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

Dr Parwez Hossain MB ChB, PhD FRCS (Ed), FRCOphth FHEA

Associate Professor in Ophthalmology, Clinical Care Group Lead for Ophthalmology

Dr Parwez Hossain's photo

Dr Parwez Hossain is Associate Professor in Ophthalmology within Medicine at the University of Southampton.

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

In 2005, he was appointed as Senior Lecturer in Ophthalmology / Consultant Ophthalmologist at Southampton University & Southampton General Hospital.

Parwez's clinician-scientist career started at Aberdeen University where he was awarded a Wellcome Trust Fellowship to study the mechanisms of lymphocyte traffic in ocular inflammation. In his 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.

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. He noted that this immune marker was dysregulated during corneal inflammatory disease and keratocyte CD34 expression distinguished ‘resting’ and ‘activated’ keratocytes in the human eye.

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 vascularization. This method allowed the effective treatment of corneal vascularization 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 vascularization.

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, Departments of Ophthalmology and Biomedical Engineering & Physics, University of Aberdeen, 1995-1998

Clinical Lecturer in Ophthalmology, Department of Ophthalmology & Visual Science, University of Nottingham, 1998-2004

Visiting Fellow(Observership) Cornea & External Eye Disease – Bascom Palmer Eye institute, University of Miami, USA, 2004

Corneal Clinical Fellow - Dept of Ophthalmology, Leicester Royal Infirmary, 2004-2005

Appointed Senior Lecturer / Honorary Consultant Ophthalmic Surgeon, University of Southampton, 2005-present

Research interests

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

Host-Pathogen Interactions in Human Bacterial Keratitis

Corneal infections are a major cause of visual impairment worldwide. In the UK alone, 6000 patients are affected from corneal microbial infections every year. Bacterial organisms such Pseudomonas aeroginosa are major 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 has set-up a clinical and laboratory investigative programme, to investigate how different pathogens interact with the human cornea. Collaborating with other 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.

Parwez’s group has recently found that activation of Pathogen Recognition Receptors (Toll-like Receptors (TLRs)) 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 uses his clinical practice to collect patient samples with severe corneal inflammatory disease. His clinical service serves a large referral base of approximately 2 million patients coming from Hampshire, Isle of Wight & the Channel Islands. With his NHS colleagues, he runs one of the busiest centers for corneal transplantation in the UK. This arrangement complements his laboratory studies, where he requires a steady supply of human corneal tissue for his explant models.

These laboratory investigations are structured so that new drugs can be assessed for their effectiveness in combating these effects.

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 immune cell infiltration and the amount of corneal tissue damage. Specific parameters during the course of 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.


Early detection of diabetic peripheral neuropathy with corneal confocal microscopy

Corneal confocal microscopy is increasingly being used to assess the changes in corneal architecture that occur in health and disease. With 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 method enables prospective and reiterative evaluation of the human cornea at high magnification. Work is continuing to assess the feasibility in applying these findings in routine clinical practice. It has been shown that the characteristics of corneal nerves are altered several years before diabetic neuropathy can be detected by standard clinical tests.

Evaluation of optimal surgical interventions for endothelial keratoplasty

With his NHS surgical colleagues, Parwez has an investigative programme to optimise the surgical methods for corneal transplantation, especially during Descemet’s Stripping Endothelial keratoplasty (DSEK). Combining his group’s expertise in anterior segment OCT, he is investigating the relationship between endothelial graft thickness and final surgical outcome (Figure 5).

Clinical Evaluation of Femto-laser assisted Cataract Surgery

Parwez is a member of International Society for Laser Cataract Surgery and is working with industrial partners to set-up pilot clinical trials to evaluate this exciting approach for cataract surgery in the NHS.

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 2
Figure 3
Figure 4
Figure 5

Research group

Clinical and Experimental Sciences

Postgraduate student supervision

Current Students:

Ahmad Elsahn (PhD)
Aristides Konstantopolous (DM/PhD)
Hussein Mohamedbhai (MMedSci)

Faculty of Medicine

BM5 BMedSci - Head of Field for Ophthalmology

National responsibilities

Associate Editor for ‘Eye’, Scientific Journal for Eye
Member of Scientific Committee, Royal College of Ophthalmologists
Programmes and Seminar Secretary, Royal College of Ophthalmologists
Specialist Training Committee (Ophthalmology) – Wessex Deanery
Member of UKISCRS, MCLOSA, EuCornea and The Cornea Society
Member of International Society for Laser Cataract Surgeons
Member of the British Society for Immunology

Personal Tutor

BM4, 5 & 6 Delivers lectures and small group teaching in years 4 that include the ‘Red Eye’. Provides clinical teaching to all years, based at the Eye Unit, Southampton General Hospital.
BMedSci Project supervisor
Part 1 MRCP course, Lecturer on ‘Eye in Systemic Disease’, Wessex Deanery
MRCGP Course, Lecture and Tutorial on ‘Ophthlamoscopy,’ Wessex Deanery

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Articles

Books

Book Chapter

  • Barbara, R., Turnball, A. M. J., Hossain, P., Anderson, D. F., & Barbara, A. (2016). Epidemiology of Keratoconus. In J. L. Alio (Ed.), Keratoconus: Recent Advances in Diagnosis and Treatment (2nd ed., pp. 13-23). (Essentials in Opthalmology). Springer Nature.
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

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