MD project and Glaucoma Fellowship
"The effects of single doses of beta irradiation on the wound healing functions of ocular fibroblasts."
I spent two years working as a fellow attached to the Glaucoma Unit at Moorfields Eye Hospital, during which time I successfully completed a period of research into the effects of focal beta radiation on ocular fibroblast wound healing functions. This work formed part of the ongoing international wound healing project, which is a collaborative study between the Institute of Ophthalmology, the Phoenix plastic surgery unit, University College, London and the University of Florida. The underlying basis for the work was the current interest in treatments which may be effective in modulating the scarring response which occurs after glaucoma filtration surgery, as this may significantly improve the outcome after drainage surgery and reduce the chance of patients suffering progressive visual field loss. During this research period I was principally engaged in laboratory based studies into the effects of beta radiation on ocular fibroblast wound healing functions, but in addition I maintained a close clinical commitment within the Glaucoma unit, with weekly special clinics in paediatric glaucoma, normal pressure glaucoma as well as general adult glaucoma and tertiary referrals with complex glaucoma problems. I also was closely involved in the weekly teaching programme within the unit, which was actively engaged in several exciting areas of glaucoma research including analysis of visual field progression, new psychophysical tests for glaucoma, optic disc analysis techniques and glaucoma epidemiology.
The research work for my thesis involved both in-vitro human cell culture experimentation and in-vivo animal work, using a new model of conjunctival healing that we developed using the New Zealand albino rabbit. I developed and used experimental assays to investigate the effects of radiation on cell proliferation and cell cycling, and the subcellular cellular mechanisms controlling this response. In addition I also studied the effects of radiation on cell contraction, migration and extracellular matrix production. In addition to this work, I was also closely involved in studies using other anti-metabolite agents such as 5-Fluorouracil and Mitomycin C and their cellular effects such as apoptosis, as well as the role of growth factors such as TGF-b. This period of research has given me a good theoretical and practical background into much of the current research in glaucoma, as well as a detailed knowledge of cell biology research techniques and experimental design, and I hope to be able to carry this experience forward into future clinical research projects. My MD was submitted to the University of Cambridge in May 1998, and awarded in October 1998.