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Corneal Disease

Mr Parwez Hossain PhD FRCOphth FRCS (Ed)

Senior Lecturer & Consultant in Ophthalmology Southampton University and Southampton General Hospital

Background

Parwez qualified in Medicine from Aberdeen University and trained in Ophthalmology in Aberdeen, Nottingham, Leicester & Bascom Palmer Eye Institute, Miami, USA. He sub-specialised in Cornea & External Eye Disease. In 2005, he was appointed as Senior Lecturer in Ophthalmology / Consultant Ophthalmologist at Southampton University & Southampton General Hospital.

Parwez's research career started at Aberdeen University where he was awarded a Wellcome Trust Research PhD Fellowship to study the mechanisms of lymphocyte traffic in ocular inflammation. He developed an interest in Immunology which continued whilst working as a Clinical Lecturer at Nottingham University; there he determined certain corneal stromal markers are dys-regulated during corneal inflammation.

Currently, his research activity is focussed on three areas of Corneal Disease:

• Determining the Mechanisms & Potential Therapies in Corneal Inflammatory Disease
  The cornea is the transparent outer coat of the eye and is important for the focusing of light rays into the eye. Damage to this structure can lead to blurred vision & blindness. The cornea is at risk of injury & developing certain diseases such as infections and ulcerations. These diseases are common and account for the fourth cause of blindness worldwide. In the UK, the main cause of corneal inflammation is due to contact lens wear or viral infections. Contact lens related corneal inflammation alone, leads to 4000 cases of severe eye infections per year in the UK.
  A common feature in these conditions is the presence & persistence of varying levels of corneal tissue damage & scarring. In severe cases, such as microbial keratitis, the inflammatory process progresses to such severe corneal tissue that corneal perforation can occur. Although antimicrobial therapy successfully treats any infectious component, it does not stop any associate tissue destruction, which often persists long after the infection has gone.
  Currently, there is no effective treatment that limits the tissue damage. If such a treatment was available, then many patients would sustain less corneal destruction & reduced the chances of sight loss. However, in order to find such therapies, we need to improve our understanding of the mechanism leading to tissue destruction. Our current knowledge is inadequate, especially during the clinical course of human disease.
  Parwez's investigative programme is aimed at examining the roles of different inflammatory mediators such as cytokines & their ability to influence both the production of tissue degradative enzymes (such as matrix metalloproteinases) and migration of white blood cells (leukocytes) during corneal inflammation. He is working alongside other groups in Southampton University that have expertise in tissue culture and leukocyte biology in other parts of the body and together he is using this experience to find the clinical relevant mechanisms in human corneal disease.
  Parwez uses his clinical practice to collect patient samples with severe corneal inflammation. By having a large referral base of approximately 2 million patients coming from Hampshire, Isle of Wight & the Channel Islands & one of the busiest centres for corneal transplantation, he has corneal tissue readily available for explant cultures. In the laboratory such tissue can be grown for their component cells & tested for inflammatory mediators that cause corneal damage. These methods are allowing him to assess whether candidate therapies can be useful in corneal inflammation & this work may form the basis of early clinical trials.
  Overall, Parwez's research programme should improve our understanding of the mechanism of tissue destruction & translate to new effective drugs to treat corneal inflammatory disease. Thus providing hope to the millions of people from going blind from corneal disease each year.
  
  
• Anterior Segment Imaging of the Eye
  Anterior segment imaging is a rapidly advancing field in ophthalmology. Currently, there are new methods such as rotating Scheimpflug imaging (Pentacam-Scheimpflug) and anterior segment optical coherence tomography (Visante OCT and Slit-Lamp OCT) to examine the anterior segment of the eye. These new methods supplement the more established imaging devices of Orbscan scanning slit topography and ultrasound biomicroscopy (UBM). The newer devices provide quantitative and qualitative information on the cornea and anterior chamber. Parwez is investigating the role of the anterior segment OCT in the evaluation of corneal diseases such infective keratitis. Parwez's research examines patients with a variety of other corneal diseases and he is devising a range of diagnostic criteria to improve the clinical evaluation of corneal disease.
  
  
• Corneal Nerve Parameters to screen early Diabetic Peripheral Neuropathy
  Corneal confocal microscopy is increasingly being used to assess the changes in corneal architecture that occur in health and disease. With assistance with his colleagues in Manchester University, Parwez has evaluated the method of in vivo corneal confocal microscopy to determine its role in the diagnosis of early diabetic peripheral neuropathy. It has been shown that the characteristics of corneal nerves are altered several years before diabetic neuropathy can be detected by standard clinical tests. The method enables prospective and reiterative evaluation of the human cornea at high magnification. Work is continuing to assess the feasibility in applying these findings in routine clinical practice.
  Links to Publications: http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=Search&Term=%22Hossain%20P%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstractPlus