Research News

2019 - A bumper year for SOVS in research

We are especially pleased with the announcement that Dr Lisa Nivison-Smith has been awarded an NHMRC Investigator Grant for her research into inner retinal remodelling in AMD. Her work may lead to improvements in the clinical assessment of AMD through identifying further prognostic biomarkers for the disease, leading to better risk assessment and more individually tailored management of the condition. These grants are incredibly competitive, and it is a testament to Lisa’s research that she was awarded this prestigious grant.

We also congratulate Dr Simin Masoudi and Dr Maria Markoulli (pictured below), who were selected as UNSW Women in Maths and Science Champions. The program develops the career and leadership skills of early career scientists while reaching out to girls and women in the community to encourage them to pursue a career in maths and science.

In July 2019 several members of the School (Professor Mark Willcox, Mr Muhammad Yasir, Dr Dinesh Subedi and Mr Parthasarathi Kalaiselvan) attended the workshop “Tackling Antimicrobial Resistance together: NUW Alliance Workshop to develop a joint Antimicrobial Research Taskforce”

This joint Antimicrobial Research Taskforce (NUW-ART) involved academics from University of Newcastle, UNSW and University of Wollongong as part of their NUW Alliance program.  Also in attendance was Prof Bob Hancock from University of British Columbia, Canada, one of the world’s leading experts on antibiotic resistance, discovery and development, as well as Dr Mark Blaskovich (University of Queensland) who runs the open access antimicrobial screening program CO-ADD. There was a commitment from all attendees to collectively work on the development of approaches to combat a particularly problematic area of antibiotic resistance, biofilms. This will hopefully have direct benefits to the continued development of antimicrobial contact lenses and other biomaterials used in optometry.

In 2019 thus far we have published 124 peer reviewed articles. These include eight in British Journal of Ophthalmology, seven in Clinical and Experimental Optometry, six in Investigative Ophthalmology and Visual Science, four in The Ocular Surface, four in Clinical and Experimental Ophthalmology. These articles cover a range of subjects, including the hot and big topics in optometry and vision science, and science and society: Myopia and its control (nine articles), the prevalence of vision problems around the world (eight articles) and antibiotics and resistance (eight articles).

The following 10 papers are some of those that we have been published as open access. We do this so you can review our work – click on the hyperlinks below to read:

1. Ye B, et al. Discrimination of indoor versus outdoor environmental state with machine learning algorithms in myopia observational studies. J Trans Med 2019; 17: 314.
2. Ho KC, et al. Systematic review of the appropriateness of eye care delivery in eye care practice. BMC Health Serv Res 2019; 19: 646.
3. Yasir M, et al.  Comparative mode of action of the antimicrobial peptide melimine and its derivative Mel4 against Pseudomonas aeruginosa. Sci Rep 2019; 9: 7063 
4. Subedi D, et al. Accessory genome of the multi-drug resistant ocular isolate of Pseudomonas aeruginosa PA34. PLoS ONE. 2019; 14: e0215038.
5. Naidoo KS, et al., Potential lost productivity resulting from the global burden of myopia. Ophthalmol, 2019; 126: 338–346.
6. Ho KC, et al.  Can the appropriateness of eye care be measured through cross-sectional retrospective patient record review in eye care practices in Australia? The iCareTrack feasibility study. BMJ Open. 2019; 9: 024298.
7. Wildsoet CF, et al. IMI – interventions for controlling myopia onset and progression report.  Invest Ophthalmol Vis Sci. 2019; 60: M106-M131.
8. Flitcroft DI, et al. IMI – defining and classifying myopia: a proposed set of standards for clinical and epidemiologic studies. Invest Ophthalmol Vis Sci 2019; 60:  M20-M30.
9. Chena AH, et al. Comparison of the pediatric vision screening program in 18 countries across five continents. J Curr Ophthalmol. In Press.
10. Long J, et al. The pitfalls of the traditional office ergonomics model in the current mobile work environment: Is visual ergonomics health literacy the remedy? Work 2019; 63: 447-456.

Research Highlights

Since out last newsletter we have had some great research outputs from SOVS.

Many of our academics were involved in TFOS DEWS II. This was a global effort that involved 150 clinical and basic research experts from 23 countries. These experts reviewed literature to provide an evidence-based global consensus on multiple aspects of this increasingly common disease. There were 10 subcommittees and a steering committee that were tasked with the overall objectives to (1) Update the definition, classification and diagnosis of Dry Eye Disease, (2) Critically assess the aetiology, mechanism, distribution and impact of this disorder, and (3) Address its management and therapy. This process took just over 2 years of intense effort.

The School had members on the following subcommittees: Steering committee (Fiona Stapleton; Mark Willcox); Definition and Classification (Fiona Stapleton); Sex, Gender, Hormone (Blanka Golebiowski, Mark Willcox); Epidemiology Report (Fiona Stapleton, Isabelle Jalbert); Tear Film (Mark Willcox, Eric Papas – and PhD alumnus Ulrike Stahl); Pain and Sensation(Fiona Stapleton); Pathophysiology (Maria Markoulli); Iatrogenic Dry Eye (Post-doc alumnus Nathan Efron); Clinical Trial Design (Fiona Stapleton). Indeed, the only committees in which SOVS was not directly involved were Diagnostic Methodology and Management and Therapy. 

Photograph of members of TFOS Board of Directors and Industry Advisory Board who met in Boston in April 2018

The report provides a new definition of  Dry Eye Disease as:

“Dry eye is a multifactorial disease of the ocular surface characterized by a loss of homeostasis of the tear film, and accompanied by ocular symptoms, in which tear film instability and hyperosmolarity, ocular surface inflammation and damage, and neurosensory abnormalities play etiological roles.”

The Sex, Gender, Hormone report highlighted the major role sex, gender and hormones play in the regulation of ocular surface and adnexal tissues, and in the difference in the prevalence of Dry Eye Disease between women and men.

The Epidemiology Report produced estimates for the prevalence of this disease and showed that prevalence increased between 2.0% (self-report of a clinical diagnosis of dry eye) and 10.5% (based on a positive Schirmer test) by decade. The prevalence of meibomian gland disease increased by 5.3% per decade. The differences in the prevalence of Dry Eye Disease between man and women become most obvious after 50 years of age.

The Pathophysiology subcommittee provided a diagram (TFOS DEWS II Pathophysiology, reproduced below with permission from Elsevier) that outlines factors associated with this disease and highlights the vicious cycle that can exacerbate the disease. 

The Vicious Circle of Dry Eye Disease” reprinted from The Ocular Surface Vol 15 2017. Bron AJ. et al 

The Tear Film report highlighted ways of measuring tear film stability, made a plea for the development of an instrument to measure tear film evaporation, and showed that new biomarkers (proteins, lipids and mucins) have been discovered that offer improved ways to diagnose the disease, monitor its progress, and measure success of therapies. Dry Eye Disease is associated with ocular pain and dryness sensations.

The Pain and Sensation subcommittee outlined the neuronal basis for this. The report explains that the inflammation associated with Dry Eye Disease causes sensitization of (polymodal and mechano-nociceptor) nerve endings and an abnormal increase in cold thermoreceptor activity, altogether evoking dryness sensations and pain.

The Diagnostic Methodology and Management and Therapy subcommittees produced what I think should be easy to use and valuable schematics to take you through their recommendations – one of these is reproduced here:

“Dry Eye Disease diagnostic test battery” reprinted from The Ocular Surface Vol 15 2017. Wolffsohn JS et al. TFOS DEWS II Diagnostic Methodology report, with permission from Elsevier. 

Early Career Researchers

Update provided by Professor Mark Willcox.

We have had another great year of research at SOVS. We have published nearly 100 papers this year and there are still some in press. I’d like to highlight a few of these in this report, especially those from our Early Career Researchers.

Dr Jerome Ozkan has a paper published in Scientific Reports (Ozkan J, et al., Temporal stability and composition of the ocular surface microbiome. Scientific Reports 2017; 7(1): 9880). He used non-culture and culture methods in this report, and found a very sparse microbiome on the ocular surface after careful removal of contaminating DNA. He found that there was some taxa that were consistently recovered within individuals suggesting the possibility of individual-specific core microbiomes. This may have implications for protection of the eye, and development of ocular surface abnormalities – and Jerome tells me he’s is looking at these aspects in future research. Figure 1 (Ozkan et al., 2017) shows the commonest bacteria from the ocular surface using DNA sequencing techniques. The most common bacteria were Corynebacterium sp and Acinetobacter sp. (11% overall).

Dr Lakshmi Bodduluri, one of our PhD students who graduated during 2017, published a paper (Bodduluri L, et al., Impact of gamification of vision tests on the user experience. Games for Health Journal 2017; 6(4): 229-236) on the use of gamification theory in vision tests. For those who don’t know (like me – I had to look up this definition) gamification is the application of elements and principals found in gaming, such as incorporation of social/reward aspects, in non-game contexts. Lakshmi found that “over the short term, the careful application of gaming elements to vision tests was found to increase the fun level of users, without affecting engagement with the vision test.” (Figure 2: From Bodduluri et al., 2017. In this picture (c) is a gamified version of a standard vision test, that incorporates aspects of gaming rewards and reinforcement).

Dr Pauline Kang, a new Lecturer at SOVS and a previous PhD student, published a paper on the effect of multifocal contact lenses on vision in young adults who have been prescribed these to control myopia (Kang P, et al. Effects of multifocal soft contact lenses used to slow myopia progression on quality of vision in young adults. Acta Ophthalmologica 2017; 95(1): e43-e53). She paper describes how these contact lenses can have a significant effect on low-contrast visual acuity and quality of vision, but not on high-contrast visual acuity. The paper recommended that clinicians should educate their patients about  these effect on vision. Figure 3 (Kang et al., 2017) shows how the multifocal (MF) contact lenses affect low contrast visual acuity compared to single vision lenses.

Conference highlights and grant successes

Not only did we have a great year for outputs such as publications, staff attended many national and international conferences throughout the year to showcase their research. These conferences included the Tear Film and Ocular Surface societies meeting on the Dry Eye Workshop II report (in Sydney in January and Rome in March; (see the tear film website for more information),  Association for Research in Vision and Ophthalmology (Baltimore USA in May), British Contact Lens Association (in Liverpool UK in June), European Academy of Allergy and Clinical Immunology (Helsinki Finland in June), International Society for Contact Lens Research (Stevenson Washington USA in August).

As well as that, we were successful in obtaining funding from the NHMRC to support our research into new antimicrobials – this time looking at their ability to protect bones from becoming infected after fractures. This was in collaboration with our colleagues Professor Naresh Kumar (UNSW Chemistry) and Professor Bill Walsh (Prince of Wales Hospital). Professor Mark Willcox has also been successful in gaining an ARC grant for investigating the synthesis of novel glyoxylamide antimicrobial peptide mimics that have the capacity to disrupt bacterial membranes.

Professor Mark Willcox Awarded 2017 H Barry Collins Research Medal 

Professor Mark Willcox is the recipient of the 2017 H Barry Collin Research Medal. This prestigous medal is "awarded to recognise outstanding contributions to the advancement of knowledge in optics, vision science or clinical optometry by a person who is an Australian citizen or a graduate of an Australian optometry school, or who has done a significant part of his or her research in an Australian institution".

New collaboration: Guangzhou Wlight Visual Health and Research Institute and Zhongshan Ophthalmic Centre, Sun Yat-Sen University

 

Professor Jian Ge and Dr Xiang Chen (from ZOC, Sun Yat-Sen University, Guangzhou), Mr Ziping Chen (from GWHRI, Guangzhou) and representatives from the Chinese Consulate in Sydney visited the School of Optometry and Vision Science in November, 2017. They toured the UNSW Optometry Clinic, the Optics and Radiometry Laboratory, the Torch Innovation Precinct and Materials Science laboratories at UNSW Sydney.  Following numerous discussions about mutual interests in research and education, the visit culminated in the signing of a Memorandum of Understanding where UNSW, GWHRI and ZOC agreed to move forward together in eye health and lighting research.

We thank Dr Daniel Cui (Visiting Fellow at the School), Mr Warwick Dawson (Director of Knowledge Exchange) and Dr Yuan Wang (Project Manager, Torch Innovation Precinct) for facilitating the visit.

The Torch Innovation Precinct (http://www.torch.unsw.edu.au/about-us) at UNSW is intended to foster entrepeneurship, showcasing Chinese and Australian collaboration. This vision was endorsed by Australian Prime Minister Malcolm Turnbull and Chinese Premier Li Keqiang at a special signing ceremony between UNSW and the Ministry of Science & Technology on 14 April 2016.

[Pictured above, Top panels L to R: Mr Ziping Chen, Prof. Jian Ge, Mr Warwick Dawson, Prof. Fiona Stapleton

Bottom panel L to R: Dr Sieu Khuu, Dr Lisa Asper, Dr Jennifer Long, Emeritus Prof. Stephen Dain, Dr Blanka Golebiowski, Prof. Mark Willcox, Dr Yuan Wang, Mr Warwick Dawson, Prof. Fiona Stapleton, Prof. Jian Ge, Mr Ziping Chen, Consul Yongfeng Hou, Secretary Zixuan Han, Dr Mei Ying Boon, Dr Daniel Cui, Mr Robin Zhang, Dr Xiang Chen.] 

Item Date: 

2016 highlighted another great year in research at the School of Optometry and Vision Science at UNSW Australia. 

Grant success!

Professor Willcox with his collaborators Professor Naresh Kumar (Chemistry, UNSW) and Professor Bill Walsh (Surgical & Orthopaedic Research Laboratories, Prince of Wales Clinical School, UNSW) were successful in obtaining an NHMRC Development grant. This scheme is designed to facilitate translational of research into products. Our grant was funded to determine whether the antimicrobial agents we have developed, Melimine and dihydropyrrolones, can reduce the incidence of infections of bone fractures. The Australian bone graft market is estimated at $70M and growing. Grafts have an infection rate of 4-32% despite meticulous care from well-trained surgeons employing staged management of open wounds. Use of systemic antibiotics and antibiotic-loaded beads locally can reduce infection by 70% - but often there is no sustained delivery, and local antibiotics have been associated with increased culture of drug-resistant bacteria. Adherent bacteria become antibiotic resistant by forming biofilms. The Development Grant will fund testing of innovative antimicrobial/bone combinations to demonstrate safety and efficacy. In other news about these antimicrobials, we are testing Melimine-coated contact lenses in a large scale clinical trial with our collaborators at the LV Prasad Eye Institute, Hyderabad, India. The trial is due to finish in mid-2017 and will determine whether antimicrobial lenses can reduce the incidence of corneal infiltrative events that occur during contact lens wear. We are also testing both of these compounds in collaboration with Cochlear Ltd, to determine whether they can be used in conjunction with their cochlear devices.

News from our Early Career Researchers

We have a strong team of early career researchers at the School. You may not often hear about them – so I thought we’d highlight what some of these have been doing over the past 6-12 months.

Dr Jackie Tan – Senior Research Fellow: Jackie is the manager of our Eye Research Group – the clinical trials arm of the School. She has been busy with clinical trials over the past year, but also made the time to write – and be award (congratulations!) a Innovation Connections grant from the Australian Government. These grants are designed to connect industry to innovation infrastructure. Jackie’s grant (with Prof Fiona Stapleton) is in collaboration with Stiltec who manufacture and supply omega-3 containing products for the relief of dry-eye.

Dr Maria Markoulli – Senior Lecturer: Maria was promoted to Senior Lecturer. Maria obtained a Juvenile Diabetes Research Foundation travel grant. This travel grant supported Maria’s attendance at the Association for Research in Vision and Ophthalmology conference in Seattle (1-5 May 2016) where she presented her team’s work on the biochemical composition of the tear film in diabetes and how this relates to corneal neuropathy. Maria has a new PhD student, Shyam Sunder Tummanapalli, whose will add to this work by focusing on the effect of diabetes of the ocular surface and the tear film. Maria was also invited to attend the Tear Film and Ocular Surface (TFOS) Conference, held in Montpellier, France in Sept 2016, where she presented an update on aspects of the TFOS Contact Lens Discomfort workshop.

Dr Jran Ozkan – NHMRC Fellow: Jran (Jerome) was awarded a prestigious Peter Doherty Biomedical Fellowship from the NHMRC in 2016. His research aims to understand what constitutes the core and transient ocular microbiome (all the different types of microbes inhabiting the ocular surface), how microbial communities change over time and over the eye’s microhabitats (conjunctiva, lids margins, surface cells/crypts), the effect of pharmaceutical agents (including antibiotics) on its composition and how microbial communities change during disease development. He has also recently published a paper from his previous research into the effects of multifocal contact lenses on short-term accommodative adaptation in myopes, which showed that multifocal contact lenses would maintain efficacy during wear as a method to potentially treat myopia progression.

Dr Alex Hui – Lecturer: Over the past year, Dr Hui was invited to contribute a review for the special issue of Optometry and Vision Science on “Revolutionary Uses of Contact Lenses”.  The publication (Hui A, Willcox M. In vivo studies evaluating the use of contact lenses for drug delivery. Optom Vis Sci 2016;93:367-76.) examined the in vivo (animal and human) investigations into the use of contact lenses as a means to delivery drugs and manage ocular diseases, investigations and developments which continue to be investigated today. Alex also presented a poster at the Tear Film and Ocular Surface Society biennial meeting in Montpellier, France on the alternative uses of cyclosporine A other than for dry eye disease. Dr Hui is completing his first supervision  of two 5th year research projects at the School – one examining the effect of fixation target for the repeatability and accuracy of retinoscopy measurements, and the second on the effects of ocular anaesthetics on the ocular surface on patients with diabetes.

Dr Lisa Nivison-Smith – Research Fellow: Lisa has had a very productive year. She was imitated to speak at International Society of Eye Research conference in Tokyo in September 2016 as part of a special session on 'Plasticity of the Retina'. Here, she highlighted her recent work on changes which occur in the inner retina of mice and humans with Retinitis Pigmentosa which could have implications for vision restoration strategies like bionic eye implants. Lisa was also awarded two competitive travel grants this year, one from the CASS foundation to attend ARVO 2016 and one from the Ian Potter Foundation to attend AAO 2016. Some of you may also know Lisa as the organiser of the first SOVS research information night. This was very successful with over 100 undergraduate students attending. Last but not least – Lisa became a Fellow of the American Academy of Optometry.

Dr Pauline Kang – Lecturer: Pauline has been awarded the prestigious 2016 American Optometric Foundation Jill and George Mertz Fellowship. As a part of this fellowship, Pauline is currently at the State University of New York, College of Optometry, collaborating Professor David Troilo and Dr Alexandra Benavente. Research through this fellowship will promote greater understanding of temporal integration of visual signals in visual development.

Item Date: 

Friday, 9 December, 2016