Skip to main navigationSkip to main content
The University of Southampton
Medicine
Phone:
(023) 8120 4270
Email:
P.N.Hossain@soton.ac.uk

Dr Parwez Hossain MBChB, PhD, FHEA, FRCOphth, FRCS (Ed)

Associate Professor & Clinical Lead for Corneal Services, Consultant Ophthalmic Surgeon (University Hospitals Southampton NHS Foundation Trust)

Dr Parwez Hossain's photo

Dr Parwez Hossain is King James IV Professor  & Associate Professor in Ophthalmology within Medicine at the University of Southampton and Consultant Ophthalmic Surgeon at University Hospitals Southampton.

Parwez qualified in Medicine from Aberdeen University and trained in Ophthalmology in South East England, Aberdeen, Nottingham, Leicester & Bascom Palmer Eye Institute, Miami, USA. He sub-specialises in Cornea & External Eye Disease.

Parwez's clinician-scientist career started as Wellcome Trust Clinical Research Fellow at Aberdeen University where he studied for his PhD in Immunology and Biomedical Physics/Engineering. His work involved developing the technology of scanning laser ophthalmoscopy to investigate the mechanisms of T-cell traffic in ocular inflammation. In his awarded PhD thesis, he established a novel method for in vivo tracking of immune cells in the retina and choroid. The technique allowed the early interactions of lymphocytes with an inflamed vascular endothelium to be observed and quantified. Allowing the role of different adhesion molecules involved in lymphocyte-endothelium to be assessed, as well as determine inhibitory therapies to alleviate the immune response.

Following his PhD, Parwez was appointed Clinical Lecturer at Nottingham University; there his interest focused on investigating the innate immune mechanisms during corneal inflammation. He found that the immune adhesion molecule CD34 is a unique marker for human corneal stromal keratocyte (corneal fibroblast) activation.

During his tenure at Nottingham, he helped to establish the effectiveness of a new surgical technique called 'Fine Needle Diathermy' to treat long-standing corneal vascularisation. This method allowed the effective treatment of corneal vascularisation, which frequently complication of chronic corneal inflammatory diseases such as chronic herpes keratitis or chronic corneal graft rejection. The procedure has been widely adopted worldwide for the treatment of corneal vascularisation.

Degree Qualifications

MB ChB, Medicine, University of Aberdeen, 1990
FRCOphth, Royal College of Ophthalmologists, 1995
PhD, Medicine, University of Aberdeen, 2001
FRCS (Ed), Royal College of Surgeons of Edinburgh, 2003
FHEA, Fellow of the Higher Education Academy, 2004

Appointments

Wellcome Trust Clinical Research Fellow, University of Aberdeen,1998
Clinical Lecturer in Ophthalmology, University of Nottingham, 1998
Visiting Fellow Cornea & External Eye Disease – Bascom Palmer Eye Institute, University of Miami, USA, 2004
Senior Lecturer in Ophthalmology, University of Southampton, 2005
Associate Professor, University of Southampton, 2014
King James IV Professor – Royal College of Surgeons, Edinburgh, 2018

Research interests

Currently, Parwez's research activity is focused on finding new approaches to manage corneal disease.

Host-Pathogen Interactions in Human Microbial Keratitis

Corneal infections remain one of the leading causes of unilateral visual loss worldwide. In the UK alone, 6000 patients are estimated to be affected by corneal infections every year. Bacterial organisms such as Pseudomonas aeruginosa are primary causative agents in pathogenesis. Visual impairment often is very rapid (within 24 hours) and frequently leads to permanent visual loss (Figure 1).

A common problem during such infection is the severe levels of corneal tissue damage. We know from animal models that this results from the combined effects from the actions of the pathogen and the host's inflammatory process. The cornea quickly loses its normal transparency, leading to visual impairment. Since the cornea is a thin structure (human central cornea thickness is only 550μm), tissue damage carries high risks of ocular perforation and visual loss.

Although antimicrobial therapies are usually successful in reducing the pathogen load, they do not help to limit tissue damage. Currently, there is no effective treatment to limit this. Such therapies are highly desirable since patients would benefit from reduced effects of uncontrolled tissue damage.

Parwez clinical and laboratory investigative programme shows investigate how different pathogens interact with the human cornea both in vivo and ex vivo. Through collaboration with groups in the University with expertise in molecular microbiology, tissue culture and leukocyte biology, he has developed, an ex vivo human explant tissue model to understand the early events in cornea-pathogen interaction. He has integrated this approach and applied to the clinical setting (see below).

Parwez's group has recently found that activation of Pathogen Recognition Receptors (Toll-like Receptors (TLRs)) and inflammasome pathways in patients with gram negative corneal infection, profoundly influence the ability of corneal stromal cells to produce pro-inflammatory cytokines such as interleukin-1beta, IL-8, IL-6, as well as, tissue degradative enzymes like matrix metalloproteinases (MMPs) and undergo TLR-4 mediated apoptosis (Figure 2).

Parwez has developed an effective regional clinical service which provides the opportunity to collect patient samples with severe corneal infection. His clinical service serves a large referral base of approximately 2 million patients coming from Hampshire, Isle of Wight & the Channel Islands. The University Hospitals Southampton NHS is one of the UK's busiest corneal transplant centres and recently awarded Tier 1 status by NHS Blood and Transplant. This arrangement complements his laboratory studies, where he requires a steady supply of human corneal tissue for his explant models.

Most recently, his group has determined that early intervention of topical steroid therapy can lessen the immune response and potentially early use in the first few days of bacterial infection could reduce visual loss.

Anterior Segment Imaging of the Eye
In Vivo Anterior Segment Imaging of Corneal Infectious Disease

Parwez's group have developed the technology of Anterior segment Optical Coherence Tomography to provide both qualitative and quantitative assessment of corneal inflammatory disease. His group has found that this method is an effective modality to measure the different stages of bacterial corneal infection (Figure 3).

His group has shown that the morphological features during bacterial corneal infection, demonstrating the extent of immune cell infiltration and the amount of corneal tissue damage. Specific parameters during the course of the disease have now been defined, and these parameters can be used for early pathogen identification, as well as, the clinical efficacy of antimicrobial and anti-inflammatory therapies. Most recently, Parwez's group has found that these morphological optical coherence parameters can distinguish between gram-negative and gram-positive corneal infection, at the time of presentation.

Rapid Detection of Ocular Microbial Pathogens

Through the University of Southampton, Network for Antimicrobial Resistance & Infection Prevention (NAMRIP), Parwez is working with Electronic Engineers, Biofilm Specialists & Infection Prevention Specialists to develop a new rapid point of care detection technologies to identify current and future microbial threats.

Corneal confocal microscopy detection and therapy of corneal neuropathy

Corneal confocal microscopy is increasingly being used to assess the changes in corneal architecture that occur in health and disease. With the assistance with his colleagues in Manchester University, Parwez has evaluated the method of in vivo corneal confocal microscopy to determine its role in the diagnosis of early diabetic peripheral neuropathy (Figure 4). The technique enables prospective and reiterative evaluation of the human cornea at high magnification.

The application of corneal confocal microscopy is being used in evaluation in clinical trials for the treatment of corneal nerve associate damage from infections such as Acanthamoeba keratitis and Neurotrophic Keratopathy.

Clinical Evaluation of Femto-laser assisted Corneal Transplantation

Parwez has a clinical investigative programme to optimise the surgical methods for corneal transplantation, particularly use of Femtolaser technology to improve outcomes from corneal transplant surgery.  His group has set-up the first randomised clinical trial of this technology for conditions such as keratoconus. The technology offers the scope of utilising different corneal layers to multiple recipients, thereby overcoming shortages of corneal transplant tissue.

His clinical research includes multiple approaches for evaluation of Femtolaser assisted keratoplasty such as Corneal Confocal Microscopy, Optical Coherence Tomography, Corneal Biomechanics.

Images

Figure 1 – Clinical Case of Pseudomonas Keratitis showing corneal abscess formation and tissue damage & opacification of the normally transparent cornea.

Figure 2 – Corneal Fibroblasts (Keratocytes) from Patient with Pseudomonas Keratitis in Explant Culture – A) Unchallenged Cells B) Challenged with Lipopolysaccharide (TLR4 ligand), showing nuclear and cytoplasmic fragmentation, suggestive of pyroptosis, taken from Wong et al Investigative Ophthalmology & Visual Science, 25;52(5):2796-803, 2011

Figure 3 – Quantification of the Clinical Course of Bacterial Keratitis in vivo using Anterior Segment Optical Coherence Tomography (AS-OCT) A) Anterior Segment of Patient’s Cornea with Bacterial Keratitis showing scan angle and area of infiltration, B) AS-OCT scan image in plane shown in (A) showing depth & width of infiltrate and corneal oedema taken on day of presentation (day=0), C) same patient AS-OCT taken in same plane on day 3, D) Day 7, E) Day 14, taken from Konstantopoulos A et al, Investigative Ophthalmology & Visual Science, 25;52(2):1093-7, 2011

Figure 4- In vivo corneal confocal microscopy of the cornea showing six nerve fibres (arrow) with typical beaded appearance, mild tortuosity, and
adequate branching in normal eye (A) compared with patient with (B) severe diabetic neuropathy showing single branch leaving main nerve trunk at bottom of frame taken from Hossain et al, The Lancet 21;366(9494):1340-3, 2005

Figure 5 – Patient with A) bullous keratopathy surgically treated with B) Descemet’s stripping endothelial keratoplasty (corneal endothelial transplant)(DSEK), C) Post operative course and transplant thickness evaluation with anterior segment optical coherence tomography, Shinton et al, British Journal of Ophthalmology 2011 Oct 25. [Epub ahead of print]

Figure 1
Figure 1
Figure 2
Figure 2
Figure 3
Figure 3
Figure 4
Figure 4
Figure 5
Figure 5

Research group

Clinical and Experimental Sciences

Postgraduate student supervision

Current Students:

Xialoi Chen
Sam Khandhadia
Aristides Konstantopoulos
Ahmad Elsahn (DM/PhD)

Associate Editor for 'Eye' – Nature Publishing Group
Deputy Chair for Ocular Tissue Advisory Group – NHS Blood & Transplant, UK
Wessex Regional Council Representative Royal College of Ophthalmologists
Trustee – Royal College of Ophthalmologists
Council Member – Medical Contact Lens & Ocular Surface Association

Sort via:TypeorYear

Articles

Books

Book Chapters

BM5 - Undergraduate Ophthalmology Lecture – 'Red Eye" 

BM5 - BMedSci – Project Supervisor 

BM5 - Personal Academic Tutor

Dr Parwez Hossain
Faculty of Medicine, University of Southampton, Building 85, Life Sciences Building, Highfield Campus, Southampton, SO171BJ

Room Number: SGH/MP104

Facsimile: (023) 8120 4120

Share this profile Share this on Facebook Share this on Twitter Share this on Weibo
Privacy Settings