Combined Immunosppression and Radiotherapy in Thyroid Eye Disease

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					The Research & Development Newsletter for Ophthalmology                                                             Spring 2006, Issue 3

Content                                       Combined Immunosppression
Front Page:                                   and Radiotherapy in
• Combined Immunosuppression                  Thyroid Eye Disease
  and Radiotherapy in Thyroid
  Eye Disease Trial (CIRTED)                  Trial (CIRTED)
Back Page:                                    Thyroid Eye Disease (TED) is an
                                              inflammatory autoimmune condition
• View Profile                                of the orbit which is clinically apparent
                                              in 25-50% of people with Graves’
• NICE Guidance on Laser Eye                  hyperthyroidism. There are 400 000 TED
  Surgery                                     sufferers in the UK. Signs of TED include
                                              chemosis, eyelid swelling, proptosis,
• R&D Contacts                                diplopia and in severe cases optic
                                              neuropathy. The majority of patients
• Ethics Committee Deadlines                  report mild symptoms but the patients
                                              who suffer from moderate or severe TED
                                              can have significant disfigurement and
In Other News...                              disability. Treatment is aimed at inducing
                                              an early remission of the condition and
National Knowledge Week                       therefore reducing the severity of signs.
                                              There is controversy about how best
for Diabetic Retinopathy                      to manage moderately active TED as
                                              there is a lot of conflicting evidence in     stage and we would appreciate the
The National Knowledge Week for Diabetic      the literature. Oral steroids have been       referral of any new thyroid eye disease
Retinopathy – running in parallel with        shown to improve TED clinically but long      patients with a history of progression
National Diabetes Week (11th to 17th          term use can cause complications. Other       of their symptoms. Our main inclusion
June 2006) – is aimed at the busy health      treatments used are radiotherapy, other       and exclusion criteria are as follows:
professional, providing them with access      immunosuppressants (azathioprine,
to accurate, up-to-date knowledge on          cyclosporine) and more novel treatments       Inclusion Criteria
Diabetic Retinopathy quickly and easily.      such as somatostatin analogues or
Information will be selected using rigorous   anti-tumour necrosis factor.                  • Active thyroid eye disease
criteria and organized on the basis of hot
topics suggested by UK diabetic retinopathy   The Combined Immunosuppression and            Exclusion Criteria
experts.                                      Radiotherapy in Thyroid Eye Disease
                                              (CIRTED) trial is a randomized controlled     • Age <20 or >75 yrs
Further Information:                          double-blind clinical trial of the                   treatment of moderately active thyroid        • Optic neuropathy
                                              eye disease. It is a collaboration which
Websites                                      was setup by Moorfields Eye Hospital          • Pre-existing glaucoma
                                              (Mr Jimmy Uddin, Mr Geoff Rose, Miss
                                              Rathie Rajendram) and United Bristol          • Pre-existing Diabetes Mellitus (not
Moorfields Eye Hospital NHS Foundation        Hospitals(Mr Mike Potts, Mr Richard             simply steroid induced disease from
Trust:                                        Lee, Dr Colin Dayan) and we are in the          recent therapy)                         process of making Western Eye Hospital
                                              a third trial centre. This trial is looking   • Within 6/12 of pregnancy/ women
Eyes & Vision Specialist Library:             at the efficacy of radiotherapy and long        planning pregnancy/ lactation                       and short term immunosuppression
                                              for the treatment of moderate thyroid         Further Information:
The Ophthalmic Research Network:              eye disease. Patients receive a standard                         oral steroid regime and are randomized        Contact: Miss Rathie Rajendram
                                              to receive radiotherapy OR sham               Web:
Do Once & Share - Glaucoma                    radiotherapy, and azathioprine OR             Email:                          placebo.
                                                                                            or Mr Jimmy Uddin’s secretary on x2055 to
National Screening Committee:                 We are currently at the recruitment           refer a patient.

Newsletter brought to you by the R&D Department @ Moorfields Eye Hospital                     
                                                                                                                                    Spring 2006, Issue 3

View Profile:
Professor PT Khaw, “Professor who Saves                                    Position:                            Name:                            Ext:
Children’s Sight”                                                          R&D Director
                                                                           R&D Deputy Director
                                                                                                                Roger Hitchings
                                                                                                                John Dart
Professor Khaw runs the Ocular Repair and Regeneration                     R&D Manager                          Sue Lydeard                      2816
research unit which concentrates on preventing scarring                    Clinical Trials Service Manager      Isabel Moldon                    2816
and regenerating the eye. Scarring and failure to regenerate
plays a part in virtually every major blinding eye disease and             Senior Medical Statistician          Catey Bunce                      2820
the exciting news is that preventing scarring can promote                  Assistant Statistician               Wen Xing                         2284
regeneration of tissues including the optic nerve.                         EVSL/DOAS Clinical Lead              Parul Desai                      2046
                                                                           R&D Applications Manager             Richard Seeberan                 2066
Over the years, several new treatments and techniques
have been developed to prevent scarring after retinal                      Chief Knowledge Officer              Shona Burman-Roy                 2066
and glaucoma surgery. Success rates in glaucoma surgery                    Graphic Web Designer                 Shaun Kirupairatnam              2066
have been improved and new treatments have been taken
                                                                           PA/EVSL Co-ordinator                 Jennifer Wood                    2818
through to large-scale international trials around the world.
These simple treatments have now been shown to benefit                     EVSL Research Fellow                 Kashif Qureshi                   2066
not just children but also adults across the world – in both               Head of Reading Centre               Tunde Peto                       2825
developed and poorer developing countries. In their latest                 Senior Image Grader                  Irene Leung                      2825
study they have shown that if scarring can be completely
controlled after glaucoma surgery no patient became worse                  Image Grader                         Mumina Khatun                    2825
over the 80 months follow up.                                              Photographer                         Christian Schmermer              2825
                                                                           Senior Research Co-ordinator         Suzanne Cabral                   2036
Professor Khaw was
awarded the first                                                          Research Co-ordinator                Norman Dudley                    2823
international ARVO/                                                        Research Co-ordinator                Laura Henderson                  2315
Pfizer Translational                                                       Research Co-ordinator                Francesca Amalfitano             2059
Research Prize. His
use of ‘the power of                                                       Research Co-ordinator                Tina Burman                      2823
scientific research                                                        CTU Research Co-ordinator            Sally Falk                       2588
to change lives and                                                        CTU Administrator                    Nicola Harris                    4246
preserve vision’ was
cited in granting the                                                      Project Co-ordinator                 Yasmene Alavi                    4250
award. Professor Khaw                                                      Research Assistant                   Anita Chauhan                    2821
explained “ It was an                                                      Senior Phenotyping Officer           Edward White                     2109
important award for
Moorfields because it                                                      Phenotyping Officer                  Felicia Ikeji                    2109
shows that we can do                                                       Phenotyping Officer                  Janine Shewry                    2109
translational research that benefits people and it was the                 Phenotyping Officer                  Kanom Bibi                       2588
first major award from ARVO which is the world’s largest
research organisation for ophthalmology.                                   Accountant                           Ade Adeola                       2817
                                                                           Cinical Governance Manager           Michael Donnelly                 2910
Further Information:                   DOAS Project Manager                 Giash Ahmed                      2825
                                                                           Clinical Effectiveness Officer       John Carmichael                  2612
Work In Progress:                                                          Clinical Effectiveness Officer       Claire Walton                    2612

NICE Issues Guidance on Laser Eye
Surgery for Treating Refractive Errors                                 MEH & Whittington Ethics Committee
The National Institute for Health and Clinical Excellence              The MEH Local Research Ethics Committee (LREC) meetings
(NICE) has issued guidance (22 March) on photorefractive               take place on the fourth Wednesday of every month to
(laser) eye surgery for the treatment of refractive errors             discuss current registered proposals. This committee
(short and long-sightedness) to determine whether it is safe           reviews submissions for ethical approval within the Trust.
enough and works well enough for use. The guidance does
not recommend that laser eye surgery should be offered
to patients routinely on the NHS, as for most people eye                   Ethics Committe Deadlines
problems can easily be corrected by wearing spectacles or                  Deadline Date:           Meeting Date:               Location:
contact lenses.
                                                                           8th June 2006            28th June 2006              Moorfields
Further Information:                                       6th July 2006            26th July 2006              Whittington
                                                                           August 2006              NO MEETING                  -
Thank you to everyone who contributed to this issue of View.
                                                                           Access to LREC is through the Research Governance Committee which
We are now taking submissions for the summer issue and the closing         meets every Wednesday afternoon - Dates Last Updated 12/12/05
date is 24th July 2006.

View needs You! Contributions - Comments - Criticisms, email: R&         

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