Experience in Research:

During his American Fellowship, Mr Stanga worked under the tuition of Prof. Harvey Lincoff at the renowned Margaret M. Dyson - Vision Research Institute, Cornell University Medical College. Cornell University belongs to the coveted Ivy League of American universities. Prof. Lincoff is a pioneer in retinal surgery having developed many of the currently used surgical techniques for the treatment of retinal detachment. During this time, Mr Stanga carried out research on the delivery of interferon alpha-2a across the posterior sclera by means of sequential infusions for the treatment of the subfoveal choroidal neovascularisation as well as the delivery of carboplatin via the same route for the treatment of intraocular tumours in children.

Mr Stanga has worked at both Moorfields Eye Hospital and at the Institute of Ophthalmology, under the supervision of Prof. Alan C. Bird and Prof. Philip Luthert. His main research projects at the time included: the characterization of the phenotype in age-related macular degeneration with a view to searching for candidate genes and a histopathology project – the subject of Mr Stanga's PhD which is currently being written-up - looking at the interrelationship between ageing changes in the different structures at the macula in a cohort of donor eyes from Argentina and comparing them with a cohort of British donor eyes.

Mr Stanga has been using Optical Coherence Tomography (OCT) technology in Ophthalmology since 1998 when he was a Fellow to Prof. Alan Bird. Mr Stanga and Prof. Bird initiated the use of OCT in the UK in a clinical setting. Since that time Mr Stanga has been involved in research utilizing OCT technology and the OCT scanner is an everyday tool in his clinics. Mr Stanga is routinely invited to give presentations and to train doctors on the use of this technology at both national and international level (see presentations section).

Mr Stanga has also worked with Mr. W. G. Aylward on the study of central visual function, imaging and histopathologic findings after the surgical excision of type II (i.e. myopic) subfoveal choroidal neovascular membranes (CNV) and after that of Type I CNV (i.e. age-related macular degeneration) followed by retinal pigment epithelium translocation. These research projects involve the use of optical coherence tomography (OCT), confocal laser scanning ophthalmoscope (cLSO) autofluorescence, Indocyanine Green angiography (ICG) and psychophysics, among others.

Working with Mr AMP Hamilton allowed Mr Stanga to carry out clinical research in the treatment of diabetic macular oedema with then novel, micropulse diode laser.

Mr Stanga's research project at St. Thomas' Hospital included participating in the setting up of a randomized trial comparing vitrectomy to standard photocoagulation in diabetic patients with diffuse macular oedema. Objective measures of retinal thickening (OCT) and subjective visual function (VF-14 and SF-36) were obtained over a 12-month follow up period. Secondary outcome measures included the classification and identification of sub-groups of diabetic maculopathy responding to treatment, and the practicality of the procedure in a clinical setting (cost effectiveness, complication rate). The aim of this pilot study was to provide essential information for the planning and implementation of a future, multicentre randomized clinical trial.

As a Lecturer in Ophthalmology to The University of Liverpool, a clinico-pathological correlation project studying choroidal neovascular membranes secondary to AMD excised during macular relocation surgery represents the core of Mr Stanga's research activity. The study was carried out under the tuition of Prof. David Wong and Prof. Paul Hiscott and was aimed at correlating the histopathological findings with the pre- and post-operative clinical ones with a view to searching for factors influencing visual prognosis and recurrence rate. This project involved the use of light and electron microscopy, immunocytochemistry, optical coherence tomography (OCT) and confocal laser scanning ophthalmoscope (cLSO) autofluorescence, among others.

At this point of his career Mr Stanga was also co-supervisor of a Liverpool University MD student whose research project was a digital imaging study of the anatomical outcome in patients undergoing novel therapies for choroidal neovascularisation (CNV) secondary to AMD; Photodynamic Therapy (PDT) with Visudyne ® or macular relocation surgery.

Mr Stanga also obtained the DDX approval of the Medical Controls Agency for the ophthalmological use of an orally administered neuroprotecting agent in retinal translocation surgery for age-related macular degeneration (AMD). Mr Stanga instigated the setting up of a multinational randomized trial on an orally administered neuroprotecting agent in retinal translocation for AMD. This project was aimed at determining vitreous levels of glutamate in patients with retinal detachments utilizing patients with macular holes as controls, vitreous penetration of a neuroprotecting agent after oral administration and the effect of neuroprotection on visual outcome following macular translocation surgery.

Since being appointed Consultant Ophthalmologist and Vitreoretinal Surgeon at the Manchester Royal Eye Hospital Mr Stanga, as Principal Investigator, has setup the following trials (not all of them are currently active):

• Fluocinolone Acetonide for Diabetic Macular Oedema (FAME)
• Sponsored by Alimera Clinical Sciences
• Dexamethasone Posterior Segment Drug Delivery System (Posurdex ®) for Retinal Vein Occlusion
• Dexamethasone Posterior Segment Drug Delivery System (Posurdex ®) for Diabetic Macular Oedema
• Pegaptanib Sodium (Macugen ®) for neovascular AMD and treatment of CNV
• Ranibizumab (Lucentis ®) for subfoveal CNV secondary to AMD
• Squalamine Lactate for CNV secondary to ARMD
• Pathologic Myopia Clinical Dose-Ranging Trial
• Posurdex ® vs. PDT for AMD
• Posurdex ® Diabetic Macular Edema vs. Laser

Mr Stanga has also set up the following study: Evaluation of the Preferential Hyperacuity Perimeter (PHP) in patients with age-related macular degeneration (AMD) and healthy controls. The PHP assesses distortion of central vision.

Experience in Teaching:

Mr Stanga has always enjoyed and maintained a high interest in teaching and continues to lecture in a variety of topics of field of Ophthalmology. Mr Stanga is also involved in the clinical teaching of Medical Students, Nursing Staff, Orthoptists and SHOs for the final RCOphth Fellowship examination

Mr Stanga has organised / chaired several international meetings including, among others, the 2004 British and Eire Vitreoretinal Association (BEAVRS) Annual Meeting (Manchester, UK)

2003 - present As Consultant with a special interest in Vitreoretinal surgery Mr Stanga is responsible for the clinical and surgical training of an SHO, an SpR and a Vitreoretinal (VR) Fellow at a time

2001 - 2002 As senior VR Fellow Mr Stanga was responsible for teaching new surgical skills and overseeing more junior VR Fellows, VR SpRs and SHOs, as well as Optometrists-in-training and medical students

As University Lecturer, Mr Stanga was responsible for the supervising and the training in imaging of 2 (two) Research Fellows

Guest speaker, Third Annual Merseyside Optical Seminars, Liverpool, UK

Mr Stanga was invited to participate in the oral examination board of the 4 th Year-Residents of King Khalid Eye Specialist Hospital and King Abdul Aziz University Hospital/College of Medicine, Riyadh, Saudi Arabia

1998 - 2000 Guest speaker, Final Fellowship Royal College of Ophthalmologists / Membership Refresher Course, Moorfields Eye Hospital, London, UK

Faculty, Diabetic Shared Care 2000 Postgraduate Certificate Courses for Optometrists, Department of Optometry and Visual Science, City University, London, UK

1997 - 1998 Faculty to the San Miguel Hospital Teaching Unit, University of Buenos Aires, Argentina

This post allowed Mr Stanga to teach Ophthalmology to undergraduate students

1994 - 1997 Resident's Instructor-Coordinator, Clinica de Ojos Dr Nano, University of Buenos Aires, Argentina

Member of the Examination Board, Residency Program, Clinica de Ojos Dr Nano, University of Buenos Aires, Argentina

1992 - 1993 Chief Resident, Clinica de Ojos Dr Nano, University of Buenos Aires, Argentina

Chairmanship of Scientific Meetings:

Mr Stanga has organised / chaired several international meetings

The most significant ones are:

• British and Eire Vitreoretinal Association (BEAVRS) Annual Meeting

Manchester, UK

1997 Moorfields Eye Hospital Skills Transfer Course

Guests of Honour: Prof. Alan C. Bird FRCOphth, Linda A. Ficker FRCOphth, David Gartry FRCOphth, John Lee FRCOphth and Prof. Susan Lightman FRCOphth

1996 Symposium on the Diagnosis and Treatment of Ocular Tumours and Pseudotumours

Guests of Honour: Jerry A. Shields MD, Clelia M. Erwenne MD and Sung B. Cha MD

• Symposium on Macular Diseases

Guests of Honour: Lawrence A. Yannuzzi MD, David Guyer MD and Dennis Orlock CRA