Spectroscopic identification of corneal infection
Lead Research Organisation:
University of Leicester
Department Name: Physics and Astronomy
Abstract
Using an adaptation of instrumentation originally developed for astronomy using the Faulkes Telescope Spectrometers, this twelve month programme is targeted at the demonstration of a low-cost, non-invasive method of identifying infections in the eye, and specifically, conditions affecting the cornea. This would permit early detection of infections which can lead to rapid and profound loss of vision, and allow accurate targeting of treatment through the unambiguous identification of the nature of the infection. The project includes instrumentation development, laboratory and clinical trials, and the pursuit of a detailed commercialisation plan which includes the identification of potential manufacturers and licensing partners.
Infections of the cornea in the eye can lead to profound loss of vision and in some cases complete destruction of the cornea within 24-48 hours. It is most common in soft contact lens wearers with an incidence of approximately 1 in 10,000 per year. Infections may be caused by bacteria of various types, fungi, viruses and amoebae. Identification of the responsible organism is crucial to selection of appropriate treatment, but techniques have progressed little since those developed by Pasteur and earlier workers in the 18th and 19th century; samples are taken from the infected area and attempts made to culture the organism in laboratories where growth rates vary: it may be several days before organisms can be identified, while the infection grows much more rapidly in the eye. In addition, only in about 50% of cases can laboratory tests identify any growth at all.
Certain bacteria are known to emit fluorescent light when illuminated with an ultraviolet light. Our project aims to characterise the fluorescence from bacteria known to cause problems in the eye, using laboratory-grown cultures. We will then install a source of UV light, together with focusing optics and a fibre optic, onto a spectrometer suitable for installation in slit lamp as found in a hospital ophthalmology department, and use this system to detect the tell-tale fluorescent signature, first in a laboratory, and then (subject to medical ethics committee approval) in a limited series of trials in a hospital, and demonstrate the ability of the system to quickly and reliably detect certain types of eye infection. This device, if proven, could offer the potential to save the sight of hundreds of people each year by allowing treatment decisions to be made more quickly than has been possible to date.
Infections of the cornea in the eye can lead to profound loss of vision and in some cases complete destruction of the cornea within 24-48 hours. It is most common in soft contact lens wearers with an incidence of approximately 1 in 10,000 per year. Infections may be caused by bacteria of various types, fungi, viruses and amoebae. Identification of the responsible organism is crucial to selection of appropriate treatment, but techniques have progressed little since those developed by Pasteur and earlier workers in the 18th and 19th century; samples are taken from the infected area and attempts made to culture the organism in laboratories where growth rates vary: it may be several days before organisms can be identified, while the infection grows much more rapidly in the eye. In addition, only in about 50% of cases can laboratory tests identify any growth at all.
Certain bacteria are known to emit fluorescent light when illuminated with an ultraviolet light. Our project aims to characterise the fluorescence from bacteria known to cause problems in the eye, using laboratory-grown cultures. We will then install a source of UV light, together with focusing optics and a fibre optic, onto a spectrometer suitable for installation in slit lamp as found in a hospital ophthalmology department, and use this system to detect the tell-tale fluorescent signature, first in a laboratory, and then (subject to medical ethics committee approval) in a limited series of trials in a hospital, and demonstrate the ability of the system to quickly and reliably detect certain types of eye infection. This device, if proven, could offer the potential to save the sight of hundreds of people each year by allowing treatment decisions to be made more quickly than has been possible to date.
People |
ORCID iD |
Nigel Bannister (Principal Investigator) |
Publications
Bannister NP
(2014)
Spectroscopic measurements in scleritis: bluish-red or deep red?
in The British journal of ophthalmology
Description | The detailed analysis of the spectrum of light from the body can yield information relevant to the diagnosis of a number of serious conditions including scleritis, infection, and cancer. We are developing instrumentation which exploits this fact, to provide rapid identification of the causes of infection, or the presence of cancerous or pre-cancerous tissue. Advantages of the technique are that it is fast (minutes, rather than days for laboratory culture plate tests), minimally invasive, and can be used to access parts of the body which are very challenging to access otherwise (e.g. the back of the eye). In 2015/16 we showed that our technique is effective at distinguishing one of the major causes of corneal ulcers (acanthamoeba) from other known causes which are difficult to distinguish. This was the subject of a paper, and is leading to further developments in our expanding collaboration. |
Exploitation Route | Use as a rapid tool for identification of microbial strains in the laboratory. Potential medical instrumentation including implementation in bronchoscopes and hospital slit lamps (for inspection of the eye). Potential licensing of instrumentation for commercial production. |
Sectors | Agriculture Food and Drink Environment Healthcare Manufacturing including Industrial Biotechology |
Description | The outputs from this work have shown that high resolution spectroscopy can provide information that is useful for the diagnosis of conditions affecting the eye, and that measurements on patients are practical with the technology in a hospital environment. Initial work from the research led to a peer-reviewed paper, and the project has now expanded to include fluorescence spectroscopy. This work has been used to file a patent application relating to the in-vivo application of the technology, and has been identified as a promising technology for use in a broader range of clinical targets (including not just the eye but the lungs, skin and other regions). Ex-Vivo tests of the autofluorescence technique have been carried out on freshly resected lung tissue and skin melanomas with encouraging results, and work on this area continues. |
First Year Of Impact | 2009 |
Sector | Healthcare |
Impact Types | Societal |
Description | East Midlands Development Agency |
Amount | £16,000 (GBP) |
Funding ID | HIRF 493 |
Organisation | East Midlands Development Agency |
Sector | Public |
Country | United Kingdom |
Start | 03/2011 |
End | 01/2012 |
Description | Mini Innovation Partnership Scheme |
Amount | £30,912 (GBP) |
Funding ID | ST/K003054/1 |
Organisation | Science and Technologies Facilities Council (STFC) |
Sector | Public |
Country | United Kingdom |
Start | 07/2012 |
End | 07/2013 |
Description | Dr John LeQuesne - MRC |
Organisation | University of Leicester |
Department | MRC Toxicology Unit |
Country | United Kingdom |
Sector | Academic/University |
PI Contribution | We are introducing concepts for potentially powerful new diagnostic capabilities for the detection and diagnosis of cancers in the respiratory system. |
Collaborator Contribution | The MRC collaboration provides us with clinical expertise in lung cancer and diagnostic/treatment methods and is significant in helping us to establish the key requirements for a diagnostic system based around our technology. It has also provided us with access to hospital laboratory facilities and resected tissue, which is being used to test the instrumentation and method. |
Impact | Outputs are currently a set of clinical data from hospital laboratory (ex-vivo) trials of our technology. Analysis of the data is in an advanced state and a publication is in preparation. |
Start Year | 2012 |
Description | Dr Simon Kilvington: Microbiology |
Organisation | University of Leicester |
Country | United Kingdom |
Sector | Academic/University |
PI Contribution | By placing our instrumentation in the microbiology laboratory, the project is providing the opportunity to evaluate the usefulness of high resolution fluorescence spectrometry in the characterisation of microbiological specimens that are responsible for infection, and more generally, to assess the value of the technique in the microbiology laboratory. |
Collaborator Contribution | Our early work has shown that the instrumentation and technique is capable of identifying a range of distinct spectral signatures in blood agar plate samples. The involvement of Dr Kilvington is critical in enabling the project to demonstrate the reproducible identification of a wide range of clinically significant microorganisms, through an initial survey phase followed by a series of double-blind trials, and is the key step needed to take the concept through to clinical trial stage. |
Impact | The collaboration is at an early stage with the first cultures currently being grown; the first spectroscopic results are expected within the next 4 weeks. |
Start Year | 2014 |
Description | Dr Wayne Heaselgrave |
Organisation | University of Wolverhampton |
Department | History |
Country | United Kingdom |
Sector | Academic/University |
PI Contribution | Introduction of new measurement technique for use in existing research programme. |
Collaborator Contribution | Dr Heaselgrave brings expertise in microbiology and contacts in the commercial healthcare sector, including companies involved in the production of healthcare products. Dr Heaselgrave's expertise is providing our project with new biological target specimens for analysis, and new applications for the spectroscopic techniques which we are developing. His background is complementary to that of the existing team, and this is opening up new avenues for funding applications, one of which is currently pending a decision. |
Impact | No outputs yet. |
Start Year | 2016 |
Description | Mr Jeremy Prydal: Ophthalmology |
Organisation | University Hospitals of Leicester NHS Trust |
Country | United Kingdom |
Sector | Academic/University |
PI Contribution | Provision of expertise in the application of spectroscopic techniques in ophthalmology and other medical fields. Instrument design and data analysis techniques. |
Collaborator Contribution | Clinical leadership in the development of instrumentation for medical applications. Access to equipment in hospital laboratories and consulting rooms and provision of portable equipment for use in our own laboratories. |
Impact | Research paper on Scleritis (Bannister, Prydal et al). IP filing. Funding beyond the initial grant period covered by the EPSRC award. |
Start Year | 2009 |
Title | High Resolution Autofluorescence Analysis |
Description | High resolution excitation wavelength-resolved autofluorescence spectroscopy for identifying the signatures of infection or cancerous/pre-cancerous tissue in vivo. |
Type | Diagnostic Tool - Non-Imaging |
Current Stage Of Development | Initial development |
Year Development Stage Completed | 2014 |
Development Status | Under active development/distribution |
Impact | Potential use as a laboratory analysis tool. |
Description | Leicester Royal Infirmary Annual Research Presentation Day |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Type Of Presentation | Paper Presentation |
Geographic Reach | Local |
Primary Audience | Health professionals |
Results and Impact | Two talks given on scleritis and microbial infection detection to an audience of ~ 30 consultants, ophthalmologists, trainees and research scientists. General interest in the technique, good questions but no specific impacts to list. |
Year(s) Of Engagement Activity | 2013 |
Description | MCLOSA |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Type Of Presentation | Paper Presentation |
Geographic Reach | International |
Primary Audience | Health professionals |
Results and Impact | Talk and poster presentation given. An audience of ~150 Consultant Ophthalmologists and Trainees attended the talk and poster presentation, with question session afterwards. The contribution was shortlisted for the Anthony Bron Award on the basis of the submitted abstract and digital poster. This prize is awarded for the best piece of individually generated UK clinical/basic sciences research by a Clinical Research Fellow or Ophthalmology Trainee working in the area of ocular surface disease. The submission did not win, but was ranked in the top three. |
Year(s) Of Engagement Activity | 2013 |
URL | http://www.mclosa.org.uk |
Description | Nottingham Eye Symposium |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Type Of Presentation | Paper Presentation |
Geographic Reach | National |
Primary Audience | Health professionals |
Results and Impact | The Nottingham Eye Symposium is an opportunity for the dissemination and discussion of cutting-edge basic science and clinical ophthalmic research. An audience of approximately 120 Consultant Ophthalmologists and trainees listened to the talk. The talk was well received. A conversation took place after the presentation, with a senior consultant from University of Sheffield. The clinician expressed the view that the work had potential and should be pushed forward. This individual may be a potential future collaborator for work on ocular tumour detection based on the technique. |
Year(s) Of Engagement Activity | 2013 |
URL | http://www.nottingham.ac.uk/conference/fac-mhs/medicine/nottingham-eye-symposium-and-research-meetin... |