Director Thomas M. Lietman, MD

Thomas M. Lietman, MD
Director, Francis I. Proctor Foundation · Professor of Ophthalmology and of Epidemiology & Biostatistics

Trachoma, Childhood Mortality, and Corneal Ulcer Treatment and Prevention

About

Dr. Lietman investigates which community treatment strategies are most effective in eliminating trachoma. With Dr. Porco, he builds mathematical models to determine who within communities needs to be targeted, how often communities need treatment, and whether the World Health Organization's antibiotic program risks generating drug resistance. With Dr. Keenan, he conducts clinical trials evaluating the long-term effects of mass antibiotic treatment to determine whether infectious trachoma can truly be eliminated through repeat community treatment. Together with Drs. Acharya, Keenan, and Rose-Nussbaumer, he leads corneal ulcer treatment and prevention trials in collaboration with the Aravind Eye Care System, Seva, and Bharatpur Eye Hospital in South India and Nepal.

Education & Training

BA, Molecular Biophysics and Biochemistry — Yale College
MD — Columbia University College of Physicians and Surgeons
Fellow — National Eye Institute, HHMI-NIH, Bethesda, MD
Residency, Ophthalmology — Wilmer Eye Institute, Johns Hopkins University
Fellow, Cornea & External Diseases and Uveitis — F.I. Proctor Foundation, UCSF
Fellow, Modeling of Infectious Diseases — Department of Epidemiology & Biostatistics, UCSF
Complex Systems Summer School — Santa Fe Institute

Research Projects

Ongoing

Mathematical Modeling of Infectious Diseases

Mathematical models help assess whether infectious trachoma can be eliminated, not just controlled. The group's work suggests infection can be eliminated with repeated mass antibiotic treatment, and that clearing a core group of children can clear an entire community. Ongoing work tailors treatment frequency to local endemicity and estimates the drug resistance that programs may generate.
Collaborators: T. Porco

Completed

Trachoma Community Treatment Strategies (TANA / TIRET)

An NIH-funded study, in collaboration with the Carter Center and the Ethiopian Ministry of Health, testing whether repeat annual mass azithromycin distribution can eliminate ocular Chlamydia. The team demonstrated that children form a core group for trachoma and that biannual treatments are more likely than annual to eliminate infection.
Collaborators: N. Stoller, Z. Zhou, J. Keenan, J. Whitcher, S. Yu, B. Gaynor, T. Porco

Mortality Reduction with Oral Azithromycin (MORDOR)

After finding that mass antibiotic treatment reduced preschool-child mortality in the Ethiopian trachoma studies, the team ran a large three-country community-randomized trial (Niger, Tanzania, and Malawi), funded by the Gates Foundation, to confirm the mortality reduction across a population of roughly 1.5 million.
Funder: Bill & Melinda Gates Foundation
Collaborators: N. Stoller, S. Yu, Z. Zhou, J. Keenan, J. Whitcher, B. Gaynor, T. Porco

Mycotic Ulcer Treatment Trials (MUTT)

Randomized, masked, controlled trials evaluating whether topical voriconazole or natamycin is the superior treatment for fungal keratitis, conducted with the Aravind Eye Hospital in Tamil Nadu, where roughly half of infectious ulcers are fungal.
Collaborators: N. Acharya, K. O'Brien, K. Ray, J. Whitcher, M. Zegans, S. McLeod, P. Lalitha, N. Prajna

Corneal Ulcer Prevention — Village Integrated Eye Worker Trial (VIEW)

A community-randomized trial, with SEVA and the Aravind Eye Hospital, testing whether corneal ulcers can be prevented: half the communities had a village eye care worker treat all corneal abrasions within 24 hours, the other half received diabetes screening, with incident corneal ulcers monitored over 24 months.
Funder: RPB and NIH / NEI
Collaborators: J. Keenan, K. O'Brien, J. Whitcher, N. Acharya, M. Srinivasan

Core-Group Targeting for Trachoma Elimination (PRET, Niger)

A Gates Foundation program (through Johns Hopkins, PI Dr. Sheila West) testing whether complete community elimination is possible by treating only a core group of children, conducted in Matamaye District, Niger, with the Programme National de Lutte Contre la Cécité.
Funder: Bill & Melinda Gates Foundation
Location: Matamaye District, Niger

Key Collaborators

Travis Porco, PhD Jeremy Keenan, MD Nisha Acharya, MD Jennifer Rose-Nussbaumer, MD John Whitcher, MD Bruce Gaynor, MD Kieran O'Brien, PhD Aravind Eye Care System Seva Foundation Bharatpur Eye Hospital

Learn More

UCSF Profile & Full Publication List

Research Areas: Trachoma, Cornea, Infectious Diseases

Learn more about UCSF Ophthalmology faculty research

Featured Media:
NYT: Global Health Infant Deaths Fall Sharply in Africa With Routine Antibiotics