Mr Alastair Denniston MA MRCP FRCOphth PhD

Mr Alastair Denniston

Institute of Immunology and Immunotherapy
Consultant Ophthalmologist (Uveitis/Medical Retina)
Honorary Reader

Contact details

Address
Institute of Immunology and Immunotherapy
College of Medical and Dental Sciences
University of Birmingham
Edgbaston
Birmingham
B15 2TT
UK

Alastair Denniston is an Honorary Reader in the College of Medical and Dental Sciences and Consultant Ophthalmologist (Uveitis and Medical Retina) at the University Hospitals Birmingham NHS Foundation Trust.

Alastair’s specialist interests within ophthalmology are ocular immunity, ocular imaging and outcome measurement in inflammatory eye disease. He was awarded an MRC Clinical Research Training Fellowship in 2006, and completed his PhD in Dendritic Cell Regulation in the Ocular Microenvironment in 2009. His laboratory work in immunology is directed towards understanding what causes intraocular inflammation (uveitis) and other forms of inflammatory eye disease.

In the clinic with his collaborator Pearse Keane (University College London, UK), he has demonstrated the potential for newer forms of imaging such as Optical Coherence Tomography (OCT) to provide much-needed objective markers for intraocular inflammation (uveitis). With Pearse Keane and colleagues across the UK and US, he has established EQUATOR, an international collaboration of researchers working on ‘Extended OCT-Quantification of Uveitis Activity for Trial Outcomes and Reporting’. He is a passionate advocate of the need to develop better measures for inflammatory eye diseases which are objective and quantifiable to improve the power of clinical trials and inform day-to-day treatment decisions. This work is balanced by a prioritisation of patient reported outcomes (PROs) for ocular inflammatory disease (with his collaborator Prof Mel Calvert, Head of PROs Group University of Birmingham).

He regularly publishes research papers in scientific journals as well as reviews and book chapters, but is best known for writing the Oxford Handbook of Ophthalmology with Professor Philip Murray (Professor of Ophthalmology and Head of the Academic Unit of Ophthalmology, University of Birmingham).  

Alastair is keen to promote awareness of ophthalmic research and has been actively involved with the MRC Max Perutz Science Writing Prize, the Big Bang and the British Science Festival.

Alastair’s motivation, whether in research or in the clinic, is to improve our care of patients with potentially blinding ocular disease.

Qualifications

  • FRCOphth, Royal College of Ophthalmologists 2010
  • PhD, University of Birmingham, 2010
  • MRCOphth, Royal College of Ophthalmologists, 2003
  • MRCP, Royal College of Physicians, 2000
  • MA, University of Cambridge 2000                    
  • MB BChir, University of Cambridge 1997           
  • BA Medical Sciences Tripos, University of Cambridge 1995 

Biography

Alastair Denniston graduated as Senior Whitby Scholar from Downing College, Cambridge in 1995 with a BA in Medical Sciences. He undertook general medical training first in Cambridge and then Birmingham gaining Membership of the Royal College of Physicians in 2000. He then trained in Ophthalmology becoming Clinical Lecturer at the University of Birmingham in 2005, before being awarded an MRC Clinical Research Training Fellowship in 2006. His PhD in Dendritic Cell Regulation in the Ocular Microenvironment was completed in 2009, work from which has been recognised internationally. He became a Fellow of the Royal College of Ophthalmologists in 2010, and was appointed Consultant at University Hospitals Birmingham and Hon Senior Lecturer at University of Birmingham in 2012. He is also Hon Consultant at the Birmingham & Midland Eye Centre, the Bristol Eye Hospital and Moorfields Eye Hospital, London.

Teaching

Teaching Programmes 

Postgraduate supervision

Alastair supervises doctoral research students in the areas of human intraocular inflammation and immunity.

If you are interesting in studying any of these subject areas please contact Alastair on the contact details above, or the Head of the Academic Unit of Ophthalmology, Professor Murray on p.i.murray@bham.ac.uk .

For a full list of available Doctoral Research opportunities, please visit our Doctoral Research programme listings.   

Research

RESEARCH THEMES

Ocular immunology, Dendritic cells, Aqueous humour, Clinical Trials, Outcome Measures, Core Outcome Sets, Optical Coherence Tomography, EMEDOCT, VITAN, EQUATOR

RESEARCH ACTIVITY

The goal of Alastair’s research is directed to:

  1. Uncovering fundamental mechanisms of ocular inflammation
  2. Translating these discoveries into novel therapies that will be of real benefit to patients.
  3. Identifying reliable measures of disease acitivitiy and damage that can be used to assess treatment response , predict outcome and stratify therapy.

1) Immunity and its regulation in the eye

Specifically he has investigated the immunosuppressive effects of human aqueous humour on cellular function, and how this is altered in intraocular inflammation, proposing that these early events in the adaptive immune response may explain both the vulnerability of some patients to uveitis, and their natural history - why some resolve quickly and others develop a chronic course.

2) Clinical studies in uveitis and other potentially blinding diseases

Alastair is chief investigator on the study Defining Outcome Measures in Ocular Inflammatory Disease (DOMINO-ID), and principal investigator on numerous observational and interventional clinical studies at University Hospitals Birmingham and Co-Investigator with Prof Philip Murray at the Birmingham & Midland Eye Centre.

3) Imaging and other novel outcome measures for inflammatory eye disease

In the clinic with his collaborator Pearse Keane (University College London, UK), Alastair has demonstrated the potential for newer forms of imaging such as Optical Coherence Tomography (OCT) to provide much-needed objective markers for intraocular inflammation (uveitis). He is a passionate advocate of the need to develop better measures for inflammatory eye diseases which are objective and quantifiable. This will significantly improve the power of clinical trials (smaller, faster trials with a higher chance of success) and inform day-to-day treatment decisions. Establishing an international collaboration of researchers working on ‘Extended OCT-Quantification of Uveitis Activity for Trial Outcomes and Reporting’ (EQUATOR) has been a key part of advancing this.

Further information on EQUATOR is available from their webpage: www.equator.vision.

This work is balanced by a prioritisation of patient reported outcomes (PROs) for ocular inflammatory disease (with his collaborator Prof Mel Calvert, Head of PROs Group University of Birmingham). Alastair is also leading on the development of a consensus Core Outcome Set for Uveitis for use across all future trials for patients with uveitis, to reduce research waste and ensure that maximum value can be gathered for each study.

Other activities

  • Protocol Committee Member for the National Eye Institute/FDA Workshop on ‘Outcomes in Inflammatory Eye Disease’
  • Associate Editor for BMC Ophthalmology
  • Reviewer for the BMA Medical Books Competition
  • Peer reviewer for a range of ophthalmic and medical journals
  • Clinical Director for the “Eye Appeal” for University Hospitals Birmingham NHS Foundation Trust.

Publications

Selected publications:

Lee A, Day A, Egan C, Bailey C, Johnston R, Tsaloumas MD, Denniston AK and Tufail A (2016) Previous intravitreal therapy is associated with increased risk of posterior capsule rupture during cataract surgery. Am J Ophthalmol [In Press]

Tallouzi M, Moore DJ, Calvert M, Murray PI, Bucknall N and Denniston AK (2016) The effectiveness of pharmacological agents for the treatment of Uveitic Macular Oedema (UMO): a systematic review protocol. Systematic Reviews [In Press]

Madhusudhan S, Keane PA and Denniston AK (2016) Adjunctive use of systematic retinal thickness map analysis to monitor disease activity in Punctate Inner Choroidopathy. Journal of Ophthalmic Inflammation and Infection [In Press]

Gower N, Barry RJ, Edmunds MR, Titcomb LC and Denniston AK (2016) Drug discovery in ophthalmology: past success, present challenges, and future opportunities. BMC Ophthalmology 16(1):11

Denniston AK and Keane PA (2016) Extramacular and Widefield OCT Imaging in Uveitis [Correspondence]. Retina 36(1):e1

Zarranz-Ventura J, Keane PA, Sim DA, Llorens V, Tufail A, Sadda SR, Dick AD, Lee RW, Pavesio C, Denniston AK and Adan A [and EQUATOR Study Group] (2016) Evaluation of Objective Vitritis Grading Method Using Optical Coherence Tomography: Influence of Phakic Status and Previous Vitrectomy. Am J Ophthalmol 161:172-180.e4

Keane PA, Balaskas K, Sim DA, Aman K, Denniston AK and Aslam T [And For The Equator Study Group] (2015) Automated Analysis of Vitreous Inflammation Using Spectral-Domain Optical Coherence Tomography. Transl Vis Sci Technol 4(5):4 

Barry RJ and Denniston AK (2015) Controversies in the Pharmacological Treatment of Uveitis. Curr Pharm Des 21(32):4682-7

Full listing