sign in sign up
<<
Home , Macular degeneration, Retinal detachment

RetinaReview A newsletter from the Wilmer Institute at Johns Hopkins SUMMER 2013

A Bright Vision for the Future

here’s little doubt that improve patient outcomes in the Wilmer faculty. Our eight other diseases and disorders in years ahead. Fernando Arevalo assistant and associate pro- , specifi- serves as chief of the retina service fessors—unquestionably some of Tcally those that involve the for Wilmer’s collaboration with the the brightest stars in ophthalmol- retina, are some of the most vex- King Khaled Eye Specialist Hospital ogy—are bringing fresh insights and ing conditions in medicine today. in Riyadh, Saudi Arabia. From energy to today’s major challenges , pig- 2006 to 2012, Neil Bressler led in retina research and patient care. mentosa, and retinal vein occlusion the National Institutes of Health- Read on to learn about how these are among retina conditions that sponsored Diabetic junior faculty members are working rob the vision of countless children Clinical Research Network, likely to harness telemedicine in the treat- and adults throughout the world. the largest collaborative clinical ment of retina diseases, attacking The good news? Thanks to ongo- research program in retina in the vision loss from retinal detachment ing advances by Wilmer’s retina world, and now serves as Past Chair. surgery or poor circulation to the specialists, dramatic strides are being retina, developing new imaging made. The most common causes of Wilmer Retina Division and robotic approaches to retinal blindness, if left untreated, are reti- By the Numbers disease, and taking their renowned nal diseases, including age-related treatments and research to those and diabetic 7 Number of endowed throughout the region. professorships retinopathy. Today, with advances As you’ll discover, Wilmer’s most in research, doctors can reverse 19 Number of faculty promising junior faculty members positions for FY14 vision loss in at least 50 percent of are establishing clinical homes in those with . For 70 Number of grants our newly opened satellite clinics— supporting retina research those with macular degeneration, from Bel Air to Bethesda—while over 90 percent can avoid blindness. continuing their presence at the We’re proud that Wilmer’s retina Susan Bressler directs Wilmer’s Johns Hopkins Hospital. For the specialists have played major roles in studies on dietary supplements first time, patients throughout the these and other opthalmic succcess for macular degeneration. Peter Baltimore/Washington region can stories, including a recent break- Campochiaro develops new treat- receive Wilmer-quality care—even through for patients with the most ments for abnormal new blood access to clinical trials—while stay- severe forms of vessels in the retina as well as ing close to home. (RP): A new retinal prosthesis sys- for retinal degenerations. Daniel The Retina Division faculty at tem, developed in part by scientists Finkelstein works with bioethicists the Wilmer Eye Institute are among working at Wilmer, now offers hope at the University. Morton Goldberg the most highly skilled and regarded for restoring some sight to people advises the Foundation Fighting medical specialists in the world. with RP who were previously com- Blindness. James Handa investigates With your support, we will con- pletely or almost completely blind. novel laboratory models to evaluate tinue to work to save—and restore The seven senior faculty (profes- potential treatments for the earlier —the vision of countless children sors) within the Retina Division stages of macular degeneration. and adults throughout the world. are collaborating on multi-center But that’s only part of the inno- projects that are sure to dramatically vative research undertaken by our

Harnessing Thinking More clinical inside: 2 telemedicine 3 SMART-ly 4 trials lthough retinal detachment, Overcoming the Impact of diabetic retinopathy, macu- Reduced Blood Flow lar holes and other retinal Ischemic reti- “Our research program fo- Adisorders often result in dire nal diseases are cuses on examining how specific consequences, the Retina Division the most com- tissues in the eye respond to faculty have had incredible success with mon causes of reduced blood flow or oxygen. what some would consider irreparable blindness in We are using molecular biology working age approaches to determine the afflictions. Faculty members use their Americans; molecular mechanisms, whereby unparal­leled medical training to advance such diseases rob the vision of reduced oxygen in the retina re- patient care and research while training millions each year. Vascular oc- sults in vision loss. These studies the next generation of retina specialists. clusions in the eye are often are then confirmed using animal associated with a concomitant models and ultimately corrobo- systemic vascular condition, and rated by studies in patients in Finding Answers may therefore be a marker for the clinic,” says Sodhi. Through Clinical Trials cardiovascular mortality or mor- Dr. Sodhi’s research also bidity. Perhaps one of the most includes medical and surgical Patients from through- terrifying aspects of ischemic ret- management of other vitreoreti- out the United States inal diseases is that they often nal diseases including diabetic and the world travel to strike without warning and may retinopathy, age-related macular Baltimore for diagnosis be a sign of a systemic disease. degeneration, epiretinal mem- and treatment by Akrit Sodhi, MD, PhD, branes, macular holes, and Sharon D. Solomon, assistant professor of ophthal- retinal detachment. Dr. Sodhi MD, Associate mology, has undertaken studies treats patients with diseases of Professor of Ophthalmology, who holds that may well save the vision of the retina at Wilmer’s Hopkins The Katharine Graham Professorship at those who suffer ischemic reti- Hospital location and also at Wilmer, and her colleagues. nal disease, which occur when Wilmer’s Columbia location. Dr. Solomon is an internationally the blood flow (and therefore “We are excited that our research recognized expert in the care and treat- oxygen supply) to the retina is may identify novel therapeutic ment of patients with age-related macular compromised due to a variety of targets that will reduce or even degeneration, diabetic retinopathy, epiret- mechanisms, often resulting in prevent vision loss in patients inal membranes, macular holes, retinal complete loss of vision. with ischemic retinal disease,” tears, and detachment. She first became he says. fascinated with the retina during the second year of her medical residency at Harnessing Telemedicine to Expand University of California at San Francisco. Access to Care As a member of Wilmer’s premiere faculty, she practices at the Wilmer’s “We are in an “Additionally, new treatments Institute’s main campus in East Baltimore exciting era for including microsurgical tech- and at the satellite facility in Greenspring. the field of niques and pharmacotherapy Her work includes a host of research ophthalmol- are now available for diseases, projects including a number of clinical ogy. There which until the recent past gen- trials through the Diabetic Retinopathy have been tre- erally resulted in poor visual Clinical Research Network (DRCR.net). mendous outcomes. As retina specialists at As a co-investigator for the Wilmer recent advances in diagnostic Hopkins, we are fortunate to be Photograph Reading Center, tools, in particular imaging de- able to offer our patients access Dr. Solomon has participated in the vices, to identify and manage to the latest technologies and Submacular Surgery Trials for age- ocular diseases,” notes Ingrid E. treatments while also providing related macular degeneration. Zimmer-Galler, MD, Associate opportunities for them to be Professor of Ophthalmology. involved in continued on pg. 4

2 Delivering SMART Solutions Focusing on When you realize “Our patients come to Wilmer that the retina is from all parts of the world. Many Pediatric Disorders an extension of the have been seen by multiple special- Pediatric retina brain, you begin to ists and may have heard that there abnormalities and understand the is no hope,” he says. Fortunately, diseases are among complexity of through the cooperative effort of the most vexing disorders that Wilmer’s uniquely expert clini- issues in ophthal- impact it. Adding to complexity of cians, and the sharing of Wilmer’s mology. In fact, care of the retina is its delicate, state-of-the-art facilities and present an underdevelopment of the fragile structure and back-of-the-eye cutting-edge treatments, there can is the leading cause of location, which makes diseases be restoration of vision where once blindness in infants in the United including diabetic retinopathy, there was no such possibility. States. Yet few researchers and macular degeneration, retinal Dr. Gehlbach’s creative achieve- practitioners have the expertise detachment, and eye cancer even ments have focused on an array and support to investigate the more difficult to diagnose and treat. of complex matters ranging from causes and possible treatments of Peter Gehlbach, MD, precise treatment for retinal cells that and other issues that affect PhD, Associate Professor of using novel delivery tools to the retina and other posterior seg- Ophthalmology, is a renowned ex- enabling the handheld tools of the ments of children’s . pert on such disorders. Patients and microsurgeon with “SMART” func- Adam S. Wenick, MD, practitioners from throughout the tions. “SMART” guided tools are PhD, Assistant Professor of U.S. and the world call regularly not simply handheld but rather Ophthalmology, treats both adult upon his clinical expertise. In addi- incorporate computer guidance and and pediatric patients with reti- tion, he is a leader in performing and micro robotic assistance to allow nal disorders and conditions that teaching complex surgical cases that unprecedented surgical maneuvers in impact other structures of the pos- require coordination with multiple the challenging surgical environment terior segment of children’s eyes. ophthalmological specialists. of the eye. Dr. Wenick’s research focuses on the study of the interaction of the retina with the vitreous Creative Solutions to Retinal Challenges gel of the eye. While we are just Retinal detach- vestibular neurophysiology, and neu- beginning to understand the ment is a rare but a roscience allows a more integrated specifics of this interface, it is un- devastating condi- approach to patient issues, which derstood that such abnormalities tion that generally sometimes leads to creative, person- are central to the development requires a surgeon alized solutions. of vision loss from eye diseases as to repair the retina Although he maintains a full clini- diverse as macular hole, epiretinal by placing a sup- cal practice in East Baltimore and membrane, diabetic retinopathy, porting band on the outside of the at Greenspring, Dr. Ying conducts retinal detachment, a variety of eye and by removing some of the a host of research projects that in- pediatric retinal diseases, and eye’s vitreous—the filling within the vestigate such challenges as ocular possibly the development of wet eye; that is, pulling on the retina dysmotility and double vision after age-related macular degeneration. from the inside of the eye. The sur- retinal surgery. His research has led His research offers promise for the geon then replaces the vitreous with to the understanding that muscle development of novel treatments something akin to a bubble to hold imbalance in the eyes after retinal for the conditions noted above, the retina against the back of the eye. surgery is caused by both mechani- including the development of Howard S. Ying, MD, cal imbalances (in part due to the medical treatments for conditions PhD, Associate Professor of supporting band outside of the eye that currently require surgery. Ophthalmology, is exceptional in to repair retinal detachment) and Dr. Wenick is among those both his approach and treatment for sensory imbalances (caused by the practicing at Wilmer’s satellite lo- patients with retinal disease. Having retinal detachment itself). cation in Bethesda. additional training in ,

3 Expanding Access to Clinical Trials

Clinical trials have Scott, MD, Assistant Professor diabetic retinopathy, retinal vascular long been a vital of Ophthalmology, is working to occlusions, macular holes, retinal de- tool used by re- change the accessibility of such trials tachments and epiretinal membranes searchers to gain by bringing some to that campus, in are among the conditions Dr. Scott, insights into spe- addition to those at Wilmer’s main and the other faculty at Wilmer in cific, often location. Dr. Scott and the other cli- Bel Air diagnose, treat and research life-changing nicians at Wilmer at Parris-Castoro each day. “In our field, much of the health conditions and possible treat- are in a unique position to do so information we have today regard- ments. Although many hope to because of the vast and complex ing diagnosis, prognosis, treatment, volunteer for such studies, the urban focus of their patient population and prevention of devastating eye locations of such clinical trials often and research investigations across conditions has come from our clini- prevent such participation. a broad spectrum of vitreoretinal cal trials,” she says. “It is critical we As medical director of Wilmer medical and surgical diseases and make access to participation in these Eye Institute at Parris-Castoro in occurrences. trials as convenient as possible for Bel Air, Maryland, Adrienne W. Age-related macular degeneration, our patients.” Harnessing Telemedicine continued from page 2 clinical research trials for potentially is largely preventable with ap- vision threatening disease. Our work blinding disorders for which optimal propriate and timely treatment. over the past decade has focused on therapies are still evolving.” Nonetheless, almost half of all promoting telehealth to enhance the Yet all the expertise and technol- patients with diabetes still do not availability, quality, efficiency, and ogy can’t help patients if they have undergo recommended examina- cost-effectiveness of remote evalua- no access to the practitioners that tions for diabetic retinopathy,” tion for diabetic retinopathy. can deliver world-class treatments. she says. “Telemedicine evaluation She is also working on ways to Dr. Zimmer-Galler has spent years for diabetic retinopathy by remote have community-based practices that researching how telemedicine might retinal imaging has been shown to work within a university setting— improve public health programs of be an effective and viable adjunct including Wilmer Eye Institute’s common retinal diseases. option to improve access to the di- satellite at Frederick, Maryland, “Evidence-based medicine has agnosis and management of diabetic where she is the Satellite Chief— proven that vision loss from dis- retinopathy as well as decreasing become centers of excellence for eases such as diabetic retinopathy the cost of identifying patients with clinical research trials.

NON-PROFIT ORG. U.S. POSTAGE PAID LUTHERVILLE, MD PERMIT NO. 171

To add/remove your name from the mailing list, please send your name and address to: The Wilmer Eye Institute RetinaReview Subscription 600 N. Wolfe Street, Wilmer 112 Baltimore, MD 21287-9015 [email protected] 410-955-2020 410-955-0866 (f) RetinaReview is published once a year by the Wilmer Eye Institute at Johns Hopkins Hospital.