Michael Gray, MD
Dr. Michael Gray, MD
, serves as the principal site investigator for Cincinnati Children's Hospital Medical Center for the Pediatric Eye Disease Investigator Group (PEDIG). PEDIG is a collaborative network dedicated to facilitating multicenter clinical research in strabismus, amblyopia and other eye disorders that affect children. The group receives funds from the National Eye Institute, part of the National Institutes of Health. They are active in several ongoing clinical trials, and the site is among the leading recruiters for IXT5 (A randomized clinical trial of overminus spectacle therapy for intermittent exotropia) and ATS20 (binocular dig rush game treatment for amblyopia - a unique binocular therapy using an iPad game to treat amblyopia). Dr. Gray served on a number of committees for PEDIG and was the leadership development fellow in 2017.
Eniolami O. Dosunmu, MD
Dr. Eniolami O. Dosunmu, MD, serves as the ophthalmologist for the CHARGE Center. The CHARGE Center consists of a multidisciplinary team of physicians and nurses who work together to deliver patient-centered and optimized care for patients with CHARGE syndrome. Through the center, which is one of its kind, Dr. Dosunmu is able to provide individualized care for each center patient. The center is in the process of furthering the care it provides to ophthalmology patients, as it will soon start both retrospective and prospective research on the patients evaluated through the center. Given the uniqueness of the center, the number of patients evaluated by Dr. Dosunmu since the inception of the center, creates an opportunity to further the knowledge of the parent and medical communities about the eyes with CHARGE syndrome.
Dr. Dosunmu also serves as an investigator for phase 1 trial of bevacizumab treatment for severe retinopathy of prematurity (ROP). Published initial results of this study are in JAMA Ophthalmology. In the past one year, she completed a retrospective research on the etiologies of cranial nerve IV palsy with published findings in the American Journal of Ophthalmology.
Virginia Miraldi Utz, MD
Dr. Virginia Miraldi Utz’s research interests involve uveitis (intraocular inflammation) and ophthalmic genetics. Uveitis is an inflammatory condition that leads to vision loss in children. Dr. Miraldi Utz is currently studying the clinical outcomes of patients with non-infectious uveitis treated with infliximab and the effect of treatment adherence on disease control. Dr. Miraldi Utz and Sabrina Bulas, student researcher, presented this work at the 2017 American Academy of Ophthalmology Meeting and additional findings at the 2018 American Association for Pediatric Ophthalmology and Strabismus (AAPOS). They found that patients had a four-fold decreased risk of active disease on infliximab compared to pre-treatment baseline, and those with reported non-adherence for any visit had a 10-fold risk of having active disease. A manuscript is currently in progress. She is also working collaboratively with principal investigator, Dr. Sheila Angeles-Han, MD, MSc, in pediatric rheumatology, to study potential biomarkers in the tear film that may help to predict the development of uveitis in patients with juvenile idiopathic arthritis. Dr. Angeles-Han will present this work at the American College of Rheumatology Meeting Annual Meeting in October (Comparison of the Tear Cytokine and Chemokine Profile of Children with JIA and JIA-Associated Uveitis). In the field of ophthalmic genetics, Dr. Miraldi Utz worked collaboratively with Dr. Arlene Drack at the University of Iowa to characterize the clinical presentation and natural history of children with TRPM1-associated congenital stationary night blindness. Published results are in the April 2018 JAMA Ophthalmology.
Dr. Miraldi Utz is also the site principal investigator for the Cerebrotendinous Xanthomatosis (CTX) Prevalence Study. CTX is a disorder of bile acids in which accumulation of bile acid metabolites leads to neurodegeneration. The presenting sign for many patients is developmental cataracts, and the goal of the study is to determine the prevalence of this condition in patients with developmental cataracts. Importantly, when diagnosed with this condition, treatment is available to prevent neurodegeneration.
Sarah Lopper, OD
Dr. Sarah Lopper, OD, works on the Division of Ophthalmology clinic outcomes with clinical research coordinators: Patricia Cobb and Katherine Castleberry. Amblyopia is a leading cause of vision loss in children and although there is evidence based research for best practice standards, initial data review indicate different treatment approaches between faculty. Reached between all faculty in 2016 was the creation and consensus of a clinical treatment algorithm and quality improvement interventions. After a successful two years of implementing the algorithm and interventions, the team is now analyzing amblyopia treatment success in a retrospective group to further identify additional interventions to continue to improve the outcomes in these patients.
Dr. Lopper is part of the new pediatric low vision service. She provides low vision examinations and interventions for children with vision impairment. This clinic is in the medical office building at Cincinnati Children’s and includes pediatric ophthalmology and optometry, occupational therapy, an orientation and mobility specialist, a low vision therapist and teacher of the visually impaired.
William Motley, MD
Dr. Walker Motley, MS, MD
, serves as the division’s co-investigator for two prospective optic pathway glioma studies: 1) Developing Evidence-Based Criteria for Initiating Treatment for Neurofibromatosis Type 1 Associated Optic Pathway Glioma (PI: Dr. Trent Hummel, MD
, Division of Oncology
), and 2) Radiographic Biomarkers and Functional Outcomes of Vision in Optic Pathway Gliomas (PI: Dr. Peter de Blank, MD, MSCE
, Division of Oncology). Optic pathway glioma tumors are common manifestations of neurofibromatosis and can lead to vision loss or blindness. These two long term prospective studies should help guide the management of these tumors to prevent vision loss. Dr. Motley’s other clinical research focuses on the pathogens of pediatric corneal ulcers, corneal collagen crosslinking for keratoconus, ocular features of plectin deficiency epidermolysis bullosa and surgical management for congenital dacryocystoceles.
Richard A. Lang, PhD
Over the last year, the Lang lab
investigated the mechanisms by which the blood vessels of the eye normally develop. We investigated the function of two atypical opsins, OPN4 and OPN5, required for normal development of eye vasculature. Our findings suggest that light response pathways mediated by these two opsins have opposing effects in regulating vascular development. OPN4, also known as melanopsin, responds to blue light and suppresses the level of the crucial vascular regulator VEGFA. We have also shown that OPN5 (neuropsin) suppresses levels of the neuroregulator dopamine, and that dopamine directly promotes regression of the fetal vasculature. These findings raise the interesting possibility that potential treatment of the vascular overgrowth disease retinopathy of prematurity is to manipulate the exposure to lighting conditions for premature infants.
Michael B. Yang, MD
Dr. Michael Yang, MD, serves as site principal investigator (PI) for the Postnatal Growth and Retinopathy of Prematurity (G-ROP) multicenter study which just concluded enrollment in 2017. G-ROP aims to analyze various risk factors, including postnatal weight gain, for incorporation into a highly accurate risk model that can help predict which premature infants will develop severe ROP, which may allow the elimination of lower risk infants from screening altogether. Initial published results suggest that a significant reduction in infants who need screening is possible, and secondary analyses are already underway, which are likely to impact recommended screening protocols nationwide in the future.
Dr. Yang is also site PI for the phase 1 trial of Bevacizumab Treatment for Severe ROP. Published initial results of this study suggest that a dose of bevacizumab as low as 1/20th of the previous standard dose for intravitreal injection is effective in the treatment of severe ROP. There is current testing of lower doses in preparation for future comparative studies.