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What's New at Scheie Eye Institute

 

Penn’s Scheie Eye Institute Explores New Treatment to Slow Degenerative Eye Disorder

Right now, patients with keratoconus, a degenerative disease of the cornea that affects one in every 2,000 Americans, don’t have very many treatment options.  They can get contact lenses to keep up with their declining vision, or eventually, may require a corneal transplant if they become intolerant to contact lens.

“We need to find ways to slow this disease so it doesn’t get to that,” said Stephen Orlin, MD, a cornea specialist and refractive surgeon at the Scheie Eye Institute at the Hospital of the University of Pennsylvania.  “And that’s why, after hearing about a procedure that could slow the disease a few years ago, I wanted to bring this new clinical trial to Penn—to help move it closer to a reality for patients.”

IMG_4849Developed over 10 years ago overseas, but not yet approved in the U.S., the procedure works to strengthen the chemical bonds in the cornea with riboflavin (vitamin B2) and ultraviolet light. Over the course of a year in the trial, different intensities of light are applied to the cornea after it has been saturated with the dye for different lengths of time.  The idea is to preserve the vision these patients already have and stop the progression of the disease.

Scheie is one of several institutions around the country recruiting patients in the trial that will test the safety and efficacy of the minimally-invasive procedure, known as corneal collagen crosslinking (KXL), for not only keratoconus, but also corneal ectasia, a complication caused by LASIK surgery.

Nine patients have already been enrolled at Scheie.

Keratoconus is a progressive eye disease in which the cornea thins and bulges into a cone-like shape.  It is the most common ectatic corneal degeneration in the United States, and its severity ranges.  Some lose their vision over time but manage it with corrective contact lenses, while others are worse off, and end up needing a corneal transplant. In that surgical procedure, a damaged or diseased cornea is replaced by donated corneal tissue in its entirety or in part.

It was a clinical study presented back in 2011 at the American Academy of Ophthalmology Meeting that caught Dr. Orlin’s attention. “This study was of particular interest to me because it evaluated a procedure which could hopefully prevent particularly young patients from having progression of their disease to the point where they ultimately might need a corneal transplant,” he said. “That’s a powerful intervention.”

 

The results of the clinical trial were promising: 30 minutes of dye and then 30 minutes of ultraviolet light was proven to be safe, but also slowed the progression of the disease in patients with keratoconus.

But this new multi-site clinical trial is taking it a step further. Instead of a 30 minute exposure of UV light, the trial is testing out higher amounts of light energy over shorter periods of time, as a way to make it more manageable for patients. 

Subjects are randomized to one of three treatment groups. Up to 2,000 study eyes with keratoconus and up to 2,000 study eyes with corneal ectasia after refractive surgery will be randomized.  Three doses of irradiation will be tested, with the highest intensity paired with the shortest amount of time (2 minutes and 40 seconds) and the lowest intensity paired with longest amount of time (8 minutes).

Results from the study are expected later next year.

“This study is critically important because, up until now, there have been no pharmacological or surgical interventions to halt the progression of keratoconus or LASIK induced corneal ectasia,” said Dr. Orlin. “There are some other less successful ways of getting contact lens intolerant patients comfortable with their lenses, but this has very limited potential. Therefore, it would be enormously advantageous to prevent this disease from progressing so that we can preclude the need for corneal transplantation in these patients and preserve their vision.”

 

 

Director of Scheie Eye Institute Receives Prestigious Award from Women in Ophthalmology

Joan M. O’Brien, MD, the George E. de Schweinitz and William F. Norris Professor of Ophthalmology, chair of the Department of Ophthalmology and director of the Scheie Eye Institute at the Perelman School of Medicine at the University of Pennsylvania, was recently presented with the Women in Ophthalmology’s Suzanne Veronneau Troutman Award.

 

Presented at the 2013 American Academy of Ophthalmology meeting in New Orleans, the award recognizes the woman, nominated by the WIO membership, who has done the most over the past year to further women in ophthalmology.

“It’s an honor be recognized in this fashion by my WIO peers whom I greatly admire and respect,” said Dr. O’Brien. “Having the opportunity to mentor women in ophthalmology is a great privilege, and I look forward to continuing this organization’s strong commitment to enhancing the diverse careers of women in the field.”

Past recipients of the award include Eydie Miller-Ellis, MD, professor of Clinical Ophthalmology and director of the Glaucoma Division at Scheie, and Eve J. Higginbotham, MD, the first Vice Dean for Diversity and Inclusion at the Perelman School of Medicine.

Women in Ophthalmology was founded to enhance and improve the professional environment for women ophthalmologists. WIO encourages diversity, impartiality, and economic parity, and strives to cultivate new opportunities for leadership, education, and public service in the field of ophthalmology for current and future generations.

Dr. O’Brien previously served as professor and vice chair of Ophthalmology and director of the Ocular Oncology Division at the University of California at San Francisco (UCSF). She received her medical degree from Dartmouth Medical School and completed her residency training in ophthalmology at Harvard Medical School and a fellowship in oculoplastic surgery and oncology at UCSF. 

Her research fellowships were in immunology at the Harvard Medical School and in molecular ophthalmic pathology at the Massachusetts Eye and Ear Infirmary and the Whitehead Institute of MIT. She specializes in the treatment of ocular tumors, including retinoblastoma, ocular melanoma, conjunctival malignancies, ocular metastases, and ocular and CNS lymphoma. Her research focuses on the genetics of eye disease, including retinoblastoma, melanoma and glaucoma.

With nearly 200 publications, Dr. O’Brien’s work has recently appeared in Nature, the New England Journal of Medicine, the Journal of the American Medical Association and the Journal of Clinical Investigation. She has received numerous honors, including a UCSF resident teaching award, the Champion of Diversity award, a Physician-Scientist Award from Research to Prevent Blindness, a Career Development Award from the American Association for Cancer Research, and an Honor Award and a Senior Achievement Award from the American Academy of Ophthalmology.

Dr. O'Brien also has a long history of research support from the National Cancer Institute for clinical trials and the National Eye Institute for basic science investigations.

More recently, Dr. O’Brien was elected as a member of the Institute of Medicine (IOM), one of the nation's highest honors in biomedicine.

 

 

Dr. Joan O'Brien Elected as Member of the Institute of Medicine (IOM)

Joan M. O’Brien, M.D., is the George E. de Schweinitz and William F. Norris Professor of Ophthalmology, chair of the Department of Ophthalmology and director of the Scheie Eye Institute at the Perelman School of Medicine. She previously served as professor and vice chair of Ophthalmology and director of the Ocular Oncology Division at the University of California at San Francisco (UCSF). Dr. O’Brien received her medical degree from Dartmouth Medical School and completed her residency training in ophthalmology at Harvard Medical School and a fellowship in oculoplastic surgery and oncology at UCSF. Her research fellowships were in immunology at the Harvard Medical School and in molecular ophthalmic pathology at the Massachusetts Eye and Ear Infirmary and the Whitehead Institute of MIT. She specializes in the treatment of ocular tumors, including retinoblastoma, ocular melanoma, conjunctival malignancies, ocular metastases, and ocular and CNS lymphoma. Her research focuses on the genetics of eye disease, including retinoblastoma, melanoma and glaucoma. With nearly 200 publications, Dr. O’Brien’s work has recently appeared in Nature, the New England Journal of Medicine, the Journal of the American Medical Association and the Journal of Clinical Investigation. She has received numerous honors, including a UCSF resident teaching award, the Champion of Diversity award, a Physician-Scientist Award from Research to Prevent Blindness, a Career Development Award from the American Association for Cancer Research, and an Honor Award and a Senior Achievement Award from the American Academy of Ophthalmology. Dr. O'Brien also has a long history of research support from the National Cancer Institute for clinical trials and the National Eye Institute for basic science investigations.

 

 

 

 

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