Dr Dianne Sharp: regarding the retina

Well-known champion of retina disease patients Dr Dianne Sharp is retiring. So we asked our optometrist writer Louise Wood to find out how it all came to be.


Dr Dianne Sharp’s dedication to ophthalmology was formally recognised in 2018 when she became an officer of the New Zealand Order of Merit. Following the announcement, Dr Sharp says her son turned to her, saying, “Mum, you have made me want to leave the world a better place than I found it” to which Dr Sharp responded that that had always been what she’d wanted to do.


A leading retina specialist and founder of Macular Degeneration New Zealand (MDNZ), medicine has long been a passion for Dr Sharp. “My first public speaking topic at the age of 11 was ‘Blood’. And in my early teens I enjoyed dissecting sheep parts obtained from the local abattoir,” she says.


Dr Dianne Sharp


Dr Sharp’s formal training began at the University of Otago Medical School. She was enrolled in the GP training scheme, but on a whim filled in on an ophthalmology run. She just loved it, she says, and asked if she could stay. “Ophthalmology was such a clean, aesthetic speciality and ophthalmologists were just lovely people.” The die had been cast.


Her interest in the retina was fuelled in 1981 when she presented the results of a retrospective retinal study at the Royal Australian and New Zealand College of Ophthalmologists (RANZCO) New Zealand branch meeting. The meeting’s keynote, Professor Alan Bird, an English ophthalmologist renowned for his research into degenerative and hereditary diseases of the retina, offered Dr Sharp a fellowship at Moorfields Eye Hospital in London, which she was delighted to accept.


Dr Sharp speaks of Prof Bird as an incredible mentor who shared with her the importance of giving patients a sense of optimism, as well as excellent ophthalmic management skills. “He modelled a practice ensuring every patient left their consultation with hope, even when our treatment options were limited or absent,” she says.


From medical retina to electrodiagnostics


During her time at Moorfields, Dr Sharp also took the opportunity to work in the hospital’s electrodiagnostic clinic. She quickly recognised the need for the technology and was instrumental in introducing it in New Zealand to provide diagnostic services for acquired and inherited retinal disorders in Auckland. Today, with seven electrodiagnostic units in five regional centres, electrophysiology has become an important ophthalmic tool, with Dr Sharp crediting her UK colleagues and New Zealand’s specialist technicians for its success. “We now have one of the highest testing rates per capita in the world,” she says, “allowing New Zealand to participate in sharing meaningful data between centres and overseas.”


Another mentor Dr Sharp credits with helping her achieve her goal to improve the outcomes and care of Kiwi patients with retinal disease is her ophthalmologist husband Dr Ian Elliott. “Throughout my career, Ian has been my number-one supporter, a teacher, colleague and great friend. He has been a constant strength and our shared commitment to ophthalmology, along with our love of the outdoors, has been a wonderful combination over the past 34 years.”


The development of better treatments…


Dr Sharp is passionate about the advances in retinal management, many of which she’s been a part of. At the end of the 20th century, treatment for the neovascular form of age-related macular degeneration (nAMD) was limited. So she helped develop the Vision Assessment Clinic in Auckland (which later became the Low Vision Clinic) to try to preserve patient independence by offering help with daily living tasks and support; for example, by providing magnification tools for reading at a time when there were few other treatment options available.


In 2000, photodynamic therapy was introduced as a management tool for nAMD. Although it was an imperfect treatment, it slowed the progressive deterioration and for some patients, central vision was retained. In 2006, when the anti-vascular endothelial growth factor (anti-VEGF) therapy bevacizumab (Avastin) was made available, there finally seemed to be a treatment that, with early intervention, could preserve vision.


…and better care


Since timely treatment of AMD affords optimum visual preservation, Dr Sharp resolved to make raising public awareness a priority. “We didn’t have the funding that our trans-Tasman neighbours had, but we were committed, followed their lead and surprised ourselves with the impact that we could make.” The result was the 2009 launch of Macular Degeneration NZ. Eight years later, recognising her work in supporting patients with retinal diseases across New Zealand and MDNZ’s subsequent success, Dr Sharp was awarded the 2017 RANZCO Distinguished Service Award. At the awards ceremony in Perth, fellow Kiwi and medical retina specialist Dr David Worsley praised Dr Sharp’s “tireless endeavours to effect nationwide improvements in retinal healthcare in New Zealand.”


Dr Dianne Sharp being interviewed by Radio NZ about the plight of New Zealand macular disease sufferers


Asked to describe her proudest moment, Dr Sharp talks of the dedicated Auckland practice, Retina Specialists, which she founded in 2003 with her husband and recent medical retina returnee Dr Rachel Barnes. “It’s been an absolute privilege to help establish and work in a dedicated retinal practice. It was my dream that bringing together a group of people within the medical retinal subspeciality would strengthen the service that we could offer.” Establishing MDNZ has also been very rewarding, she says. “Forming a national organisation and reaching out to so many people, knowing that it’s making a difference, that’s what I’m really proud of.”


Reflecting on retirement, Dr Sharp is characteristically gracious, praising her Retina Specialists successor Dr Leo Sheck*. “Leo returned to Auckland with a high level of skill and expertise in medical retinal diseases, electrodiagnostic testing and ophthalmic genetics. It was perfect timing for me to step aside.”


The future


It would be too much, however, to expect Dr Sharp to completely step away from ophthalmology. With a smile she admits that she expects to continue to be involved with MDNZ and the many patients it supports in some way and perhaps even continue her research work. “I am honoured to have served this community with whatever contributions I have been able to make. Over the years it has been a pleasure to work alongside fellow ophthalmologists, nurses, orthoptists, optometrists, technicians, photographers and clerical staff. I thank them for their collegiality, advice, co-operation, assistance and friendship.”


Looking to the future, Dr Sharp is certain there will be advancements in nAMD management. “When I just think back over the last 30 years, I couldn’t have imagined we’d be where we are today, so the future is exciting.” Sustained, longer-term drug delivery systems are available, some with anti-VEGF drugs and others linked to gene therapy close to commercialisation. Our understanding of atrophic macular degeneration is also evolving, she says – with current thinking linking it to the complement pathways – but there are likely to be even more developments in the next few years.


Beyond ophthalmology, Dr Sharp is already enjoying spending more time with her three grandsons, recently travelling New Zealand together. “It’s so lovely to see the world from a child’s perspective; everything is so new and exciting.” She also has a passion for skiing and hopes to hit the slopes (preferably overseas) again this year.


When asked if she has any advice for future ophthalmologists, Dr Sharp offers some unexpected wisdom: be aware of your posture! Dr Sharp underwent neck surgery last year after years of ‘micro trauma’ from slumping forward caused irreversible degenerative change. “Really take the time to adjust the slit lamp to suit you. Of course we worry about getting our patient comfortable, but also ensure you are not sitting in a compromising position for long periods. This is a real issue in ophthalmology and young ophthalmologists should be aware of it.”


It was a privilege to sit down with Dr Sharp and learn more about her inspirational legacy. I came away from our coffee meeting with an overwhelming appreciation of her incredible warmth and kindness, something I’m sure I share with her many, many patients.


* https://eyeonoptics.co.nz/articles/archive/end-of-an-era-new-beginnings/


Louise Wood is a therapeutically qualified optometrist working at City Eye Specialists in Auckland, New Zealand and a regular contributor to NZ Optics.


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