International Clinical Trials Day
International Clinical Trials Day (ICTD) is celebrated around the world in May to recognise the day that James Lind started what is often considered the first randomised clinical trial aboard a ship on May 20, 1747. ICTD is an annual event where we raise awareness of clinical trials to encourage patients, carers, public and the staff to get involved in research. We also celebrate our achievements and take time to be grateful for the improvements made to public health. The NIHR Moorfields Clinical Research Facility (CRF) has been celebrating ICTD since 2013. At Moorfields the day is an opportunity to celebrate our world leading research of activity along with raising awareness of the need for research.
Our Facility
The NIHR Moorfields CRF is the only facility dedicated to vision research in the UK and the largest such facility worldwide. The NIHR Moorfields CRF has 26 patient examination specialty rooms housing dedicated structural and functional ophthalmic testing devices.
- 11 functional assessment rooms for visual fields, psychophysical tests and colour vision testing and perimetry
- 8 structural assessment rooms for high resolution imaging for diagnosis and assessing disease progression
- 3 treatment rooms for intravitreal injections and laser treatments
- 4 clinical rooms for patient consultation and ocular examinations
- 1 laboratory for blood and tissue sample processing and storage
Having dedicated space has enabled us to house specialist equipment that can examine, image and test the eye in its entirety. The provision of specialty rooms is paramount to the accurate calibration of our study instruments as movement of these between rooms would disrupt precise settings of mirrors and lenses.
From idea to clinical trials to market
Our NIHR Moorfields CRF Staff
Often patients entering studies require multiple visits, each involving the support of six or seven members of the CRF staff, comprising of Research Clinicians, Research Nurses, Research Technicians, Photographers, Optometrists, Orthoptists, and electrodiagnostic specialists. Each of these in turn perform protocol-specific assessments or interventions in separate areas within the NIHR Moorfields CRF, using a range of imaging and clinical equipment. The successful recruitment to studies is achieved due to the dedicated workforce and specialist facilities within the NIHR Moorfields CRF. Forming part of the patient’s clinical care team, Recruitment Coordinators are posted within Moorfields outpatient clinics actively recruiting patients to trials. Our administration team (Research Managers, Study Coordinators and Data Officers) support the clinical team, manage and coordinate the studies and ensure study visits run smoothly.
Recruiting to Research
Researchers continue to be supported by a well-trained, multidisciplinary research team which provides comprehensive specialist expertise to deliver our diverse research portfolio. Patient pathways through the NIHR Moorfields CRF are mapped out for each project to ensure that the resources are used appropriately, and studies are delivered within the target time.
Research Highlights
PRIMAvera study involves a medical device being developed for people with retinal degenerative conditions such as age-related macular degeneration (or geographic atrophy). In this disease the light sensitive cells in the middle area of the back of the eye are degenerated, which leads to a loss of the central vision. The PRIMA System aims to partially restore visual function by electrical stimulation of the retina using a stimulator surgically implanted under the retina. A patient from Moorfields has been able to detect signals in her blind left eye thanks to a revolutionary new implant. She is the first UK patient to receive this new device, as part of a Europe-wide clinical trial. This groundbreaking device offers the hope of restoration of some sight to people suffering vision loss
https://www.moorfields.nhs.uk/news/revolutionary-bionic-chip-inserted-moorfields-patient-s-blind-eye
Click2Print Ocular Prosthetic study
Click2Print Ocular prosthesis is a new digital process to potentially replace the current hand-made artisan style production methods that are currently deployed Worldwide. The purpose of the investigational device is to determine if a Click2Print Ocular prosthesis is non-inferior to the current hand-made ocular prosthesis. A Moorfields patient was the first person in the world to be supplied solely with a fully digital 3D printed prosthetic eye on 25 November 2021..
https://www.moorfields.nhs.uk/news/moorfields-patient-receives-world-s-first-3d-printed-eye
This project has been supported by Moorfields Eye Charity through the generous philanthropy of the Drayson Foundation and enabled by the National Institute for Health Research (NIHR) Moorfields Biomedical Research Centre.
LiGHT Trial
This study investigated if starting treatment of glaucoma or ocular hypertension with laser therapy (using eye drops later, if needed) affected the patients’ quality of life more or less than starting treatment with eye drops alone. The study also investigated if initial treatment with laser or eye drops are equally good and safe at controlling eye pressure and how much they cost the NHS. 700 patients were randomly assigned to starting treatment with either laser or eye-drops, and the two groups were then compared.
Key findings and outcome
The results from the study showed that the pathway using a combination of SLT and traditional medicines was more effective than traditional medicines alone.
The patients on this pathway required fewer reactive procedures that often are necessary with glaucoma, such as surgery or cataract extractions.
The findings from the LiGHT Trial could also bring significant cost reductions for the NHS
https://www.moorfieldsbrc.nihr.ac.uk/news/light-study-leads-to-updated-nice-guidelines-for-glaucoma
NICE looked at the outcomes of this study and as of January 2022, NICE recommends SLT as the first-line treatment, not just as an option to be considered. Previously, SLT was advised as a second choice, and was generally only considered if there was issue with the patient taking drops.
The LiGHT study was funded by the NIHR Biomedical Research Centre at Moorfields Eye Hospital with help from Moorfields Eye Charity.
Moorfields Eye Charity is the main fundraising and grant-making charity for Moorfields Eye Hospital and its academic partner the UCL Institute of Ophthalmology. We invest in life changing eye health by funding innovative research, patient care and training to improve people’s sight – benefitting patients in the UK and around the world.
What are patients say
"Very kind and informative team, always courteous. I have been most impressed by the fact that my individual welfare is very bit as important as the research goals. I feel that I could not be in better hands and trust my precious eyesight is of concern to all. This team led by Simona is outstanding and of course the present conditions do not make their work easy, though as a participant on the Panda trial, I have never had any impression that anyone is experiencing any difficulties. I cannot think of anything that would make my experience better. The level of care has been exceptional, outstanding."
"I just wondered if you can pass on that I thought the staff have been exceptional in the recent visit to Moorfields. All staff’s care to explain to us what going on is really fantastic. Please pass this on for us to their seniors."
Child-Friendly Research
At Moorfields we also specialise in designing and delivering eye and vision research for children and young people. Our researchers, clinicians, operational staff and research coordinators work together to review study protocols to ensure assessments are feasible for children and young people.
We have developed a new treatment for “lazy eye”. The standard treatment is wearing an eye patch on the better eye for a few hours every day, or using blurring eye drops (atropine) twice a week. The new treatment involves watching a movie on a Nintendo 3DS XL console for one hour every day.
We are also a leading centre for research into new treatments for myopia (short-sightedness, which now affects a quarter of all teenagers in the UK. If short-sightedness starts at a young age and progresses to high numbers in the glasses, it can cause sight-threatening complications later in life. We are running several clinical trials to test new eye drops to slow down the worsening of myopia. More trials are in the pipeline. Our data support the move to ask the NHS to fund new myopia treatments for children and young people, to stop a rise in severe eye complications in the future.
EyeYPAG
In 2019 we started the Moorfields Young People's Advisory Group for research, the eyeYPAG. Our group has learned about the steps from a research idea to the finished product, and is now regularly advising researchers about how to make their projects more child-friendly. We are part of a network of similar groups across England, Europe and the whole world. Our members are 11-16 years old. Some have eye conditions, others have taken part in research as healthy volunteers, and some are just interested in science. We meet 4 to 6 times a year, in person or online.
In June 2020 we won the Moorfields BRC Patient and Public Involvement and Engagement in Research award: https://moorfieldsbrc.nihr.ac.uk/news-andevents/ppie-award-2020
In order to make our group the best it can be, we listen to what all our members have to say and have co-produced our own logo and our code of behaviour during our meetings. If you want to read more about us, have a look at our self-evaluation.
“We learn from researchers, and researchers learn from us”
Take part in Research
Research opportunities at Moorfields (ROAM) is a brand new way to recruit people to take part in our research. ROAM is an easy to use web application where you can express an interest in taking part in research at Moorfields. Our clinicians will use the information gathered to identify people who are suitable to take part in the wide range of studies that we lead.
You can also sign up to shape research questions and how research is conducted at Moorfields. This forms part of our patient and public involvement (PPI) programme.
If you are not a patient of Moorfields Eye Hospital and would like to register on ROAM, please provide your NHS number and ask your GP to:
- send a copy of your medical records;
- and a referral to Moorfields for your participation in research to moorfields.roam@nhs.net
Once your GP actions this request and your medical records are received, we will be able to add you to our hospital records and a member of our research team will then be able to check your eligibility for research opportunities at Moorfields.
Thank you to all patients, researchers, healthcare professionals and partners. Your efforts are not only recognised today on International Clinical Trials Day, but every day for the work you do in advancing the treatment, prevention and diagnosis of disease.