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Research

Prof. Paulo E. Stanga is a former Consultant Ophthalmologist and Vitreoretinal Surgeon for the Manchester Royal Eye Hospital, Professor of Ophthalmology and Retinal Regeneration for the University of Manchester and Director of the Manchester Vision Regeneration (MVR) Lab at NIHR/Wellcome Trust Manchester CRF.

Prof. Stanga is a past Member of the Scientific Committee of the Royal College of Ophthalmologists (RCOphth) and past President of the Ophthalmic Imaging Association (OIA).

Previous appointments include: Lecturer in Ophthalmology for the University of Liverpool, Vitreoretinal Fellow at the Royal Liverpool University Hospital, Medical Retina Fellow at Moorfields Eye Hospital and Retina Research Fellow, New York Hospital, Cornell University Medical College, New York, USA.

Prof. Stanga specialises in vitreo-retinal disorders that require either medical or surgical treatment. Since 1993, Prof. Stanga has worked in the development and application of new outpatient and surgical therapies and technologies such as retrobulbar Interferon alpha-2a, genetics of AMD, retinal pigment epithelium translocation surgery, macular translocation surgery, micropulse diode and Pascal® laser photocoagulation, Time and Spectral Domain and Swept-Source (DRI-OCT1 Atlantis®) optical coherence tomography (OCT), wide-angle (Optos®) fundus fluorescein angiography and fundus autofluorescence technology, antiangiogenic intravitreal drugs and high speed phaco/vitrectomy surgical systems.

His current research interests are in the pharmacological, surgical and laser treatment of proliferative diabetic retinopathy and macular oedema, laser-tissue interaction, electronic retinal implants for artificial vision, non-cutter based high-speed vitrectomy, gene therapy and robotic surgery.

Prof. Stanga introduced OCT into the clinical setting in the UK in 1998 and Pascal Laser into the EU in 2006, developing new retinal laser photocoagulation techniques/strategies for the treatment of Diabetic Retinopathy. Prof Stanga has also pioneered Swept-Source OCT having introduced it into the EU in 2012.

As a result of some of the previously mentioned this research, the Manchester Royal Eye Hospital/UoM are now one of the world leaders in this field. Some of this research in the treatment of diabetic retinopathy is now listed in F1000 and recommended as being of special significance in its field.

Prof Stanga is the Manchester PI for the Argus II (Bionic Eye) 10-centre international trial on the epiretinal electronic implant for blindness in Retinitis Pigmentosa, having operated upon and presented at international meetings the results on the first patients in the trial to achieve word-reading, colour perception or face detection capability with the implant.

Prof. Stanga has also set-up and is PI and surgeon for a Manchester-only Pilot Study of the Argus II system in Age-Related Macular Degeneration (AMD) and has successfully carried out the first ever implantations of an electronic retinal implant in AMD, which have resulted in the first ever persons with integrated artificial (central) and natural (peripheral) vision.

Prof. Stanga has played a successful and significant role working with NHS England for the Argus II system to be funded and evaluated in patients with advanced Retinitis Pigmentosa and making this the first use of Artificial Vision in the NHS (2016).

Prof. Stanga has performed himself first Argus II implantations in Retinitis Pigmentosa in several countries helping set up artificial vision programs with which he continues to collaborate; i.e. Russia.

Prof. Stanga UK is former CI and Manchester PI and surgeon for an interventional Gene Therapy Study in Retinitis Pigmentosa (RPGR) as well as Manchester PI and surgeon for an interventional Gene Therapy Study in Choroideremia.

Prof. Stanga has successfully taken the new Hypersonic Vitrectomy technology from the lab, through FDA 510(k) clearance, to its FIRST-IN-HUMAN use (2017) as well as FIRST-IN-EU (2018).

Prof. Stanga has also participated in the development and assessment of new Imaging/Treatment modalities: wide-angle retinal angiography and fundus autofluorescence imaging, adaptive optics imaging of photoreceptors and retinal pigment epithelium, intraoperative optical coherence tomography vitreoretinal imaging, slit-lamp fundus autofluorescence, slit-lamp retinal laser photocoagulation with simultaneous fundus autofluorescence and OCT imaging, amongst others.

Since 2004, Prof. Stanga has secured the equivalent of a total in excess of £2,300,000 in research grant income, research fellow and trial coordinator’s salary and research equipment. The income comes through NHS/NIHR and is therefore held in CMFT.

Prof. Stanga has set up the Manchester Vision Regeneration (MVR) Lab and an independent Retinal Clinical-Research Fellowship Program.

Prof. Stanga has established collaborations with, amongst others: Universities of Cornell, Heidelberg and Stanford , Dohenny Eye Institute-University of Southern California, Kings College Hospital, Moorfields Eye Hospital and University College London.

In 2010, Prof. Stanga and Mr Susmito Biswas established one of only two national Regional Paediatric Vitreoretinal Services. They regularly carry out a joint Paediatric Vireoretinal Clinic.

Prof. Stanga has been involved in the Undergraduate/Postgraduate Teaching of Medical, PhD and Optometry Students, Nurses, Orthoptists, Ophthalmology and Vision Sciences MSc. He has been an Accredited Trust Educational Supervisor providing clinical and surgical training for F2, SpR and VR Fellow at any given time and lectures to the GP and Optometric community.

Prof. Stanga has chaired several international meetings, amongst others and in Manchester: the British and Eire Vitreoretinal Association (BEAVRS) Annual Meeting in 2004 and the Tubingen Retinal Detachment Course and Manchester Retina Course in 2009. In 2014, he chaired the Imaging Day during the MREH Bicentenary celebrations as well as the Retina Day and the Retinal Imaging Symposium and during the Annual Meeting of the Royal College of Ophthalmologists.

As a marker of his national standing, it can be mentioned that Prof. Stanga has been invited by the Royal College of Ophthalmologists in 2010 be a member of the panel of Key Opinion Leaders tasked with updating the National Diabetic Retinopathy College Guidelines and to chair the RCOphth Annual Vitreoretinal Update Seminar. By invitation from the RCOphth, Prof. Stanga has chaired the Retinal Imaging Symposium for 10 consecutive years as well as the Retina Day for 5 consecutive years during its Annual Meeting until 2017. Prof. Stanga is a Guest Speaker at the 2019 RCOphth Annual Meeting President’s Session.

Prof Stanga’s research on Artificial Vision has been highlighted as a significant achievement by the University of Manchester and the NHS Central Manchester Foundation Trust and listed as an important research landmark in the rich research heritage of the city of Manchester by the Manchester European City of Science 2016 Committee.

Prof Stanga’s research is also one of only two highlighted on the current national NIHR brochure.

NIHR England has hailed the start of gene therapy surgery at MREH a Historical Achievement for the city of Manchester.

Prof. Stanga is a frequent Invited Speaker at national and international meetings representing the MREH, MVR Lab/NIHR Wellcome Trust Manchester CRF and the University of Manchester.

Prof. Stanga is PI on several industry-sponsored trials and Scientific Advisor to several commercial companies that develop pharmacological therapies, diagnostic or therapeutic equipment.

Prof. Stanga is also a member on the Data monitoring Committee for the STAR study, sponsored by King’s College Hospital.

NHS managerial experience at MREH/CMFT include: Associate Head of Ophthalmology Division (2005-2007), Chairman Theatre Users Committee (2005-2008), Laser Safety representative (2005-2017), Member of the MREH Diabetic Retinopathy Management Committee (2013-2015), Chair of the Laser Safety Sub-Committee for the University of Manchester (2013-2016), MREH Lead for Retinal Laser Services (2014-2016) and Chair of the MREH Research Steering Committee (2014-2016) and Director, Manchester Vision Regeneration (MVR) Lab at NIHR/Wellcome Trust Manchester CRF (2010-Present).

Some of Prof. Stanga’s accolades include: Award for Outstanding Contribution to Ophthalmology in Singapore (Singapore, 2006), Award in Appreciation for Support and Far Reaching Contributions at the NGH Eye Institute (Singapore, 2008), American Academy of Ophthalmology Achievement Award (USA, 2011), Outstanding Personality in Science by the City Council (Legislatura Portena) of the city of Buenos Aires (Argentina, 2012), Award for Outstanding Contribution to Retinology in Poland (Krakow, 2014).

Manchester Vision Regeneration Lab

The MVR Lab:

         Commercially - funded and fully self-supported team founded and directed by Prof. Stanga at MREH, NIHR Manchester CRF and its Clinical, Surgical and Research Fellowship Program.

         The MVR Lab was created to provide a unique and new clinical environment for patients by removing the boundary between research and clinical care, creating ‘research clinics’ and thus offering a blended and not previously seen approach within Ophthalmology.  This outreach from the Manchester Royal Eye Hospital at CMFT is a truly transformational change within the NHS.

         Focuses on Innovation, development of new diagnostic treatment devices and work in the development/application of new outpatient and surgical therapies & technologies to improve the health and wealth of the nation through research.

         Has benefitted patients of all ages from new-borns to senior citizens by providing faster access to results of translational research and latest and most innovative treatments.

         Offers a multi-disciplinary approach working at the MCRF by integrating research as part of patient’s clinical care. This approach makes patient participation in research available to a wider audience, as well as allowing all patients seen to benefit from new research prior to their approval for commercialization.

         Offers an inclusive environment for the benefit of patients by:

  • Reducing number of appointments per clinic, allowing more allocated time per patient (multiple tests).
  • Carrying out the clinics at the NIHR Manchester CRF, as patients have access to food and beverages whilst they wait for testing or consultation improving patient experience.
  • Patients benefit from being seen only by a specially trained team of MCRF nurses, hand at all times to deal with both research and clinical activities alike. MVR and MCRF Patient satisfaction surveys conducted have confirmed the success of this new holistic approach.

         Has attracted some of the best research professionals, organisations and health related commercial companies, establishing a whole community of research benefitting patients with a multi-disciplinary approach. E.g Centre for Genomic Sciences (St Mary’s), Manchester Royal Eye Hospital, NIHR Manchester CRF as well as Universities of Oxford, York and Washington (USA).

         Has raised awareness of pioneering work through national and international media exposure, not only raising public awareness to the availability of new treatments, but has benefitted the local community by raising awareness that they no longer need to travel to London to have access to latest/most innovative therapies.

         Has been instrumental in the development of all projects it is involved with from a conceptual phase, as well as their adoption into the National Institute of Health research (NIHR) Portfolio.

         A close working relationship between the MVR Lab and NIHR provides the foundation that has allowed for the development of new therapies that benefit all NHS patients in a supportive environment, while providing them with an enhanced experience.

         The MVR Lab clinics carried out at the NIHR MCRF are perhaps the most cost effective ones within CMFT, with all involved clinical staff being funded by the industry sponsored research carried out by it, thus saving the NHS considerable sums of money.

I.e. MedTech companies that MVR Lab works with provide all diagnostic and laser equipment used for research and also for the treatment of NHS patients. In addition this has brought income into the MCRF with a series of high budget clinical trials.

         The MVR Lab has, through the presentation of its research at scientific conferences, publications and media exposure significantly contributed to the now established perception both at a national and international level of the Manchester Royal Eye Hospital as the centre of excellence for the treatment of eye diseases.

i.e. The bionic eye study in AMD was the most significant ever NHS MFT media exposure, with an equivalent value in printed press over only the first 24 hours of 1.4M€.

http://www.bbc.co.uk/news/health-33571412.

 

This work was cited by Louise Wood at the 2017 UK Clinical Research Facilities Network Conference (Glasgow, July 2017) as an Example of Excellent in CRFs.

 

Here are just two examples of the MVR Lab’s translational research with direct patient benefit:

Second Sight Argus II Retinal Prosthesis System Dry AMD Feasibility Study
CPMS/portfolio ID: 18268

Prof Stanga leads the study as Principal Investigator.

MVR lab set-up Manchester-only Pilot Study of the Argus II system in Age-Related Macular Degeneration (AMD) and has successfully carried out the first ever implantations of an electronic retinal implant in AMD, which have resulted in the first ever persons (5) with integrated artificial (central) and natural (peripheral) vision. This is a pioneering benchmark study that is opening new avenues into the study of artificial vision in sighted patients, as all previous research in the field has only been carried out in blind patients.

MVR lab have played a successful and significant role working with NHS England  for the Argus II system to be funded and evaluated in patients with advanced Retinitis Pigmentosa, making this the first use of Artificial Vision in the NHS (2017). Achieving CTE approval is a great achievement for the MVR lab, showing their pioneering research has provided evidence to support NHS England’s decision to fund the bionic eye.

http://www.bbc.co.uk/news/health-38391247

A Dose Escalation, Phase ½ Clinical Trial of Retinal Gene Therapy for X-Linked Retinitis Pigmentosa Using Adeno-Assocciated Viral Vector (AAV8) Encoding Retinitis Pigmentosa GTPase Regulator – XIRIUS Study.

CPMS/portfolio ID: 32371

Prof Stanga leads the study as Chief Investigator.

This is the first clinical trial of its type in X-Linked Retinitis Pigmentosa (XLRP) worldwide. CMFT selected as a site due to the MVR lab, NIHR CRF and MREH’s world-leading expertise in ophthalmology.

NIHR has stated it as a Historical Milestone for NHS MFT, with the MVR Lab having successfully carried out the first ever ophthalmic gene therapy surgery outside of London and Oxford (August 2017). Two surgeries have now been successfully carried out with further screening and surgeries planned, with international sites in Denmark and France sending patients to Manchester Royal Eye Hospital for this surgical intervention as part of the international trial.

This study highlights MVR Lab’s commitment to helping patients with the devastating consequences of inherited retinal diseases such as X-linked retinitis pigmentosa. The Manchester Royal Eye Hospital is now thanks to the MVR Lab and its research, one of only a handful of sites worldwide able to offer treatment strategies for patients with inherited degenerative diseases with visual function ranging diagnosis to blindness.

Open Studies:

Second Sight Argus II Retinal Prosthesis System Dry AMD Feasibility Study

CPMS/portfolio ID: 18268

Prof Stanga leads the study as Principal Investigator.

MVR lab set-up Manchester-only Pilot Study of the Argus II system in Age-Related Macular Degeneration (AMD) and has successfully carried out the first ever implantations of an electronic retinal implant in AMD, which have resulted in the first ever persons (5) with integrated artificial (central) and natural (peripheral) vision. This is a pioneering benchmark study that is opening new avenues into the study of artificial vision in sighted patients, as all previous research in the field has only been carried out in blind patients.

MVR lab have played a successful and significant role working with NHS England for the Argus II system to be funded and evaluated in patients with advanced Retinitis Pigmentosa, making this the first use of Artificial Vision in the NHS (2017). Achieving CTE approval is a great achievement for the MVR lab, showing their pioneering research has provided evidence to support NHS England’s decision to fund the bionic eye.

http://www.bbc.co.uk/news/health-38391247

A Dose Escalation, Phase ½ Clinical Trial of Retinal Gene Therapy for X-Linked Retinitis Pigmentosa Using Adeno-Assocciated Viral Vector (AAV8) Encoding Retinitis Pigmentosa GTPase Regulator – XIRIUS Study.

CPMS/portfolio ID: 32371

Prof Stanga leads the study as Chief Investigator.

This is the first clinical trial of its type in X-Linked Retinitis Pigmentosa (XLRP) worldwide. MFT selected as a site due to the MVR lab, NIHR CRF and MREH’s world-leading expertise in ophthalmology.

NIHR has stated it as a historical milestone for MFT, with the MVR Lab having successfully carried out the first ever ophthalmic gene therapy surgery outside of London and Oxford (August 2017). Two surgeries have now been successfully carried out with further screening and surgeries planned, with international sites in Denmark and France sending patients to Manchester Royal Eye Hospital for this surgical intervention as part of the international trial.

This study highlights MVR Lab’s commitment to helping patients with the devastating consequences of inherited retinal diseases such as X-linked retinitis pigmentosa. The Manchester Royal Eye Hospital is now thanks to the MVR Lab and its research, one of only a handful of sites worldwide able to offer treatment strategies for patients with inherited degenerative diseases with visual function ranging diagnosis to blindness.

Vitesse Project: Pars Plana Vitrectomy with Hypersonic Vitrector system (HV) in Live Human Eyes

Funding Granted:

 

Since 2004, equivalent total in excess of £2,000,000 secured (research grant income, research fellows/trial coordinator’s salary and research equipment).

         WTE Coordinator role (1 year funding agreed awaiting signatures)

         0.33 WTE Coordinator role (funded 2016-2019)

         1.00 WTE Fellow (funded 2016-2019)

         1.00 WTE Research Assistant (funded 2017-2019)

         1 year fellowship grant awarded to The MVR Lab from ESASO

Grants:

2016: C2D2 (Centre for Chronic Diseases and Disorders) funding for assessing the visual cortex in Age-Related Macular Degeneration patients implanted with a retinal prosthesis. This is a joint project where I collaborate with the Universities of York and Washington and the Health Sciences/HYMS Research Centre/Unit/Group: Centre for Health and Population Sciences (CHaPs) ( http://www.york.ac.uk/c2d2).

New Technology acquired:

         Adaptive Optics -rtx1 AO Retinal Camera (Allows visualisation of individual photoreceptors. One of only two in the UK)

         Operating Microscope with incorporated OCT

         Octopus 900 Pro Perimeter

         Triton OCT Machine