Dr Crowston is a Professor of Ophthalmology in the Neuroscience and Behavioural Disorders programme at Duke-NUS Medical School, and a glaucoma consultant at the Singapore National Eye Centre. His research focuses on understanding why ageing predisposes individuals to optic nerve damage in glaucoma, and developing new therapeutic approaches to boost neuronal repair.
He obtained his medical degree at the Royal Free Hospital SOM, London, and a PhD at University College London. Following ophthalmology training at Moorfields Eye Hospital, he completed glaucoma fellowships at Westmead Hospital in Sydney and the University of California, San Diego. He was subsequently appointed as a faculty member in the University of California, San Diego, and served as Director of the Hamilton Glaucoma Center Basic Research Laboratories. He moved to Melbourne in July 2006 and established the Glaucoma Research Laboratory at the Centre for Eye Research Australia (CERA). He was subsequently appointed as Head of Ophthalmology at the University of Melbourne and Director of CERA.
The goal of our research is to understand why advancing age predisposes to loss of retinal ganglion cells and from this determine new therapeutic approaches for protecting the optic nerve in glaucoma and other optic neuropathies.
We have discovered that retinal ganglion cells in mice enter a “comatose” non-functional state after injury but retain the capacity for functional recovery. Age is a major determinant of how well retinal ganglion cells recover following an acute intraocular pressure challenge. Importantly, this negative effect of aging is modifiable. Diet restriction and exercise profoundly improving the rate of functional recovery and synapse reformation. A specific focus is the role of bioenergetic compromise on retinal ganglion cell vulnerability. Together with Ian Trounce in Melbourne we have demonstrated impaired mitochondrial activity in glaucoma patients, specifically in complex-I of the electron transport chain (OXPHOS). We are now aiming to uncover the key pathways involved in driving neurorecovery.
Another key area of our research is to develop diagnostic tests that inform on the state of RGC health. We believe these are needed to facilitate translation of candidate neuroprotective treatments into clinical trial. Functional recovery is increasingly recognised in response to treatment in human glaucoma. We have recently completed a clinical trial demonstrating visual recovery in human glaucoma in response to nicotinamide, a larger clinical study is in train.