Developing New Treatments

Age Related Macular Degeneration (AMD) is the leading cause of blindness in the UK. This condition strikes those over 50 and blinds some 43,000 people a year in the UK alone.

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Funding Research

We focus on funding research, including Fellowships, which has the potential to make breakthroughs in understanding and treating currently incurable eye diseases, and on operational research to improve best practice and delivery of eye care services.

BCPB has a Research Strategy which can be viewed here.

BCPB supports The Association of Medical Research Charities’ statement on the use of animals in research 
http://www.amrc.org.uk/publications/statement-on-the-use-of-animals-in-research

BCPB endorses The Association of Medical Research Charities’ position statement supporting research in universities
http://www.amrc.org.uk/publications/statement-supporting-research-universities

Below you can read about two examples of BCPB funded research.

Preventing Trachoma

BCPB awarded a Barrie Jones Fellowship grant of £176,000 to Dr Victor Hu to pursue research into prevention of trachoma in 2008. In 2011 Dr Hu has been awarded an additional £43,000 for a separate trachoma project (see BCPB Newsdesk)

Trachoma is the leading infectious cause of blindness worldwide. Infection with Chlamydia trachomatis triggers a poorly understood inflammatory response in children, mainly in the conjunctiva (the membrane lining the inner surface of the eyelid). These children are then at risk of developing scarring complications: the eyelashes turn in and rub against the eye which leads to blindness.

It is unknown whether current control measures, including antibiotic treatment, will halt this process as scarring develops over many years.
Worldwide, there are at least 1.3 million people estimated to be blind from trachoma, with many more having poor vision, and 8.2 million with painful, in-turned lashes scratching against the eye. There are an additional 40 million at risk of blindness in endemic countries. The disease is largely found in poor, rural communities in developing countries, particularly in Sub-Saharan Africa.

The aims of the project are:
  • to improve understanding of how blinding trachoma develops and progresses, which is necessary for the development of blindness prevention measures.
  • to develop and validate research tools to identify early markers for progressive disease.
  • Finally, these tools will be used to investigate whether current interventions result in a reduction in factors associated with progressive scarring and will help to lead to the development of new trachoma control strategies.

amrc peer preview audit 2015

Confocal microscopy being performed by Dr Hu

Preventing Glaucoma

By 2020, it is projected that 80 million people will suffer from glaucoma, making it the most common cause of irreversible blindness worldwide. Primary angle closure glaucoma (PACG) is the predominant form of glaucoma in people who live in Asia, responsible for around a quarter of all blindness in Asian populations. People at risk of PACG have less room in the front of their eyes for aqueous (fluid) to drain out. These people can be detected with a portable ultrasound machine. A laser procedure (iridotomy) creating a hole in the iris can open up the drainage area and reduce the pressure. A study investigating whether screening for people at risk using ultrasound and treatment with laser can prevent glaucoma was first piloted in Mongolia in the 1990s in collaboration with the Mongolian Ministry of Health. Professor Paul Foster (now a trustee of BCPB, but then a researcher just beginning his career) did the first study, funded by BCPB, in 1995. Seed funding such as this, provided by BCPB, can often be instrumental in bringing forth more substantial funding further down the line from larger organisations. In this case that is exactly what happened as this research later attracted funding from the Wellcome Trust. In 2011 BCPB has funded further research in this area by Dr Sanny Jiang, based in China - and supervised by Professor Paul Foster at the Institute of Ophthalmology, University College London (UCL).

Professor Foster himself tells the story:

My first research project was funded by BCPB when, in 1995, I joined the UCL Institute of Ophthalmology to study glaucoma in East Asian people. We knew from previous research carried out by Prof Baasanhu in Mongolia that the country had an unusually high rate of blindness from glaucoma. There was as much blindness there from glaucoma as from cataract - a unique situation. I was sent to Mongolia to work out why. We found that Mongolian people suffer from a condition called angle-closure glaucoma, which although it causes about 12% of glaucoma cases in the UK, is responsible for 60% of cases in Mongolia. Our research over the last 15 years in Mongolia and other locations in Asia- Singapore, Thailand and China- has shown that angle-closure glaucoma carries a three fold greater risk of blindness than the commoner form of glaucoma in Europe, known as open angle glaucoma. We have found that being Asian (and especially Chinese), female and elderly all confer a significantly greater risk of the disease. Being aged over 60 increases the risk of angle-closure glaucoma nine fold. Angle closure is a disease that affects those who are socially and economically deprived, both between and within nations.

The results in Mongolia in 1995 naturally led us to ask whether we could identify people at high risk before they developed the disease. In 1997, in conjunction with Dr Poul Helge Alsbirk, a Danish expert on angle-closure glaucoma, we designed and tested a method of screening for angle-closure, which allowed us to pick up 85% of all those who required preventive treatment. In 1995, my friends and colleagues Miss Winnie Nolan (now a consultant glaucoma surgeon at Moorfields Eye Hospital) and Prof Gordon Johnson at UCL, who led this research in Mongolia, were awarded funding by the Wellcome Trust to study the use of this screening test, combined with a single, quick laser treatment for those at risk, as a means of preventing angle-closure. Unfortunately, at the time we started this study, Mongolia suffered its worst winter in living memory, killing livestock in vast numbers. This was a severe blow to a nation that has very deep roots in nomadic culture, with the population living in harmony with their animals. At about the same time, there was considerable political upheaval, which together with the severe winters, meant that many of the participants in our research either move into the cities, or possibly perished. Dr Jennifer Yip (now at the Department of Public Health at Cambridge University) was then funded by BCPB to study the results of the work we did in Mongolia from 2000 onwards, and has just been awarded a PhD at UCL for this work.

At around this time at Dr Yip was starting work in Mongolia, a brilliant young eye specialist from Guangzhou in China came to London to study for a Masters Degree in Public Health for Eye Care at the London School of Hygiene and Tropical Medicine. He later became my PhD student at UCL, and began replicating our research in China. It has since become apparent that China has far and away the largest problem with angle-closure glaucoma worldwide. About 5 million people in China are blind in at least one eye from angle-closure glaucoma. We have shown that the same treatment and screening test can be applied in detecting and preventing angle-closure glaucoma in China. The young ophthalmologist from China is now a full professor, head of his university department and deputy director of his hospital- Prof Mingguang He of The Department of Preventive Ophthalmology at Sun Yat-Sen University in Guangzhou, and Zhongshan Ophthalmic Center in Guangzhou. One of Prof He's staff, Dr Sanny Jiang, has just been awarded a PhD studentship by BCPB (see BCPB Newsdesk) to come to UCL for three years to analyse data from our latest collaborative project- The ZAP study- Zhongshan Angle-closure Prevention study. This mammoth piece of research has involved us examining 11,991 people in Guangzhou, China, to identify 890 people at high risk of angle-closure glaucoma. We have treated one eye of these people, and will continue to see them over the next 3 years to identify who gets disease, in which eye. By doing this, we hope to determine if laser treatment for angle-closure helps prevent glaucoma damage to the optic nerve, and also identify if there are particular characteristics that can help us identify who is at high risk of suffering damage to their vision.

Jennifer Yip carries out an eye examination during the Mongolia
Survey Photo: Pak Sang Lee