IGA Chair of Ophthalmology

Professor David (Ted) Garway-Heath is IGA Chair of Ophthalmology for Glaucoma and Allied Studies at Moorfields Eye Hospital and UCL Institute of Ophthalmology in London.

Professor Garway-Heath

In addition to his clinical work, Professor Garway-Heath’s research focuses on the development and evaluation of techniques for effective diagnosis, monitoring and management of glaucoma, the identification of risk factors for glaucoma progression, and decision-support systems for healthcare delivery services. He has managed to attract funding for his research totalling over £4 million over the last 5 years, and is the author of around 200 peer-reviewed publications. 

The IGA trustees are delighted to share Ted’s 2018-19 report on his work as IGA Professor of Glaucoma during yet another busy and productive year:

Leadership activities

European Glaucoma Society

  • As President of the Society, I have been providing strategic input into and guidance for the planning, organization and implementation of the first joint European Glaucoma Society/American Glaucoma Society Members’ Meeting in Bordeaux to be held in late summer 2019 and for the landmark biennial congress of the Society to mark its 40th anniversary in 2020.

ORIEL: the new Moorfields and Institute of Ophthalmology

  • I was appointed Lead for the Whole Building Design Workstream by Moorfields and the Institute. In this role, I have been working extensively with professionals across departments from both institutions to produce the Creative Strategy Brief. My document formed the basis for the brief sent out to the architects shortlisted for submitting a bid proposal for the new joint Moorfields and Institute building.

  • I was appointed by Moorfields to develop the Research Informatics Strategy document, which is being used by the Research Informatics Implementation Group to develop a business case for Research Informatics at Moorfields.

Research activities 

  • I was  again been voted onto The Ophthalmologist power list, which recognises the top 100 most influential people who have made the biggest impact in the field of ophthalmology worldwide.

  • My Lancet paper reporting the findings from the UK Glaucoma Treatment Study reached the status of ‘highly cited papers’ by Web of Science. “Selected from the most recent 10 years of data, Highly Cited Papers reflect the top 1% of papers by field and publication year. Highly Cited Papers help identify breakthrough research within a research field and are used within Web of Science to identify and refine the most influential research papers.”


Research 

Recently completed research grants:

  • Development of a new platform for monitoring vision function in glaucoma; NIHR i4i; £891,000, 2014-17. The report has been accepted by the NIHR. 

  • Project summary: To reduce variability between visual field tests, we developed a new technique called T4. Compared with the standard test, the new technique reduced variability between tests in 86 patients. IP for the new technique has been protected by a patent, and licencing terms have been agreed between a commercial partner and UCLB.


On-going research grants:

Chief investigator

  • Identifying the genetic basis for heritable normal tension glaucoma, with a focus on mitochondrial function; International Glaucoma Association; £40,000.

  • Which mitochondrial mechanisms confer resistance to glaucomatous neurodegeneration in ocular hypertension patients; identifying potential therapeutic targets? Fight for Sight PhD Studentship; £100,00.00.

  • Exploration of outcomes for clinical trials of neurodegeneration; Santen PhD Studentship: £270,670.

Co-investigator

  • Imaging-based CUSTOMised EYE diagnostics (IMCUSTOMEYE); Horizon 2020 (call H2020-ICT-2016-2017; EU grant); €5,933,669.

  • NIHR BRC for Ophthalmology at Moorfields Eye Hospital and UCL Institute of Ophthalmology; NIHR 5-year Infrastructure Grant; £19m.

  • Treatment of Advanced Glaucoma Study (TAGS trial); NIHR HTA; £1.9m.

  • Health-Related Quality of Life in two treatment pathways for primary open angle glaucoma and ocular hypertension: a randomised controlled trial of initial selective laser trabeculoplasty versus conventional medical therapy (LIGHT study); NIHR HTA; £1.81m.

  • Purchase of ‘Bespoke adaptive optics scanning laser ophthalmoscope for evaluation of retinal structure and function in disease; Moorfields Eye Charity; £395,000.


Patents

My work led to the following patents.

  • Moorfields Motion Displacement Test – laptop-based visual field test 

  • T4 – faster and more precise method for measuring visual fields 

  • ANSWERS – method for more accurate measurement of visual field changes 


Research presentations

My research in 2018-19 was the subject of 11 presentations at the Association for Research in Vision and Ophthalmology (ARVO) annual meeting, the worlds’ most important scientific congress in vision research gathering more than 11,000 participants worldwide:

1 invited lecture given:

  • Translating laboratory research: clinical trials for new therapies

5 oral presentations by me or my fellows and students:

  • Clinically relevant artefactual intraocular pressure lowering resulting from corneal biomechanical changes under latanoprost treatment: data from the UKGTS
     
  • A new perimetry thresholding algorithm with size-modulated stimuli reduces variability by half in damaged regions of the visual field compared to SITA Standard.

  • Effects of fundus tracking on structure-function relationship in glaucoma.

  • Does intraocular pressure reduction prevent visual field progression in patients with disc haemorrhages?

  • Bilateral disc haemorrhages in the United Kingdom glaucoma treatment study (UKGTS): a probabilistic approach to explore a possible systemic pathophysiological mechanism. 

5 posters by my fellows and students.

Publications

In 2018-19 I was the author of 10 peer-reviewed publications across the following research fields.

Clinical Trials 

  • Selective laser trabeculoplasty vs drops for the treatment of ocular hypertension and glaucoma (LiGHT): a multicentre randomised controlled trial. Gazzard G, Konstantakopoulou E, Garway-Heath D, Garg A, Vickerstaff V, Hunter R, Ambler G, Bunce C, Wormald R, Nathwani N, Barton K, Rubin G, Buszewicz M, on behalf of the LiGHT Trial Study Group. Lancet. 2019: on line March 09. doi: https://doi.org/10.1016/S0140-6736(18)32213-X

  • Laser in Glaucoma and Ocular Hypertension (LiGHT) trial. A multicentre, randomised controlled trial: design and methodology. Gazzard G, Konstantakopoulou E, Garway-Heath D, Barton K, Wormald R, Morris S, Hunter R, Rubin G, Buszewicz M, Ambler G, Bunce C; LiGHT Trial Study Group. Br J Ophthalmol. 2018 May;102(5):593-598.

  • Are Patient Self-Reported Outcome Measures Sensitive Enough to Be Used as End Points in Clinical Trials?: Evidence from the United Kingdom Glaucoma Treatment Study. Jones L, Garway-Heath DF, Azuara-Blanco A, Crabb DP; United Kingdom Glaucoma Treatment Study Investigators. Ophthalmology. 2018 Sep 28. [Epub ahead of print] 

  • Treatment of Advanced Glaucoma Study: a multicentre randomised controlled trial comparing primary medical treatment with primary trabeculectomy for people with newly diagnosed advanced glaucoma-study protocol. King AJ, Fernie G, Azuara-Blanco A, Burr JM, Garway-Heath T, Sparrow JM, Vale L, Hudson J, MacLennan G, McDonald A, Barton K, Norrie J. Br J Ophthalmol. 2018 Jul;102(7):922-928. 

Health Technology Assessments 

  • A Comparison between the Compass Fundus Perimeter and the Humphrey Field Analyzer. Montesano G, Bryan SR, Crabb DP, Fogagnolo P, Oddone F, McKendrick AM, Turpin A, Lanzetta P, Perdicchi A, Johnson CA, Garway-Heath DF, Brusini P, Rossetti LM. Ophthalmology. 2019 Feb;126(2):242-251.

  • Diagnostic accuracy of optical coherence tomography for diagnosing glaucoma: secondary analyses of the GATE study. Virgili G, Michelessi M, Cook J, Boachie C, Burr J, Banister K, Garway-Heath DF, Bourne RRA, Asorey Garcia A, Ramsay CR, Azuara-Blanco A. Br J Ophthalmol. 2018 May;102(5):604-610 

 Clinical studies 

  • Rates of Visual Field Loss in Primary Open-Angle Glaucoma and Primary Angle-Closure Glaucoma: Asymmetric Patterns. Yousefi S, Sakai H, Murata H, Fujino Y, Matsuura M, Garway-Heath D, Weinreb R, Asaoka R. Invest Ophthalmol Vis Sci. 2018 Dec 3;59(15):5717-5725. 

  • Asymmetric Patterns of Visual Field Defect in Primary Open-Angle and Primary Angle-Closure Glaucoma. Yousefi S, Sakai H, Murata H, Fujino Y, Garway-Heath D, Weinreb R, Asaoka R. Invest Ophthalmol Vis Sci. 2018 Mar 1;59(3):1279-1287. 

 Genetics 

  • A Common Glaucoma-risk Variant of SIX6 Alters Retinal Nerve Fiber Layer and Optic Disc Measures in a European Population: The EPIC-Norfolk Eye Study. Khawaja AP, Chan MPY, Yip JLY, Broadway DC, Garway-Heath DF, Viswanathan AC, Luben R, Hayat S, Hauser MA, Wareham NJ, Khaw KT, Fortune B, Allingham RR, Foster PJ. J Glaucoma. 2018 Sep;27(9):743-749

  • The treatment of refractory angle-closure glaucoma in a patient with X-linked juvenile retinoschisis. Low S, Mohamed R, Ting M, Webster AR, Garway-Heath DF. Ophthalmic Genet. 2018 Oct;39(5):625-627. 

Teaching and lectures

  • As President of the European Glaucoma Society (EGS), I organized, worked on the programme and presided the 13th biennial Congress of the EGS held in Florence, Italy, which attracted nearly 2,800 participants from 87 countries. I gave the welcome lecture at the opening ceremony of the EGS Congress highlighting the educational activities and key achievements of the Society.

  • I chaired, provided input into, and taught at the annual EGS Residents’ Course held in Mainz, Germany, which attracted over 100 residents with an interest in Glaucoma from and beyond Europe.

  • For the 2018-19 calendar year, I was invited to give 25 lectures worldwide. The IGA was acknowledged in each of these presentations (please see PDF attached).

  • I chaired and lectured at the EGS Symposium, which I organized at the World Glaucoma Congress in Melbourne. They objective of this symposium was to report the findings on the definition of glaucoma and outcome measures for glaucoma care from the EGS members’ meeting that I organized in 2017 (please see my previous report). 


Examinations

  • I provided input into, and was examiner for, the annual joint European Board of Ophthalmology (EBO)–EGS examinations. These examinations aim at raising the standards of glaucoma care in Europe, and are designed to offer “the opportunity for ophthalmologists with particular interest in Glaucoma to have their knowledge and expertise acknowledged. Successful candidates are awarded the Glaucoma Subspecialty EBO Diploma, which is expected to be recognised as a proof of advanced knowledge and competence in this field.”