Annual Report 2015 prevent & cure blindness & eye disease ontents

Contents

Contact Information Lions Eye Institute 2 Verdun Street Nedlands WA 6009

Phone +61 8 9381 0777 Fax +61 8 9381 0700 Email [email protected] ABN 48 106 521 439

Media Contact A digital version of this report is Francesca Robb available on our website: Mobile 0409 102 556 [email protected] www.lei.org.au C2 Lions Eye Institute Annual Report 2015 ontents

4 Vision & Mission 55 ProfilePhilomena Grant 6 Profile Ray Watson 56 ProfileKaren McLachlan 7 Chairman & Managing 57 Clinicians Profiles Director’s Report 63 ProfileAdam Gajdatsy 10 Board of Directors 64 Lions Laser Vision 13 Scientific Advisory Committee 66 Lions Eye Bank 14 Genetics & Population Health 68 ProfileEnid Gelden 19 Profile Seyhan Yazar 69 Clinic Design 20 Immunology 71 Collaborators & Visitors 23 Molecular Ophthalmology 74 Myopia Rates in the Spotlight 25 Profile June Walker 75 Conferences & Invited Lectures 26 Physiology & Pharmacology 79 Ian Constable Lecture 29 ProfileDr Paula Yu 80 Open Day 30 Ocular Tissue Engineering Laboratory 81 ProfileMark & Natasha’s Ride 33 Miocevich Fellowship 82 Acknowledgements 34 Lions Outback Vision 84 Lions Save-Sight Foundation 35 ProfileStephen Copeland 86 Volunteers 37 ProfileVeronica Harvey 87 ProfileRobin Miller 38 Clinical Trials 88 Grants 41 Profile Cora Pierce 90 Financial Statements 42 Publications 92 Visionaries Luncheon 51 Clinical Services Report 94 Acronyms Used in this Report C Lions Eye Institute Annual Report 2015 3 Vision & Mission

Vision

To prevent and cure blindness and eye disease

4 Lions Eye Institute Annual Report 2015 Mission

To achieve leadership in scientific research and clinical practice in the prevention of blindness and eye disease through:

• global leadership in scientific research • translation of research into community outcomes • a commitment to growing the reach of our research capabilities and clinical services • development and training of outstanding eye care professionals and researchers • community engagement and education to build awareness, maintain a high reputation and increase funding

Lions Eye Institute Annual Report 2015 5 Profile Ray Watson

Treament putsRay back in the driver’s seat

Ray Watson risked at Royal Perth Hospital, where he to continue with my workshop and losing not only his was sent to the eye clinic. would have to rely on a pension. livelihood but his passion A referral was made to Dr Fred “All of my work is very hands-on when his eyesight Chen at the LEI, who diagnosed the and requires very good eyesight to began deteriorating wet form of age-related macular ensure the quality of the finished dramatically in 2014. degeneration. product.”

He spent his working life as a “After some consultation and While the treatment was unpleasant, mechanic and design engineer, and discussion, he asked me to come Ray said the progress with his sight in semi-retirement had set up a on his clinical trial into treatment of had been fantastic. one-man business restoring classic AMD,” Ray said. Sports and GT cars. He is able to drive confidently at “He explained the injection into night again and has returned to the “In 2014, my health began to the eye and all of the procedures intricate work on the classic cars he deteriorate and the most dramatic involved, saying he felt there was loves so much. effect was on my eyes,” he said. a very definite chance of reversing the problem with my left eye, and “Within a few months my left eye returning a good percentage of my was so bad that I could not focus sight in the left eye. at all.” “To me this was a very reassuring ABOVE Unable to get a doctor’s appointment thing as the problem - if it got any Ray Watson immediately, Ray went to emergency worse - meant I would not be able

6 Lions Eye Institute Annual Report 2015 Chairman & Managing Director’s Report

Chairman &Managing Director’s Report C7 Chairman & Managing Director’s Report

through The University of Western LEI researchers were also part of two Australia and the LEI. major international genetics studies that identified new genes involved in In late 2015 a campaign was started aged-related macular degeneration to fund, in perpetuity, this professorial and glaucoma – the two leading chair, a post-doctoral fellowship and a causes of blindness in Australia. The continuous PhD scholarship program. findings were published in Nature Genetics. The AFPB (WA) started the campaign with a generous donation, and Dr The Genetics and Epidemiology Group Sjakon Tahija of Jakarta, Indonesia continued its research work into the Stephen Pearce has accepted the role of International Asian myopia epidemic, the Western Ambassador for the ongoing Australian Eye Protection Study, the campaign. Kidskin Eye Health Study and WA Pregnancy Cohort (Raine) Eye Health This exciting new chair in research Study. will boost the scientific capabilities of the LEl and promote new scientific The Ocular Tissue and Engineering developments of international group continued to investigate importance to eye care. the causes of - and develop new treatments for – age-related macular During the year, one of the world’s degeneration and inherited retinal most prominent medical journals, diseases. The Lancet, reported on the one-year follow-up of the human gene therapy The Division of Immunology is working Professor David A Mackey research for wet age-related macular on a number of research projects degeneration. focused on understanding how common viral infection affects vision. 2015 once again The Lancet publication was the first highlighted the in the LEI’s history and underscores During 2015 many advances commitment of our the significance of this research: have been made by the group on conceived, executed and written by establishing new in vivo models that people, with Lions Eye our Molecular Ophthalmology group. closely mimic the natural history of Institute staff delivering human eye infections. excellence in research, The Physiology and Pharmacology clinical services, group achieved a major translational It was a landmark year for Lions teaching and training. achievement with a new treatment for Outback Vision (LOV), which secured glaucoma. $5.1 million to build a new mobile We continue to strive to achieve our health clinic. Once on the road in vision to prevent and cure blindness The start-up company 2016, the LOV Van will travel more and eye disease. 2015 was a year commercialising the technology was than 24,000km each year offering in which we moved a step closer to purchased by the multi-national comprehensive optometry and realising our goal. pharmaceutical company Allergan, ophthalmology care for up to 200 ensuring the world-wide marketing of patients each week in remote and To celebrate the outstanding this technology. regional locations around the State. contribution to ophthalmic science and clinical practice by Professor Ian Clinical trials are already With the commissioning of the van, Constable for more than 40 years, the demonstrating significant advantages LOV continues a long and proud Australian Foundation for Prevention of the procedure compared to tradition of providing ophthalmic of Blindness, Western Australia AFPB conventional surgery and it is very services in regional and remote (WA) has decided to establish The likely that the advanced technology Western Australia that began with the Ian Constable Chair in Discovery and developed at the LEI will be used first mass glaucoma screenings in the Translational Ophthalmic Science worldwide. 1960s.

8 Lions Eye Institute Annual Report 2015 Chairman & Managing Director’s Report

LEI’s Clinical Services continued to throwing light on our understanding of collaboratively with the business grow significantly in 2015, with a new the cell and disease mechanisms. sector in research, social innovation record of just under 60,000 patients and philanthropy. treated throughout the year. Significant LEI researchers were delighted to planning toward the expansion and spend time with Professor Blackburn She has a passion for strengthening relocation of clinical services was and were inspired by her enthusiasm links between the public sector and completed with construction beginning and generosity. business community and will be an in 2016. This work will ensure the LEI exciting addition to our suite of skills can continue to meet patient demand On a much sadder note, our long-time and experience at Board level. as it grows over the years to come. Patron Sir James Cruthers passed away in October after a long illness. Over the course of 2015, the The LEI has generated a financial Sir James played a central role in the LEI continued to implement the surplus for 2015 of $4.5 million original fundraising campaign to build organisational goals identified in on revenue of $18.3 million. Key a stand-alone facility for the LEI. a strategic review of operations. contributors to this result were $1.9 These are focused on growing and million in donations which will be used Sir James and his wife Lady Sheila improving our research capabilities, to endow the Professorial Chair at were long-term, passionate supporters clinical services, teaching and training, UWA, and an increase of $2.4 million who contributed enormously to the community engagement and financial in the market value of shares that LEI’s reputation and we remember sustainability – none of which can the LEI owns in a US gene therapy them for their many years of dedicated be achieved without the passion and company. While these are shown as service. commitment of our people. part of our surplus they are one-off in nature, and we are pleased that the At a Board level, the activities of the We thank all staff for your LEI’s underlying operations broke even LEI were again expertly assisted by a dedication to achieving our vision financially despite the inevitable cost mix of highly skilled professionals. and acknowledge those many pressures. organisations and individuals – Dr Stephanie Allen resigned from the the Lions Save-Sight Foundation, A major highlight of the year was Board in 2015 and we sincerely thank Australian Foundation for the the visit by Nobel Laureate Professor her for an excellent contribution over Prevention of Blindness, donors, Elizabeth Blackburn. several years. institutional partners, trusts, foundations, and bequestors – whose Professor Blackburn delivered the Following Dr Allen’s departure, we support sustains and drives our 2015 Ian Constable Lecture on her look forward to welcoming Margaret commitment to saving sight. ground-breaking discovery of how Crowley to the Board in 2016. chromosomes are protected by Stephen Pearce telomeres and telomerase – thus Dr Crowley has been CEO of the CHAIRMAN solving a major problem in biology and Australian Association for the Blind Professor David Mackey for the past 15 years and worked MANAGING DIRECTOR

Vale Sir James... we said goodbye Nobel Laureate Professor Elizabeth Blackburn with some of the LEI’s to our long standing Patron Sir female staff James Cruthers in 2015

Lions Eye Institute Annual Report 2015 9 Board of Directors

Boardof

Directors Stephen Pearce joined the Board in 2012 and was appointed Chairman in 2014.

He is Chief Financial Officer of Fortescue Metals Group Limited and has nearly 30 years’ experience in senior management roles in the mining, oil and gas and utilities industries. Prior to joining Fortescue, Mr Pearce held the position of Managing Director and CEO of Southern Cross Electrical Engineering Limited and before that was Chief Financial Officer with Alinta Limited. He also served as a member of the Western Australian Business and Industry Committee of the Salvation Army for seven years and is currently a Non-Executive Director of Cedar Woods Limited. Mr Pearce received a Bachelor of Business from the Royal Melbourne Institute of Technology and a Graduate Diploma in Company Secretarial Practice. He is a Fellow of the Institute of Chartered Accountants, a Chartered Secretary and Member of the Australian Institute of Company Directors. B10 Board of Directors

David Mackey was Rudolf Brunovs joined Tony Joyner joined appointed Managing the Board in 2005. the Board in 2013. Director of the LEI and Professor of Ophthalmology He is a Fellow of the Institute of He has 30 years’ experience as a at UWA in March 2009. Chartered Accountants and the commercial and corporate lawyer. Mr Australian Institute of Company Joyner is Managing Partner of the He heads UWA’s Centre for Directors and holds a Masters of Perth office of the international law Ophthalmology and Visual Science. Business Administration. Mr Brunovs firm of Herbert Smith Freehills, and Professor Mackey studied medicine retired as a partner of the chartered Head of the firm’s Technology, Media at the University of Tasmania and accounting firm Ernst & Young after and Telecommunications Practice. He trained in ophthalmology at the 27 years as a partner in a number sits on the firm’s Board. He is also the Royal Victorian Eye and Ear Hospital of their offices. He is currently a Chair of Scitech, and a Board member in Melbourne, subsequently doing Director and the Principal of Mainstay of the WA Chamber of Commerce. a fellowship in paediatric and Consulting Pty Ltd and Chairman of He has a broad commercial practice, genetic eye diseases at the Royal Deep Yellow Limited. but has particular interest in the Children’s Hospital in Melbourne. fields of technology, data, health and After fellowships at the Johns Hopkins infrastructure. Centre for Hereditary Eye Diseases in Baltimore and the Great Ormond Street Hospital for Sick Children in London, he returned to Australia to specialise in genetic eye diseases. He is past president of the International Society for Genetic Eye Disease and Retinoblastoma, a member of the Board of the Ophthalmic Research Institute of Australia and Chair of the ORIA Scientific Advisory Committee, Australian representative on the Council of the Asia Pacific Academy of Ophthalmology and an executive committee member of the Glaucoma Research Society. He is a fellow of the Australian Academy of Health and Medical Sciences and a fellow of the Association for Research in Vision and Ophthalmology. Professor Mackey is a member of the Board’s Investment Committee.

Lions Eye Institute Annual Report 2015 11 Board of Directors

Ian McAllister joined Peter Forbes joined Stephanie Allen joined the Board in 2011. the Board in 2014. the Board in 2012.

He studied medicine at UWA, A chartered accountant, he is a former She resigned in October 2015 to completed his ophthalmological CEO of specialist medical indemnity take on the leadership role of Deloitte training in hospitals in Western mutual MDA National and former Australia’s Health and Human Services Australia and a fellowship in Managing Director of its wholly owned consulting practice, based in Sydney. vitreoretinal disorders at the Cleveland insurer, MDA National Insurance Pty Prior to that, she was a health Clinic Foundation in Cleveland, Ohio. Ltd. He is Chair of Victorian health consulting leader for PwC in both the He has been with the LEI since fund provider Transport Health. Mr UK and Australia, with an extensive 1988 providing vitreoretinal services Forbes was a founding partner and background across the primary, aged to metropolitan hospitals and has former Managing Director of the WA care and disability sectors. She holds also been involved in research branch chartered accountants’ HLB a PhD from the University of Oxford into disorders affecting the retina. Mann Judd. He was also director of and has written several books on the Professor McAllister holds a number LawCover, the NSW statutory insurer impact of social policy. of NHMRC grants as well as numerous for NSW solicitors, from 2004 to minor grants and has published more 2010. than 120 papers in scientific journals. He has also been awarded an American Academy of Ophthalmology Achievement award for distinguished service to ophthalmology. He has recently been awarded a Doctorate in Medicine by UWA. Professor McAllister is the Director of Clinical Services at the LEI and has extensive experience in research and eye health care. He is a consultant ophthalmologist at RPH and SCGH.

12 Lions Eye Institute Annual Report 2015 Scientific Advisory Committee

Scientific Professor Lyn Beazley advisory committee Emeritus Professor Lawrie Beilin

The Scientific Advisory Oceans Institute Professor Shaun Committee was created Collin, Head of the School of Animal Professor Shaun Collin to advise the LEI’s Biology Professor Sarah Dunlop and Current Chief Scientist of Western Managing Director on Australia Professor Peter Klinken. the implementation of research strategy and During 2015, the committee to offer assistance in participated in an LEI Pitch Your achieving external, State Project session, where researchers and Commonwealth presented ideas for new research support and collaboration grant applications. towards these ends. They also reviewed most of the LEI grant submissions to the NHMRC as Professor Sarah Dunlop Members of the LEI Scientific part of the UWA internal peer review Advisory Committee are past Chief process. Scientist of Western Australia, Professor Lyn Beazley, Emeritus The committee’s advice will become Professor of Medicine and increasingly important as new Pharmacology Professor Lawrie researchers are recruited to the LEI. Beilin, Acting Director of the UWA

Professor Peter Klinken

Lions Eye Institute Annual Report 2015 13 Genetics & Population Health

Genetics& Population Health

G14 Genetics & Population Health

Our researchers gene therapy trials for specific rare Program to investigate whether contributed to two eye diseases. changing time spent time outdoors major international during childhood affects myopia Several trials have begun in Europe (short-sightedness) in early adulthood. genetics studies that and the United States. Although there identified new genes are some people in Australia who Also in 2015, Postdoctoral Research involved in age-related would be eligible to participate, we Fellow Seyhan Yazar was awarded macular degeneration usually find there are too few in one a 4-year NHMRC early career and in glaucoma – the area to justify an independent arm of fellowship after she passed her PhD two leading causes of these trials. for her thesis exploring genetic and blindness in Australia. environmental influences on eye The aim of his fellowship is to learn measurements in healthy young The study results bring us closer to how Australians might participate in adults. Seyhan will spend two years in providing testing to predict which future studies of these rare diseases Scotland before returning to Australia individuals are at higher risk of and what barriers exist to patients for the final two years. developing these diseases. The results having the treatment overseas but also help us better understand the then being monitored in Australia, as Dr Charlotte McKnight completed a molecular pathways involved in these part of a truly international study. Master of Medical Science for her diseases and open the possibility of research into sun damage to the eyes new treatments. In 2015, Professor Mackey was of young adults in Western Australia. appointed to the role of Associate The findings were published online in Dean (Research) with The University As part of the LEI’s ongoing Nature Genetics in December 2015. of Western Australia’s Faculty of commitment to translation of Also during the year, Genetics and Medicine, Dentistry and Health research, Research Fellow Annette Population Health Director Professor Sciences. Hoskin participated in a review of the David Mackey was awarded a Australian sunglasses standard AS/ Churchill Fellowship to examine He also won a $72,000 grant from NZS 1067. barriers to Australians participating in the Perpetual IMPACT Philanthropy

Professor David Mackey receives his Churchill Fellowship from WA Governor Kerry Sanderson AO

Lions Eye Institute Annual Report 2015 15 Genetics & Population Health

Research projects Preventing and managing myopia will of WA-born Caucasian 20-year-olds in soon be the primary area of work for the Raine Study. The Western Australian paediatric ophthalmologists. Eye Protection Study A staggering 95 per cent of Chinese As part of our international Outdoor sports involve exposure to medical students we examined during collaborations with the Consortium for sun, which has both beneficial and a winter school in WA were myopic, Refractive Error and Myopia (CREAM) potentially harmful effects on eye compared to 45 per cent of WA-born group, we hope to identify the specific sight. For example, outdoor exposure Chinese 20-year-olds and 23 per cent risk factor differences between East seems to protect adolescents from developing short-sightedness (myopia) but excess UV exposure increases the risk of damage to the front of the eye, causing pterygium. Wearing hats and sunglasses is practical for some sports but less so for others. Researchers at LEI continue to investigate the optimal balance of sun exposure that can reduce the risk of sun-related eye disease while also preventing short-sightedness. Rates of myopia in Asian students The Genetics and Population Health group is examining the rise in rates of blindness from pathological myopia, retinal detachment, myopic maculopathy and glaucoma. Worldwide, there is an epidemic of myopia – most evident in East Asian cities where 90 per cent of high school graduates are myopic.

The environmental factors that contribute to myopia, including lack of outdoor activity and higher levels of education, have their effect during childhood.

Major international research collaborations are identifying genetic pathways involved in myopia. Understanding genetic risk factors and how they interact with environmental risk factors will allow us to predict which children are at the highest risk for developing myopia and to target new interventions. Senator Chris Back has his eyes checked for sun damage

16 Lions Eye Institute Annual Report 2015 Genetics & Population Health

Asian and Australian myopia rates Colour Discrimination Raine Eye Health Study such as time outdoors, levels of light Colour vision deficiency (CVD) or The Raine Study is a longitudinal or levels of study. We hope this will colour blindness (CB) is usually study that is one of the world’s largest identify interventions that can be considered to be a mild disability. and most successful studies of the implemented in China and Singapore. However, in a world where colour influences of genetics, pregnancy, is now widely used in both printed childhood and adolescence on This project is focused on research and digital information systems, subsequent health and developmental that is likely to highlight the health employment opportunities for people outcomes. The 20-year-old follow-up and lifestyle benefits for families, with CVD have become increasingly of 1350 cohort participants had a and students in particular, who restricted. major focus on eye health and was travel to WA to live or study. If we one of the first studies of eye health could demonstrate reduced myopia Nevertheless, this trait has been and diseases in young adults. progression in students who come preserved in the population (eight Data from this study have been to WA to study, for example, an per cent of males). This suggests shared with two international consortia Australian education may be an there may be circumstances where that have identified genes involved attractive option for Chinese parents. CVD conveys some level of biological in variation of many eye measures advantage, e.g. in seeing through between individuals and risk factors The LEI aims to recruit Chinese camouflage. for eye diseases such as refractive students studying in schools and error and keratoconus. Several studies universities in WA for a baseline Our study will compare the speed exploring the environmental factors refraction and test them every six and accuracy of normal-sighted influencing eye health of young adults months for four years to assess males with CVD males to detect and have also been published. progression in their myopia, identify objects in a variety of complex axial length, vitamin D levels and textured settings. Western Australian Strabismus conjunctival autofluorescence. We will Inheritance Study compare age and education-matched The LEI and UWA launched a Strabismus (misalignment of the students remaining in Singapore, Crowdfunding campaign in November eyes) affects about five per cent of Shanghai and Wenzhou. 2015 seeking community support to the general population. It is often finance the study. associated with amblyopia, a failure of normal visual development (otherwise known as a lazy eye) and reduced or absent binocular (stereoscopic) vision. Thus early diagnosis and treatment enables optimal visual outcomes.

As part of parallel NEI and NHMRC funding we have been collaborating with the Engle laboratory at the Children’s Hospital, Boston, affiliated with the Harvard Medical School, since 2003 as part of the Strabismus Inheritance Studies in Tasmania and Western Australia with a primary focus a common type of strabismus – esotropia. Professor Engle was a Raine Visiting Professor to Perth in 2013. Eight in 100 men and one in 100 women are colour blind for red and green, affecting the way they see the world

Lions Eye Institute Annual Report 2015 17 Genetics & Population Health

Busselton Healthy Ageing Study Eye Injury Epidemiology Grants / Funding The Busselton Study is well known as and Injury Prevention • Channel 7 Telethon Trust a major population health study that This project is funded by the Joyce • National Health and Medical has been ongoing since the 1960s. Henderson Paediatric Ophthalmology Research Council In 2010, the Busselton Population Bequest Fund. Significant progress Medical Research Foundation has been made in determining the started a study to explore why some incidence and nature of paediatric Staff people are able to remain healthy ocular trauma in Western Australia. • Professor David Mackey and active throughout their senior A retrospective review of children’s (Group leader) years, whilst others suffer ongoing eye injuries presenting to Princess • Ms Tracey Dickens (Research illness and infirmity – the Busselton Margaret Hospital for Children was team manager) Healthy Ageing Study. There is an conducted by the Joyce Henderson • Ms Lisa Booth (Research Assistant) eye component within this study, Research Fellow. The data analyses • Ms Julie Crewe (Research Assistant) for which the LEI, through Professor included eye injuries from 2002 to the • Mr George Gooden David Mackey is providing financial end of 2014. Information about the (Research Assistant) and equipment support. We now have nature of injuries will be fundamental • Ms Emily Hunyh data on 5000 baby boomers and are for developing strategies to prevent (Research Assistant) continuing our analysis. eye injury. • Mr Kashif Syed (Data Management Officer) Eye protection is known to reduce • Ms Kate Hanman the incidence of eye injuries in sport. (Research Assistant) Currently in Australia a standard exists • Dr Anne-Marie Yardley for sports eye protection for squash (Joyce Henderson Research and face shields for cricket. The Fellow to Feb 2015) LEI was instrumental in developing • Dr Kate Barnes (Joyce Henderson a Sport’s Eye Protection proposal Research Fellow to Aug 2015) approved by Standards Australia and • Mr Alex Burton (Research Assistant) initiated in 2015. The LEI continues to • Ms Annette Hoskins actively participate on the International (Research Fellow) Organization for Standards (ISO) and • Ms Carole Collins (Research Fellow) Standards Australia (SA) committees • Ms Jordan Fitz-Gerald to develop eye protection and (Research Fellow) sunglass standards. • Dr Alex Hewitt PhD (NHMRC Research Fellow) • Dr Justin Sherwin (Research Associate) • Mr Paul Sanfilippo (Research Associate) Students • Ms Seyhan Yazar (PhD) • Dr Hannah Forward (Masters by research) • Dr Charlotte McKnight (Masters by research)

18 Lions Eye Institute Annual Report 2015 Profile Seyhan Yazar

Researcher wants to bridge the gap between dreams and reality

The intricate world “I am a trainee working in an environmental influences on eye of eye genetics is the apprenticeship mode in disease development in a group stamping ground of LEI preparation to be an independent of young people from the 20-year scientist,” she said. eye health review of the Western Postdoctoral Research Australian Pregnancy Cohort (Raine) Fellow Seyhan Yazar. “One of my main responsibilities is Study and provided a benchmark for to oversee the projects in our unit the relatively “normal” range of eye Seyhan has worked in the Genetics with Professor Mackey and learn parameters. and Population Health research how to manage projects and a group since 2010. laboratory. “Now, taking this to the next step, I aim to work on disease networks “My work is very satisfying,” she “Where possible using my orthoptic and identify new therapeutic targets said. “I know it is the hope of many skills, I help our team with at the molecular level using highly patients suffering from various examinations of the participants specialised computer programs,” debilitating eye diseases and with in our clinical research projects. I she said. every new discovery we are closing also co-supervise medical students a small gap between a dream and a and postgraduate students in their reality.” research projects.”

Seyhan’s main research focus is Seyhan said if scientists were to the genetic and environmental prevent and cure blindness and eye factors in common, complex eye disease, a better understanding of diseases, including myopia, corneal the disease and ageing process was astigmatism, keratoconus and needed. ABOVE glaucoma. She performs statistical Seyhan Yazar is working data analysis, interprets the results In her postdoctoral studies, she to better understand eye and prepares publications. has explored the genetic and disease and ageing

Lions Eye Institute Annual Report 2015 19 Immunology

Immunology

IM20 Immunology

The Division of babies with symptomatic congenital uveitis, both in the setting of infection Immunology comprises CMV and include chorioretinitis, and autoimmunity. four research groups: strabismus and optic atrophy. Up to one third of babies born with Dr Iona Schuster, Assistant Professor Ocular Immunology symptomatic congenital CMV infection Chris Andoniou and Professor Degli- and Autoimmunity develop strabismus. In addition, Esposti are assessing the impact led by Professor John macular scars may lead to loss of of viral infections on the triggering Forrester, Cell Signalling vision. or exacerbation of autoimmune and Apoptosis led by diseases. This work has demonstrated Assistant Professor Understanding how cytomegalovirus the role of viral infection in the Chris Andoniou, Viral causes disease, how the immune development of a Sjogren’s like Immunology led by system responds to this infection, Syndrome. Sjogren’s Syndrome is the and why the virus is not completely second most common autoimmune Dr Jerome Coudert cleared, is essential to designing disease in humans, affecting up to and Experimental preventative and curative therapies for three per cent of the population or Immunology led by this infection. Using a model of human three quarter of a million people in Professor Mariapia cytomegalovirus (HCMV) infection in Australia. In its “mildest” form SS Degli-Esposti. the mouse, the Immunology division is affects the production of tears and addressing these questions. saliva, so people with the disease One of the Division’s main research have constantly dry eyes, which are projects focuses on understanding During 2015 many advances have sore, often sensitive to light, itchy, how a common viral infection affects been made on establishing new in vivo red and feeling as though they have vision. The viral pathogen of interest models that closely mimic the natural sand in them. In work published in is cytomegalovirus. This virus causes history of human eye infections. In the prestigious international journal a persisting infection that can lead these physiological models of viral Immunity, research completed to date to significant systemic disease, as eye infection there is reduced access described how natural killer (NK) cells well as severe ocular complications, of the virus to the eye, however there regulate CD4 T cell responses to limit especially in individuals whose are profound changes in most eye the development of autoimmunity. immune systems are compromised or compartments, including the neural This study has made a number of not fully functional. One such group retina. How these changes affect important discoveries; it has proven are babies. vision, and whether these effects a link between chronic viral infection are temporary or long-term, is being and autoimmune disease, has Cytomegalovirus is the most common investigated. generated a model of the second cause of congenital infection, most common autoimmune disease occurring in 0.2 per cent to 2.4 per An additional focus of our immunology in humans, and has provided critical cent of all live births. Five to 10 per research is inflammatory ocular insights into immune pathways cent of babies with congenital CMV disease or uveitis. Uveitis is an that might be targeted to improve infection are symptomatic. Babies inflammatory disease that affects the treatments for a common and with symptomatic CMV infection at eye, damaging the retina and causing debilitating human condition. birth have a wide spectrum of clinical blindness. Uveitis mainly occurs in disease, including visual impairment the 20-50 year age group, and can Dancing with death: and hearing loss. These problems affect one or both eyes. Uveitis is an Host/Viral interactions important problem and accounts for most often occur as part of a more Apoptosis is an important 10 per cent of blindness in people general sensorineural loss, with other physiological process and of working age in the western world. symptoms comprising microcephaly, dysregulation in apoptotic pathways Little is known about the cause of motor defects and mental retardation. can lead to a number of degenerative uveitis and it remains one of the Indeed, visual problems caused by disorders, including many which most important unsolved problems congenital CMV infection can be due affect the eye. Therefore, a better in ophthalmology. Professor John to either cortical visual impairment understanding of the processes Forrester and Dr Valentina Voigt are and/or optical visual impairment. that regulate apoptosis is critical investigating the development of Ophthalmological abnormalities are to improve the treatment of these reported in a high percentage of diseases, including for example retinal

Lions Eye Institute Annual Report 2015 21 Immunology

degenerative disorders. Assistant function and are regulated in normal we have established a program to Professor Chris Andoniou and Mr and pathologic conditions. investigate complications that occur Peter Fleming have made significant during bone marrow transplantation discoveries in the area of programmed Dr Coudert has reported novel (BMT) and have developed unique cell death or apoptosis. One of their interactions of the murine mouse models. One common major on-going studies aims to cytomegalovirus (MCMV) complication following BMT is ocular investigate the interplay between viral immunoevasin m157 with multiple graft versus host disease (ocular and host proteins which regulate the receptors (both with activating and GVHD). Symptoms of ocular GVHD sensitivity of specific cell populations inhibitory functions) expressed by NK include blurry vision, severe light to apoptotic death. cells. As a result of collaborative work sensitivity, chronic conjunctivitis (pink with two groups located in Melbourne, eye), dry eyes, burning sensation and In related work published in the this work has uncovered an unusual general eye pain. In severe cases, influential journal Plos Pathogen, mode to engage NK cell receptors. ocular surface disease with corneal Assistant Professor Andoniou and The role of other viral immunoevasins perforation can ensue. Our studies Professor Degli-Esposti showed in interfering with anti-viral protection are addressing whether immune- the deleterious consequences of mediated by NK cells is currently mediated mechanisms participate possessing a natural variant of a gene under investigation. In addition, using in the pathology of ocular GVHD, encoding a protein involved in cell a set of genetically recombinant mice and whether this complication is killing. These studies showed that previously generated by his group, exacerbated by concomitant viral mice possessing a naturally occurring Dr Coudert achieved a more precise infection. Ultimately, we aim to variant to granzyme B are highly understanding of the molecular develop improved therapies for this susceptible to infection with MCMV interactions that regulates NK cell important ocular condition. and develop a fulminant pathology. development, differentiation and In collaboration with colleagues functions. Since NK cells are critical Immunology Division at the Peter MacCallum Cancer for the control of viral infections • Head of Division: Professor Centre, work is continuing to assess and malignancies in all mammalian Mariapia Degli-Esposti the mechanism that underlies the species, these studies have uncovered deleterious pathology that results from information that pave the way to ineffective apoptotic responses. manipulating NK cell function for Group Leaders therapeutic purposes. • Professor Mariapia Degli-Esposti Viral escape from NK • Professor John Forrester mediated immunity Investigating the • Assistant Professor profound effects of Graft Christopher Andoniou Dr Jerome Coudert leads a • Dr Jerome Coudert research program aimed at better Versus Host Disease understanding how NK cells, a key cell With our collaborators at the QIMR Research Staff population of early immune responses, Berghofer Medical Research Institute, • Dr Valentina Voigt • Dr Iona Schuster • Dr Monique Ong • Dr Serani van Dommelen • Dr Andrew Lucas • Peter Fleming • Slavica Pervan • Tom Casey

Dr Iona Schuster in the laboratory

22 Lions Eye Institute Annual Report 2015 Molecular Ophthalmology

Molecular Ophthalmology M23 Molecular Ophthalmology

The Human Gene Therapy Members of the Human Gene Therapy team – Trial is the culmination Professor Elizabeth Rakoczy, Director Dr Aaron of the basic research Magno and Associate Professor May Lai work by the Molecular Ophthalmology group.

In December 2015, the results for Articles the rAAV.sFlt-1 Phase 1 clinical trial were published in The Lancet, one of the oldest, best known and most prestigious medical journals in Gene therapy with recombinant adeno-associated vectors the world. for neovascular age-related macular degeneration: 1 year follow-up of a phase 1 randomised clinical trial

Elizabeth P Rakoczy, Chooi-May Lai, Aaron L Magno, Matthew E Wikstrom, Martyn A French, Cora M Pierce, Steven D Schwartz, The paper reported on the results Mark S Blumenkranz, Thomas W Chalberg, Mariapia A Degli-Esposti, Ian J Constable of a one-year follow-up on the new Summary Background Neovascular, or wet, age-related macular degeneration causes central vision loss and represents a major Published Online health problem in elderly people, and is currently treated with frequent intraocular injections of anti-VEGF protein. September 30, 2015 therapy for wet age-related macular http://dx.doi.org/10.1016/ Gene therapy might enable long-term anti-VEGF therapy from a single treatment. We tested the safety of rAAV.sFLT-1 S0140-6736(15)00345-1 in treatment of wet age-related macular degeneration with a single subretinal injection. degeneration (wet AMD). See Online/Comment http://dx.doi.org/10.1016/ Methods In this single-centre, phase 1, randomised controlled trial, we enrolled patients with wet age-related S0140-6736(15)00346-3 macular degeneration at the Lions Eye Institute and the Sir Charles Gairdner Hospital (Nedlands, WA, Australia). Centre for Ophthalmology and Eligible patients had to be aged 65 years or older, have age-related macular degeneration secondary to active Visual Science subfoveal choroidal neovascularisation, with best corrected visual acuity (BCVA) of 3/60–6/24 and 6/60 or better in (Prof E P Rakoczy PhD, This is the first time that work C-M Lai PhD, M E Wikstrom PhD, the other eye. Patients were randomly assigned (3:1) to receive either 1 × 10¹⁰ vector genomes (vg; low-dose Prof M A Degli-Esposti PhD, conceived, executed and written by an rAAV.sFLT-1 group) or 1 × 10¹¹ vg (high-dose rAAV.sFLT-1 group), or no gene-therapy treatment (control group). Prof I J Constable FRANZCO), Randomisation was done by sequential group assignment. All patients and investigators were unmasked. Staff School of Pathology and doing the assessments were masked to the study group at study visits. All patients received ranibizumab at baseline Laboratory Medicine LEI team has been published in (Prof M A French MD), The and week 4, and rescue treatment during follow-up based on prespecified criteria including BCVA measured on the University of Western Early Treatment Diabetic Retinopathy Study (EDTRS) scale, optical coherence tomography, and fluorescein Australia, Crawley, WA, The Lancet. angiography. The primary endpoint was ocular and systemic safety. This trial is registered with ClinicalTrials.gov, Australia; Lions Eye Institute, number NCT01494805. Nedlands, WA, Australia (Prof E P Rakoczy, C-M Lai, A L Magno PhD, M E Wikstrom, Findings From Dec 16, 2011, to April 5, 2012, we enrolled nine patients of whom eight were randomly assigned to C M Pierce RN, receive either intervention (three patients in the low-dose rAAV.sFLT-1 group and three patients in the high-dose Prof M A Degli-Esposti, Outcomes rAAV.sFLT-1 group) or no treatment (two patients in the control group). Subretinal injection of rAAV.sFLT-1 was Prof I J Constable ); University of California, Los Angeles, CA, highly reproducible. No drug-related adverse events were noted; procedure-related adverse events (subconjunctival or USA (Prof S D Schwartz MD); The Molecular Ophthalmology subretinal haemorrhage and mild cell debris in the anterior vitreous) were generally mild and self-resolving. There Stanford University, Palo Alto, was no evidence of chorioretinal atrophy. Clinical laboratory assessments generally remained unchanged from CA, USA (Prof M S Blumenkranz MD); baseline. Four (67%) of six patients in the treatment group required zero rescue injections, and the other two (33%) team completed the first year data Avalanche Biotechnologies, required only one rescue injection each. Inc, Menlo Park, CA, USA (T W Chalberg PhD); and collection for the rAAV.sFlt-1 Phase 2a Interpretation rAAV.sFLT-1 was safe and well tolerated. These results support ocular gene therapy as a potential Sir Charles Gairdner Hospital, Nedlands, WA, Australia long-term treatment option for wet age-related macular degeneration. (Prof I J Constable) trial for an additional 32 patients and Correspondence to: Funding National Health and Medical Research Council of Australia, Richard Pearce Bequest, Lions Save Sight Prof Elizabeth P Rakoczy, Lions Foundation, Brian King Fellowship, and Avalanche Biotechnologies, Inc. Eye Institute, 2 Verdun St, data analysis and reporting Nedlands, 6009 WA, Australia [email protected] Introduction pro-angiogenic and anti-angiogenic factors potentially has started. Age-related macular degeneration is the most common underlying the patho physiology of neovascularisation.8 cause of visual impairment in high-income countries.1 VEGF inhibitors, including pegaptanib sodium,9 LancetThe neovascular, paper or wet, form of the disease is ranibizumab,10,11 and aflibercept,12 are safe and effective characterised by abnormal choroidal blood vessel for slowing disease progression and, in some cases, growth beneath the macula, which is responsible for improving vision. However, such treatments must be Staff high-resolution vision.2 Wet age-related macular administered frequently via intravitreal injection; degeneration leads to rapid vision loss and, when left treatment intervals greater than every 4–8 weeks can • Professor P. Elizabeth Rakoczy untreated, central blindness.3 Excessive secretion of result in rapid vision decline.12–17 When given pro re nata VEGF plays a key part in promoting neovascularisation (PRN) or as needed according to a flexible dosing • Associate Professor May Lai in this disease.4,5 Additionally, downregulation of regimen, patients required seven or more injections per anti-angiogenic factors, such as the naturally occurring year.14,18 Frequent intravitreal injections are associated • VEGF-blockers sFLT-16 and PEDF,7 might also promote with increased cumulative risk of vision-threatening Dr Aaron Magno the disorder, contributing to an imbalance between adverse events, including endophthalmitis19,20 and

www.thelancet.com Published online September 30, 2015 http://dx.doi.org/10.1016/S0140-6736(15)00345-1 1

24 Lions Eye Institute Annual Report 2015 Profile June Walker New gene therapy offers June hope

June Walker was one of support oxygen supply to tissue she is able to do day-today tasks the first people in the when circulation is inadequate. once again, like making a cup of tea world to participate in When too much VEGF is produced it and preparing breakfast. can cause disease, including blood trials of a revolutionary vessel disease in the eye. “There’s a lot of improvement,” gene therapy treatment she said. for wet age-related Current treatment for wet AMD is macular degeneration intensive and intrusive – involving “I can see a lot better than I could do (wet AMD). monthly injections of anti-VEGF but I [still] can’t drive the car and I drugs that limit production of the can’t read,” she said. The science behind the treatment protein. The gene therapy involves began more than 20 years ago when a single injection of a modified “I can see things that I couldn’t see Professor Ian Constable recruited and harmless version of a virus before, and I can see the TV, which molecular ophthalmologist Elizabeth containing a specific gene that is good, but I can’t read the letters Rakoczy to the LEI. stimulates supply of a protein which on it.” then blocks over-production of VEGF. It was the first research in Australia June was a special guest at a using gene therapy in ophthalmology June told Channel 9 in a national morning tea held to thank supporters or any other medical field and was report aired in October, 2015, that of the LEI during 2015. named by the NHMRC in its 10 of her loss of vision resulted in a the best national research projects crushing loss of confidence. in 2005. “I lost all my courage. I didn’t want Wet AMD occurs when there is to go out,” she said. ABOVE an overproduction of the protein June Walker vascular endothelial growth factor Her participation in the trial has led (VEGF) in the retina. VEGF helps to improvement in her vision and

Lions Eye Institute Annual Report 2015 25 Physiology & Pharmacology

Physiology& Pharmacology

P26 Physiology & Pharmacology

During 2015, the It is also proving to be useful in lasers. New areas of research looking Physiology and the non-invasive assessment of at the auto-regulatory capacity of Pharmacology intracranial pressure, an important blood vessels in the eye have been group achieved a issue in traumatic brain injury patients. established. major translational The Physiology and Pharmacology 2015 also saw the expansion of achievement with a new group and collaborating clinicians our translational research using treatment for glaucoma. have published 13 papers in the new imaging techniques to monitor ophthalmic literature. improved retinal blood flow in patients The US-based start-up company undergoing a new treatment for commercialising the technology was During the year Professor Yu accepted occlusive retinal vascular disease. purchased by the multi-national an invitation to join the Editorial pharmaceutical company Allergan. Board of the highest ranked journal Preliminary work was completed in This ensures the word-wide marketing in ophthalmology, Progress in Retinal preparation for four NHMRC grant of this technology and clinical trials and Eye Research. He has been applications in 2016. are already demonstrating significant appointed for five years. advantages of the procedure compared to conventional surgery. Professor Yu also presented the highly Staff It is very likely that the advanced prestigious “Ida Mann Lecture” at the • Professor Dao-Yi Yu – Director technology developed by our team will Australia and New Zealand College of • Professor Ian McAllister be used worldwide. Ophthalmology meeting in Wellington. • Professor Stephen Cringle • Professor William Morgan Research into ultrafine intraocular The group completed the re- • Associate Professor Er-Ning Su surgery has also progressed well. establishment of its laboratories after • Associate Professor Paula Yu This involves a laser-based technique relocating to allow works on a ground • Associate Professor for cutting a micron level target floor clinical facility to commence. Sarojini Vijayasekaran tissue from the eye. Currently most • Dean Darcey intraocular surgeries use mechanical We continued with our collaborative • Kathryn Morgan instruments which have less precision project with a team in Canada • Dr Chandra Balaratnasingam and could potentially cause unwanted looking at a new form of ocular • Graeme Hewitt damage to normal tissue. coherence tomography which can • Fraser Cringle view the human retinal vasculature Professor Ian McAllister, Professor at the capillary level. We were able to Dao-Yi Yu and their collaborators demonstrate that the entire vascular are working on a new treatment for tree can be imaged in real time branch retinal vein occlusion. Initial and non-invasively using low level results are looking encouraging. This project is a fine example of translation of laboratory-based research into a clinical setting. New imaging technologies that can measure blood flow in the eye are being used to assess the improvement in blood flow following treatment.

Professor William Morgan is being assisted by Professor Yu and his team to develop new methods of analysing pulsation of the retinal vein near the optic disk. This is proving to be a new diagnostic technique for predicting glaucoma progression. The Physiology and Pharmacology team

Lions Eye Institute Annual Report 2015 27 Physiology & Pharmacology

Ophthalmic world seeks Professor Yu’s expertise

In 2015, Professor Dao-Yi Professor Yu was in the spotlight in This lecture is named after Ida Mann, Yu accepted an invitation another way during the year when he who was the first female professor at to join the Editorial Board delivered the Ida Mann Lecture at the Oxford University before immigrating RANZCO annual scientific meeting in to Western Australia where she of the highest ranked Wellington, New Zealand. established a notable career as an journal in ophthalmology ophthalmologist and was an advocate Progress in Retinal His lecture Research discoveries to for improved health care among and Eye Research. clinical application: developing a new Indigenous people. glaucoma filtration surgery outlined The aim of the journal is to publish the development of the Xen glaucoma high impact review articles in tube. ophthalmology/eye research written by experts from around the world. There was considerable interest in this device when it was presented Cutting edge eye research that is by Aquesys at the World Glaucoma likely to find a clinical application is Conference in June. particularly welcomed by this highly prestigious journal.

This image, used by Professor Yu during his Ida Mann Lecture, is a schematic diagram of the tiny drainage tube which lowers the pressure in the eyes of glaucoma patients. The tube drains excess fluid from the inside of the eye

28 Lions Eye Institute Annual Report 2015 Profile Dr Paula Yu

The eye “amazing and delicate”

After more than 20 Paula’s research investigates “If we have a more comprehensive years at the LEI, the the function and structure of understanding of the fundamental eye still holds great ocular vascular endothelium and variation that exists normally, microvasculature in normal and how different cell types adapt in fascination for Paula Yu. disease states. response to environmental (macro and micro) stresses, we have a Paula joined the LEI in 1993 and The main technique used for better chance of understanding the now works as a Senior Research structural studies are histology and disease processes and knowing Fellow (Research Associate confocal microscopy while functional how to approach the development of Professor) with The University of studies are done using isolated eye treatment strategies. Western Australia. Within the LEI, perfusion technique. she is attached to the Physiology “It is my hope to contribute to and Pharmacology Group. In collaboration with colleagues, she bettering the lives of others through is also involved in studies that use research.” The opportunity to work with isolated vessel perfusion and laser “wonderful and good people” has ablation techniques. Investigations given Paula great work satisfaction. involving animal eyes and human donor eyes have also lead to a “I have many reasons to love what greater understanding of the I do - the chance to be invigorated structure and function of the ocular and encouraged by bright minds, the microvasculature. opportunity to apply my knowledge to further understanding of this “Many of the blinding diseases carry amazing and delicate organ and the a vascular component,” Paula said. opportunity to realise the vastness in ABOVE variations between one micro-region Dr Paula Yu to another,” she said.

Lions Eye Institute Annual Report 2015 29 Ocular Tissue Engineering Laboratory

Ocular Tissue Engineering Laboratory

O30 Ocular Tissue Engineering Laboratory

Since its inception With a focus on clinical translation, technology that can remove the five years ago, the we examined potential sources of mutation from retinal cells. These LEI’s Ocular Tissue autologous (patient’s own) retinal treatments will be unique for each pigment epithelial (RPE) cells, such patient as there are over 4000 Engineering Laboratory as the induced pluripotent stem different types of mutations in 260 (OTEL) has continued to cells (iPSC) and human limbal stem genes that cause IRD. investigate the causes cells for RPE patch engineering. In of - and develop new addition, we have been developing Our laboratory is currently banking treatments for - the methods for direct reprogramming patient tissue samples harbouring a most common blinding of RPE cells from patient cells using wide range of known and potential diseases in Australia: retinal transcription factors. Finally, we retinal disease causing mutations. age-related macular have tested novel carrier substrates These patients are also tracked six- for RPE patch engineering, including monthly to allow us to measure their degeneration and bioengineered Bruch’s-like membrane disease progression accurately using inherited retinal diseases. and a primitive microvasculature advanced retinal imaging devices. capable of integrating with the host Our research streams include stem choroid. No-dye angiography and cell therapy, disease modelling, cone cell imaging analyses of new structural Although not at clinical trial stage The retina clinic acquired a state- retinal imaging modalities (no- yet, we are excited by the potential of-the-art adaptive optics retinal dye angiography and cone cell prospect of being able to generate camera that can allow us to see imaging) and functional imaging of RPE cells from the patient’s own cells individual cone cells within the the retina (autofluorescence and on the cornea. Further testing and retina of a patient. Using technology microperimetry). validation work is ongoing. borrowed from the Hubble telescope, optical imperfection of the human Research projects: Disease modelling of eye is measured and corrected inherited retinal diseases instantaneously to improve resolution Stem cell therapy for Inherited retinal disease (IRD), down to three micrometres. Our macular degeneration such as retinitis pigmentosa and imaging team has developed and Age-related macular degeneration Stargardts disease, is the most validated a novel circle detection (AMD) is the most common cause common cause of blindness in the algorithm that can improve on of blindness in the Western world. A working age group in Australia. In current automated methods of cone common final pathway in AMD is the 2015, we started a prospective trial counting. We have also developed a degeneration of specialised layers called the Western Australian Retinal classification system for describing of support cells and extracellular Degeneration Study to investigate image artefacts in non-invasive matrix situated between the retina the use of patient skin cells to model vascular imaging of the retinal blood and the choroid; consisting of the their eye disease. The stem cells vessels using optical coherence retinal pigment epithelium (RPE), generated from skin cells can be tomography angiography. This type of Bruch’s membrane (BrM) and capillary used for examining the effect of gene imaging technique does not require network of the choroid. Our aim is to mutation on retina development and dye injection for visualisation of blood develop a cure for AMD by replacing cell survival. Personalised treatment vessels. these structures using the patient’s can be developed by using these own cells. cells to screen for potentially effective drugs and test the new gene editing

Superficial Deep capillary plexus capillary plexus Outer retina Choriocapillaris Sattler’s layer Haller’s layer

Examples of no-dye angiography

Lions Eye Institute Annual Report 2015 31 Ocular Tissue Engineering Laboratory

Microperimetry and • ANZSRS Congress, Local/national autofluorescence imaging Sydney, Jul 2015 • Professor Rod Dilley, Ear Sciences In 2015, we published several • Retina Australia National Centre, School of Surgery, UWA technical reports of using Congress, Melbourne, Oct 2015 • Professor Robyn Guymer, Centre microperimetry, a specialised form of • Annual Medicines update, for Eye Research Australia, visual field test, to describe features Pharmaceutical Society of University of Melbourne of unusual clinical conditions such as Australia, Oct 2015 • Professor Mel Ziman, Edith torpedo maculopathy, accidental laser • Lions Club District Convention, Cowan University, Perth injury and posterior cortical atrophy Perth, Oct 2015 • A/Prof Aron Chakera, Department masquerading as glaucoma. Our of Nephrology, Sir Charles validation study of microperimetry has Research Team Gairdner Hospital, Perth been completed and variability of the • A/Prof Seng Khee Gan, device was published. We also started Staff Department of Endocrinology, examining patients with distortion • Dr Fred Chen (Director) Royal Perth Hospital, Perth and blind spots in their central vision • Dr Samuel McLenachan • A/Prof Damien Harkin, School using the adaptive optics retinal (Senior Scientist) of Biomedical Sciences, camera to explore the relationship • Dr Dana Zhang (Senior Scientist) Faculty of Health, QUT and between cone cell mosaic and these • Dr Xiao Zhang (Research Associate) Queensland Eye Institute symptoms. We showed that near • Dr Danuta Bukowska (Post- • Dr Elin Gray, Edith Cowan infrared light may be more useful doctoral Research Fellow) University, Perth than blue light autofluorescence • Dr Evan Wong (Research Associate) • Dr Kristen Nowak, Perkins imaging in the assessment and • Dr Avenell Chew Institute, Perth monitoring of progression in dry (Research Associate) • Dr John De Roach, macular degeneration. As a result of • Ms Ivy Tang (Research Orthoptist) Australian Inherited Retinal this study, we purchased a dedicated • Ms Jade Knapp (Research Disease Registry, Perth near infrared light retinal camera that Administrator) will enable IRD and AMD patients Prizes to be monitored more comfortably Visiting researchers and doctors • High Flyers Think Tanks • Dr Ling Zhang (Post- and accurately for their disease Award, Australian Academy doctoral research fellow) progression and treatment response. of Science. 2015 • Dr Erwei Hao (Post-doctoral • Delegate at the Think Tank: The research fellow) Stem Cell Revolution: Lesson Invited talks and • Dr Jinping Wang (Post- and Imperative for Australia presentations: doctoral research fellow) • Chen FK (travel and • Dr Wei Chen (Post-doctoral International accommodation expenses) research fellow) • Lions Eye Institute, Perth Australia • ARVO conference, Denver, • Infrastructure Grant, Health USA, May 2015 Visiting Professor and Speakers Department of Western • APVRS Annual Congress, • Dr Peter Van Wijngaarden, Centre Australia, Australia. 2015 Sydney, Jul 2015 for Eye Research Australia • Cone counting software • UWA-UMGU-UCL Collaborative development to analyse retinal Research Meeting, Perth, Nov 2015 Research collaborators images from adaptive optics camera • RANZCO Annual Congress, • Chen FK (AUD $10,000) Wellington, Nov 2015 International • Lions Eye Institute, Perth Australia • Professor Lyndon Da Cruz, National and State Moorfields Eye Hospital, • Optometrist Association Australia London - Vision Eye Institute Donations in 2015 (WA), Perth, Feb 2015 • Dr Michael Edel, Research • Miocevich Family, Autoimmune • RANZCO ophthalmological Institute of Hospital Val d retinopathy fellowship colloquium, Mar 2015 Hebron, Barcelona, Spain • Saleeba Family, Disease modelling • Centre for Cell Therapy and • Dr Robert Johnston, Cheltenham using iPSC and CRISPR technology Regenerative Medicine, General Hospital, Cheltenham, UK • Other donations were gratefully Symposium, Perth, Apr 2015 received from the Hogg, Penny, Reid and Taylor families.

32 Lions Eye Institute Annual Report 2015 Miocevich Fellowship

Miocevich Fellowship

LEI researchers are The research is being inspired and “It is our wish that this new investigating one of the financially supported by Brad and research, which will be conducted rarest and most baffling Carolyn Miocevich. Mrs Miocevich within Dr Fred Chen’s OTEL group, was in her 30s when she began to will help others who may be affected eye disorders, Auto- lose her eyesight. by this disorder now and in the immune Retinopathy future.” or AIR, thanks to the The couple’s support saw the support of Perth’s creation of the position of Miocevich Miocevich family. Retinal Fellow in 2015.

Still controversial and difficult “She went from being able to read to diagnose, it is believed that to the point where she couldn’t ABOVE antibodies generated by the body drive, then walk without assistance. Dr Fred Chen examines to fight an unrelated infection or It was a dramatic change,” Carolyn Miocevich’s eyes illness attack and damage the retina, Mr Miocevich said. while her husband Brad resulting in rapid vision loss. looks on

Lions Eye Institute Annual Report 2015 33 Lions Outback Vision

Eye care delivered ... rain, hail or shine

When your office is the outback, you have to be prepared for anything.

Lions Outback Vision optometrist Stephen Copeland delivers eye care to more than 20 regional and remote communities across the Pilbara and Kimberley.

While he usually confines more ambitious journeys to the dry season, there are times when a foray into the wet is unavoidable. One trip to the Tanami communities south of Halls Creek saw Stephen hitch a ride on the mail plane from Kununurra.

“We climbed and manoeuvred around bulging clouds that were foreshadowing what was to come,” he said.

“I looked out the port-side window of the Cessna 208B Caravan to see the rim of Wolf Creek Crater in the distance as we started descending into Billiluna.

The Lions Outback Vision Van being fitted out in Brisbane “After buzzing the community we arced over Sturt Creek, its banks bleeding milo-coloured water over the landscape. I saw the bridge standing proud of the water. It was Li34 Profile Stephen Copeland Lions Outback Vision

Our Vision To eliminate preventable blindness and vision loss in people living in regional and remote Western Australia Our mission To achieve leadership in clinical practice and scientific research in the prevention of blindness and vision loss through: • delivering equitable, timely and cost effective outreach services my sign that I should disembark in “I continued to Mulan but not so that West Australians can Billi. I started my optometry clinic before negotiating a section of enjoy better health outcomes as planned.” road that could have passed for a irrespective of where they live rice-paddy.” • providing a coordinated eye In the early afternoon, the heavens health service integrating retinal opened and it rained for three screening, optometry and hours. ophthalmology services • improving access to best practice “The ground around the clinic eye health services in regional and was now a moving sheet of remote WA water,” he said. “I learned through hearing the nurse in the next room • translating best clinical practice singing ‘there were 3 in the bed’ into scientific research that I would have to overnight in The weather prevented the plane Billiliuna because my ride from from landing so it was back to Activities Balgo was no longer able to get Balgo by car for a Broome flight In 2015, Lions Outback Vision (LOV) through.” the next day. saw continued growth in terms of staff and service delivery. The next day, Stephen set off for “The pilot weaved around storm Balgo by car – a drive he said was cells with the skill of a Skywalker In 2014, LOV treated 5969 patients. In more suited to an amphibious and landed us safely in Broome,” 2015, this grew to 6965 patients. Of vehicle. He saw diabetic and Stephen said. post-operative patients who had this, 1203 were for retinal screening, been treated for cataracts during “It had been a memorable few 1861 for optometry appointments, a “surgery blitz” in Kununurra in days in the north where the 3335 for ophthalmology consults and October 2015. Kimberley had turned on a show.” 566 for telehealth consultations.

The next day involved a drive to Highlights the Mulan Community for another In 2015, LOV secured funding to clinic before a scheduled charter design, construct and fit-out a new flight back to Broome. “A flowing mobile eye health clinic – the Lions creek forced me to stop,” he said. Outback Vision Van (LOVV). The Van “It was the first time I’d ever had ABOVE will be launched in 2016 and will to remove my shoes and socks to Stephen Copeland back visit 16 sites throughout regional and check a stream before going to at LOV in Perth remote Western Australia. work.

Lions Eye Institute Annual Report 2015 35 Lions Outback Vision

The LOV Van will be the first mobile Lions Outback Vision • Terri Leverty – Lions Outback clinic to showcase the protocols and Van supporters Vision Van Logistics Manager principles developed by the Aboriginal • Alex Ramirez – Pilbara Diabetic Health Council of Western Australia for • State Government of Eye Health Coordinator Western Australia outback service delivery. • Kitty Shakur – resident • Lotterywest It will have the capacity to treat • Ben Host - resident • Commonwealth Government 200 patients per week providing • Verity Moynihan – DR screening • Lions Eye Institute comprehensive optometry and • Veronica Harvey – ophthalmology care for cataracts, • Device Technologies Administration Assistant refractive error, trachoma, glaucoma • Telstra and diabetic retinopathy. Students Staff • Richard O’Halloran In June 2015, LOV Director Associate • McCusker Director Associate Professor Angus Turner was appointed Professor Angus Turner inaugural McCusker Director, Lions • Josephine Muir – Manager Outback Vision. • Julie Maiolo – Outreach Administrator The position is an appointment of • Chathri Amaratunge – Fred The University of Western Australia Hollows Foundation Fellow and is the first academic role within • Helen Wright – Optometry the University to specifically focus on Coordinator reducing high rates of preventable • Stephen Copeland – Optometrist blindness and vision loss in the • Angela Aicken – Statewide Kununurra Indigenous population. Associate Telehealth Manager Derby Professor Turner was also named “first among equals” in the 2015 Broome 40Under40 awards. Fitzroy Port Hedland Halls Crossing New projects in 2016 Karratha Creek Does real time tele-ophthalmology provide comparable accuracy to face- Roebourne to-face consultations for the diagnosis and recommended treatment for Newman common eye health conditions?

How accurate is a new visual field iPad application in visual field testing Wiluna in patients with glaucoma and neuro- ophthalmic diseases? Leonora Grants and Funding This map shows the towns the • Lions Eye Institute Lions Outback Kalgoorlie • The University of Western Australia Vision Van will Perth • McCusker Charitable Foundation travel to in 2016 • The RANZCO Eye Foundation Katanning • The Fred Hollows Foundation Esperance

Albany

36 Lions Eye Institute Annual Report 2015 Profile Veronica Harvey

Outback work accords with Veronica’s vision

There is a reason for chasing up referrals, Medicare This will hopefully ensure problems Veronica Harvey’s face details, booking theatre dates with are identified earlier and help to is so familiar to many. patients, typing letters, making prevent issues that may cause long appointments and other general term vision damage. She has worked in a office duties. range of roles across the “I have worked at the LEI for four LEI, from ground floor Having lived in the Kimberley, years and I know the staff here are receptionist to positions Veronica finds her new role very continually working toward providing in the Glaucoma and satisfying. an efficient, friendly and professional Oculoplastics clinics. service to those who have issues “I know how important it is to have with their sight. Now, she has taken on the role of access to specialist health care so administrative assistant with Lions it is extremely rewarding to be part “The aim is always to do what is Outback Vision – the LEI’s outreach of a team that aims to provide an best for the patient.” arm which delivers crucial eye excellent level of care within the health services to some of the most community whenever possible,” remote parts of Western Australia. Veronica said.

Veronica supports the coordination “Outback Vision has given me an of clinics all over the State. Regular opportunity to assist in the work consultations are also conducted via that is being done to bring eye care ABOVE Telehealth and she is responsible services to people in the outback Veronica Harvey... understands the and regional country areas. importance of delivering services where people live

Lions Eye Institute Annual Report 2015 37 Clinical Trials

Clinical Trials

C38 Clinical Trials

The LEI Clinical Trials There is currently no proven therapy The inflammation may affect only one Department continues for dry AMD but the LEI is trialling both eye, but in many cases, both eyes are to grow with over laser-based and novel drug based involved and symptoms may include approaches. decreased vision, eye pain, ocular 40 studies currently redness, tearing, photophobia (pain underway and is Dry AMD may progress to wet AMD, and/or sensitivity to light), elevated one of the largest which is currently treated with an intraocular pressure, intraocular ophthalmological anti-VEGF (Vascular Endothelial scarring, macular oedema, and even clinical trials research Growth Factor) therapy. Science has vessel occlusion. Uveitis can lead to centres in the world. made great steps in this area and vision loss. we are currently looking at improved We conduct a wide range of clinical therapeutic approaches and novel We are currently investigating the trials, including the testing of new compounds for AMD treatment. impact of novel anti-TNF monoclonal drugs or devices, the collection of antibodies alone or in combination information from patients to better Retinal Vein Occlusion with high-dose corticosteroids for understand a particular ophthalmic Retinal vascular diseases such as vein active or inactive non-infectious condition and audits of patient medical occlusions can cause significant visual intermediate, posterior, or pan-uveitis. notes to establish treatment outcomes impairment. In Central Retinal Vein and ways in which patient outcomes Occlusion (CRVO), there is a build-up Glaucoma and Ocular may be improved. of fluid and leakage from the affected hypertension blood vessel resulting in the distortion Open angle glaucoma is an eye Our approach enables patients with of the central vision. Branch Retinal condition in which the pressure in specific eye disorders, or previously Vein Occlusion (BRVO) can also the eye results in damage to the untreatable eye conditions, access result in leakage of fluid and visual optic nerve and loss of vision. Ocular to new treatments and therapeutic disturbances are in the region of hypertension results when pressure approaches well before they are retina supplied by the affected vessel. in the eye is abnormally high and available to the general public. The LEI is involved in ongoing trials there is a risk of the development for both CRVO and BRVO, refining of glaucoma. Treatments for both All trials run by the group are subject treatment protocols and regimes. conditions aim to lower the pressure to the approval of a Human Research in the eye. At the LEI we are hoping Ethics Committee and comply with Ocular Inflammatory to identify new medications which stringent national and international are more effective at treating both regulations and guidelines. Disease Ocular inflammatory diseases, such glaucoma and ocular hypertension and also easier to use. New therapies for retinal conditions, as uveitis, usually involve inflammation especially dry AMD were the main affecting the structures in the eye. focus of clinical trials during 2015, but we are also developing studies investigating new approaches for glaucoma. Novel treatments for dry AMD Age-related macular degeneration (AMD) is a leading cause of vision loss in older people. There are two types of the disease – dry and wet AMD. Dry AMD is the most common type of macular degeneration, affecting 90 per cent of people with the condition. TCentral Retinal Vein Occlusion (vascular block) Drusen in the retina

Lions Eye Institute Annual Report 2015 39 Clinical Trials

Non-treatable Eye Diseases We continue to study Macular telangiectasia type 2 (MacTel), a rare degenerative condition of the macula that may cause progressive loss of vision. Currently, there is no effective treatment for MacTel.

The continued success of Clinical Research at the LEI is only made possible by the study participants who volunteer their time and are happy to take part in our studies and the dedication and professionalism of our clinicians, nurses, coordinators and staff. The Clinical Trials team Clinical Research Manager • Tracey-Anne Dickens Clinical Trial Coordinators • Holly Brown • Toni Busby • Amelia Jason • Gareth Lingham • Rachel Matthews • Richard McKeone • Cora Pierce • Lynne Smithies • Jordanna Wilson Clinical Trials Administration Diana Bowman Dedicated contact line (08) 9381 0750 More information • [email protected]

40 Lions Eye Institute Annual Report 2015 Profile Cora Pierce ‘Golden patients’ why Cora’s work is so rewarding

Getting a new treatment has driven medical researchers at the Cora’s role has also involved liaison or even cure for an LEI to seek new treatments. with the theatres and clinics, taking eye disease from the bloods, doing fluorescein angiograms Cora’s job involves guiding patients and ECGs, family and GP liaison. laboratory bench to with wet AMD through the trial She must ensure the trial follows the the bedside involves process. strict guidelines set up by the Gene many people. Technology Regulator of Australia. “The most rewarding part of my job is Not least of those are the people who that all 40 of my patients see me as Cora also works at Royal Perth participate in clinical trials. Without a friend who is looking after their best Hospital trauma theatres on night them, medical researchers could interests,” she said. shifts. never prove a new therapy is safe and effective. “I know all the intricate details of their As well as bringing passion to her day-to-day lives and although the job work, Cora brings considerable That is the reason why the LEI’s has been the most demanding work experience. clinical trial coordinator/research that I have ever had to do, it is also nurse Cora Pierce calls such people the most rewarding. Trained at the renowned Moorfields “golden patients.” Eye Hospital in London as an “Research patients are ‘golden ophthalmic nurse, she became its first After joining the LEI in 2011, she patients’ and I like to think that my vitreoretinal research coordinator in began recruiting patients for the LEI’s interactions with them are indicative the late 1990s. landmark gene therapy trial for wet of that.” Aged Related Macular Degeneration (AMD). The human gene therapy trial has involved the injection of a gene Wet AMD is the most common cause therapy into the eyes of patients with of blindness in the developed world, wet AMD, a procedure done at Sir causing rapid and devastating vision Charles Gairdner Hospital. LEFT loss. Its social and economic costs Cora with a patient

Lions Eye Institute Annual Report 2015 41 Publications

Publications

P42 Publications

Genetics and Yang, P. Frezzotti, S. Kinoshita, J. J. D. Faul, W. Zhao, T. M. Bartz, M. P. Population Health H. Fingert, M. Inatani, K. Tashiro, A. Concas, N. Franceschini, S. Enroth, Reis, D. P. Edward, L. R. Pasquale, V. Vitart, S. Trompet, X. Guo, D. I. 1. Aung, T., M. Ozaki, T. Mizoguchi, T. Kubota, J. L. Wiggs, F. Pasutto, F. Chasman, J. R. O’Connel, T. Corre, R. R. Allingham, Z. Li, A. Haripriya, Topouzis, M. Dubina, J. E. Craig, N. S. S. Nongmaithem, Y. Chen, M. S. Nakano, S. Uebe, J. M. Harder, Yoshimura, P. Sundaresan, S. W. John, Mangino, D. Ruggiero, M. Traglia, A. A. S. Chan, M. C. Lee, K. P. Burdon, R. Ritch, M. A. Hauser and C. C. Khor E. Farmaki, T. Kacprowski, A. Bjonnes, Y. S. Astakhov, K. K. Abu-Amero, J. (2015). “A common variant mapping A. van der Spek, Y. Wu, A. K. Giri, C. Zenteno, Y. Nilgun, T. Zarnowski, to CACNA1A is associated with L. R. Yanek, L. Wang, E. Hofer, C. A. M. Pakravan, L. A. Safieh, L. Jia, Y. susceptibility to exfoliation syndrome.” Rietveld, O. McLeod, M. C. Cornelis, C. X. Wang, S. Williams, D. Paoli, P. G. Nat Genet 47(4): 387-392. IF = 29.3 Pattaro, N. Verweij, C. Baumbach, A. Schlottmann, L. Huang, K. S. Sim, J. N. Abdellaoui, H. R. Warren, D. Vuckovic, Foo, M. Nakano, Y. Ikeda, R. S. Kumar, 2. Awadalla, M. S., J. H. Fingert, H. Mei, C. Bouchard, J. R. Perry, S. M. Ueno, S. Manabe, K. Hayashi, S. B. E. Roos, S. Chen, R. Holmes, Cappellani, S. S. Mirza, M. C. Benton, Kazama, R. Ideta, Y. Mori, K. Miyata, S. L. Graham, M. Chehade, A. U. Broeckel, S. E. Medland, P. A. Lind, K. Sugiyama, T. Higashide, E. Chihara, Galanopolous, B. Ridge, E. Souzeau, G. Malerba, A. Drong, L. Yengo, L. K. Inoue, S. Ishiko, A. Yoshida, M. T. Zhou, O. M. Siggs, A. W. Hewitt, F. Bielak, D. Zhi, P. J. van der Most, Yanagi, Y. Kiuchi, M. Aihara, T. Ohashi, D. A. Mackey, K. P. Burdon and J. E. D. Shriner, R. Magi, G. Hemani, T. T. Sakurai, T. Sugimoto, H. Chuman, F. Craig (2015). “Copy number variations Karaderi, Z. Wang, T. Liu, I. Demuth, Matsuda, K. Yamashiro, N. Gotoh, M. of TBK1 in Australian patients with J. H. Zhao, W. Meng, L. Lataniotis, S. Miyake, S. Y. Astakhov, E. A. Osman, primary open-angle glaucoma.” Am J W. van der Laan, J. P. Bradfield, A. R. S. A. Al-Obeidan, O. Owaidhah, L. Al- Ophthalmol 159(1): 124-130 e121. Wood, A. Bonnefond, T. S. Ahluwalia, Jasim, S. Al Shahwan, R. A. Fogarty, P. IF = 3.9 L. M. Hall, E. Salvi, S. Yazar, L. Leo, Y. Yetkin, C. Oguz, M. R. Kanavi, 3. Cuellar-Partida, G., H. Carstensen, H. G. de Haan, M. Abney, A. N. Beni, S. Yazdani, E. L. Akopov, K. U. Afzal, M. A. Allison, N. Amin, F. W. Y. Toh, G. R. Howell, A. C. Orr, Y. Goh, Springelkamp, S. E. Lucas, S. Yazar, A. W. Hewitt, A. I. Iglesias, Asselbergs, S. J. Bakker, R. G. Barr, W. Y. Meah, S. Q. Peh, E. Kosior- S. E. Baumeister, D. J. Benjamin, Jarecka, U. Lukasik, M. Krumbiegel, G. W. Montgomery, N. G. Martin, C. E. Pennell, E. M. van Leeuwen, S. Bergmann, E. Boerwinkle, E. P. E. N. Vithana, T. Y. Wong, Y. Liu, A. E. Bottinger, A. Campbell, A. Chakravarti, Koch, P. Challa, R. M. Rautenbach, D. V. J. Verhoeven, A. Hofman, A. G. Uitterlinden, W. D. Ramdas, R. C. Y. Chan, S. J. Chanock, C. Chen, Y. A. Mackey, A. W. Hewitt, P. Mitchell, D. Chen, F. S. Collins, J. Connell, A. J. J. Wang, A. Ziskind, T. Carmichael, Wolfs, J. R. Vingerling, M. A. Brown, R. A. Mills, J. E. Craig, C. C. Klaver, C. M. Correa, L. A. Cupples, G. D. Smith, G. R. Ramakrishnan, K. Narendran, R. Davies, M. Dorr, G. Ehret, S. B. Ellis, Venkatesh, S. Vijayan, P. Zhao, X. van Duijn, K. P. Burdon, S. MacGregor and D. A. Mackey (2015). “WNT10A B. Feenstra, M. F. Feitosa, I. Ford, C. Chen, D. Guadarrama-Vallejo, C. S. Fox, T. M. Frayling, N. Friedrich, Y. Cheng, S. A. Perera, R. Husain, exonic variant increases the risk of keratoconus by decreasing corneal F. Geller, G. Scotland, I. Gillham- S. L. Ho, U. C. Welge-Luessen, C. Nasenya, O. Gottesman, M. Graff, Mardin, U. Schloetzer-Schrehardt, A. thickness.” Hum Mol Genet 24(17): 5060-5068. IF = 6.4 F. Grodstein, C. Gu, C. Haley, C. J. M. Hillmer, S. Herms, S. Moebus, M. Hammond, S. E. Harris, T. B. Harris, M. Nothen, N. Weisschuh, R. Shetty, 4. Gharahkhani, P., K. P. Burdon, A. W. N. D. Hastie, N. L. Heard-Costa, K. A. Ghosh, Y. Y. Teo, M. A. Brown, I. Hewitt, M. H. Law, E. Souzeau, G. W. Heikkila, L. J. Hocking, G. Homuth, J. Lischinsky, G. T. Blue Mountains Montgomery, G. Radford-Smith, D. A. J. Hottenga, J. Huang, J. E. Huffman, Eye Study, C. Wellcome Trust Case Mackey, J. E. Craig and S. MacGregor P. G. Hysi, M. A. Ikram, E. Ingelsson, A. Control, J. G. Crowston, M. Coote, (2015). “Accurate Imputation-Based Joensuu, A. Johansson, P. Jousilahti, B. Zhao, J. Sang, N. Zhang, Q. Screening of Gln368Ter Myocilin J. W. Jukema, M. Kahonen, Y. You, V. Vysochinskaya, P. Founti, A. Variant in Primary Open-Angle Kamatani, S. Kanoni, S. M. Kerr, N. M. Chatzikyriakidou, A. Lambropoulos, E. Glaucoma.” Invest Ophthalmol Vis Sci Khan, P. Koellinger, H. A. Koistinen, Anastasopoulos, A. L. Coleman, M. R. 56(9): 5087-5093. IF = 3.4 M. K. Kooner, M. Kubo, J. Kuusisto, J. Wilson, D. J. Rhee, J. H. Kang, I. May- Lahti, L. J. Launer, R. A. Lea, B. Lehne, 5. Joshi, P. K., T. Esko, H. Mattsson, Bolchakova, S. Heegaard, K. Mori, W. T. Lehtimaki, D. C. Liewald, L. Lind, M. N. Eklund, I. Gandin, T. Nutile, A. U. L. Alward, J. B. Jonas, L. Xu, J. M. Loh, M. L. Lokki, S. J. London, S. J. Jackson, C. Schurmann, A. V. Smith, Liebmann, B. Chowbay, E. Schaeffeler, Loomis, A. Loukola, Y. Lu, T. Lumley, A. M. Schwab, F. Lerner, N. Wang, Z. W. Zhang, Y. Okada, A. Stancakova,

Lions Eye Institute Annual Report 2015 43 Publications

Lundqvist, S. Mannisto, P. Marques- J. Sinisalo, P. Knekt, M. Johannesson, A. D. Paterson, J. E. Bailey-Wilson, J. Vidal, C. Masciullo, A. Matchan, R. A. P. K. Magnusson, A. Hamsten, R. A. Guggenheim and C. Consortium Mathias, K. Matsuda, J. B. Meigs, C. Schmidt, I. B. Borecki, E. Vartiainen, (2015). “Genome-wide association Meisinger, T. Meitinger, C. Menni, F. D. M. Becker, D. Bharadwaj, K. L. study for refractive astigmatism D. Mentch, E. Mihailov, L. Milani, M. Mohlke, M. Boehnke, C. M. van Duijn, reveals genetic co-determination with E. Montasser, G. W. Montgomery, A. D. K. Sanghera, A. Teumer, E. Zeggini, spherical equivalent refractive error: Morrison, R. H. Myers, R. Nadukuru, P. A. Metspalu, P. Gasparini, S. Ulivi, the CREAM consortium.” Hum Genet Navarro, M. Nelis, M. S. Nieminen, I. C. Ober, D. Toniolo, I. Rudan, D. J. 134(2): 131-146. IF = 4.8 M. Nolte, G. T. O’Connor, A. Ogunniyi, Porteous, M. Ciullo, T. D. Spector, C. S. Padmanabhan, W. R. Palmas, J. Hayward, J. Dupuis, R. J. Loos, A. F. 7. Li, Z., R. R. Allingham, M. Nakano, S. Pankow, I. Patarcic, F. Pavani, P. Wright, G. R. Chandak, P. Vollenweider, L. Jia, Y. Chen, Y. Ikeda, B. Mani, L. J. A. Peyser, K. Pietilainen, N. Poulter, I. A. R. Shuldiner, P. M. Ridker, J. I. Chen, C. Kee, D. F. Garway-Heath, S. Prokopenko, S. Ralhan, P. Redmond, Rotter, N. Sattar, U. Gyllensten, K. Sripriya, N. Fuse, K. K. Abu-Amero, S. S. Rich, H. Rissanen, A. Robino, L. E. North, M. Pirastu, B. M. Psaty, D. C. Huang, P. Namburi, K. Burdon, M. Rose, R. Rose, C. Sala, B. Salako, R. Weir, M. Laakso, V. Gudnason, S. A. Perera, P. Gharahkhani, Y. Lin, V. Salomaa, A. P. Sarin, R. Saxena, H. A. Takahashi, J. C. Chambers, J. S. M. Ueno, M. Ozaki, T. Mizoguchi, S. Schmidt, L. J. Scott, W. R. Scott, B. Kooner, D. P. Strachan, H. Campbell, J. R. Krishnadas, E. A. Osman, M. C. Sennblad, S. Seshadri, P. Sever, S. N. Hirschhorn, M. Perola, O. Polasek Lee, A. S. Chan, L. S. Tajudin, T. Do, Shrestha, B. H. Smith, J. A. Smith, N. and J. F. Wilson (2015). “Directional A. Goncalves, P. Reynier, H. Zhang, Soranzo, N. Sotoodehnia, L. Southam, dominance on stature and cognition R. Bourne, D. Goh, D. Broadway, R. A. V. Stanton, M. G. Stathopoulou, in diverse human populations.” Nature Husain, A. K. Negi, D. H. Su, C. L. Ho, K. Strauch, R. J. Strawbridge, M. J. 523(7561): 459-462. IF = 41.5 A. A. Blanco, C. K. Leung, T. T. Wong, Suderman, N. Tandon, S. T. Tang, K. A. Yakub, Y. Liu, M. E. Nongpiur, J. D. Taylor, B. O. Tayo, A. M. Toglhofer, 6. Li, Q., R. Wojciechowski, C. L. C. Han, N. Hon do, B. Shantha, B. M. Tomaszewski, N. Tsernikova, J. Simpson, P. G. Hysi, V. J. Verhoeven, Zhao, J. Sang, N. Zhang, R. Sato, K. Tuomilehto, A. G. Uitterlinden, D. M. K. Ikram, R. Hohn, V. Vitart, A. W. Yoshii, S. Panda-Jonas, A. E. Ashley Vaidya, A. van Hylckama Vlieg, J. van Hewitt, K. Oexle, K. M. Makela, S. Koch, L. W. Herndon, S. E. Moroi, P. Setten, T. Vasankari, S. Vedantam, E. MacGregor, M. Pirastu, Q. Fan, C. Y. Challa, J. N. Foo, J. X. Bei, Y. X. Zeng, Vlachopoulou, D. Vozzi, E. Vuoksimaa, Cheng, B. St Pourcain, G. McMahon, C. P. Simmons, T. N. Bich Chau, P. M. Waldenberger, E. B. Ware, W. J. P. Kemp, K. Northstone, J. S. Rahi, F. Sharmila, M. Chew, B. Lim, P. O. Wentworth-Shields, J. B. Whitfield, S. P. M. Cumberland, N. G. Martin, P. Tam, E. Chua, X. Y. Ng, V. H. Yong, Y. Wild, G. Willemsen, C. S. Yajnik, J. Yao, G. Sanfilippo, Y. Lu, Y. X. Wang, C. F. Chong, W. Y. Meah, S. Vijayan, S. G. Zaza, X. Zhu, P. BioBank Japan, R. Hayward, O. Polasek, H. Campbell, Seongsoo, W. Xu, Y. Y. Teo, J. N. Cooke M. Salem, M. Melbye, H. Bisgaard, N. G. Bencic, A. F. Wright, J. Wedenoja, Bailey, J. H. Kang, J. L. Haines, C. Y. J. Samani, D. Cusi, D. A. Mackey, R. S. T. Zeller, A. Schillert, A. Mirshahi, K. Cheng, S. M. Saw, E. S. Tai, I. C.-G. Cooper, P. Froguel, G. Pasterkamp, S. Lackner, S. P. Yip, M. K. Yap, J. S. Consortium, N. Consortium, J. E. F. Grant, H. Hakonarson, L. Ferrucci, Ried, C. Gieger, F. Murgia, J. F. Wilson, Richards, R. Ritch, D. E. Gaasterland, R. A. Scott, A. D. Morris, C. N. Palmer, B. Fleck, S. Yazar, J. R. Vingerling, A. L. R. Pasquale, J. Liu, J. B. Jonas, D. G. Dedoussis, P. Deloukas, L. Bertram, Hofman, A. Uitterlinden, F. Rivadeneira, Milea, R. George, S. A. Al-Obeidan, K. U. Lindenberger, S. I. Berndt, C. M. N. Amin, L. Karssen, B. A. Oostra, X. Mori, S. Macgregor, A. W. Hewitt, C. Lindgren, N. J. Timpson, A. Tonjes, Zhou, Y. Y. Teo, E. S. Tai, E. Vithana, A. Girkin, M. Zhang, P. Sundaresan, P. B. Munroe, T. I. Sorensen, C. N. V. Barathi, Y. Zheng, R. G. Siantar, K. L. Vijaya, D. A. Mackey, T. Y. Wong, Rotimi, D. K. Arnett, A. J. Oldehinkel, Neelam, Y. Shin, J. Lam, E. Yonova- J. E. Craig, X. Sun, S. Kinoshita, J. L. S. L. Kardia, B. Balkau, G. Gambaro, Doing, C. Venturini, S. M. Hosseini, H. Wiggs, C. C. Khor, Z. Yang, C. P. Pang, A. P. Morris, J. G. Eriksson, M. J. S. Wong, T. Lehtimaki, M. Kahonen, N. Wang, M. A. Hauser, K. Tashiro, Wright, N. G. Martin, S. C. Hunt, J. O. Raitakari, N. J. Timpson, D. M. T. Aung and E. N. Vithana (2015). M. Starr, I. J. Deary, L. R. Griffiths, Evans, C. C. Khor, T. Aung, T. L. Young, “A common variant near TGFBR3 is H. Tiemeier, N. Pirastu, J. Kaprio, P. Mitchell, B. Klein, C. M. van Duijn, associated with primary open angle N. J. Wareham, L. Perusse, J. G. T. Meitinger, J. B. Jonas, P. N. Baird, glaucoma.” Hum Mol Genet 24(13): Wilson, G. Girotto, M. J. Caulfield, O. D. A. Mackey, T. Y. Wong, S. M. Saw, 3880-3892. IF = 6.4 Raitakari, D. I. Boomsma, C. Gieger, O. Parssinen, D. Stambolian, C. J. Hammond, C. C. Klaver, C. Williams, 8. McKnight, C. M., J. C. Sherwin, P. van der Harst, A. A. Hicks, P. Kraft, S. Yazar, H. Forward, A. X. Tan, A. W.

44 Lions Eye Institute Annual Report 2015 Publications

Hewitt, E. Smith, D. Turton, P. Byrd, 12. Sanfilippo, P. G., L. S. Kearns, P. G. Lemij, J. J. Wang, C. C. Klaver, D. C. E. Pennell, M. T. Coroneo and Wright, D. A. Mackey and A. W. Hewitt A. Mackey, J. E. Craig, C. M. van Duijn D. A. Mackey (2015). “Pterygium (2015). “Current landscape of direct- and S. MacGregor (2015). “ARHGEF12 and conjunctival ultraviolet to-consumer genetic testing and its influences the risk of glaucoma by autofluorescence in young Australian role in ophthalmology: a review.” Clin increasing intraocular pressure.” Hum adults: the Raine study.” Clin Experiment Ophthalmol 43(6): 578- Mol Genet 24(9): 2689-2699. IF = Experiment Ophthalmol 43(4): 300- 590. IF = 2.3 6.4 307. IF = 2.3 13. Sanfilippo, P. G., C. H. Wilkinson, 18. Springelkamp, H., A. Mishra, P. 9. Meier, M. H., N. A. Gillespie, N. J. B. Ruddle, G. Zhu, N. G. Martin, A. G. Hysi, P. Gharahkhani, R. Hohn, C. K. Hansell, A. W. Hewitt, I. B. Hickie, W. Hewitt and D. A. Mackey (2015). C. Khor, J. N. Cooke Bailey, X. Luo, Y. Lu, J. McGrath, S. MacGregor, S. “Don’t it make your brown eyes blue? W. D. Ramdas, E. Vithana, V. Koh, S. E. Medland, C. Sun, T. Y. Wong, M. J. A comparison of iris colour across Yazar, L. Xu, H. Forward, L. S. Kearns, Wright, G. Zhu, N. G. Martin and D. A. latitude in Australian twins.” Clin Exp N. Amin, A. I. Iglesias, K. S. Sim, E. M. Mackey (2015). “Retinal microvessels Optom 98(2): 172-176. IF = 2.3 van Leeuwen, A. Demirkan, S. van der reflect familial vulnerability to Lee, S. C. Loon, F. Rivadeneira, A. Nag, psychotic symptoms: A comparison 14. Sanfilippo, P. G., S. Yazar, L. P. G. Sanfilippo, A. Schillert, P. T. de of twins discordant for psychotic Kearns, J. C. Sherwin, A. W. Hewitt Jong, B. A. Oostra, A. G. Uitterlinden, symptoms and controls.” Schizophr and D. A. Mackey (2015). “Distribution A. Hofman, N. Consortium, T. Zhou, K. Res 164(1-3): 47-52. IF = 3.9 of astigmatism as a function of age P. Burdon, T. D. Spector, K. J. Lackner, in an Australian population.” Acta S. M. Saw, J. R. Vingerling, Y. Y. Teo, L. 10. Miyake, M., K. Yamashiro, Y. Ophthalmol 93(5): e377-385. IF = 2.8 R. Pasquale, R. C. Wolfs, H. G. Lemij, Tabara, K. Suda, S. Morooka, H. 15. Souzeau, E., M. Hayes, J. B. E. S. Tai, J. B. Jonas, C. Y. Cheng, T. Nakanishi, C. C. Khor, P. Chen, F. Aung, N. M. Jansonius, C. C. Klaver, Qiao, I. Nakata, Y. Akagi-Kurashige, Ruddle, J. E. Elder, S. E. Staffieri, L. S. Kearns, D. A. Mackey, T. Zhou, B. J. E. Craig, T. L. Young, J. L. Haines, S. N. Gotoh, A. Tsujikawa, A. Meguro, S. MacGregor, D. A. Mackey, N. Pfeiffer, Kusuhara, O. Polasek, C. Hayward, Ridge, K. P. Burdon, A. Dubowsky and J. E. Craig (2015). “CYP1B1 T. Y. Wong, J. L. Wiggs, A. W. Hewitt, A. F. Wright, H. Campbell, A. J. C. M. van Duijn and C. J. Hammond Richardson, M. Schache, M. Takeuchi, copy number variation is not a major contributor to primary congenital (2015). “Meta-analysis of Genome- D. A. Mackey, A. W. Hewitt, G. Cuellar, Wide Association Studies Identifies Y. Shi, L. Huang, Z. Yang, K. H. Leung, glaucoma.” Mol Vis 21: 160-164. IF = 2.0 Novel Loci Associated With Optic Disc P. Y. Kao, M. K. Yap, S. P. Yip, M. Morphology.” Genet Epidemiol 39(3): Moriyama, K. Ohno-Matsui, N. Mizuki, 16. Souzeau, E., M. Hayes, T. Zhou, 207-216. IF = 2.6 S. MacGregor, V. Vitart, T. Aung, S. M. O. M. Siggs, B. Ridge, M. S. Awadalla, Saw, E. S. Tai, T. Y. Wong, C. Y. Cheng, J. E. Smith, J. B. Ruddle, J. E. Elder, D. 19. Staffieri, S. E., L. Rose, A. Chang, P. N. Baird, R. Yamada, F. Matsuda, G. A. Mackey, A. W. Hewitt, P. R. Healey, J. N. De Roach, T. L. McLaren, D. Nagahama Study and N. Yoshimura I. Goldberg, W. H. Morgan, J. Landers, A. Mackey, A. W. Hewitt and T. M. (2015). “Identification of myopia- A. Dubowsky, K. P. Burdon and J. E. Lamey (2015). “Clinical and molecular associated WNT7B polymorphisms Craig (2015). “Occurrence of CYP1B1 characterization of females affected provides insights into the mechanism Mutations in Juvenile Open-Angle by X-linked retinoschisis.” Clin underlying the development of Glaucoma With Advanced Visual Field Experiment Ophthalmol 43(7): 643- myopia.” Nat Commun 6: 6689. IF = Loss.” JAMA Ophthalmol 133(7): 826- 647. IF = 2.3 11.5 833. IF = 3.3 20. Van Bergen, N. J., J. G. 11. Sanfilippo, P. G., R. J. Casson, S. 17. Springelkamp, H., A. I. Iglesias, G. Crowston, J. E. Craig, K. P. Burdon, L. Yazar, D. A. Mackey and A. W. Hewitt Cuellar-Partida, N. Amin, K. P. Burdon, S. Kearns, S. Sharma, A. W. Hewitt, (2016). “Review of null hypothesis E. M. van Leeuwen, P. Gharahkhani, A. D. A. Mackey and I. A. Trounce significance testing in the ophthalmic Mishra, S. J. van der Lee, A. W. Hewitt, (2015). “Measurement of Systemic literature: are most ‘significant’ F. Rivadeneira, A. C. Viswanathan, R. Mitochondrial Function in Advanced P values false positives?” Clin C. Wolfs, N. G. Martin, W. D. Ramdas, Primary Open-Angle Glaucoma and Experiment Ophthalmol 44(1): 52-61. L. M. van Koolwijk, C. E. Pennell, J. Leber Hereditary Optic Neuropathy.” IF = 2.3 R. Vingerling, J. E. Mountain, A. G. PLoS One 10(10): e0140919. IF = Uitterlinden, A. Hofman, P. Mitchell, H. 3.2

Lions Eye Institute Annual Report 2015 45 Publications

21. Wan, S. L., S. Yazar, L. Booth, Rooijen, R. Ganss, J. K. Olynyk and 6. Souza-Fonseca-Guimaraes, F., V. Hiew, J. Hong, D. Tu, J. Ward, S. G. C. Yeoh (2015). “Kupffer cell- A. Young, D. Mittal, L. Martinet, C. Gengatharen, L. X. Barbosa and D. monocyte communication is essential Bruedigam, K. Takeda, C. E. Andoniou, A. Mackey (2015). “Do recycled for initiating murine liver progenitor M. A. Degli-Esposti, G. R. Hill and M. spectacles meet the refractive needs cell-mediated liver regeneration.” J. Smyth (2015). “NK cells require IL- of a developing country?” Clin Exp Hepatology 62(4): 1272-1284. IF = 28R for optimal in vivo activity.” Proc Optom 98(2): 177-182. IF = 1.3 11.1 Natl Acad Sci U S A 112(18): E2376- 2384. IF = 9.6 22. Yardley, A. M., A. K. Hoskin, K. 3. Rakoczy, E. P., C. M. Lai, A. L. Hanman, S. L. Wan and D. A. Mackey Magno, M. E. Wikstrom, M. A. French, 7. Wikstrom, M. E., P. Fleming, R. (2015). “Animal-inflicted ocular C. M. Pierce, S. D. Schwartz, M. S. D. Kuns, I. S. Schuster, V. Voigt, G. and adnexal injuries in children: A Blumenkranz, T. W. Chalberg, M. Miller, A. D. Clouston, S. K. Tey, C. E. systematic review.” Surv Ophthalmol A. Degli-Esposti and I. J. Constable Andoniou, G. R. Hill and M. A. Degli- 60(6): 536-546. IF = 3.8 (2015). “Gene therapy with Esposti (2015). “Acute GVHD results recombinant adeno-associated vectors in a severe DC defect that prevents 23. Yardley, A. M., D. A. Mackey for neovascular age-related macular T-cell priming and leads to fulminant and A. Tandon (2015). “Running with degeneration: 1 year follow-up of a cytomegalovirus disease in mice.” scissors.” J Pediatr 166(1): 205. IF = phase 1 randomised clinical trial.” Blood 126(12): 1503-1514. IF = 10.4 3.8 Lancet 386(10011): 2395-2403. IF = 45.2 24. Yazar, S., G. Cuellar-Partida, C. Molecular Ophthalmology M. McKnight, P. Quach-Thanissorn, Robinson, P. C., T. A. Claushuis, 4. 1. McLenachan, S., A. L. Magno, D. J. A. Mountain, M. T. Coroneo, C. E. A. Cortes, T. M. Martin, D. M. Pennell, A. W. Hewitt, S. MacGregor Ramos, J. Catita, P. G. McMenamin, F. Evans, P. Leo, P. Mukhopadhyay, L. K. Chen, E. P. Rakoczy and J. Ruberte and D. A. Mackey (2015). “Genetic A. Bradbury, K. Cremin, J. Harris, and environmental factors in (2015). “Angiography reveals novel W. P. Maksymowych, R. D. Inman, features of the retinal vasculature in conjunctival UV autofluorescence.” P. Rahman, N. Haroon, L. Gensler, JAMA Ophthalmol 133(4): 406-412. healthy and diabetic mice.” Exp Eye J. E. Powell, I. E. van der Horst- Res 138: 6-21. IF = 2.7 IF = 3.3 Bruinsma, A. W. Hewitt, J. E. Craig, L. 25. Hoskin AK, Yardley AE, Hanman L. Lim, D. Wakefield, P. McCluskey, 2. Rakoczy, E. P., C. M. Lai, A. L. K, Lam G, Mackey DA.(2015) “Sports- V. Voigt, P. Fleming, A.-A.-A. S. C. Magno, M. E. Wikstrom, M. A. French, related eye and adnexal injuries in I. G. o. A. S. C. W. T. C. C. S. M. C. M. Pierce, S. D. Schwartz, M. S. the Western Australian paediatric D.-E. Spondyloarthritis Research Blumenkranz, T. W. Chalberg, M. population” Acta Ophthalmol. doi: Consortium of Canada, M. Degli- A. Degli-Esposti and I. J. Constable 10.1111/aos.12911. IF= 2.8 Esposti, J. J. Pointon, M. H. Weisman, (2015). “Gene therapy with B. P. Wordsworth, J. D. Reveille, J. recombinant adeno-associated vectors T. Rosenbaum and M. A. Brown for neovascular age-related macular Experimental Immunology (2015). “Genetic dissection of acute degeneration: 1 year follow-up of a 1. Baillet, A. C., L. M. Rehaume, anterior uveitis reveals similarities and phase 1 randomised clinical trial.” H. Benham, C. P. O’Meara, C. W. differences in associations observed Lancet 386(10011): 2395-2403. IF Armitage, R. Ruscher, G. Brizard, M. with ankylosing spondylitis.” Arthritis = 45.2 C. Harvie, J. Velasco, P. M. Hansbro, J. Rheumatol 67(1): 140-151. IF = 7.8 V. Forrester, M. A. Degli-Esposti, K. W. 5. Sester, D. P., V. Sagulenko, S. J. Ocular Tissue Beagley and R. Thomas (2015). “High Thygesen, J. A. Cridland, Y. S. Loi, Engineering Laboratory Chlamydia Burden Promotes Tumor S. O. Cridland, S. L. Masters, U. Necrosis Factor-Dependent Reactive Genske, V. Hornung, C. E. Andoniou, 1. Alvarez Palomo, A. B., S. Arthritis in SKG Mice.” Arthritis M. J. Sweet, M. A. Degli-Esposti, McLenachan, F. K. Chen, L. Da Cruz, Rheumatol 67(6): 1535-1547. IF = K. Schroder and K. J. Stacey R. J. Dilley, J. Requena, M. Lucas, 7.8 (2015). “Deficient NLRP3 and A. Lucas, M. Drukker and M. J. Edel (2015). “Prospects for clinical use of 2. Elsegood, C. L., C. W. Chan, M. AIM2 Inflammasome Function in Autoimmune NZB Mice.” J Immunol reprogrammed cells for autologous A. Degli-Esposti, M. E. Wikstrom, treatment of macular degeneration.” A. Domenichini, K. Lazarus, N. van 195(3): 1233-1241. IF = 4.9

46 Lions Eye Institute Annual Report 2015 Publications

Fibrogenesis Tissue Repair 8: 9. SJR 9. Wong, E. N., S. Fraser-Bell, A. retinal capillary networks using = 1.9 P. Hunyor and F. K. Chen (2015). speckle variance optical coherence “Novel optical coherence tomography tomography with quantitative clinico- 2. Bukowska, D. M., A. L. Chew, E. classification of torpedo maculopathy.” histological correlation.” Microvasc Huynh, I. Kashani, S. L. Wan, P. M. Clin Experiment Ophthalmol 43(4): Res 100: 32-39. IF = 2.1 Wan and F. K. Chen (2015). “Semi- 342-348. IF = 2.3 automated identification of cones in 4. Gillies, M. C., A. Campain, D. the human retina using circle Hough 10. Wong, E. N., D. A. Mackey, W. Barthelmes, J. M. Simpson, J. J. transform.” Biomed Opt Express 6(12): H. Morgan and F. K. Chen (2016). Arnold, R. H. Guymer, I. L. McAllister, 4676-4693. IF = 3.6 “Intersession test-retest variability of R. W. Essex, N. Morlet, A. P. Hunyor conventional and novel parameters and G. Fight Retinal Blindness Study 3. Chen, F. K., Y. J. Khoo and using the MP-1 microperimeter.” Clin (2015). “Long-Term Outcomes of I. Tang (2015). “Near-Infrared Ophthalmol 10: 29-42. SJR = 0.66 Treatment of Neovascular Age-Related Autofluorescence Imaging in Macular Degeneration: Data from an Geographic Atrophy Using Spectralis 11. Wong, E. N., A. Thompson, M. L. Observational Study.” Ophthalmology Single and Combined Wavelength Tay-Kearney and F. K. Chen (2015). 122(9): 1837-1845. IF = 6.1 Modes.” Asia Pac J Ophthalmol (Phila) “Spontaneous resealing of perforated 4(6): 334-338. IF = 2.0 scleral ectasia associated with atypical 5. Gillies, M. C., A. Campain, R. retinochoroidal coloboma.” Clin Walton, J. M. Simpson, J. J. Arnold, 4. Chen, F. K., R. D. Viljoen and D. M. Experiment Ophthalmol 43(7): 696- R. H. Guymer, I. L. McAllister, A. P. Bukowska (2015). “Classification of 699. IF = 2.3 Hunyor, R. W. Essex, N. Morlet, D. image artefacts in optical coherence Barthelmes and G. Fight Retinal tomography angiography of the Blindness Study (2015). “Time to choroid in macular diseases.” Clin Physiology and initial clinician-reported inactivation Experiment Ophthalmol. IF = 2.3 Pharmacology of neovascular age-related macular 5. Chew, A. L., D. Bukowska and F. 1. Arnold, J. J., A. Campain, D. degeneration treated primarily with K. Chen (2015). “Structure-function Barthelmes, J. M. Simpson, R. H. ranibizumab.” Ophthalmology 122(3): correlation and natural history of Guymer, A. P. Hunyor, I. L. McAllister, 589-594 e581. IF = 6.1 R. W. Essex, N. Morlet, M. C. Gillies accidental juxtafoveal injury from a 6. Kang, M. H. and D. Y. Yu (2015). and G. Fight Retinal Blindness Study 250 milliwatt recreational hand-held “Distribution pattern of axonal (2015). “Two-year outcomes of “treat green laser device.” Clin Experiment cytoskeleton proteins in the human and extend” intravitreal therapy for Ophthalmol. IF = 2.3 optic nerve head.” Neural Regen Res neovascular age-related macular 10(8): 1198-1200. IF = 0.22 6. McLenachan, S., A. L. Magno, D. degeneration.” Ophthalmology 122(6): Ramos, J. Catita, P. G. McMenamin, F. 1212-1219. IF = 6.1 7. Mammo, Z., C. Balaratnasingam, K. Chen, E. P. Rakoczy and J. Ruberte P. Yu, J. Xu, M. Heisler, P. Mackenzie, 2. Barthelmes, D., R. Walton, A. E. (2015). “Angiography reveals novel A. Merkur, A. Kirker, D. Albiani, K. B. Campain, J. M. Simpson, J. J. Arnold, features of the retinal vasculature in Freund, M. V. Sarunic and D. Y. Yu I. L. McAllister, R. H. Guymer, A. P. healthy and diabetic mice.” Exp Eye (2015). “Quantitative Noninvasive Hunyor, R. W. Essex, N. Morlet, M. C. Res 138: 6-21. IF = 2.7 Angiography of the Fovea Centralis Gillies and I. Fight Retinal Blindness! Using Speckle Variance Optical 7. Shaw, A. and F. K. Chen (2015). Project (2015). “Outcomes of Coherence Tomography.” Invest “Lacquer crack formation following persistently active neovascular age- Ophthalmol Vis Sci 56(9): 5074-5086. pars plana vitrectomy.” Clin related macular degeneration treated IF = 3.4 Experiment Ophthalmol 43(5): 476- with VEGF inhibitors: observational 478. IF = 2.3 study data.” Br J Ophthalmol 99(3): 8. Mehta, H., S. Fraser-Bell, A. 8. Wan, S. L., D. M. Bukowska, S. 359-364. IF = 3.0 Yeung, A. Campain, L. L. Lim, G. J. Quin, I. L. McAllister, P. A. Keane Ford and F. K. Chen (2015). “Posterior 3. Chan, G., C. Balaratnasingam, J. and M. C. Gillies (2015). “Efficacy of Cortical Atrophy Presenting with Xu, Z. Mammo, S. Han, P. Mackenzie, dexamethasone versus bevacizumab Superior Arcuate Field Defect.” Case A. Merkur, A. Kirker, D. Albiani, M. on regression of hard exudates in Rep Ophthalmol Med 2015: 796381. V. Sarunic and D. Y. Yu (2015). diabetic maculopathy: data from the “In vivo optical imaging of human

Lions Eye Institute Annual Report 2015 47 Publications

BEVORDEX randomised clinical trial.” study of the microvasculature and its Hayward (2015). “Deep sequencing of Br J Ophthalmol. IF = 3.0 endothelial cells in the porcine iris.” uveal melanoma identifies a recurrent Exp Eye Res 132: 249-258. IF = 2.7 mutation in PLCB4.” Oncotarget. IF = 9. Morgan, W. H., A. Abdul-Rahman, 6.4 D. Y. Yu, M. L. Hazelton, B. Betz- 16. Yu, P. K., C. Balaratnasingam, Stablein and C. R. Lind (2015). J. Xu, W. H. Morgan, Z. Mammo, 5. Ashworth Briggs, E. L., T. Toh, “Objective detection of retinal S. Han, P. Mackenzie, A. Merkur, A. R. Eri, A. W. Hewitt and A. L. Cook vessel pulsation.” PLoS One 10(2): Kirker, D. Albiani, M. V. Sarunic and (2015). “TIMP1, TIMP2, and TIMP4 e0116475. IF = 3.2 D. Y. Yu (2015). “Label-Free Density are increased in aqueous humor Measurements of Radial Peripapillary from primary open angle glaucoma 10. Morgan, W. H., C. Capillaries in the Human Retina.” patients.” Mol Vis 21: 1162-1172. IF Balaratnasingam, C. R. Lind, S. Colley, PLoS One 10(8): e0135151. IF = 3.2 = 2.0 M. H. Kang, P. H. House and D. Y. Yu (2016). “Cerebrospinal fluid pressure 6. Cuellar-Partida, G., H. and the eye.” Br J Ophthalmol 100(1): Clinician-Scientists Springelkamp, S. E. Lucas, S. 71-77. IF = 3.0 Yazar, A. W. Hewitt, A. I. Iglesias, Constable I.J G. W. Montgomery, N. G. Martin, 11. Su, E. N., M. E. Kelly, S. J. 1. Rakoczy, E. P., C. M. Lai, A. L. C. E. Pennell, E. M. van Leeuwen, Cringle and D. Y. Yu (2015). “Role of Magno, M. E. Wikstrom, M. A. French, V. J. Verhoeven, A. Hofman, A. Endothelium in Abnormal Cannabidiol- C. M. Pierce, S. D. Schwartz, M. S. G. Uitterlinden, W. D. Ramdas, R. Induced Vasoactivity in Retinal Blumenkranz, T. W. Chalberg, M. C.Burdon, K. P., R. D. Fogarty, W. Arterioles.” Invest Ophthalmol Vis Sci A. Degli-Esposti and I. J. Constable Shen, S. Abhary, G. Kaidonis, B. 56(6): 4029-4037. IF = 3.4 (2015). “Gene therapy with Appukuttan, A. W. Hewitt, S. Sharma, 12. Tan, P. E., C. Balaratnasingam, recombinant adeno-associated vectors M. Daniell, R. W. Essex, J. H. Chang, J. Xu, Z. Mammo, S. X. Han, P. for neovascular age-related macular S. Klebe, S. R. Lake, B. Pal, A. Jenkins, Mackenzie, A. W. Kirker, D. Albiani, A. degeneration: 1 year follow-up of a G. Govindarjan, P. Sundaresan, E. B. Merkur, M. V. Sarunic and D. Y. Yu phase 1 randomised clinical trial.” L. Lamoureux, K. Ramasamy, M. (2015). “Quantitative Comparison of Lancet 386(10011): 2395-2403. IF Pefkianaki, P. G. Hykin, N. Petrovsky, Retinal Capillary Images Derived By = 45.2 M. A. Brown, M. C. Gillies and J. Speckle Variance Optical Coherence E. Craig (2015). “Genome-wide Tomography With Histology.” Invest Francina M association study for sight-threatening Ophthalmol Vis Sci 56(6): 3989-3996. 2. Abulafia, A., W. E. Hill, M. diabetic retinopathy reveals IF = 3.4 Franchina and G. D. Barrett (2015). association with genetic variation near “Comparison of Methods to Predict the GRB2 gene.” Diabetologia 58(10): 13. Xu, J., S. Han, C. Residual Astigmatism After Intraocular 2288-2297. IF = 6.7 Balaratnasingam, Z. Mammo, K. S. Lens Implantation.” J Refract Surg Wong, S. Lee, M. Cua, M. Young, 31(10): 699-707. SJR = 1.9 Hewitt A.W A. Kirker, D. Albiani, F. Forooghian, 7. Farr, R. J., A. S. Januszewski, M. V. P. Mackenzie, A. Merkur, D. Y. 3. Franchina, M., S. Yazar, L. Booth, Joglekar, H. Liang, A. K. McAulley, A. Yu and M. V. Sarunic (2015). S. L. Wan, K. Cox, M. H. Kang, W. Hewitt, H. E. Thomas, T. Loudovaris, “Retinal angiography with real-time A. W. Hewitt and D. A. Mackey T. W. Kay, A. Jenkins and A. A. Hardikar speckle variance optical coherence (2015). “Swimming goggle wear is (2015). “A comparative analysis tomography.” Br J Ophthalmol 99(10): not associated with an increased of high-throughput platforms for 1315-1319. IF = 3.0 prevalence of glaucoma.” Br J validation of a circulating microRNA Ophthalmol 99(2): 255-257. IF = 3.0 14. Yang, H., P. K. Yu, S. J. Cringle, X. signature in diabetic retinopathy.” Sci Sun and D. Y. Yu (2015). “Intracellular 4. Johansson, P., L. G. Aoude, K. Rep 5: 10375. IF = 5.6 cytoskeleton and junction proteins Wadt, W. J. Glasson, S. K. Warrier, A. 8. Gharahkhani, P., K. P. Burdon, A. W. of endothelial cells in the porcine iris W. Hewitt, J. F. Kiilgaard, S. Heegaard, Hewitt, M. H. Law, E. Souzeau, G. W. microvasculature.” Exp Eye Res 140: T. Isaacs, M. Franchina, C. Ingvar, T. Montgomery, G. Radford-Smith, D. A. 106-116. IF = 2.7 Vermeulen, K. J. Whitehead, C. W. Mackey, J. E. Craig and S. MacGregor Schmidt, J. M. Palmer, J. Symmons, (2015). “Accurate Imputation-Based 15. Yang, H., P. K. Yu, S. J. Cringle, X. A. M. Gerdes, G. Jonsson and N. K. Sun and D. Y. Yu (2015). “Quantitative Screening of Gln368Ter Myocilin

48 Lions Eye Institute Annual Report 2015 Publications

Variant in Primary Open-Angle Challa, J. N. Foo, J. X. Bei, Y. X. Zeng, Gajdatsy A Glaucoma.” Invest Ophthalmol Vis Sci C. P. Simmons, T. N. Bich Chau, P. 16. Andrew, N. H., A. Gajdatsy 56(9): 5087-5093. If = 3.4 F. Sharmila, M. Chew, B. Lim, P. O. and D. Selva (2015). “Intraorbital Tam, E. Chua, X. Y. Ng, V. H. Yong, Y. corticosteroid injection for the 9. Johansson, P., L. G. Aoude, K. F. Chong, W. Y. Meah, S. Vijayan, S. treatment of IgG4-related ophthalmic Wadt, W. J. Glasson, S. K. Warrier, A. Seongsoo, W. Xu, Y. Y. Teo, J. N. Cooke disease.” Br J Ophthalmol. IF = 3.0 W. Hewitt, J. F. Kiilgaard, S. Heegaard, Bailey, J. H. Kang, J. L. Haines, C. Y. T. Isaacs, M. Franchina, C. Ingvar, T. Cheng, S. M. Saw, E. S. Tai, I. C.-G. 17. Wu, A., N. H. Andrew, A. Tsirbas, Vermeulen, K. J. Whitehead, C. W. Consortium, N. Consortium, J. E. P. Tan, A. Gajdatsy and D. Selva Schmidt, J. M. Palmer, J. Symmons, Richards, R. Ritch, D. E. Gaasterland, (2015). “Rituximab for the treatment A. M. Gerdes, G. Jonsson and N. K. L. R. Pasquale, J. Liu, J. B. Jonas, D. of IgG4-related orbital disease: Hayward (2015). “Deep sequencing of Milea, R. George, S. A. Al-Obeidan, K. experience from five cases.” Eye uveal melanoma identifies a recurrent Mori, S. Macgregor, A. W. Hewitt, C. (Lond) 29(1): 122-128. IF = 2.1 mutation in PLCB4.” Oncotarget. IF = A. Girkin, M. Zhang, P. Sundaresan, 6.4 L. Vijaya, D. A. Mackey, T. Y. Wong, Hoskin A.K 10. Kaidonis, G., K. P. Burdon, M. J. E. Craig, X. Sun, S. Kinoshita, J. L. 18. Hoskin, A. K., M. D. Atlas and C. Gillies, S. Abhary, R. W. Essex, J. Wiggs, C. C. Khor, Z. Yang, C. P. Pang, D. A. Mackey (2015). “The Sydney H. Chang, B. Pal, M. Pefkianaki, M. N. Wang, M. A. Hauser, K. Tashiro, siege: courage, compassion and Daniell, S. Lake, N. Petrovsky, A. W. T. Aung and E. N. Vithana (2015). connectedness.” Med J Aust 202(7): Hewitt, A. Jenkins, E. L. Lamoureux, “A common variant near TGFBR3 is 360. IF = 4.1 associated with primary open angle J. M. Gleadle and J. E. Craig (2015). 19. Hoskin, A. K., S. J. Dain and “Common Sequence Variation in glaucoma.” Hum Mol Genet 24(13): 3880-3892. If = 6.4 D. A. Mackey (2015). “Severe alkali the VEGFC Gene Is Associated with burns from beer line cleaners warrant Diabetic Retinopathy and Diabetic 13. Lidgerwood, G. E., S. Y. Lim, mandatory safety guidelines.” Med J Macular Edema.” Ophthalmology D. E. Crombie, R. Ali, K. P. Gill, D. Aust 202(2): 79. IF = 4.1 122(9): 1828-1836. If = 6.1 Hernandez, J. Kie, A. Conquest, H. S. 20. Hoskin, A. K., S. Philip, S. J. Dain 11. Landers, J., A. W. Hewitt, T. Waugh, R. C. Wong, H. H. Liang, A. W. Hewitt, K. C. Davidson and A. Pebay and D. A. Mackey (2015). “Spectacle- Straga, K. P. Burdon and J. E. Craig related eye injuries, spectacle-impact (2015). “Screening phenotypically (2015). “Defined Medium Conditions for the Induction and Expansion of performance and eye protection.” Clin normal Caucasian Australians for Exp Optom 98(3): 203-209. IF = 1.3 the lysyl oxidase-like 1 gene.” Clin Human Pluripotent Stem Cell-Derived Experiment Ophthalmol 43(2): 189- Retinal Pigment Epithelium.” Stem Cell 21. Hoskin, A. K., A. E. Yardley, K. 190. IF = 2.3 Rev. IF = 2.7 Hanman, G. Lam and D. A. Mackey 14. McAuley, A. K., M. Dirani, J. J. (2015). “Sports-related eye and 12. Li, Z., R. R. Allingham, M. adnexal injuries in the Western Nakano, L. Jia, Y. Chen, Y. Ikeda, B. Wang, P. P. Connell, E. L. Lamoureux and A. W. Hewitt (2015). “A genetic Australian paediatric population.” Acta Mani, L. J. Chen, C. Kee, D. F. Garway- Ophthalmol. IF = 2.8 Heath, S. Sripriya, N. Fuse, K. K. variant regulating miR-126 is Abu-Amero, C. Huang, P. Namburi, K. associated with sight threatening 22. Hoskin, A. K., A. M. Yardley and Burdon, S. A. Perera, P. Gharahkhani, diabetic retinopathy.” Diab Vasc Dis D. A. Mackey (2015). “Recreational Y. Lin, M. Ueno, M. Ozaki, T. Mizoguchi, Res 12(2): 133-138. IF = 2.8 fishing eye injuries and eye S. R. Krishnadas, E. A. Osman, M. C. 15. Staffieri, S. E., L. Rose, A. Chang, protection.” Acta Ophthalmol 93(8): Lee, A. S. Chan, L. S. Tajudin, T. Do, J. N. De Roach, T. L. McLaren, D. e678. IF = 2.8 A. Goncalves, P. Reynier, H. Zhang, A. Mackey, A. W. Hewitt and T. M. 23. Yardley, A. M., A. K. Hoskin, K. R. Bourne, D. Goh, D. Broadway, R. Lamey (2015). “Clinical and molecular Husain, A. K. Negi, D. H. Su, C. L. Ho, Hanman, S. L. Wan and D. A. Mackey characterization of females affected (2015). “Animal-inflicted ocular A. A. Blanco, C. K. Leung, T. T. Wong, by X-linked retinoschisis.” Clin A. Yakub, Y. Liu, M. E. Nongpiur, J. and adnexal injuries in children: A Experiment Ophthalmol 43(7): 643- systematic review.” Surv Ophthalmol C. Han, N. Hon do, B. Shantha, B. 647. IF = 2.3 Zhao, J. Sang, N. Zhang, R. Sato, K. 60(6): 536-546. IF = 3.8 Yoshii, S. Panda-Jonas, A. E. Ashley Koch, L. W. Herndon, S. E. Moroi, P.

Lions Eye Institute Annual Report 2015 49 Publications

Morgan W.H Wong EN 24. Crewe, J. M., K. Spilsbury, N. 30. Wong, E. N., S. Fraser-Bell, A. Morlet, W. H. Morgan, A. Mukhtar, P. Hunyor and F. K. Chen (2015). A. Clark and J. B. Semmens (2015). “Novel optical coherence tomography “Health Service Use and Mortality classification of torpedo maculopathy.” of the Elderly Blind.” Ophthalmology Clin Experiment Ophthalmol 43(4): 122(11): 2344-2350. IF = 6.1 342-348. IF = 2.3

25. Golzan, S. M., W. H. Morgan, D. 31. Wong, E. N., D. A. Mackey, W. Georgevsky and S. L. Graham (2015). H. Morgan and F. K. Chen (2016). “Correlation of retinal nerve fibre layer “Intersession test-retest variability of thickness and spontaneous retinal conventional and novel parameters venous pulsations in glaucoma and using the MP-1 microperimeter.” Clin normal controls.” PLoS One 10(6): Ophthalmol 10: 29-42. SJR = 0.66 e0128433. IF = 3.2 32. Wong, E. N., A. Thompson, M. L. 26. Morgan, W. H., A. Abdul- Tay-Kearney and F. K. Chen (2015). Rahman, D. Y. Yu, M. L. Hazelton, “Spontaneous resealing of perforated B. Betz-Stablein and C. R. Lind scleral ectasia associated with atypical (2015). “Objective detection of retinal retinochoroidal coloboma.” Clin vessel pulsation.” PLoS One 10(2): Experiment Ophthalmol 43(7): 696- e0116475. IF = 3.2 699. IF = 2.3

27. Souzeau, E., M. Hayes, T. Zhou, O. M. Siggs, B. Ridge, M. S. Awadalla, J. E. Smith, J. B. Ruddle, J. E. Elder, D. A. Mackey, A. W. Hewitt, P. R. Healey, I. Goldberg, W. H. Morgan, J. Landers, A. Dubowsky, K. P. Burdon and J. E. Craig (2015). “Occurrence of CYP1B1 Mutations in Juvenile Open-Angle Glaucoma With Advanced Visual Field Loss.” JAMA Ophthalmol 133(7): 826- 833. IF = 3.3

28. Yu, P. K., C. Balaratnasingam, J. Xu, W. H. Morgan, Z. Mammo, S. Han, P. Mackenzie, A. Merkur, A. Kirker, D. Albiani, M. V. Sarunic and D. Y. Yu (2015). “Label-Free Density Measurements of Radial Peripapillary Capillaries in the Human Retina.” PLoS One 10(8): e0135151. IF = 3.2

Tay-Kearney M.L 29. Xiao, D., J. Vignarajan, J. Boyle, M. Zhang, M. R. Estai, M. Tennant, M. L. Tay-Kearney and Y. Kanagasingam (2015). “Development and Practice of Store-and-Forward Telehealth Systems in Ophthalmology Dental and Emergency.” Stud Health Technol Inform 214: 167-173.

50 Lions Eye Institute Annual Report 2015 Clinical Services Report

Clinical Services Report C51 Clinical Services Report

Clinical services provided treatment to just under 60,000 patients in 2015.

This was our busiest year on record and consistent with recent patterns of growth. The Elsie Gadd Clinic treated 56,000 patients. Throughput at our Murdoch rooms continues to rise and increased 10 per cent in 2015.

Clinical Services Throughput 2011 - 2015

60,000

50,000

40,000

30,000

20,000 Consults plus injections

10,000

0 2011 2012 2013 2014 2015

52 Lions Eye Institute Annual Report 2015 Clinical Services Report

The first stage of the AA our patients safely to their destination of the National Safety and Quality in Block renovation was within the AA block. The team worked Health Care Standards - Partnering successfully completed in shifts from 7am to 7pm. with Consumers). This recognises and reflects the contemporary approach with the installation of Planning for the next stage of the the organisation takes to service a larger more reliable clinic refurbishment is at an advanced delivery and our ongoing commitment lift. Extensive planning stage with relocation of critical ITC to providing the highest standards of and marketing of the infrastructure to the Perkins Building care. project resulted in well under way. Detailed design is minimal disruption nearing completion and staging plans Patient feedback is an important tool to the function of the for each phase of the works have in measuring the effectiveness of our clinics and day surgery. been developed. service delivery. We are proud that our patient feedback continues to Each year our services are audited improve. In 2015, we saw the highest During the six-week lift replacement by external agencies to ensure we scores yet achieved, with patients program, patients were diverted to meet all legislative requirements and giving out compliments on 49% of the the “A” block lifts. A team of Patient industry standards. For the first time feedback forms submitted. Flow Assistants - or “pinkies” as we were awarded “Met with merit” they became affectionately known in one of the standards (Standard 2 - helped to direct, assist and deliver

The team of Patient Flow Assistants – or Pinkies – who supported patients during the six-week lift installation period

Lions Eye Institute Annual Report 2015 53 Clinical Services Report

The Day Surgery Facility Once again our Day Surgery facility scored highly in the area of patient satisfaction with all but one criteria achieving 90 per cent or more.

Patient Satisfaction

100.00% 94.49% 93.99% 94.29% 91.29% 92.97% 91.40% 93.27% 91.93% 90.00% 83.37% 80.00% 70.00% 60.00% 50.00% 40.00% Percent score Percent 30.00% 20.00% 10.00% 0% Section

Overall patient billing process Patientwith satisfaction information Patient satisfactionPatient satisfaction & physical access satisfaction index Patient satisfaction with services & treatment with transfer process making & involvementwith discharge process Patient satisfaction with care Patient satisfaction with the appointmentPatient & waiting satisfaction times with location Patient satisfaction with decision

In 2015 The Day Surgery installed a new Phaco Machine ensuring that patients undergoing cataract surgery have access to the latest technology.

Teamwork and cooperation by all staff in all departments has helped deliver a high quality, caring and safe service to our patients.

54 Lions Eye Institute Annual Report 2015 Profile Philomena Grant

Philomena gives new meaning to patient care

Interacting with patients Philomena has worked at the LEI for “I also value the close relationship I and making a difference the last 14 years and the patient is have with clinical staff. We work in a to their quality of life are at the centre of everything she does. very busy clinic setting so we need to work very closely together. key motivators for the “What gives me the most LEI’s Philomena Grant. satisfaction in my role would have to “As there are so many different and be the interaction with the patients diverse staff nationalities working As level two floor manager, she - knowing that we are making a at the LEI, it’s become like a second manages staff and oversees the difference to improve their quality of family. I couldn’t imagine working day-to-day running of retina clinics. life,” she said. anywhere else.”

Another part of her role is assisting “My ultimate goal in dealing with patients – performing tests, patients is providing the best nursing providing support and helping practice possible and giving the best patients understand what to expect customer service. of their treatment. ABOVE Philomena Grant

Lions Eye Institute Annual Report 2015 55 Profile Karen McLachlan

Diversity thekey to Karen’s role

Every day at the LEI with different groups of people offers a fresh set of from patients to doctors and work challenges for Karen colleagues. McLachlan – and that’s ABOVE “Working directly with Dr Giubilato Karen McLachlan just the way she likes it. and interacting with our patients allows me to experience first-hand As practice manager and personal the great work that is carried out assistant to glaucoma specialist Dr here at LEI.” Antonio Giubilato, she interacts with a wide group of people. Karen initially worked in the e-Health Department when she joined the LEI “I like the diversity of my role,” in 2005. Karen said. “I like that my job allows me to help and interact

56 Lions Eye Institute Annual Report 2015 Clinicians Profiles

Clinicians Profiles C57 Clinicians Profiles

Dr Andrea Ang Adjunct Clinical Professor Dr Fred Chen Graham Barrett Dr Andrea Ang trained in Dr Fred K Chen was born in Taiwan ophthalmology in Perth (MBBS (Hons) Professor Graham Barrett and studied medicine in Perth at The UWA) and the USA (MPH, Harvard) Professor Graham Barrett trained University of Western Australia (UWA). before undertaking fellowships in ophthalmology in Perth, Western After completion of ophthalmology in cornea, anterior segment and Australia, and undertook specialty training at Royal Perth Hospital (RPH), external diseases at the Cincinnati training in the USA. He is a he moved to London for advanced Eye Institute, USA, and the Singapore consultant ophthalmic surgeon at training in medical and surgical retina National Eye Centre, Singapore. SCGH. Professor Barrett is founding at Moorfields Eye Hospital. He also Dr Ang is a consultant ophthalmologist and current president of the completed a Doctorate of Philosophy at RPH and a member of FRANZCO. Australasian Society of Cataract & (PhD) in surgical techniques of retinal Refractive Surgeons, and immediate pigment epithelium transplantation Areas of Expertise past president of the Asia Pacific for treatment of dry and wet macular Management of cornea, anterior Association of Cataract and Refractive degenerations at the University segment and external diseases; Surgeons. He is the recipient of major College of London Institute of corneal surgery; pterygium surgery, international awards including the Ophthalmology. Dr Chen returned to corneal transplantation (penetrating Ridley Medal (European Society of Perth in 2010 as a Senior Research keratoplasty, deep anterior lamellar Cataract & Refractive Surgeons), the Fellow at the UWA Centre for keratoplasty, endothelial keratoplasty); Binkhorst Medal (American Society Ophthalmology and Visual Science. ocular surface reconstruction; of Cataract and Refractive Surgeons) He is also a consultant vitreoretinal limbal cell transplantation and and the Ridley Medal (Congress of surgeon at RPH. His research keratoprostheses; cataract surgery, German Ophthalmic Surgeons) and is teams are involved in testing of new refractive surgery, LASIK, PRK. the 2016 recipient of the Innovators treatments in dry age-related macular Kelman Lecture Award (American degeneration, high resolution retinal Society of Cataract & Refractive imaging, monitoring of inherited retinal Surgeons). diseases and application of stem cell technology in personalised medicine. Areas of Expertise Cataract and refractive surgery, Areas of Expertise corneal and anterior segment Surgical retina: retinal detachment disorders and surgery. and macular hole repair, epiretinal membrane peel, complications in cataract surgery and ocular trauma. Medical retina: treatment of dry and wet macular degeneration, Lucentis and Eylea injections, Stargardt disease, retinitis pigmentosa and clinical trials of new drugs and lasers. 58 Lions Eye Institute Annual Report 2015 Clinicians Profiles

Professor Ian Constable AO Adjunct Clinical Professor Dr Jean-Louis deSousa Geoffrey Crawford Professor Ian Constable AO trained in Dr Jean-Louis deSousa trained ophthalmology in New South Wales Professor Geoffrey Crawford in ophthalmology in Perth before before being appointed as a Retinal completed his ophthalmic training in completing fellowships in ophthalmic Fellow at the Massachusetts Eye Western Australia and is a RANZCO plastic and reconstructive surgery in and Ear Infirmary and a Lecturer Fellow and a Fellow of the Royal Oxford and East Grinstead in the UK. at Harvard University. He became Australasian College of Surgeons. He is a member of the Australian and the foundation Lion’s Professor of He completed further sub-specialty New Zealand Society of Ophthalmic Ophthalmology at The University training in oculoplastic surgery at Plastic Surgeons. A consultant of Western Australia in 1975 and Moorfields Eye Hospital in London and ophthalmologist at RPH, he also founded the Lion’s Eye Institute in then cornea and refractive Surgery at provides ophthalmic services to the 1983. He is past president of the Asia- Emory University in Atlanta, Georgia, central wheatbelt from Merredin. Dr Pacific Academy of Ophthalmology USA. He is the Director of Surgical deSousa is abasic sciences examiner and Chairman of the Asia-Pacific Services and the Director of the for RANZCO and a consultant and Association of University Professors. Laser Vision Centre at the LEI and a visiting surgeon and lecturer for He is a consultant retinal surgeon at consultant ophthalmic surgeon at RPH humanitarian eye projects in Bali and SCGH. and PMH. East Timor. Areas of Expertise Areas of Expertise Areas of Expertise Vitreoretinal surgery, retinal vascular Refractive surgery: LASIK, PRK, Phakic Oculoplastic surgery – eyelid tumours, disease, diabetic retinopathy, macular IOL’s; refractive lens surgery, corneal eyelid malposition, cosmetic surgery, degeneration, complex referrals and transplantation, pterygium surgery, non-surgical cosmetic procedures. cataracts. corneal collagen crosslinking, insertion Orbital disease – tumours, trauma and of Intra-corneal ring segments, inflammatory orbital disease. Lacrimal management of keratoconus, ocular surgery – endoscopic lacrimal surgery. surface tumours, cataract surgery. He is a pioneer in many of these techniques.

Lions Eye Institute Annual Report 2015 59 Clinicians Profiles

Professor John Forrester Adjunct Clinical Associate Dr Antonio Giubilato Professor Adam Gajdatsy Professor Forrester graduated Dr Antonio Giubilato underwent from the University of Glasgow in Associate Professor Adam Gajdatsy specialty fellowship training in 1970 and is Emeritus Professor of trained in ophthalmology in Western glaucoma at the Royal Victorian Ophthalmology at the University of Australia before undertaking Eye and Ear Hospital after training Aberdeen. He was previously Editor of fellowship training at the University in ophthalmology in Perth, Western the British Journal of Ophthalmology Hospital of Wales in Cardiff and at Australia. This included both clinical and has over the years received Moorfields Eye Hospital in London and surgical management of several awards including the London in oculoplastic, lacrimal and orbital glaucoma as well as research into Hospital Prize for Original Research surgery. He is currently operating as new therapies for the condition. He is in Ophthalmology in 1977, the Duke an ophthalmic surgeon consultant presently consultant ophthalmologist Elder Medal and the Ida Mann Medal at the LEI, Osborne Park Hospital in the Glaucoma Clinic at RPH and in 1991. In 2012 he was awarded and Murdoch Surgicentre. He also also consults at Bentley Hospital the Donders Medal, the Bowman acts as an honorary ophthalmologist for public patients. Dr Giubilato is Medal and the Mildred Weisenfeld consultant at PMH. Associate currently Director of Training for the Award. In 2013 he gave the Ian Professor Gajdatsy sits on the WA branch of RANZCO and an LSSF Constable Lecture on latent infection Curriculum Review Committee of Board Member. and autoimmunity. He is currently RANZCO. He is also President Elect Professor of Ocular Immunology at of the Australian and New Zealand Areas of Expertise Glaucoma. UWA and Consultant Ophthalmologist Society of Ophthalmic Plastic with special interest in ocular Surgeons (ANZSOPS). He is the inflammatory disease at the Lions Eye coordinator of ophthalmology teaching Institute. at UWA. Areas of Expertise Areas of Expertise Ocular immunology, uveitis, Lid malposition repair (droopy lid autoimmune disease; wound corrections), lid cancer management, healing and experimental corneal cosmetic eyelid surgery, tear drainage transplantation; diabetic retinopathy, surgery, eye socket surgery and orbital angiogenesis, endothelial cell function; surgery. clinical studies in uveitis, translational research in ophthalmology, imaging in ophthalmology.

60 Lions Eye Institute Annual Report 2015 Clinicians Profiles

Dr Tim Isaacs Professor David Mackey Professor Ian McAllister

Dr Tim Isaacs studied medicine in Professor David Mackey is Managing Professor Ian McAllister undertook the UK, and underwent ophthalmic Director of the LEI and Professor of training in Western Australia with training at the Western Ophthalmic Ophthalmology/Director of the Centre additional sub-specialty training in Hospital and Moorfields Eye Hospital in for Ophthalmology and Visual Science vitreoretinal disorders in the USA. He London. He completed sub-specialty (COVS) at UWA. Professor Mackey is Director of Clinical Services at the training in vitreoretinal surgery at is a world authority on the genetics LEI and a consultant ophthalmologist RPH and SCGH. He is currently a of eye disease, with his research at the Royal Perth and Sir Charles consultant ophthalmologist at RPH extending beyond the laboratory to Gairdner hospitals. Professor and also practices at the LEI’s satellite cascade genetic screening for at-risk McAllister is actively involved in clinic at Murdoch. His research individuals. He was born and educated research for cures for vitroretinal interests include the diagnosis and in Tasmania, studying medicine at the disorders – especially retinal vascular management of intraocular tumours, University of Tasmania, completing disorders – and has held 10 NHMRC evaluation of new therapies for fellowships in Melbourne, Baltimore grants in this area as well as diabetic retinopathy and macular and London. He was on the NHMRC numerous minor grants. He has been degeneration. Human Genetics Advisory Committee involved for many years in Statewide and chief investigator for the NHMRC diabetic retinopathy screening and Areas of Expertise Centre of Research Excellence – treatment and was vice-chairman of Vitreoretinal surgery, diabetic Translating Genetic Eye Research. the Ophthalmic Research Institute retinopathy, macular degeneration, Professor Mackey is also president of of Australia and chairman of the retinal vascular disease, ocular the International Society for Genetic research board for many years. He oncology, choroidal melanoma. Eye Disease and Retinoblastoma. has published more than 130 papers in scientific journals and has given Areas of Expertise more than 170 papers at meetings Hereditary and genetic eye diseases. as an invited guest speaker. He has He sees patients at the LEI for received an achievement award for second opinions on rare genetic eye distinguished service to ophthalmology diseases and more common genetic from the American Academy of eye diseases involving new genetic Ophthalmology. He was recently research. awarded a Doctorate in Medicine by The University of Western Australia. Areas of Expertise Vitreoretinal surgery and disorders, retinal vascular disease, diabetic retinopathy, macular degeneration, ocular trauma, cataract surgery.

Lions Eye Institute Annual Report 2015 61 Clinicians Profiles

Professor William Morgan Associate Professor Associate Professor Mei-Ling Tay-Kearney Angus Turner Professor William Morgan initially trained in Perth, Western Australia, Associate Professor Mei-Ling Tay- Associate Professor Angus Turner and undertook his fellowship at Kearney completed her medical completed medical training at UWA COVS. He is Head of Department training in Perth, Western Australia, before studying at Oxford University of Ophthalmology and consultant before pursuing postgraduate study at and completing a Masters of Evidence ophthalmologist at RPH, consultant Johns Hopkins Hospital in Baltimore, Based Medicine. Ophthalmology ophthalmologist at PMH, a Professor USA. In 2003, she was appointed training was undertaken in Melbourne, at UWA and co-Director of the LEI’s Head of Department of Ophthalmology followed by post-graduate training at McCusker Glaucoma Centre. He has at RPH. She is a senior lecturer at the University of Sydney in refractive completed a doctorate in philosophy UWA and a member of the Australian surgical procedures. As Director of studying the response of the optic Society for HIV Medicine and the Lions Outback Vision (LOV), Associate nerve to pressure, particularly in Australian Uveitis Study Group. She Professor Turner is actively involved relation to glaucoma. Professor is the Chair of Qualifications and in the delivery of specialist outreach Morgan maintains an active research Education as well as an examiner services to remote and Indigenous interest in glaucoma as well as in the for the RANZCO Part 2 College communities in the Kimberley, epidemiology of blinding eye disease Examinations. Pilbara, Goldfields, Great Southern and eye diseases within Aboriginal and South-West regions and has populations. Areas of Expertise overseen the LOV Van project – a Ocular infections, uveitis and state-of-the-art mobile eye healthcare Areas of Expertise inflammatory disorders of the eye. service that will begin delivering Glaucoma, ophthalmic public health. specialist ophthalmic services in regional and remote WA from 2016. He is an Associate Professor at UWA, where he is engaged in a number of research projects at the LEI, focusing on service delivery for remote and Indigenous people. Dr Turner is also a consultant at Fremantle Hospital and an ophthalmology teacher for the Rural Clinical School. Areas of Expertise General ophthalmology.

62 Lions Eye Institute Annual Report 2015 Profile Adam Gajdatsy

Adam’s surgical precision

Dr Steven Wiffen

Dr Steven Wiffen trained in Eye surgeon Adam ophthalmology in Western Australia before undertaking fellowships Gajdatsy’s focus is at the Corneo-Plastic Unit, East protecting the eye Grinstead, UK, and at the Mayo Clinic, from the outside in. Rochester, Minnesota, USA. Dr Wiffen is a consultant ophthalmologist at As an oculoplastic, lacrimal and Fremantle Hospital and a Senior orbital specialist, he deals with Lecturer at UWA. He is the Director problems that impact on vision from unsurprisingly the only position on of the Lions Eye Bank of Western outside the eye itself. the ground to wear face and eye Australia. protection. “This includes quite a lot of tumour Areas of Expertise management – both benign and “I am considered at least slightly Ocular surface disorders, corneal and malignant - as well as eyelid and mad by several people I know refractive surgery, anterior segment watery eye disorders,” he said. – including the hockey players,” disorders and surgery. Adam trained in ophthalmology in he said. Western Australia before undertaking fellowship training at the University Back at work, it’s the positive Hospital of Wales in Cardiff and the difference his surgeon’s skills can Moorfields Eye Hospital in London. make to a patient’s quality of life that gives him most satisfaction. He operates as a surgeon at the LEI, Osborne Park Hospital and Murdoch “Faulty lids and tear drainage cause Surgicentre. He is also an honorary loss of visual performance, where ophthalmologist consultant at tumours of the orbits or around the Princess Margaret Hospital. eye may blind or kill,” he said.

Adam has worked at the LEI for 11 “My research collaboration into years and outside of work, loves orbital and ocular cancers will hockey and plays in the position of hopefully make a difference down goal keeper – perhaps the track too.”

LEFT Associate Professor Adam Gajdatsy on the hockey pitch - Photo by Toni Cronk

Lions Eye Institute Annual Report 2015 63 Lions Laser Vision

LionsLaser Vision

Li64 Lions Laser Vision

The Lions Laser Vision human cornea and achieve correction There are four refractive surgeons Centre is the only clinic of refractive errors in the eye that at the Lions Laser Vision; Professor in Perth to use the normally would require glasses or Geoffrey Crawford, Professor Graham contact lenses. Barrett, Associate Professor Steven world’s fastest and most Wiffen and Dr Andrea Ang, all of advanced excimer laser Initially the surface of the cornea whom have had specialist fellowship source, the Schwind was lasered to flatten the cornea training in refractive and corneal 1050RS, which corrects for correction of short sightedness surgery in the United States. one dioptre of myopia (myopia). It is now possible to also in just 1.3 seconds. correct long-sightedness (hyperopia) The future is bright for laser vision and astigmatism. In 1990 the correction with new techniques Our continued investment in the latest technique was improved by adding becoming available to correct all forms and most advanced technology in the the creation of a flap with the ablation of refractive errors. world, combined with the extensive performed under this. LASIK was more experience of the Lions Laser Vision effective and accurate, and more The Lions Laser Vision Centre will Centre’s surgeons, means patients will comfortable post-operatively with continue to provide the latest and have the best possible visual outcome more rapid visual recovery. safest technology for patients to after laser vision correction. provide them with the best possible LASIK is the gold standard of laser vision without glasses or contact Patient safety is the centre’s number refractive surgery and the second lenses. one priority and ongoing investment most commonly performed eye in the latest technology supports this operation in the world after cataract goal. surgery.

The history of the Lions Laser Vision Centre has been one of firsts - the first refractive laser centre in Western Australia; the first centre to perform laser PRK surgery in Australia in 1991, the first centre to perform LASIK in Western Australia in 1996 and the first and still the only accredited laser vision centre in Western Australia.

The centre has achieved accreditation each year since 2006 with ISO 9001 - an internationally-recognised quality management system.

Laser refractive surgery began with the introduction of an excimer laser Lions Laser Vision surgeons Professor Geoffrey Crawford, Professor Graham in 1982 to reshape the surface of the Barrett, Dr Andrea Ang and Associate Professor Steven Wiffen

Lions Eye Institute Annual Report 2015 65 Lions Eye Bank

Lions Eye Bank

Li66 Lions Eye Bank

Established in 1986, a graft, transplants are now being banks to maintain consistently high the Lions Eye Bank is performed within a matter of weeks. levels of quality, safety, proficiency and the only facility in WA This chart below shows how ocular ethics. Excess tissue is shared when transplantation rates have more than appropriate and emergency requests that coordinates the doubled in 10 years. for tissue are always supported. collection, processing and distribution of eye State-of-the-art surgical techniques The goals of the Lions Eye Bank are tissue for transplantation. have also evolved so only the diseased to: portion of the cornea is replaced, • Prevent blindness and improve Almost 4400 corneal transplants enhancing the recovery period the outcome of eye disease by have been performed to date - 190 of and visual outcome for the patient. providing corneal and sclera tissue those in 2015. During the year, 176 Previously, the entire cornea was for transplantation corneas were sourced locally and 14 replaced regardless of the diagnosis. • Raise the profile of the LEI in from interstate. In addition to corneal the community, both locally and transplants, scleral tissue was used in Ten surgeons perform corneal grafts nationally, by educating the public 144 other surgical procedures. for both public and private patients and medical providers about the including LEI clinicians Professor critical role of the Eye Bank in All donor tissue is used either for Graham Barrett, Professor Geoffrey sight-saving procedures transplantation or, if unsuitable, for Crawford, Associate Professor Steven • Continue to remain a sustainable ethically approved research or surgical Wiffen and Dr Andrea Ang. unit within the LEI by generating training with the consent of the sufficient proceeds through donor’s family. This tissue is crucial to Glaucoma surgeons Professor William the provision of eye tissues for advancing research and developing Morgan and Dr Antonio Guibilato use transplantation surgical techniques. scleral grafts in surgery to reduce intraocular pressure. New storage methods have As an independent organisation, the contributed to the most significant As a member of the Eye Bank Lions Eye Bank of Western Australia is growth in almost 30 years of eye Association of Australia and New self-funded through cost recovery and banking in WA. Where some patients Zealand (EBAANZ), the Lions Eye Bank is supported by the Lions Save-Sight used to wait more than two years for works collaboratively with other eye Foundation.

Ocular Transplants 2005-2014

2005 2006 2007 2008 2009 2010 2011 2012 2013 2014

Corneas 86 97 99 121 132 142 188 199 184 183

Sclera 74 88 70 76 72 94 89 136 148 167

Lions Eye Institute Annual Report 2015 67 Profile Enid Gelden Gift of sight transforms Enid’s life

Enid Gelden can “It was a very traumatic experience,” “I can see very well. My light- experience the joy she said. “I had to attend endless sensitivity is almost gone and I am no of watching her eye specialist appointments with a longer squinting.” screaming newborn. two children grow Enid is acutely aware that while she up because of two “I was sleep deprived and wanted received the gift of sight twice, there sight-saving corneal to do everything right – as first-time are donor families dealing with the transplants through mothers do – and was afraid the loss of a loved one. the Lions Eye Bank. steroid drops I had to take would do my little boy harm.” “I am extremely grateful for both of my The 40-year-old from Margaret River, corneal donations and, being a parent, was diagnosed with keratoconus in Enid said her vision was so bad it I feel so deeply sorry for the families,” her left eye, which caused her cornea was like looking through white frosted she said. to bulge into a conical shape, at the glass. age of 16. “I can only imagine how hard it would Her ophthalmologist was able to stop be to consent to a loved one’s organs By the time she left high school, a complete rejection of the cornea but being donated. But hopefully, knowing conventional methods to correct she was on constant medication, her what a positive impact this selfless act her vision were failing and she was eye was extremely light sensitive, she had on me and countless other donor placed on a waiting list for a cornea was in pain and discomfort and her recipients would bring some comfort transplant. vision fluctuated. to families.”

At the time, there was a waiting list of Enid waited until her second child up to two years but at the age of 21, Joel was two before contemplating Enid had her first corneal transplant. another corneal graft and in 2014, a new cornea was inserted under the The operation was successful and existing one. after a long recovery, her vision improved dramatically. “Within a week, my vision started clearing and constantly improving,” But 13 years later, after the birth she said. ABOVE of her first child Jesse, Enid’s body Enid Gelden with her husband Lance rejected the cornea for no obvious “To this day I can’t believe what an and their children Jesse and Joel reason. improvement the new cornea made.

68 Lions Eye Institute Annual Report 2015 Clinic Design

Clinic Design C69 Clinic Design

New clinic designed for future growth

Throughout the year, a visit. Such services include the • Upgrades to the lobby and main design work has photography suite, patient facilities entrance, including relocation of continued on the new and access to secretary and the front reception, coffee shop administrative functions. and other facilities to greatly ground floor clinic and improve patient “way finding”. ancillary services. • Additional consultation and testing rooms to meet the demands and Other works include the removal volumes of patients attending the of the staircase and infill of the The design process has involved clinics. Modular style rooms have 1st Floor void to improve both substantial careful planning, many been created which offer flexibility acoustics and air temperature. external consultants, multiple user in use and can be adapted to suit • An office for the Development group meetings and input from the needs of the LEI over time if Group in the ground floor area to various stakeholders within the LEI to required. better support its work in attracting ensure the creation of a facility that funding for the LEI’s important will meet the community’s ever- • A separate injection suite research activities. increasing demand for medical and consisting of dedicated waiting research services. areas, two injection rooms, In other significant works during recovery bays and administrative the year a new lift car was installed, “The objective is to create a ground functions. This will enable providing safer and more reliable floor facility that will offer greater segregation from the main clinic transport between floors. Construction flexibility, improved patient flows and once again improve patient works were carried out over a period and “future proof” clinical services flows within the entire clinic. of six weeks with little or no disruption for many years to come,” Project • A dedicated clinical trials area, to the clinics. Works are often difficult Manager Steve Atkins said. featuring two clinical trials within an operational environment, rooms plus a separate waiting however the service provided was to “Aside from the actual tangible area that will further enhance expectations and completed within the or visible outcomes, a degree of the experience of our important time frames. intangible works will be implemented clinical trial participants. within the Plant Room and other services to complement and efficiently run the new ground floor. The design is nearing completion and construction will begin in 2016.”

Some of the key aspects of the new ground floor will include: • Relocation of the Retina clinic to significantly improve the experience for all attending patients and provide greater convenience. The move will also consolidate the services for patients within one area minimising travel distances during An artist’s impression of the new LEI lobby area

70 Lions Eye Institute Annual Report 2015 Collaborators & Visitors

Collaborators & Visitors C71 Collaborators & Visitors

Genetics and Queensland Institute of Centre for Experimental Population Health Medical Research, Brisbane Immunology • Professor Nick Martin - Visitors Queensland Institute of Visitors • Wenzhou Medical Medical Research, Brisbane • Professor Dirk Busch – Director of University delegation • Professor Paul Mitchell - Technische Universität München, Centre for Vision Research, Institute for Medical Microbiology, Collaborators Department of Ophthalmology and Immunology and Hygiene • Associate Professor Kathryn Burdon Westmead Millennium Institute, • Professor Geoff Hill – Bone – University of Tasmania, Hobart University of Sydney, Sydney Marrow Transplant Laboratory, • Professor Minas Coroneo - • Professor Grant Montgomery Queensland Institute of University of Sydney, Sydney - Queensland Institute of Medical Research, Brisbane • Associate Professor Jamie Craig Medical Research, Brisbane • Professor Paul Mc Menamin -Flinders University, Adelaide • Professor Anthony (Tony) Moore – Department of Anatomy & • Professor Jonathan Crowston - Institute of Ophthalmology, Developmental Biology, Monash - Centre for Eye Research University College London UK University, Melbourne Australia, University of • Associate Professor Craig Melbourne, Royal Victorian Eye Pennell - School of Women’s Collaborators and Ear Hospital, Melbourne and Infants’ Health, University • Professor Matt Brown - • Dr Elizabeth Engle - Howard Hughes of Western Australia, Perth Diamantina Institute, University Medical Institute Engle Lab & • Professor Carmel Toomes - Leeds of Queensland, Brisbane Center for Strabismus Research, Institute of Molecular Medicine, • Dr Gabrielle Belz – The Walter and Children’s Hospital, Boston USA Leeds University, Leeds UK Eliza Hall Institute, Melbourne • Associate Professor Jeremy • Professor Ian Trounce - Centre for • Professor Dirk Busch – Institute for (Jez) Guggenheim - Hong Eye Research Australia, University Medical Microbiology, Immunology Kong Polytechnic University of Melbourne, Royal Victorian Eye and Hygiene, Munich, Germany • Professor Chris Hammond - and Ear Hospital, Melbourne • Professor Ian Frazer – Translational King’s College London School • Dr Rohit Varma - Doheny Eye Research Institute, University of Medicine, London, UK Centre, Los Angeles, California USA of Queensland, Brisbane • Dr Alison Hardcastle - UCL Institute • Dr Cathy Williams - University • Associate Professor Nadia Guerra – of Ophthalmology, London, UK of Bristol, Bristol UK Faculty of Natural Sciences, Imperial • Professor Mingguang He • Dr Mary Wirtz - Oregon College London, United Kingdom - Zhongshan Ophthalmic Health & Science University, • Professor Geoff Hill - Bone Centre, Sun Yat-sen University, Portland, Oregon USA Marrow Transplant Laboratory, Guangzhou, China • Professor Tien Wong - Singapore Queensland Institute of • Dr Alex Hewitt – University Eye Research Institute, Singapore Medical Research, Brisbane of Tasmania, Hobart • Dr Terri Young – University • Dr David Huang - Molecular • Dr Simon John - The Jackson Wisconsin, Madison, Wisconsin Genetics of Cancer Division, The laboratory, Bar Harbor, Maine USA Walter and Eliza Hall Institute of • Associate Professor Geoff Lam - Medical Research, Melbourne Princess Margaret Hospital, Perth • Professor Philip Hugenholtz - • Dr Stuart MacGregor -

72 Lions Eye Institute Annual Report 2015 Collaborators & Visitors

Australian Centre for Ecogenomics, Ocular Tissue and • Associate Professor Damien University of Queensland Engineering Laboratory Harkin - School of Biomedical • Dr Nicholas Huntington – The Walter Sciences, Faculty of Health, QUT and Eliza Hall Institute, Melbourne Visiting Researchers and Queensland Eye Institute • Professor Wallace Langdon and Doctors • Dr Elin Gray – Edith Cowan - School of Pathology and • Dr Ling Zhang (Post- University, Perth Laboratory Medicine, University doctoral research fellow) • Dr Kristen Nowak – Perkins of Western Australia, Perth • Dr Erwei Hao (Post-doctoral Institute, Perth • Professor Shaun McColl - Director, research fellow) • Dr John De Roach – The Centre for Molecular Pathology, • Dr Jinping Wang (Post- Australian Inherited Retinal Adelaide University, Adelaide doctoral research fellow) Disease Registry, Perth • Professor Paul McMenamin • Dr Wei Chen (Post-doctoral - Department of Anatomy & research fellow) Physiology and Developmental Biology, Monash Pharmacology University, Melbourne Visiting Professor and Speakers • Professor Stephen Nutt – The Walter • Dr Peter Van Wijngaarden - Centre Research Collaborators and Eliza Hall Institute, Melbourne for Eye Research Australia • Dr Gerhard Zinser - Heidelberg • Professor Stan Riddell, Research Collaborators Engineering, Germany Fred Hutchinson Cancer International • Dr Mukesh Jain - Custom Center, Seattle, USA • Professor Lyndon Da Cruz Vis Lasers, Perth • E/Professor John Papadimitriou - Moorfields Eye Hospital, • Professor Mark Humayun – School of Pathology and London- Vision Eye Institute - University of Southern Laboratory Medicine, University • Dr Michael Edel - Research California, USA of Western Australia, Perth Institute of Hospital Val d • Professor Marinko Sarunic - Simon • Professor Mark Smyth - Hebron, Barcelona, Spain Fraser University, Canada Cancer Immunology Program, • Dr Robert Johnston - Cheltenham • Professor Martin Hazelton - Peter MacCallum Cancer General Hospital, Cheltenham, UK Massey University, New Zealand Centre, Melbourne • Prof Mark Gillies - Sydney • Dr Fernando Souza-Fonseca- Local/National Save sight Institute Guimaraes – Queensland • Professor Rod Dilley - Ear Sciences • Richard Keeler - Curator Institute for Medical Research Centre, School of Surgery, UWA Museum Royal College of • Professor Joseph Trapani - • Professor Robyn Guymer - Centre Ophthalmologists, London Cancer Immunology Program, for Eye Research Australia, • Victor Previn - Ellex Medical Peter MacCallum Cancer University of Melbourne lasers Adelaide Centre, Melbourne • Professor Mel Ziman – Edith • Rohan Essex - Australian • Professor Ranjeny Thomas - Cowan University, Perth National University, Canberra Diamantina Institute, University • Associate Professor Aron Chakera of Queensland, Brisbane - Department of Nephrology, Sir • Professor George Yeoh – Charles Gairdner Hospital, Perth School of Chemistry and • Associate Professor Seng Khee Biochemistry, University of Gan – Department of Endocrinology, Western Australia, Perth Royal Perth Hospital, Perth

Lions Eye Institute Annual Report 2015 73 Myopia Rates in the Spotlight

High Chinese myopia rates in the spotlight

A leading expert on Professor He’s Raine Lecture shared myopia rates in China some findings from a newly- delivered a well-attended established high myopia registry study in China. Raine Lecture in 2015. ABOVE Professor He and LEI Managing Director Professor Professor Mackey Formerly the Deputy Director of David Mackey hosted his visit. Zhongshan Ophthalmic Centre at Sun-yat Sen University in Guangzhou, Professor Mingguang He is now Professor of Ophthalmic Epidemiology at the University of Melbourne. LEFT He ran China’s first glaucoma Professor He with survey and the largest twin registry Professor Mackey and in China and has published almost friends at UWA 200 papers in international peer- reviewed journals.

74 Lions Eye Institute Annual Report 2015 Conferences & Invited Lectures

Conferences &Invited Lectures C75 Conferences & Invited Lectures

January New Zealand Cornea Society benefits of diabetic retinal Meeting, Perth, Australia screening: OCT versus DRS • Schuster I. Oral presentation • Chen F. RANZCO Ophthalmological cameras.” RANZCO Colloquium - Selected participant and Colloquium, Perth, Australia meeting, Perth, Australia speaker. Recipient of a Network • McAllister I. Devices and • Host B. “Evaluating patient and of Immunology Frontiers Travel aids for the teaching and practitioners’ perceptions and Award. 4th Network of Immunology demonstration of ophthalmoscopy experiences of teleophalmology.” Frontiers Winter School on in the nineteenth century. Cogan RANZCO Colloquium Advanced Immunology, Singapore meeting. New York, USA. meeting, Perth, Australia • Turner A. “Increasing the rate February April of diabetic screening in WA.” • Schuster I. Oral presentation RANZCO Colloquium meeting, • Mackey D. How convicts, – Selected participant and mutineers and sun worshippers Perth, Western Australia speaker. Recipient of a • Chen F. “Tissue engineering of shaped genetic eye research prestigious Keystone Symposia Bruch’s membrane for retinal in Australia. Invited speaker. Scholarship. Autoimmunity and regeneration.” Centre for Cell Manton Center Seminar, Boston Tolerance Keystone Symposium, Therapy and Regenerative Medicine Children’s Hospital, Boston, USA Keystone, Colorado, USA Annual Research Symposium, • Mackey D. How convicts, mutineers • Chen F. Optometrist and sun worshippers shaped Curtin University, Perth, Australia Association Australia (WA) • McLenachan S. “ARPE19 cell- genetic eye research in Australia. derived extracellular matrix Invited speaker. Massachusetts promotes RPE differentiation.” March Eye and Ear, Boston, USA Science on the Swan Inaugural • Mackey D. Myopia or Pterygium, • Mackey D. Strabismus and what’s the choice for your Refractive Error – Prevalence Conference, Perth, Australia children and how much time they and Associations in the Twins spend outdoors? Invited speaker. Eye Study in Tasmania, Brisbane May Royal Australian & New Zealand Adolescent Twin Study, and the • Degli-Esposti M. Plenary Speaker, College of Ophthalmologists Western Australian Raine Eye NK2015: 15th Meeting of the Victorian State Branch Meeting, Health Study. Invited speaker. Society for Natural Immunity, Melbourne, Australia Boston Children’s Hospital Montebello, Canada • Mackey D. Predicting glaucoma in Ophthalmology/Radiology Monthly • Magno A. Presentation on data family members. Invited speaker. Conference Seminar, Boston, USA from the LEI’s gene therapy clinical Royal Australian & New Zealand • Mackey D. Retinal Dystrophies trial for Age-related Macular College of Ophthalmologists – five genes a clinician should Degeneration at the Australasian Victorian State Branch Meeting, know. Invited speaker, Paediatric Gene and Cell Therapy Society’s Melbourne, Australia Ophthalmology & Strabismus 9th Biennial Conference in • Mackey D. Draw the family tree Session, Asia-Pacific Association of Melbourne, Australia, and the – interactive case for registrars. Ophthalmology, Guangzhou, China Science Lands in Parliament event Training course for registrars. • Chen F. 30th Asia Pacific organised by the WA Branch of Royal Australian & New Zealand Academy of Ophthalmology the Australian Society for Medical College of Ophthalmologists meeting, Guangzhou, China Research (ASMR). Perth, Australia Victorian State Branch Meeting, • Chen F. Centre for Cell Therapy • McLenachan S. Presentation Melbourne, Australia and Regenerative Medicine at the ASMR event, presenting • Degli-Esposti M. Invited Speaker, Symposium, Perth, Australia a poster titled Personalised Rheumatology Department • Chen F. Poster presentation. Cell Therapy for Macular Meeting, Fiona Stanley The Association for Research in Degeneration. Perth, Australia Hospital, Perth, Australia Vision and Ophthalmology (ARVO) • Turner A. Two-point optometry • Degli-Esposti M. Plenary Conference, Denver, USA CPD accredited education session Speaker, 32nd Australia and • O’Halloran R. “Evaluating the

76 Lions Eye Institute Annual Report 2015 Conferences & Invited Lectures

on teleophthalmology, Kalgoorlie • Degli-Esposti M. Invited Speaker, not? 3. Intravitreal Aflibercept Regional Hospital, Australia Infection and Immunity Seminar for the Treatment of Diabetic • McAllister I. Invited Speaker. Program, Charles Perkins Centre, Macular Edema: Evaluating the Retinal vein occlusion. Current and University of Sydney, Australia Impact on Diabetic Retinopathy. future treatment trends. Optomax • Chen F. Australian and New Zealand ANZSRS/APVRS Conjoint meeting. Perth, Western Australia. Society of Retinal Specialists meeting. Sydney, Australia. • McAllister I. Invited Speaker. Congress, Sydney, Australia • McAllister I. Treatment of retinal Posterior segment complications • Chen F. Asia-Pacific Vitreo- vein occlusions in the age of in ocular trauma. Evaluation and retina Society Annual anti-VEGF.Future directions in management of posterior segment Congress, Sydney, Australia Ophthalmology, Brisbane, Australia. trauma. International Ophthalmology • Andoniou C. Oral presentation Symposium. Bali, Indonesia. – Selected speaker. 40th September International Herpesvirus • Degli-Esposti M. Invited Speaker, June Workshop, Boise, Idaho, USA Annual Scientific Meeting, Australian • Mackey D. Genetics and its clinical Rheumatology Association WA application. Invited speaker. World August State Branch, Perth, Australia Glaucoma Congress, Hong Kong • Mackey D. Return of results • Mackey D. UV and eyes. • Schuster I. Invited speaker Seminar for imputed myocilin mutations Invited speaker, D-Light Series of the Peter Doherty Institute in GWAS studies. Ophthalmic Symposium, Telethon Kids for Infection & Immunity, The Genetics Session. Invited Institute, Perth, Australia University of Melbourne, Australia moderator and speaker. • Mackey D. What colour are your • Degli-Esposti M. Invited Speaker, International Society for Genetic eyes? Invited speaker, Institute Animal Models of Disease, EMBL Eye Diseases & Retinoblastoma of Advanced Studies Public Australia PhD Course, Harry ISGEDR, Halifax, Canada Lecture for International Year of Perkins Institute of Medical • McAllister I. Invited Speaker. 1. Light, The University of Western Research, Perth, Australia Neil Della Lecture: Retinal Vein Australia, Perth, Australia • Degli-Esposti M. Invited Speaker, Occlusion: Where are we going • Mackey D. The International AILS2015 1st Australian Innate and when are we going to get Glaucoma Genetics Consortium Lymphocyte Symposium, there? 2. Wide field imaging in (IGGC) and the Consortium for Melbourne, Australia retina vein occlusion. Useful or Refractive Error and Myopia • Mackey D. Genetic Optic Neuropathies. Invited speaker, RANZCO Inter-Hospital Clinical Meeting, Perth, Australia • Mackey D. Why do you wear glasses? Genes and environment affecting myopia. Invited speaker, Harry Perkins Institute of Medical Research, Perkins Seminar Series, Perth, Australia • Mackey D. Twins Eye Studies of Strabismus. Invited speaker, Bayer Continuing Education for Orthoptics Australia Western Australian branch. Perth, Australia • Mackey D. Paediatric and Genetic Eye Disease. Royal Australian College of Surgeons teaching to eye trainees Dili, East Timor David Mackey speaks at the D-Light Symposium

Lions Eye Institute Annual Report 2015 77 Conferences & Invited Lectures

(CREAM), Invited speaker, Raine November • Mackey D. “The future progression Study Day, The University of of myopia: seeing where we • Mackey D. Mitochondrial Western Australia, Perth, Australia are going”. Marshall M Parks optic neuropathies – how do I • Mackey D. Global assessment Lecture. The 2015 American differentiate these from glaucoma? of retinal dystrophies. Invited Academy of Ophthalmology Symposium – Diagnostic Dilemmas speaker, Retina Genetics meeting, Las Vegas, USA in Glaucoma. Invited speaker. session, World Congress of • Chen F. RANZCO Annual Congress, Royal Australian & New Zealand Paediatric Ophthalmology and Wellington, New Zealand College of Ophthalmologists Strabismus, Barcelona, Spain • Chen F. UWA-UMGU-UCL 47th Annual Scientific Congress, • Mackey D. Pedigrees and Collaborative Research Wellington, New Zealand Populations: Success with Meeting, Perth, Australia • Mackey D. Why find a gene? Sequencing and GWASK. Invited • McAllister I. Thrombolytics and Translating Genetic Eye Research. speaker World Congress of clots and the eye. RANZCO 2015,. Symposium. Invited Chair and Panel Paediatric Ophthalmology and Wellington, New Zealand. Speaker. Royal Australian & New Strabismus, Barcelona, Spain Zealand College of Ophthalmologists • Mackey D. Phenotype: genotype 47th Annual Scientific Congress, December correlates in retinal dystrophies. Wellington, New Zealand • Degli-Esposti M. Session Chair, Invited speaker, Retina Medical • Degli-Esposti M. Invited speaker, Australasian Society of Immunology session, World Congress of Immunotherapy@Brisbane meeting Canberra, Australian Paediatric Ophthalmology and 2015, Brisbane, Australia Capital Territory, Australia Strabismus, Barcelona, Spain • Yu D-Y. “Research discoveries to • Degli-Esposti M. Plenary Speaker, • McAllister I. Invited Speaker. Role clinical application: developing a 8th Australasian Virology Society of Chorioretinal anastomosis in the new glaucoma filtration surgery.” Meeting and 11th Annual Meeting management of CRVO. Euretina Ida Mann Lecture. Royal Australian of the Australian Centre for annual meeting. Nice, France. and New Zealand College Hepatitis & HIV Virology Meeting • McAllister I. Technique of laser of Ophthalmology congress, 2015, Hunter Valley, Australia anastomosis creation and Wellington, New Zealand • Degli-Esposti M. Invited speaker, improved success rates with new purpose designed laser photocoagulator. Retina Society annual meeting, Paris, France. October • Mackey D. Ophthalmic Genetics. Invited speaker, The Royal Children’s Hospital Paediatric Seminar, Melbourne, Australia • Mackey D. Genetic and environmental influences in development of strabismus. Invited speaker, European Strabismological Association, Venice, Italy • Degli-Esposti M. Invited speaker, 38th Annual Scientific Meeting of the Australasian Cytometry Society, Perth, Australia • Chen F. Lions Club District Convention Perth, Australia • Chen F. Annual Medicines update, Pharmaceutical Society of Australia • Chen F. Retina Australia National Fellow Nobel Laureate Professor Barry Marshall (right) was one of the many Congress, Melbourne, Australia special guests to attend Professor Blackburn’s Ian Constable Lecture at UWA

78 Lions Eye Institute Annual Report 2015 Ian Constable Lecture

15th International CMV/Betaherpes workshop, Brisbane, Australia

2015 Ian Constable Lecture

Australian-born Nobel Professor Blackburn won the Nobel Laureate Professor Prize for Physiology and Medicine Elizabeth Blackburn in 2009 after discovering the molecular nature of telomeres - ABOVE delivered the 2015 Ian protective DNA-protein complexes Constable Lecture. Professor David Mackey, that help stabilise the body’s genetic Nobel Laureate Professor information. The 16th annual lecture was very Elizabeth Blackburn and well received with more than 500 Professor Ian Constable Her research has linked short at the LEI people packing UWA’s Octagon telomeres to heart disease, diabetes, Theatre to hear her speak. cancer, chronic stress and post- traumatic stress disorder. Professor Blackburn spoke on Implications of Telomere LEI Managing Director Professor Maintenance in Ageing-Related David Mackey said it was wonderful Processes and Diseases, exploring to have such a successful Australian how stress, poverty, diet and lifestyle researcher as a role model for our as well as genes contribute to rapid scientists delivering this year’s ageing of the body’s cells. lecture.

Lions Eye Institute Annual Report 2015 79 Open Day

Open Day

A key part of the LEI’s mission is community engagement and education to build awareness, maintain a high reputation and increase funding.

An increasingly important way for the LEI to connect with the community is through the annual Open Day, which invites people to a behind-the-scenes look at our research and clinical work.

The 2015 Open Day was no different, giving visitors a chance to discover what it is like to be colour blind or have glaucoma.

Angus Turner at LEI Open Day Also on offer was “Coffee with a Professor”, clinic tours and information on laser surgery, eye research and clinical trials, and the Lions Outback Vision Van project. C80 Profile Mark & Natasha’s Ride

Mark & Natasha’s ride to save sight

Eight years ago, Uveitis affects one in 4500 people – Mark’s daughter Kim usually the young and working age was diagnosed with group - and is estimated to account for 15 per cent of visual impairment ABOVE uveitis. She was just in Australia. six at the time. Mark and his daughter Natasha at Land’s End, Cornwall, at the start “To help raise funds for the Lions of their fundraising bike ride in The condition caused an Eye Institute, my eldest daughter June, 2015 inflammation of Kim’s inner eye, Natasha and I decided to ride from which would have eventually led to Land’s End in Cornwall to John tissue damage and severe visual O’Groat’s in Scotland,” Mark said. impairment if left untreated. Kim was immediately referred to “Over 12 days we covered 1550km Professor Mei-Ling Tay-Kearney and the total elevation of 18,000 at the LEI and since her initial metres was the equivalent of diagnosis, she has received weekly climbing Everest twice. I’d forgotten injections and medication to how hilly Cornwell is! manager her condition. “We raised around $15,000 for the LEI and we are thankful for everyone’s support.”

Lions Eye Institute Annual Report 2015 81 Acknowledgements

Acknowledgements

A82 Acknowledgements

Bequests • Mrs Petrina Freedman Major Institutional Support • Golden Group • Estate of the Late Edna Bailey • Bayer Global Ophthalmology Awards • Mr Norman Hogg • Estate of the Late Alan • Device Technologies • Dr Patricia Kailis AM OBE and Lilian Cameron • Federal Government of • Mandurah Murray Mayday Club • Estate of the Late Clarice Australia – Australian Research • Medical Centre Chemist, Nedlands Edna Copper Council Discovery Project, • Mr and Mrs Brad and • Estate of the Late Marie Fanlo Commonwealth Department Carolyn Miocevich • Estate of the Late Margaret Kerman of Health, National Health and • Mrs Elva Moore • Estate of the Late Medical Research Council • Oxford Compounding Barbara Morganari • Government of Western • Mrs Nancy Patterson • Estate of the Late Carolyn Pool Australia – Department of • Prime Movers (Inc) • Estate of the Late Anna Taphorn Health, Country Health Service • Mrs Gwynneth Roberts • Estate of the Late Gladys Whitford • Lotterywest • Mr and Mrs John and Lee Saleeba • Ophthalmic Research • Drs Sjakon and Shelley Tahija Memorial gifts, honouring Institute of Australia • Perpetual IMPACT Philanthropy • Anonymous Trusts and Foundations • Quadrant Energy Pty Ltd • Mr John Fussell • Australian Foundation for the • Retina Australia (WA) • Mr Peter Kidd Prevention of Blindness (AFPB) • Sir Charles Gairdner Hospital • Ms Rhoda Mullins • Berg Family Foundation Pty Ltd • Telstra • Mrs Pearce • BrightFocus Foundation • The University of Western Australia • Ms Lorraine Penny • Channel 7 Telethon Trust • Mr John Regan • Constantine Family • Ms Doreen Stewart Foundation Pty Ltd • Mr Tan • Fred Hollows Foundation • Ms Katina Yiannakis • Lions Save-Sight Foundation • McCusker Charitable Foundation Special Gifts • The Patrick Foundation • Anonymous • Quality of Life Foundation • Mr Kevin Bowen • RANZCO Eye Foundation • Dr Fred Chen • Stan Perron Charitable • Mr George Church Foundation Ltd John and Lee Saleeba were • Professor Geoffrey Crawford generous supporters of the LEI • Mr John Cruickshank in 2015. They are pictured here • Dr Jean-Louis deSousa with Dr Fred Chen and research assistant Xiao Zhang A Lions Eye Institute Annual Report 2015 83 Lions Save-Sight Foundation

Lions Save-Sight Foundation

Li84 Lions Save-Sight Foundation

The year under review, Conventions in October 2015. His to acknowledge the advancement of 2015, has again been address was very well received, and Professor Angus Turner to his role with one of collaboration we are grateful for his giving time to UWA and Lions Outback Vision. With us and allowing Lions members to many Lions clubs in non-metropolitan and assistance between gain an insight into the excellent work areas, the vision of a Lions mobile the Lions Save-Sight being undertaken at the LEI. clinic van (and a very large one at Foundation and the LEI. that!) going through their towns will be On this same note, we are grateful for a great morale boost for them. Dr Matthew Wikstrom completed his those senior executive members of the PDG Brian King Fellowship and we LEI team who have made themselves Yet again, we look forward to the year now await the selection of our next available to act as guides for those ahead and trust that LEI will again fellow appointment. Applications Lions clubs which have undertaken go from strength to strength. We are currently being considered and visitations to the LEI. All who have continue to stand behind them with we stand ready to fund the new visited are excited to find such a our support. appointee. In recent times we have facility and even more delighted that it not had suitable students to avail exists under the name of Lions. themselves of the Dr Jack Hoffman Scholarship but have at a recent During this last year, I have been able Board meeting approved a sum of to represent both organisations as a $10,000 to support a post-graduate guest speaker at various clubs and student of Chinese background who social group organisations (outside comes highly recommended from The of Lions) to “spread the word” about University of WA. our work. It has been a privilege to do so, and it is especially important, Earlier in 2015, a grant application in that day time meetings ensures by LEI to the National Health and busy professionals at the LEI are not Medical Research Council for funding taken away from their valuable work. to continue a project in conjunction I strongly believe it is important to with the Busselton Health Study accept these invitations and spread was unsuccessful. Following the our great story at every opportunity. presentation of a proposal from Ambrose Depiazzi Professor Mackey, LSSF have provided In concluding, I would like to firstly CHAIRMAN, LIONS SAVE-SIGHT funding of $15,000 to cover this congratulate Professor David FOUNDATION (WA) INC. project. Mackey on his winning of a Churchill Fellowship. They are not easy to come Lions’ members in Western Australia by and reflect his high standing in were privileged to have Professor the profession. Secondly I would like Fred Chen attend both our District

Lions Eye Institute Annual Report 2015 85 Volunteers

Volunteers

The LEI’s warm and friendly volunteers are among the first people patients encounter when they walk through the doors of the LEI.

Established in 2010, the Volunteer Program is coordinated by Robin Miller. She took over the role from Kay Hooper during 2015.

They play a crucial support role for patients and support many of the LEI’s activities during the year, including the annual Open Day, Ian Constable Lecture, Telethon and Visionaries Luncheon.

Other work involves assistance with Christmas decorations and festivities and maintenance of brochures and magazines in the Robert Linton Library.

Interest in joining the Volunteer Volunteers manning the desk in the Verdun St building offer great Program remains strong and overall support to our patients and visitors numbers grew to 34 during the year.

All volunteers undergo an induction and participate in training, including Hand Hygiene Australia initiatives and wheelchair use. V86 Profile Robin Miller

Volunteering reaps its own rewards

“What is the essence - escorting the elderly and vision small way to make a difference to a of life? To serve others impaired, collecting medications from patient’s visit - either by offering a tea and to do good.” the QEII pharmacy or providing safe or coffee, having a chat, arranging access to refreshments. transport or just a cheerful ‘hi’. Aristotle might have lived more As coordinator, Robin supervises the “I believe volunteering is good for the than 2000 years ago, but his words LEI Volunteer Program, helps to recruit soul and very rewarding!” still resonate for the LEI’s band of and train volunteers and, along with volunteers, who support vulnerable Team Leaders, ensures appropriate patients requiring help and support rostering to meet workloads and before and after their medical changing circumstances. treatment. “I first heard about the LEI’s Volunteer This dedicated group of 34 women Program from a friend who was a and men is led by Volunteer volunteer at the time and joined up in ABOVE Coordinator Robin Miller. July 2011,” she said. Volunteer Coordinator Robin Miller: Decked out in their red vests, “I love and enjoy the interaction with “volunteering is good volunteers are often the first to greet for the soul” staff and our volunteers but get the patients as they arrive at the LEI. most satisfaction from helping in a The volunteers assist in many ways

Lions Eye Institute Annual Report 2015 87 Grants

Grants

G88 Grants

Australian Competitive NHMRC Early Career Fellowship Government of Western Australia Grants • Chen F Department of Health • NIRIS Award NHMRC Scholarship NHMRC Program Grant • Chen F • Kang M • Immunological therapies for cancer, Government of Western Australia chronic infection and autoimmunity ARC Discovery Project Department of Health • Chief investigator – Degli-Esposti M • Utilising virally-encoded • Lions Outback Vision NHMRC Centre for proteins to decipher apoptotic • Turner A Research Excellence regulatory mechanisms • Chief investigators – Andoniou WA Country Health Service • Translation of genetic eye C, Degli-Esposti M • Turner A research integrating education, counselling and testing with Ophthalmic Research Other Grants gene discovery and gene-based Institute of Australia therapies for eye disease • Investigating mechanism of visual Channel 7 Telethon Trust • Chief investigators – Mackey D, scotoma and metamorphopsia • Turner A Hewitt A, Burdon K, Craig J due to macular disease using Fred Hollows Foundation NHMRC Project Grant multimodal imaging • Chief investigator – Bukowska D • Turner A • Understanding the role of CD4 T cells in viral infection a means of Ophthalmic Research RANZCO improving anti-viral immunotherapy Institute of Australia • Chief investigators - Degli- • Assessment of Tenecteplase Sir Charles Gairdner Hospital Esposti M, Andoniou C (metalyase) as an acute • Scholarship NHMRC Project Grant interventional treatment for branch • McLenachan S retinal vein occlusion (BRVO) • Developing a new glaucoma • Chief investigators – McAllister Stan Perron Charitable surgery using precision ablation I, Shaw A, Yu D-Y Foundation of the trabecular meshwork • Degli-Esposti M • Chief investigators – Yu D-Y, Retina Australia Morgan W, Cringle S • Accelerating therapeutic discoveries Lions Save-Sight Foundation • Research support NHMRC Project Grant for Retinitis Pigmentosa • Chief investigator – Mackey D • Non-invasive retinal vein pulsation The University of pressure measurement Perpetual IMPACT Western Australia • Chief investigators – Philanthropy Program • Centre for Ophthalmology and Visual Morgan W, Yu D-Y • Does modification of time Science Infrastructure Funding outdoors during childhood affect NHMRC Project Grant The University of myopia in early adulthood? • A fibroin-based prosthetic Bruch’s Western Australia • Chief investigator - Mackey D membrane for the treatment of • AA Saw Scholarship Top Up Age-Related Macular Degeneration • Kang M • Chief investigator – Chen F Government Grants International Grants NHRMC Development Grant Commonwealth • BrightFocus Foundation • Non-invasive intra-cranial Department of Health pressure measurement • Turner A • Mackey D • Chief investigator – Morgan W Government of Western Australia GOAP Bayer NHMRC Principal Department of Health • Chen F Research Fellowship • Round 18 MHRIF • Degli-Esposti M

Total Grants 2015 $5,676,043

Lions Eye Institute Annual Report 2015 89 Financial Statements

Financial Statements

F90 Financial Statements

The summary below is an aggregate of the Institute’s financial results and research grants administered by the Institute.

Income Statement 2015 2014

For the year ended 31 December $ $ Total income including research grants 18,308,056 20,596,746

Total expenditure including research expenses (16,556,480) (20,518,533)

Operating profit before significant items 1,751,576 78,213

Fair value adjustment of investments 347,601 609,387

Operating profit after significant items 2,099,177 687,600

Change in the fair value of available for sale financial assets 2,367,702 -

Accumulated profit at the beginning of the year 32,637,545 31,949,945

Accumulated Profit at the End of the Year 37,104,424 32,637,545

Balance Sheet 2015 2014

At 31 December $ $

Total Funds 37,104,424 32,637,545

Represented by

Cash assets 14,790,421 18,337,101

Available for sale financial assets 2,878,780 -

Other assets 1,964,431 2,472,646

Other financial assets 24,925,916 18,157,868

Property, plant and equipment 8,212,963 8,110,447

Total Assets 52,772,511 47,078,062

Payables 3,887,686 2,665,536

Research grant funds not yet spent 10,228,062 10,479,404

Provision for employee entitlements 1,552,339 1,295,577

Total Liabilities 15,668,087 14,440,517

Net Assets 37,104,424 32,637,545

Lions Eye Institute Annual Report 2015 91 Visionaries Luncheon

You’re saving sight too

Visionaries Luncheon

Generous supporters Mr Pearce thanked LEI’s of the LEI enjoyed “visionaries” – those people whose meeting researchers and philanthropic support helps the LEI to fund vital eye research, facilities ABOVE clinicians at the 2015 and infrastructure. Visionaries Luncheon at Professor Mackey addresses attendees at UWA’s University Club. Professor Mariapia Degli-Esposti the annual Visionaries presented a talk called “Immunology Luncheon Guests heard about the work of the at the forefront of improved LEI from Professor David Mackey therapies for eye diseases”. and Institute highlights over the past year from Board Chair Stephen Pearce.

92 Lions Eye Institute Annual Report 2015 You’re saving sight too

The Lions Eye Institute is on a quest to save sight. We offer a full range of eye health services through our clinic, and as a non-for-profit organisation, part proceeds directly support our world leading medical researchers.

Visit our website: lei.org.au Acronyms Used in this Report

Acronyms

Contact Information Lions Eye Institute 2 Verdun Street Nedlands WA 6009

Phone +61 8 9381 0777 Fax +61 8 9381 0700 Email [email protected] ABN 48 106 521 439

Media Contact A digital version of this report is Francesca Robb available on our website: Mobile 0409 102 556 [email protected] www.lei.org.au A94 Lions Eye Institute Annual Report 2015 95 Lions Eye Institute Annual Report 2015 Australian Foundation for the Prevention of Blindness Trust of Blindness for the Prevention Australian Foundation of CompanyAustralian Institute Directors Australian AssociationMedical of Australian and New Zealand Society Ophthalmic Plastic Surgeons Association of Cataract Asia-Pacific and Refractive Surgeons American Society of Cataract and Refractive Surgery Australasian Society of Cataract and Refractive Surgeons Visual Science, Centre of Ophthalmology and The University Australia of Western New Australian and of the RoyalFellow Zealand College of Ophthalmologists Intraocular lens Laser epithelial keratomileusis in-situ keratomileusis Laser-assisted Lions Eye Institute Lions Outback Vision Lions Save-Sight Foundation National Health and Medical Research Council Engineering LaboratoryTissue Ocular Princess Margaret Hospital Photorefractive keratectomy Australian and New Zealand Royal College of Ophthalmologists Royal Hospital Perth Sir Charles Gairdner Hospital The University Australia of Western

AFPB AICD AMA ANZSOPS APACRS ASCRS AUSCRS COVS FRANZCO IOL LASEK LASIK LEI LOV LSSF NHMRC OTEL PMH PRK RANZCO RPH SCGH UWA

acronyms A Contact Information Lions Eye Institute 2 Verdun Street Nedlands WA 6009

Phone +61 8 9381 0777 Fax +61 8 9381 0700 Email [email protected] ABN 48 106 521 439