving more accurate and precise measurements of damage
    • Develop new imaging devices
    • Develop techniques to provide insight into disease pathophysiology and treatment response
    • Develop data analytical techniques
  • Cross-institutional Research, Collaborative Themes and Training

     

    Overview

    Our new cross-institutional research structure (spanning UCL Institute of Ophthalmology and Moorfields Eye Hospital and linking UCL and other sectors) is providing a more comprehensive range of training opportunities for discovery scientists and clinical scientists at all stages of their career and from a wide range of disciplines. 

    We are aspiring to provide a premier environment for training and the delivery of translational ophthalmic research by growing and empowering an integrated community of diverse experts. 

    Key activities

    We are providing all of the research themes and their staff with the best possible research environment and facilities to ensure success. We are working to increase our grant rate and increase the average funding applied for in each application. We are also expanding our provision of statistical support to ensure that our studies achieve the highest level of statistical rigor and methodological expertise to generate reproducible, reliable data. 

    We have a responsibility to provide a rich range of educational opportunities as a global leader in eye research. In addition, we aim to identify and recruit talented individuals and inspire a new generation to consider ophthalmology as a speciality. 

    We will provide education and training support for new and existing staff to improve effectiveness, career progression, joint working and engagement with patients. The training programmes we will offer will aim to guarantee job satisfaction and progression and therefore collaboration and leadership in the future. We want to empower researchers to find solutions rapidly to ensure the success of our other theme aims. 

    Objectives

    • Increase large-scale multidisciplinary research programmes in conjunction with external funding
    • Expand and develop our education and training opportunities for our long-term needs
    • Continue to be the ‘go-to’ site globally for diverse education and training opportunities in ophthalmology, particularly research
  • Patient and Public Involvement/Engagement & Clinical Studies Development

     

    Overview

    We are striving to ensure that public discussion reaches through to our research and discoveries while influencing and improving early-phase trials and healthcare delivery. 

    Our Patient and Public Involvement and Engagement (PPIE) team has already made a positive impact in facilitating the development of research projects in experimental research. The team’s involvement has ensured that our work represents the views of patients and health care professionals.  We are working on developing innovative new methodologies with a deeper involvement of patients, particularly in priority setting and protocol development.

    Key activities

    We are focussing on engagement events and therefore learning experiences for patients and healthcare professionals. These events provide opportunities for patients to become part of our Research Community. The PPI team will also ensure that continuous training is offered to researchers in the network who are new and inexperienced in PPI as well as encourage and support patients wishing to join the community. 

    We have recognised the need for streamlining our support in research and have therefore integrated with UCL’s new Translational Research and Enterprise Accelerator which is providing a common support pathway for us and our partners. 

    We are engaging with patient groups to ensure they can help address the research priorities in their areas. We are also working on a fully refreshed and targeted survey for vision research. 

    Objectives

    • Broaden public contribution and equip researchers to work in a public partnership
    • Develop fully responsive research support pathway
    • Embed patient and healthcare priorities for vision research