NZ-NEC research

This research area includes diseases of the lid margin, conjunctiva, tear film and the cornea i.e. the front and external portion of the eye. In clinical terms it often overlaps with disease of the iris and the lens (see section 2) and a number of corneal diseases have a genetic basis (see section 7). Certain corneal diseases such as keratoconus (a progressive thinning and bowing forward of the cornea) are more common in New Zealand than elsewhere and in severe cases may lead to corneal transplantation. The New Zealand National Eye Bank, that provides the tissue for approximately 240 corneal transplantations in New Zealand each year, is based in the Department of Ophthalmology.

Research in this area is both clinical and laboratory based with a bias toward translational research i.e. research emanating from the laboratory that will eventually be used in the treatment of eye disease.

The Cornea and Anterior Segment Research Group (Department of Ophthalmology) is a large collaborative research group of 15-20 clinicians, scientists and research fellows that cross boundaries with several NZ-NEC research groups. Professor Charles McGhee leads the group in conjunction with Dr Dipika Patel, Dr Sue Ormonde, Dr Trevor Sherwin and Professor Colin Green. Current research fellows include: Dr Rasha al Taie, Dr Jennifer Fan, Ms Charlotte Jordan and Dr James McKelvie.

The group attracts a large number of international clinical and research fellows from as far afield as Australia, Brazil, Bulgaria, Germany, Great Britain, Iraq, Taiwan and the USA. Research projects have resulted in a large number of successful MD and PhD thesis completions. Successful grant funding has enabled the acquisition of a number of items of expensive, state-of-the-art, clinical research equipment unavailable elsewhere in New Zealand. This equipment and the associated clinical expertise of the team are also made available to patients being treated in the public or private health sector.

The interests of this research group are particularly wide-ranging and include a) studies on the pathogenesis and treatment of keratoconus, b) analyses of inherited corneal dystrophies (with Dr Andrea Vincent), c) surgical and laboratory components of corneal transplantation and graft rejection, d) cataract and corneal refractive surgery, e) several aspects of computerized corneal topography, f) in-vivo confocal microscopy of the corneal microstructure, g) ocular trauma, ocular healing and anterior segment reconstruction, h) ocular infections and ocular pharmacology including novel therapeutics (with Professor Colin Green) and i) medical education and aspects of publication and citation in scientific journals (with Dr Jennifer Fan and Ms Vicky Cartwright). These interests have led to three textbooks and more than one hundred peer-reviewed research papers in the last ten years. (Selected publications 1,2,3).

The Ocular Surface Investigation Laboratory (Department of Optometry and Vision Science) is led by Dr Jennifer Craig and primarily focuses on diseases associated with the ocular surface and is the only laboratory facility of its kind in New Zealand, equipped with highly specialised equipment for the evaluation of the tear film and ocular surface.

The team includes Miss Nisha Jeyaseelan and Mr Grant Watters (Visiting Lecturers) and collaborates with Dr Raid Alany (School of Pharmacy), Professor Charles McGhee (Dept. of Ophthalmology), Dr Paul Murphy, Dr Christine Purslow (Cardiff, UK), Professor James Wolffsohn (Birmingham, UK), Dr Rob Fuller (Plymouth, UK) and Dr Ian Pearce (Glasgow, UK).

Key clinical and research interests include a) study of the tear film and ocular surface in the normal eye and in various ocular surface diseases, including dry eye and keratoconus, b) evaluation of the effect of novel drug delivery systems, including liposomal sprays, on normal, dry eye and contact lens wearing eyes and c) evaluating a novel therapy for meibomian gland dysfunction and tear film lipid deficiency. (Selected publications 4,5,6)

The CORⁿE^a Laboratory Group (Department of Ophthalmology) is led by Dr Trevor Sherwin, an internationally recognized cell biologist, and aims to understand disease processes in the cornea and works towards therapeutic treatments for corneal repair. The work in the laboratory focuses on 3 main aspects of corneal research: a) elucidating the pathogenesis of corneal dystrophies, b) modeling the human cornea and c) the role of stem cells in corneal wound healing.

Recent collaborations between Professor Charles McGhee, Dr Trevor Sherwin and Dr Dipika Patel have led to the submission of an international research patent in relation to transplantation of individual corneal cells (keratocytes) into recipient corneas as a potential treatment for blinding corneal diseases.

The principal research team includes Jane McGhee (Senior Research Technician), Nigel Brookes (Senior Technical Officer), Judy Loh (Research Technician), Dr Rachael Niederer, Ally Chang and Tarn Donald (PhD students) and Dr Jennifer Fan (MD student). The work is performed in collaboration with Professor Charles McGhee and Professor Colin Green. (Selected publications 7,8,9)

A cataract is opacity or loss of transparency in the lens of the eye resulting in reduced vision and is probably the most well-known age related eye disease. Currently the only treatment option to rehabilitate vision is surgical intervention. Indeed cataract surgery is the most common cause of blindness worldwide, and is also the most common surgical procedure performed on New Zealanders over the age of 65 years.

Although cataract surgery is highly effective in eyes that are otherwise healthy, it is anticipated that the demand for cataract surgery will increase by 60% over the next 10 years placing an overwhelming demand on the public health system that is unlikely to be met. Therefore making improvements in the surgical approach, or finding alternatives to surgery, have the potential to make an enormous impact not only for the individual but also for global health systems. Within NZ-NEC a large number of researchers are working both on the laboratory and clinical aspects of cataract development and treatment.

The Molecular Vision Laboratory (Department of Optometry and Vision Science), led by Professor Paul Donaldson and Dr Julie Lim, has been conducting groundbreaking research on the human lens and cataract for a number of years. Professor Donaldson has recently been appointed as Professor of Optometry and Vision Science and he will relocate and integrate his Molecular Vision Laboratory team into an expanded Department of Optometry and Vision Science in 2008.

This team is investigating several aspects of the lens including: a) development of a computer model that encapsulates experimental data into an integrative model of lens function, b) targeting in-situ proteomic approaches to investigate the changes in lens membrane proteins involved in the initiation of lens cataract and c) development of an experimental model of age related nuclear cataract.

Significant research funding has been received from several sources, the major ones are: USA National Institutes of Health subcontract, a New Zealand Health Research Council International Investment Opportunity Fund and the Marsden Fund. The research from this team has been internationally recognized and has resulted in many high profile scientific publications in the last ten years. (Selected publications 10,11,12)

The Anterior Segment Clinical Research Team in the Department of Ophthalmology continues to have extensive research interests in cornea, cataract and cataract surgery. Professor Charles McGhee, Dr Andrew Riley, and Dr Jennifer Craig led the large multidiscipline team including Dr Christina Grupcheva and Dr Tahira Malik, that conducted the Auckland Cataract Study which analysed 500 consecutive patients and their outcomes over two years before and following surgery. The group has also worked closely with Professor Donaldson’s Molecular Vision Laboratory team with joint research funding and supervision of PhD students including Dr Nisha Sachdev. (Selected publications 13,14,15)

The optic nerve is the ‘nerve of sight’ and responsible for carrying the images of sight from the eye to the brain. Diseases of the optic nerve encompass the glaucoma and neuro-ophthalmic disorders such as tumours of the brain that compress the pathways of vision and “strokes” of the optic nerve that can result in blindness, Alzheimer’s disease and multiple sclerosis.

Glaucoma is the leading cause of preventable blindness in New Zealand. It is sometimes called ‘the sneak thief of sight’ because it is a disease of the eye that can be present without symptoms for a number of years while vision loss is slowly occurring. It is a disease of the optic nerve that affects all ages, however, it is more prevalent in adults occurring in at least 2% of the population over 40 years of age - increasing to 1 in 10 adults over 70 years of age.

The Optic Nerve and Glaucoma Team (Department of Ophthalmology) has a clinical and basic science arm. The clinical arm is led by Associate Professor Helen Danesh-Meyer and has extensive collaborations with the world’s leading ophthalmology units including Wills Eye Hospital (Philadelphia), Johns Hopkins University (Baltimore), University of Montreal, and the University of Melbourne. Research is also performed across clinical departments at the University of Auckland in conjunction with Neuro- surgery and Older People’s Health. The clinical Optic Nerve Research Unit has acquired state-of-the art technology for both clinical and research use, which has resulted in more than fifty major publications.  The research team currently comprises Helen Danesh-Meyer and her three doctoral research fellows, Dr Taras Papchenko, Dr Shenton Chew and Dr Nathan Kerr.

The clinical focus of this group has been to develop new strategies for providing better healthcare as well as investigating the underlying causes of optic nerve diseases. Recent research in the area of brain tumours that cause blindness has been hailed as a ‘revolutionary’ breakthrough by international researchers and has significantly influenced clinical practice. Other areas of research by this group have led to the identification of biomarkers that correlate with disease severity or that allow the early recognition of impending diseases.

The basic science arm of the team, led by Associate Professor Helen Danesh-Meyer in close conjunction with Professor Colin Green, is focused on translational ophthalmic research. The team includes the three doctoral fellows and a research assistant, Miss Elizabeth Eady. This team’s main areas of interest are: a) optic nerve ischaemia: the involvement of connexin knockdown in ischaemic optic neuropathy and investigation of the role of the inflammatory response in strokes of the optic nerve and b) glaucoma filtration surgery: investigating the use of a gel to regulate direct cell-to-cell communication during glaucoma surgery to decrease inflammation and scar formation and improve surgical results. (Selected publications 16,17,18)

The Connexin Biology Group based in the Department of Ophthalmology is led by Professor Colin Green and has wide-ranging research collaborations within the University of Auckland (Pharmacy, Anatomy, Physiology) and with international wound healing groups. Professor Colin Green’s research interest is connexins (cell to cell communicating junctions) primarily focused on corneal wound healing. The connexin biology group also conducts research on spinal nerve and optic nerve repair, glaucoma filtration surgery research and brain epilepsy studies.

The main areas of research include: a) corneal healing following refractive laser surgery or severe trauma, b) optic nerve repair and glaucoma filtration surgery research (with Associate Professor Helen Danesh-Meyer), c) Pharmacy - the delivery of the wound-healing product in the ocular environment (with Dr Raid Alany) and d) spinal cord injuries investigating nerve regeneration post injury with and without treatment with connexin knockdown agents and investigating if there can be neuronal recovery after epilepsy (with Associate Professor Louise Nicholson, Anatomy).

Professor Green and colleagues’ work led him to found the drug discovery companies CoDaTherapeutics (NZ) Ltd. and CoDa Therapeutics Inc. USA. to commercialise their patents in the field of connexin biology. CoDaTherapeutics has raised US$20 million to develop potential therapies based on connexin technology. Recently phase I/II international trials of Nexagon, a single dose drug to improve corneal healing following surgery, commenced in Auckland in 2008 in conjunction with Dr Sue Ormonde and Professor Charles McGhee. (Selected publications 19,20,21)

This group incorporates colour vision, clinical research and the myopia laboratory.

The theme of the Clinical Research Group (Department of Optometry and Vision Science) is clinical research in ocular function, ocular disorders and refractive error. Within the study of corneal function, areas of research include computer modelling of the contact lens correction of keratoconus. Other research activities have explored the relationship between intra-ocular pressure and age. More recently, working with Nicola Anstice (Visiting Lecturer), the prevalence of refractive error in central Auckland school children has been studied. This continuing work, for the first time, offers a quantitative analysis of the visual function of New Zealand school children. Additionally, educational and interesting cases seen in the Optometry Clinic are written up for publication. The team includes: Geraint Phillips (Senior Lecturer), Nicola Anstice (Visiting Lecturer), Grant Watters (Visiting Lecturer), Richard Johnson (Visiting Lecturer), Melinda Calderwood (Visiting Lecturer), Nisha Jeyaseelan (Visiting Lecturer), and Associate Professor Rob Jacobs. (Selected publications 31,32,33)

The main theme of the Ecology of Colour Vision Laboratory (ECVL) (Department of Optometry and Berlin). Psychophysical methods are utilised to study colour vision of human beings and animals. To understand the ecological significance of diversity of photoreceptor designs in animal kingdom, the group use computational optics. The team comprises Dr. Misha Vrobyev and Associate Professor Robert Jacobs. (Selected publications 34,35,36)

Research in the Myopia Laboratory (Department of Optometry and Vision Science) addresses the underlying causes of myopia (genetic and environmental influences), why myopia inevitably progresses with time and how myopia development might be inhibited in children. There are three separate research threads within the group: a) a guinea pig model in which eye enlargement and myopia is studied in animals by manipulating the visual environment – the aims are to understand the changes in biomechanical properties and cellular populations of the sclera and the retino-scleral signal pathways involved in myopia, b) a canine model of myopia - dogs are the only non-human species with naturally occurring myopia, our studies have shown that the myopia is inherited and are further studying the genetics of myopia now that the dog genome is available, c) clinical studies of children with myopia. The aim is to investigate optical manipulations aimed at inhibiting the progression of myopia in children – including a clinical trial of a new soft contact lens designed by this team, aimed at inhibiting the progression of myopia in schoolchildren. Commercially funded clinical trials of the lens will commence in 2008. The team consists of Dr John Phillips, Mr Andrew Collins, Simon Backhouse (PhD student), Nicola Anstice (PhD student), and Joanna Black (PhD student). (Selected publications 37,38,39)