Professor Alastair Denniston MA MRCP FRCOphth PhD

Image of Mr Alastair Denniston

Institute of Inflammation and Ageing
Consultant Ophthalmologist (Uveitis/Medical Retina)
Honorary Professor

Contact details

Address
Institute of Inflammation and Ageing
College of Medical and Dental Sciences
University of Birmingham
Edgbaston
Birmingham
B15 2TT
UK

Alastair Denniston is a consultant ophthalmologist (eye specialist) at University Hospitals Birmingham leading research into the use of health data research and artificial intelligence to improve patient care in the ‘real world’. He is Professor at the University of Birmingham, and part of the Biomedical Research Centre for Ophthalmology at Moorfields Eye Hospital/UCL.

Alastair has particular interest in how we can ensure that the innovation within the broad field of ‘artificial intelligence’ is translated efficiently but safely to benefit patients. This includes improving the reporting standards of trials (CONSORT-AI and SPIRIT-AI), helping define the regulatory framework for AI in healthcare, and working with HDRUK and other relevant organisations to support the best of these innovations right through the implementation pathway.

He is Director of INSIGHT, the HDRUK Health Data Research Hub for Eye Health which is focused on eye disease and its application to wider health, including diabetes and dementia. It will use anonymised large-scale data and advanced analytics, including artificial intelligence, to develop new insights in disease detection, diagnosis, treatments and personalised healthcare.

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 working with Professor Mel Calvert as part of CPROR).

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 the care of patients with potentially blinding 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 complemented by a prioritisation of the 'Patient Voice in Ophthalmic Research' including patient reported outcomes (PROs) for ocular inflammatory disease (with his collaborator Prof Mel Calvert, Head of CPROR 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

Denniston AK, Keane PA, Aojula A, Sinclair AJ, Mollan SP. The Ocular Glymphatic System and Idiopathic Intracranial Hypertension: Author Response to "Hypodense Holes and the Ocular Glymphatic System". Invest Ophthalmol Vis Sci. 2017 Feb 1;58(2):1134-1136. doi: 10.1167/iovs.17-21479. PubMed PMID: 28196227.

Blair J, Barry R, Moore DJ, Denniston AK. A comprehensive review of mTOR-inhibiting pharmacotherapy for the treatment of non-infectious uveitis. Curr Pharm Des. 2017 Jan 11. [Epub ahead of print] PubMed PMID: 28078989.

Chu CJ, Dick AD, Johnston RL, Yang YC, Denniston AK; UK Pseudophakic Macular Edema Study Group.. Cataract surgery in uveitis: a multicentre database study. Br J Ophthalmol. 2017 Jan 2. pii: bjophthalmol-2016-309047. doi 10.1136/bjophthalmol-2016-309047. [Epub ahead of print] PubMed PMID: 28043984.

Egan C, Zhu H, Lee A, Sim D, Mitry D, Bailey C, Johnston R, Chakravarthy U, Denniston A, Tufail A, Khan R, Mahmood S, Menon G, Akerele T, Downey L, McKibbin  M, Varma A, Lobo A, Wilkinson E, Fitt A, Brand C, Tsaloumas M, Mandal K, Kumar V, Matha S, Crabb D; UK AMD and DR EMR Users Group.. The United Kingdom Diabetic Retinopathy Electronic Medical Record Users Group, Report 1: baseline characteristics and visual acuity outcomes in eyes treated with intravitreal injections of ranibizumab for diabetic macular oedema. Br J Ophthalmol. 2017 Jan;101(1):75-80. doi: 10.1136/bjophthalmol-2016-309313. PubMed PMID: 27965262.

Denniston AK, Keane PA. "Black Holes" and the Ocular Glymphatic System: Author Response to "The Glymphatic System: A New Player in Ocular Diseases?" Invest Ophthalmol Vis Sci. 2016 Oct 1;57(13):5428. doi: 10.1167/iovs.16-20479. PubMed PMID: 27768787.

Williams GP, Nightingale P, Southworth S, Denniston AK, Tomlins PJ, Turner S,  Hamburger J, Bowman SJ, Curnow SJ, Rauz S. Conjunctival Neutrophils Predict Progressive Scarring in Ocular Mucous Membrane Pemphigoid. Invest Ophthalmol Vis  Sci. 2016 Oct 1;57(13):5457-5469. doi: 10.1167/iovs.16-19247. PubMed PMID: 27760272; PubMed Central PMCID: PMC5072540.

Ahnood D, Madhusudhan S, Tsaloumas MD, Waheed NK, Keane PA, Denniston AK. Punctate inner choroidopathy: A review. Surv Ophthalmol. 2017 Mar - Apr;62(2):113-126. doi: 10.1016/j.survophthal.2016.10.003. Review. PubMed PMID: 27751823.

Mollan SP, Keane PA, Denniston AK. The use of transdermal optical coherence tomography to image the superficial temporal arteries. Eye (Lond). 2017 Jan;31(1):157-160. doi: 10.1038/eye.2016.206. PubMed PMID: 27740619; PubMed Central PMCID: PMC5233932.

Lane M, Moult EM, Novais EA, Louzada RN, Cole ED, Lee B, Husvogt L, Keane PA, Denniston AK, Witkin AJ, Baumal CR, Fujimoto JG, Duker JS, Waheed NK. Visualizing the Choriocapillaris Under Drusen: Comparing 1050-nm Swept-Source Versus 840-nm Spectral-Domain Optical Coherence Tomography Angiography. Invest Ophthalmol Vis Sci. 2016 Jul 1;57(9):OCT585-90. doi: 10.1167/iovs.15-18915. PubMed PMID: 27547891; PubMed Central PMCID: PMC4995042.

Denniston AK, Sen HN. VISUALising a new framework for the treatment of uveitis. Lancet. 2016 Sep 17;388(10050):1134-6. doi: 10.1016/S0140-6736(16)31327-7. PubMed PMID: 27542304.

Full listing

View all publications in research portal