Clinical Trials
Oxford Eye Hospital
The Eye Hosptial posesses strengths in the following areas:- Cornea, Glaucoma, Genetics, External
Eye, 
The Oxford Eye Hospital website
Ongoing Clinical trails:
Genetics of proliferative vitreoretinopathy
Phacoemulsification and removal of gas for rapid rehabilitation after macular hole surgery
Microperimetry in patients with enhanced S-cone syndrome
The Clinical and genetic analysis of inherited retinal degenerations
Geographic atrophy treatment evaluation (GATE)
Genetics of proliferative vitreoretinopathy
Robert MacLaren jointly with Moorfields Eye Hospital, the University of Valladolid in Spain and the Erasmus University Rotterdam, The Netherlands. A study to identify risk factors for the development of scarring after retinal detachment surgery [still recruiting]
Phacoemulsification and removal of gas for rapid rehabilitation after macular hole surgery
Robert MacLaren jointly with Moorfields Eye Hospital. A study to assess early surgical removal of gas combined with cataract surgery in patients who would otherwise be unable to undergo macular hole surgery due to a contraindication to having gas in the eye [recruited].
Microperimetry in patients with enhanced S-cone syndrome
Robert MacLaren jointly with Moorfields Eye Hospital. A study comparing structure and function of the retina in patients with enhanced S-cone (Goldman-Favre) syndrome in order to understand the mechanism of degeneration and whether or not surgical approaches may be of benefit in affected patients [still recruiting]
The Clinical and genetic analysis of inherited retinal degenerations
The primary objective is to evaluate new technologies for identifying pathogenic mutations in genes causing inherited retinal degeneration in individual patients or families. This is a collaborative translational study between the NHS (Oxford Eye Hospital, the John Radcliffe Hospital and the Churchill Hospital) and Oxford University (The Welcome Trust Centre for Human Genetics). Patients are assessed in a specialist Ophthalmic Genetics clinic at the Oxford Eye Hospital and receive specialist clinical assessment and genetic counselling. Samples will be analysed anonymously at the Wellcome Trust centre for Human Genetics using both the Roche 454 and Illumina sequencing platforms.
Principal Investigators: Susan M Downes, Consultant Ophthalmic Surgeon, Oxford Eye Hospital, Andrea H Nemeth Consultant Clinical Geneticist, Churchill Hospital.
Study Nurses: Sister Alexina Fantato and N/P Clare Arnison Newgass.
Collaborators: Head of Sequencing, Ioannis Ragoussis Wellcome Centre for Human Genetics, Anneke SellerHead of Medical Genetics Laboratories, Churchill Hospital, Richard Mott, Head of Bioinformatics (WTCHG), Post-doctoral Rsearch Fellow Morag Shanks, Administrator of BRC Genomics Theme Jenny Taylor
Funded by The Oxford Biomedical Research Centre funding
The impact of cataract surgery on circadian rhythm and sleep timing using both clear and yellow lens implants.
This is a randomized controlled trial on patients receiving bilateral UV-blocking or bilateral blue-filtering lens implants. Pre- and postoperative testing will include vision measurements and full ocular examination, cataract grading, and assessments of sleep/wake timing and mood. The scattering and yellow filtering of a cataractous lens in the aging eye alters both the quantity and quality of light reaching the retina, with a notable reduction of short wavelength photons Such an attenuation of the overall amount of light, particularly in the blue part of the spectrum, might be expected to have an impact upon sleep timing. Indeed, our preliminary questionnaire-based study would support this. We have examined the sleep patterns in 750 cataract patients before and after implantation with clear (UV-blocking) lens implants. The results show a high incidence of sleep disturbance in pre-operative patients and a statistically significant improvement in sleep quality following surgery. The choice of lens implant has been complicated by the suggestion that blue light contributes to the progression of AMD, and although direct evidence is lacking, this hypothesis has led to the development and widespread use of lens implants designed to reduce transmission of blue light. Little attention, however, has been paid to the potential impact of these blue-light attenuating lenses on sleep and circadian rhythm disruption which are mediated via the blue-light sensitive pRGCs.
Principal investigators: Susan M Downes Consultant Ophthalmic Surgeon, Professor Russell Foster, Head of Nuffield Laboratory of Ophthalmology MD Student Fiona Cuthbertson
Co-investigators: Katharina Wulff, Stuart Peirson, Ruksana Safa (Nuffield Laboratory of Ophthalmology)
Supported by NLO and Oxford Biomedical Research Centre funding
Augmented vision I and II
The objective of this project is to develop a ‘augmented reality visual system’ which can image the visual scene, enhance it, and display it back to patients via electronic handheld or headmounted display. The development of the device is currently being undertaken by Dr Patrick Degenaar at Imperial College, London and the testing of the device will be at the Oxford Eye Hospital where the efficacy of the processing concepts and device will be field tested. Currently individuals with poor sight have traditionally been offered low visual aids and other ancillary aids such as a white stick, or a guide dog, to help them. This project aims to develop and field test an augmented reality system to enhance the remaining functional sight of the large numbers of individuals who do have some vision, which can be usefully enhanced. A pilot study has already been performed on patients with macular dystrophies at the John Radcliffe hospital. (Augmented vision I). Images were displayed to patients with macular dystrophies and degeneration using a specially design programme which timed patient responses. The display was provided in a dimly lit room using a high power projection system. Tests included assessing responses to basic physical images and then was followed up by showing real and augmented images and videos of various scenes. Testing included both qualitative and quantitative elements. The pilot results provided significant qualitative evidence supporting the use of image enhancement algorithms. Augmented Vision II will involve not only clinical trials of functional image processing algorithms, but highly novel electronic implementations.
Principal investigators: Patrick Degenaar, Electronic Engineering, Imperial College London, Susan M Downes Consultant Ophthalmic Surgeon, Oxford Eye Hospital.
Study nurse: Anna Rudenko
Supported by
IVAN
A 2-year randomized controlled trial of alternative treatments to inhibit VEGF in Age related macular degeneration (AMD). Lucentis (Ranibizumab) and Avastin (Bevacizumab), 2 new drugs given as intravitreal injections for wet AMD are being compared for efficacy regarding treatment benefits, duration of treatment and cost effectiveness. This trial has been rolled out across 21 centers in the UK, with the view to being able to offer the best treatment in the NHS. Principal Investigator: SM Downes, Consultant Ophthalmic Surgeon Study Nurses: Sister Alexina Fantato and Senior Staff Nurse Wendy Hart Data Coordinator: Miss Vicky Hart Supported by CLRN funding The natural history of geographic atrophy progression (GAP) This is an 18-month study being performed to understand more about the condition called geographic atrophy (GA). GA is one form of advanced AMD, often referred to, as dry late AMD for which there is currently no treatment. It progresses at different rates in different people; therefore the aim of this study is to gain a better understanding of what influences its progression. The knowledge gathered from this study will be added to existing information already known about GA and may prove to be useful in the future for developing new medicines for treating dry AMD.
Principal investigator: Susan Downes Consultant Ophthalmic Surgeon.
Study nurse: Anna Rudenko
Commercially funded: ALCON
Geographic atrophy treatment evaluation (GATE)
This is a phase 3 clinical trial that is a continuation of the GAP study. This is a 24-month trial looking at the safety and efficacy of a topical ocular drop for the treatment of Dry AMD.
Principal investigator: Susan M Downes, Consultant Ophthalmic Surgeon Oxford Eye Hospital
Clinical study nurse: Anna Rudenko
Commercially funded: ALCON
CRAD001A2203
A Phase 2 randomized, double masked, parallel group study for neovascular AMD for 6 visits over 56 days. The study will assess the efficacy of oral Everolimus 5mg taken once a day, alone or in addition to intra vitreal injections of Lucentis. Potential participants will not have had a favourable response to VEGF inhibitors in the study eye.
Principal investigator: Mr Victor Chong, Consultant Ophthalmic Surgeon
Study nurse: Alexina Fantato
Commercially funded: Novartis
PRESSOP 1
A clinical trial with the aim to determine the effectiveness of a device, which offers an alternative relief for Blepharospasm. Benign Essential Blepharospasm is a focal dystonia, which causes involuntary spasmodic eye closure due to over-activity of the orbicularis oculi muscle. Botulinum Toxin injections are currently the most effective form of treatment, however some individuals do not respond, or gain little benefit. A device which has been developed here at the Oxford Eye Hospital is attached to the arm of a pair of spectacles, this device stimulates the afferent nerve pathway with impulses thus blocking the efferent nerve pathway to relieve spasm. This device is being field tested in patients with blepharospasm.
Principal investigators: John Elston, Consultant Ophthalmic Surgeon and Sister Alexina Fantato
Funded by Dystonia Society
