RetinaReview A newsletter from the Wilmer Eye 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 retina pro- ophthalmology, 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 Retinal detachment, retinitis 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 Retinopathy 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 macular degeneration 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 diabetic retinopathy. 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 retinitis pigmentosa 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 unparal leled 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 optic nerve 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 gene delivery tools to the retina and other posterior seg- Ophthalmology, is a renowned ex- enabling the handheld tools of the ments of children’s eyes. pert on such disorders.