Category: Conditions

As COVID-19 Disrupts Education, Ophthalmology Residents Adapt

COVID Residents
Pictured above: Three of our many ophthalmology residents, all of whom continue their education amidst the COVID-19 pandemic.

By Eric Weintraub

When Dr. Charles DeBoer, a second-year resident in the USC Department of Ophthalmology, learned that barrier shields meant to protect patients and physicians from COVID-19 droplet transfer were nationally backordered, he spent his own time and personal resources to build PPE customized for ophthalmic exams.

“I saw a barrier shield design in the paper, ‘Stepping up infection control measures in ophthalmology during the novel coronavirus outbreak: an experience from Hong Kong (2020)’ and thought the way they implemented infection control made sense,” said Dr. DeBoer. “So I copied it for our clinics and we refined the design.” In collaboration with co-resident Dr. Diana Lee and two attending physicians, Drs. Vivek Patel and Annie Nguyen, Dr. DeBoer created barrier shields out of polycarbonate sheets for slit lamps, the microscopes used to look into patients’ eyes.

Dr. DeBoer’s barrier shields now enable physicians to examine a patient closely while still reducing the risk of infection for them both at LAC+USC Medical Center (LAC+USC) and Keck Medical Center (KMC) ophthalmology clinics. This is only one example of how residents are adapting within the drastically disrupted learning environment due to the ongoing COVID-19 pandemic.

barrier shield slit lamp
Dr. DeBoer demonstrates how to assemble a slit lamp barrier shield.

In addition, residents are continuously implementing the latest COVID-19 industry responses provided by the American Academy of Ophthalmology (AAO). They are strengthening their history taking skills to learn more about their patients’ health histories, and have increased in-depth provider-to-provider discussions with their fellow residents, fellows, and faculty. Furthermore, residents are learning how to use new technology to provide telehealth services to meet patient needs.

“Telehealth allows us to perform a quick external exam of a patient’s eye,” said Dr. Hong-Uyen Hua, a second-year resident. “While it does not allow for a full assessment, it can help patients avoid in-office visits for non-urgent issues.”

Dr. Hua elaborated that patients often call with eye problems that can be resolved over the phone. Several patients who tested positive for COVID-19 have called with concern that they are developing an eye infection, as well. “In this situation, we ensure that the patient has no vision-threatening issues. We educate and counsel them on supportive care, emphasize the importance of social distancing, and make sure they practice good hygiene. As a result, we minimize exposure for everyone.”

Several residents expressed their belief that COVID-19 will permanently affect the ophthalmology landscape and that it has opened the door for telemedicine to play a more frequent role in the field.

Due to the California Governor’s Executive Order, as well as LA County requirements, clinic volume has been drastically limited to only treating patients with emergency eye conditions. The residency program has taken additional measurements to decrease the likelihood of a COVID-19 infection by having residents rotate in teams at LAC+USC, one week on and one week. In addition, KMC clinics are only seeing urgent patients and all elective surgeries have been canceled. Due to these changes, residents are not rotating in Keck clinics.

“The education and experience we get from seeing patients and operating on them has drastically declined,” said Dr. Ravi Shah, a third-year resident and co-chief resident. “This is likely going to affect different years of residents in different ways. For those that take advantage of the time to continue learning, it may be beneficial for them. But without that motivation, knowledge will quickly atrophy.”

Dr. Shah shared that away from clinic, residents are reading journal articles to stay updated on their respective fields and studying for their annual Ophthalmic Knowledge Assessment Program (OKAP) exams. In addition, the residency program’s education curriculum has quickly shifted to online learning. All faculty lectures and Grand Rounds continue to be conducted via Zoom.

Despite the disruption that COVID-19 has caused to the residents’ training, they share great pride in their colleagues’ resilience. “Too often likened to war, this pandemic has heroic troops battling this microscopic, insidious enemy every day,” said Dr. Hua. “When we chose medicine as a career, no healthcare worker imagined we would have to risk our own lives to save others. I am in awe of all of my colleagues on the frontline. I feel re-affirmed in my decision to choose medicine as a career and vocation during this unprecedented pandemic.”

Ask the Expert: How COVID-19 Affects the Eyes

Interviewed by Eric Weintraub, Additional Expertise Contributions by Dr. Brian Toy

With healthcare information changing daily amidst the COVID-19 pandemic, little attention has been given to its effect on one of the most sensitive parts of our bodies: the eyes. To provide an update, Dr. Annie Nguyen, Assistant Professor of Clinical Ophthalmology and Assistant Director of the Cornea & Refractive Surgery Fellowship at the USC Roski Eye Institute, answers frequently asked questions about whether our eyes are vulnerable to the novel coronavirus.
 

If COVID-19 droplets land in your eye, are you susceptible to infection?

The evidence of ocular transmission has not been well studied. However, mucous membranes, which line many body cavities and organs including the respiratory tract, are most susceptible to the novel coronavirus and viruses in general. The surface of the eye and inner eyelids are also lined by mucous membrane called the conjunctiva. Therefore, if infected droplets land in your eye, you are possibly susceptible to the infection.

The mode of COVID-19 transmission is still believed to be primarily through respiratory droplets from person-to-person. However, the virus can also live on surfaces up to a few days; therefore touching an infected surface, then touching your eyes, noses or mouth without washing your hands may lead to infection.
 
 

Can cleaning the eyes with water or over the counter eyedrops decrease the chance of infection?

The ocular surface has its own protective mechanisms, including antimicrobial proteins and natural lubrication. Therefore, routine cleaning or flushing of the eyes with water is not necessary and may actually strip away some of the ocular surface’s natural protective barriers, leading to increased risk of infection.

If your eyes become irritated or red, using over-the-counter artificial tears may help alleviate your symptoms. If symptoms are persistent, you should contact your eye care provider.
 

Is it true that contact wearers have a higher risk of infection for COVID-19?

With proper hygiene, there is no evidence that wearing contact lenses in itself increases your risk of infection for COVID-19. However, contact lens wearers touch their eyes more often than the average person. If you have a tendency to touch or rub your eyes, it may be best to switch to glasses temporarily, given risk of transmission from rubbing without proper hand hygiene. Also, glasses minimize risk of irritation from contact lens wear and also serve as a barrier that forces you to pause before touching your eyes.

Although not that best protection, glasses can also serve as a partial shield from respiratory droplets. If you do continue contact lens wear, make sure you carefully adhere to contact lens hygiene and wash your hands. If you develop redness or irritation, please discontinue contact lens wear and contact your eye doctor.
 

Is it true that pink eye is an early sign of COVID-19?

Yes, pinkeye, or conjunctivitis, has been reported to be a possible sign of infection from COVID-19. It is still uncertain exactly what percentage of patients with COVID-19 have ocular manifestations and different sources are reporting different numbers.

Although a recent study in JAMA Ophthalmology reported up to one-third of patients hospitalized with COVID-19 had ocular abnormalities, more studies are still needed. Of course, causes of conjunctivitis that are not COVID-19 related continue to persist.
 

Can COVID-19 cause temporary or permanent damage to your eyes (perhaps from lack of oxygen)?

Although conjunctivitis, which is a temporary condition, has been linked to COVID-19, at this point permanent eye damage from COVID-19 has not been reported. If a patient were in respiratory distress long enough, theoretically poor perfusion and oxygen deprivation could lead to possible damage to metabolically active tissues, such as the optic nerve or retina, but this has yet to be reported in COVID-19 related cases. In this instance, eye damage would be caused by decreased oxygen, rather than the virus itself.
 

Can COVID-19 be transmitted through tear droplets and is this something to worry about?

Transmission through infected ocular tissue or fluid has been controversial. Novel coronavirus has been detected in tear samples in a small number of cases. Given the presence of viral particles, it is, therefore, possible to transmit COVID-19, although the risk is likely low. However, the infectivity or clinical significance is not known and additional studies are needed at this time.
 

What precautions should you take if you are on immunosuppressive medications?

Patients who are immunosuppressed may be more vulnerable to COVID-19 infection, so it is important to adhere to physical distancing measures to minimize risk. Please discuss potential modification of your medication regimen with your physician (uveitis specialist or rheumatologist). In most cases of patients who are not ill, the risk of vision loss from uncontrolled eye inflammation is greater than the possible increased risk of acquiring COVID-19.
 
 

Dr. Nguyen closed the interview by reminding us that the COVID-19 situation is always evolving and we are learning more about the virus every day. Please contact your primary care physician if you are experiencing symptoms of COVID-19. If you have irritation or pain in the eye or difficulty seeing, please reach out to an eye care provider.

Dr. Nguyen based much of the information from this interview on what she learned in the following sources:

Cataract Surgery- What to Expect?



This surgery is used to remove a cataract. During the procedure, the cloudy lens in your eye is replaced with an artificial lens that will let you see clearly. This procedure is sometimes called “no-needle, no-stitch” cataract surgery. It’s quick, painless, and you can go home the same day.

When do you need cataract surgery?

Cataracts can be age-related and may occur from the age of 40 and up. Generally visual impairment from age-related cataracts can occur over the age of 60. Cataracts can also form from diseases such as diabetes, through injury or surgery, and even from prolonged exposure to sunlight. If you are experiencing symptoms such as blurred vision, halos or difficulty seeing at night, then it may be time to visit your eye care specialist who will access whether you have cataracts and if you require surgery.

How long does cataract surgery take?

Simple cataract removal can be as short as 10 minutes. However, the procedure may take anywhere from 30-60 minutes as patients need to recover from sedation or anesthesia. Cataract operations are out-patient procedures and patients may go home the same day.

Is cataract surgery painful?

Cataracts are rarely painful. Patients may feel some discomfort and pressure in the eye. Your doctor will prescribe eye drops for the first week following surgery.

How long can you drive after cataract surgery?

Generally patients may drive 24 hours after cataract surgery with full recovery from anesthesia.

How long does it take to recover?

Overall recovery of cataract surgery is typically one week. Be careful not to lift heavy things or getting water directly in the eye for one week. The visual recovery is very quick, most patients see well a day or two after surgery.

Blindness from Cataracts? Five Questions Answered

1. Did you know that cataracts are the leading cause of preventable blindness in the US and even worldwide?

Caused by a clouding of the lens in the eye, cataracts can result in vision loss and have a major impact on quality of life. Cataract-related visual impairment can take away a person’s independence and ability to do every day tasks like drive, cook, or even read.

2. Who is at risk and what are the causes?

Cataracts are not just found in the elderly. Although it may not affect vision at this stage, early signs of cataracts can occur from age 40 and up. Cataracts become progressive and debilitating with age, where almost half of Americans are estimated to have cataracts by the age of 65. Through population-based studies, USC Roski clinicians have also found that a projected 180,000 U.S. Latinos aged 40 and over nationwide have an unmet need for cataract surgery.

Cataracts can be caused by many factors including diseases such as diabetes, exposure to UV light or even smoking and alcohol use. Obesity, high blood pressure, eye injury, or surgery can also result in cataracts.

3. What are the signs?

It is important to recognize the signs. An eye exam is essential if you see halos of light, blurred or poor vision at night, double vision in a single eye or fading yellow of colors. In general, while these symptoms could be related to cataracts, visiting a skilled eye specialist for an evaluation is key to ensuring healthy vision.

4. How to prevent cataracts?

Healthy vision can come from leading a health lifestyle. Quit smoking, eat a well-balanced diet and take care of your health issues by seeing a physician regularly.

5. Cataract surgery – what to expect?

USC Roski cataract surgeons offer the latest advanced technology in cataract extraction. Typically cataract surgery is an outpatient procedure, lasting 30-60 minutes. Cataract surgery entails performing a lens exchange; the surgeon replaces the cloudy cataract lens with a clear lens implant.

In addition to standard lenses, we also offer our patients a large selection of premium lenses that are customizable including, mutifocal, toric and accommodative lenses. USC Roski Eye offers a minimally invasive technique such as femtosecond laser cataract surgery (custom laser cataract surgery) procedure, which allows for more precision in lens removal and gives surgeons the opportunity to treat corneal astigmatism at the time of cataract surgery.

Schedule an Appointment at USC Roski Eye Institute Today

Please contact our USC Roski Eye Institute cataract specialists today if you are experiencing any of the symptoms above. The exceptional eye doctors at USC Roski Eye Institute are experts at diagnosing and treating a wide variety of eye conditions. To receive a comprehensive eye exam and ensure that your vision is protected please complete our online contact form or call 323-442-6335 today!
References

  • Richter GM et al. Prevalence of Visually Significant Cataract and Factors Associated with Unmet Need for Cataract Surgery: Los Angeles Latino Eye Study. Ophthalmology. 2009, 116: 2327-2335.
  • https://nei.nih.gov/health/cataract/cataract_facts

Harmful UV Light Can Cause Eye Damage & Blindness

What do all of these conditions have in common? UV light, UVA, UVB and UVC, is powerful radiation from the sun that can damage your eyes.

Type of Ocular Condition Image
Photokeratitis– Caused by swelling of the cornea, outer most aspect of the eye, results in redness, swelling, blurred vision and pain.
Pinguecula– Often referred to as surfer’s eye, white or yellow raised bumps are found on the conjunctiva, or white part of the eye.
Pterygium– This growth extends beyond the conjunctiva and on to the cornea, and many require surgery. This condition is often found in those who live closer to the equator.
Cataracts– As the leading cause of preventable blindness, this condition which can be removed surgically, results in a cloudiness of the lens of the eye and cause blurred vision, halos of light, poor vision at night, among other symptoms.
Macular Degeneration– With no known cure, this retinal degenerative disease results in central vision loss, where those diagnosed are unable to drive, read or even recognize faces.
Skin Cancer– Basal cell carcinoma, squamous cell carcinoma and melanoma are all examples of skin cancers. Most are found on the lower lid. 5-10% of all skin cancers are melanomas.
Eye Cancer– Eye cancers include intraocular melanoma and conjunctival melanoma. While rare, conjunctival melanoma has become more common, with 10% prevalence among white men.

Tips to Protect Your Eyes from the Sun and Prevent Sun Damage!

  • Ensure you purchase sunglasses with the UV protection label
  • Make sure they fit well to prevent exposure to residual sunlight
  • Bring a pair with you wherever you go!

UV damage can lead to serious skin and eye cancer. Looks for lumps or bumps, pigmentation, elevated growths, bleeding, etc. Any of these symptoms could be a sign of melanoma.

Schedule an Appointment at USC Roski Eye Institute Today

Please contact our USC Roski ocular oncology team today if you are experiencing any of the symptoms above. The exceptional eye doctors at USC Roski Eye Institute are experts at diagnosing and treating a wide variety of eye conditions. To receive a comprehensive eye exam and ensure that your vision is protected please complete our online contact form or call 323-442-6335 today!

Sunglasses, Sunglasses, Sunglasses!

A great pair of sunglasses goes a long way! We have two conveniently located optical shops on campus to help you find your perfect pair. No appointment necessary! If you’re looking for prescription sunglasses, our on-site lab can have your lenses ready in as little as 24 hours!

Crossed Eyes (Strabismus) – Causes and Treatments – A Q&A with Dr. Patel

Harand before and after

What is Strabismus?

Michael-strab testimonial

Strabismus is a general term used to describe any misalignment of the eyes. It can occur in the context of childhood eye diseases (amblyopia or “lazy eye), or problems acquired in adulthood, including trauma, thyroid eye disease, nerve damage, or neurological disorders. Strabismus can be very debilitating, mainly from double vision. Importantly, strabismus can be an early sign of severe ocular, orbital or neurological disease.

What Causes Crossed Eyes in Children?

In some cases strabismus can be inherited (congenital) or result from vision-related problems. In addition, since approximately half of the brain is involved in vision, certain neurological conditions can also cause strabismus, resulting from disordered communication between the brain and the muscles that move the eyes. Vision in children is highly sensitive to refractive errors (nearsightedness and farsightedness) and may also cause strabismus if left untreated.

What Causes Crossed Eyes in Adults?

Like in children, strabismus in adults can be inherited and may worsen over time. As such, we have helped many adults who have had complications or recurrences despite previous strabismus surgeries in the past. Adult strabismus may also result from neurological conditions such as stroke, tumors, degenerative diseases such as Parkinson’s, to name a few. We specialize in evaluating the nature and cause of strabismus in adults, as well as developing an appropriate plan for intervention.

What Treatments are Available for Strabismus?

Strab before and after 2
Children and adults may be treated differently. In children, strabismus can often be corrected using eye patching, eyeglasses, vision therapy and surgery. In adults, special lenses such as prisms can correct or improve double vision in some cases; however, surgery may also be required to correct the misalignment. Over the past few decades, strabismus surgery has advanced considerably. Here at USC we have the necessary experience and expertise to address even the most complex cases, using the latest techniques and up-to-date practices.

USC Roski Eye Institute Neuro-Ophthalmology and Adult Strabismus Service

headshot-Vivek-Patel

Vivek R. Patel, MD, is an Associate Professor of Clinical Ophthalmology, Director of Neuro-Ophthalmology Service and Adult Strabismus specialist. He is also co-principal investigator for a $4 million grant from the National Eye Institute (NEI), leading a multidisciplinary team of investigators studying the relationship between the brain and blinding eye diseases.

Gokoffski website final

Kimberly K. Gokoffski, MD, PhD, is an Assistant Professor of Ophthalmology and Adult Strabismus specialist. Her doctoral work and current active research investigations focus on exploring the use of electrical fields to guide regenerating nerves in the context of optic nerve disease. She is funded by the NEI’s K-grant system of mentored original research.

Schedule an Appointment at USC Roski Eye Institute Today

Please contact our USC Roski adult strabismus team today to treat misalignment of your eyes or double vision. The exceptional eye doctors at USC Roski Eye Institute are experts at diagnosing and treating a wide variety of eye conditions. To receive a comprehensive eye exam and ensure that your vision is protected please complete our online contact form or call 323-442-6335 today!

To learn more about a new funding initiative for children’s strabismus surgery or for donations, please contact Rebecca Melville, senior director of development, via email at Rebecca.Melville@med.usc.edu or by calling USC Roski Eye Institute.

LASIK Testimonial: When the Doctor Becomes the Patient

Berry LASIK cover final

So….eye doctors, in general, don’t get Lasik. Or Lasek. Most of them have seen too many contact lens complications to even wear those. When you deal with all the complications you tend to forget about the 99.99% of people who do just fine. Recently, USC Roski Eye Institute’s Dr. Jesse Berry decided to take the plunge and get LASIK (as the residents looked on with wide-eyed wonderment). Her only regret? She didn’t do it sooner!

Dr. Berry took a moment to sound off with us below:

 

Why did you decide to get LASIK?

Mostly because I was sick of being attached to contact lenses and glasses. With my too-busy professional women life balancing work and personal life, I was also wearing contacts for 18 hours a day, most days of the week. My eyes started to be irritated by them and I wasn’t willing to be dependent on glasses so I looked for alternatives.

 

Who did your procedure?

One of USC Roski Eye Institute’s voluntary faculty members, Dr. Gregg Feinerman, while he was hosting a refractive surgery seminar for the residents.

 

How long did the procedure last?

The procedure was about seven minutes per eye! It was so fast, completely painless, and I saw better IMMEDIATELY after.

 

What was recovery like?

I operated the next day! Before LASIK without glasses or contact lenses beforehand I was 20/400 or worse, I was about 20/60 immediately after. I felt a little scratchy but pretty ok. By the time I went to bed I was 20/30 and I woke up 20/15 (I am not even kidding!)

 

Would you recommend it to your friends and family?

100%. My only regret is that I didn’t do it earlier! It has changed my whole life and I am so happy to not be linked to contacts all the time!

 

To learn more about Dr. Berry’s journey, please click here.
Dr_Berry_New_Headshot-MF (1)

Dr. Jesse Berry is an Assistant Professor of Ophthalmology at the USC Roski Eye Institute, and specializes in ocular oncology, melanoma, and retinoblastoma.

Poor Mascara Removal Leads to Eye Lesions and Serious Infection

Clumpy Mascara final

For over 25 years, a woman admitted to using excessive mascara each day without completely removing it at night before she slept. Complaining of feelings that something was in her eye, the 50-year-old sought help from her ophthalmologist. After a thorough eye exam, the ophthalmologist discovered dark pigmented depositions on the conjunctiva, the mucous membrane lining the inside of the eyelid. In addition, the ophthalmologist noted eye lesions or sub-conjunctival concretions. Following a biopsy of the conjunctiva, results of which were published in the American Academy of Ophthalmology, physicians found deposits of mascara as well as evidence of conjunctivitis or infection.
“It is important to ensure you wash your hands and clean around your eyes regularly to prevent infections from occurring. Having treated cases like this often, infections can lead to very serious consequences and in some cases even vision loss,” says Charles Flowers, MD, associate professor of clinical ophthalmology at USC Roski Eye Institute and cornea specialist.

Tips to Preventing Eye Infections

  • Wash your hands thoroughly before touching your eyes or face
  • Do not share your makeup, face towels, or any eye drops
  • Remove your makeup thoroughly before bed and do not reuse make up if you have had an eye infection to prevent it from reoccurring
  • Thoroughly clean your contact lenses, store in clean containers, and use fresh solutions without sharing
  • Wear protective eyewear outdoors or in a workplace where there may be hazards
  • Seek medical attention immediately if you notice symptoms of a suspected eye infection
  • Always use protection to prevent STI

Infections of the Eye

Infections of the eye can occur in one or both eyes and in individuals of all ages. Typically, those who have ocular infections may describe redness, irritation, discharge, swelling around the eyelid and eye, pain and possible loss in vision.

Schedule an Appointment at USC Roski Eye Institute TodayEye infections can be viral, bacterial or even fungal. Please see your eye care specialist if you suspect that you may have an infection, are experiencing irritation or pain in your eye. The exceptional eye doctors at USC Roski Eye Institute are experts at diagnosing and treating a wide variety of eye conditions. To receive a comprehensive eye exam and ensure that your vision is protected please complete our online contact form or call 323-442-6335 today!To learn more about the health services at the USC Roski Eye Institute or to support the Institute with a tax-deductible gift, please contact Rebecca Melville, senior director of development, via email at Rebecca.Melville@med.usc.edu or by calling USC Roski Eye Institute.
By: Debbie Mitra, PhD

Area of Inflammation

Conjunctivitis Surface of the eye
Blepharitis Eyelid
Keratitis Cornea, the transparent outermost part of the eye
Uveitis Uvea, the inner layer of the eye
Vitritis “Jelly-like” ocular fluid in the eye
Neuroretinitis Optic nerve and retina

Rare Eye Cancer Cases Found in Two States Leave Physicians Perplexed

Melanoma 3Several people in both Alabama and North Carolina have been diagnosed with a rare eye cancer known as ocular melanoma. Although found in only 6 out of 1 million in the US, dozens of ocular melanomas were diagnosed in mostly women 20 to 30 years of age.

Interestingly, through the use of social media, multiple cases were discovered through websites formed by groups from Auburn University, Alabama as well as in Huntersville, North Carolina.

Similar to skin cancer, the melanin or pigmented cells within your eye can also mutate and cause melanoma in or around the eye although this only accounts for about 5% of cases. Specifically uveal melanoma, or melanoma on the inside of the eye, was discovered in these cases. Such rare melanomas are generally seen in patients between 50 and 60 years of age. Ongoing investigations by physicians have not yet revealed the cause for this unusual geographical collection of cases.

“These reported cases are bizarre in both the incidence and how young the patients are. I applaud the work that is being done to find a common thread, however given the rarity of the disease this will be difficult even in the setting of a localized spike,” says ocular oncologist, Jesse L Berry, MD and assistant professor of clinical ophthalmology at the USC Roski Eye Institute.

Unlike skin cancer, which can be caused by sun damage, identifying the causes of eye cancers has been a challenge. Research has revealed that certain eye cancers can be hereditary or caused by random genetic mutations. Depending on the severity of the eye cancer, treatment options may include radiation via brachytherapy or with proton beam, or even removal of the eye.

Possible symptoms related to uveal melanomas generally include: blurring, distortion or loss of vision, shadow over vision which may come and go, as well as flashes and floaters.

“This is a devastating disease that can lead to blindness and even death if not appropriately diagnosed and treated early – and many of these tumors are asymptomatic so a complete dilated exam by an ophthalmologist is necessary to diagnose melanoma. Bringing awareness to this rare disease through social media platforms can give physicians and epidemiologists more information on the incidence of this disease in hopes of one day finding a cure, “ says Dr. Berry.

If you would like to learn about retinoblastoma, another eye cancer that occurs in children, and the development of a novel liquid biopsy method by Dr. Berry’s team please follow the link below: http://eye.keckmedicine.org/?post_type=post_press_release&p=14339.

Schedule an Appointment at USC Roski Eye Institute Today

The exceptional eye doctors at USC Roski Eye Institute are experts at diagnosing and treating a wide variety of eye conditions. To receive a comprehensive eye exam and ensure that your vision is protected from diabetes-related conditions, please complete our online contact form or call 323-442-6335 today!

To learn more about the health services at the USC Roski Eye Institute or to support the Institute with a tax-deductible gift, please contact Rebecca Melville, senior director of development, via email at Rebecca.Melville@med.usc.edu or by calling USC Roski Eye Institute.

By: Debbie Mitra, PhD

References

1. https://www.nbcnews.com/health/cancer/unusual-cases-rare-eye-melanoma-puzzle-doctors-two-states-n870551
2. https://www.cancer.org/cancer/eye-cancer/about/what-is-eye-cancer.html

USC Roski Eye Institute Researchers Report First Results in Stem Cell-Based Clinical Trial for Dry Age-Related Macular Degeneration

OTEP

Researchers, clinicians, scientists from the USC Roski Eye Institute and collaborators report encouraging results of a first-in-kind stem-cell based implant in a featured article in Science Translational Medicine entitled, “A Bioengineered Retinal Pigment Epithelial Monolayer for Advanced, Dry Age-Related Macular Degeneration.”

The novel minimally invasive stem cell-based therapy for dry age-related macular degeneration (AMD) was developed by a team at USC Roski Eye Institute, led by Mark S. Humayun MD, PhD, and David R. Hinton, MD, which was funded by the California Institute for Regenerative Medicine. The implant consists of stem cell-derived retinal pigment epithelium cells (RPE) on an ultrathin synthetic substrate. The implanted scaffold of RPE are localized and can function to support and replenish light sensing cells of the eye, which would help restore and prevent vision loss in patients with AMD.

“This is the first human trial of this novel stem cell–based implant, which is designed to replace a single-cell layer that degenerates in patients with dry age-related macular degeneration,” says lead author and surgeon for the study Amir H. Kashani, MD, PhD, assistant professor of clinical ophthalmology at the Keck School of Medicine of USC. “This implant has the potential to stop the progression of the disease or even improve patients’ vision. Proving its safety in humans is the first step in accomplishing that goal.”

Photo courtesy of Britney O. Pennington, PhD
Photo courtesy of Britney O. Pennington, PhD

The first results of the phase I/IIa clinical trial conducted at the USC Roski Eye Institute has been reported on four patients which were followed up to one year to assess safety. It was determined that the implant is safe and integrates well with the patient’s retinal tissue. One patient had improvement in visual acuity by up to 17 letters and two patients had gains in visual function, which was measured by how well they could use the area of the retina treated by the implant. None of the patients showed evidence of progression in vision loss.

Dry AMD can have a profound affect on the quality of life of an individual. In time as the disease progresses, patients will be unable to recognize faces, read or even drive. It is projected that over 3 million will be diagnosed with dry AMD by 2020.

“Our study shows that this unique stem cell–based retinal implant thus far is well-tolerated, and preliminary results suggest it may help people with advanced dry age-related macular degeneration,” says coauthor and lead inventor of the implant Mark S. Humayun, MD, PhD, director of the USC Institute for Biomedical Therapeutics, co-director of the USC Roski Eye Institute, affiliate principal investigator with the Eli and Edythe Broad Center for Regenerative Medicine and Stem Cell Research at USC and University Professor of Ophthalmology at the Keck School.

Stem Cell AMD blog final
Other USC researchers include Biju B. Thomas, PhD; Debbie Mitra, PhD; and Danhong Zhu, MD, PhD.

Collaborating institutions for the study include Regenerative Patch Technologies LLC, which also contributed to the funding of the study, as well as Camtek LLC, the California Institute of Technology, Retina Vitreous Associates Medical Group, California Retina Consultants, Atlantis Eyecare, City of Hope, University of California, Santa Barbara and Denney Research Center. Additional sources of funding for the study include Lori Mars and David Fields Gift, Estate of Beatrice Apple, William K. Bowes Foundation, Vermont Community Foundation, Breaux Foundation, Wilcox Family Foundation and Research to Prevent Blindness.

For more information about the study, visit https://clinicaltrials.gov/ct2/show/NCT02590692?term=nct02590692&rank=1. To participate in the study, please call (323) 442-6335.

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Disclosures: Regenerative Patch Technologies LLC was founded by Mark Humayun, MD, PhD, and David R. Hinton, MD, from Keck Medicine of USC and Dennis O. Clegg, PhD, from the University of California, Santa Barbara. The technology to produce the stem cell–based retinal implant is exclusively licensed to Regenerative Patch Technologies LLC from the University of Southern California, the California Institute of Technology and the University of California, Santa Barbara. Humayun and Hinton have an equity interest in and are consultants for Regenerative Patch Technologies LLC.