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Researchers strive to save sight of preemies

Deborah Costakos, MD, MS, Assistant Professor of Ophthalmology, and Joseph Carroll, PhD, Associate Professor of Ophthalmology, Biophysics, and Cell Biology, Neurobiology and Anatomy, are collaborating to detect changes in the retina that may signal retinopathy of prematurity, a blinding disease in infants.

Oct. 28, 2013 College News - It is estimated that one in every 100 children who enter the neonatal intensive care unit at birth will go blind due to a disease called retinopathy of prematurity (ROP). Aided by a $300,000 grant from the Russell J. and Betty Jane Shaw Fund of the Greater Milwaukee Foundation, Medical College of Wisconsin researchers are trying to save the sight of infants with ROP before they go blind.

When premature babies are born, their blood vessels are not yet fully developed. They continue to form after birth but in an abnormal way that leads to bleeding, scarring and even detachment of the retina. Determining when to treat ROP is critical because the treatment itself can cause irreparable damage if given too early or too late.

Colleagues Joseph Carroll, PhD, Associate Professor of Ophthalmology, Biophysics, and Cell Biology, Neurobiology and Anatomy; and Deborah Costakos, MD, MS, Assistant Professor of Ophthalmology, are developing methods to detect and characterize the earliest changes in the retina of premature children. Through the Froedtert & the Medical College of Wisconsin Eye Institute’s Advanced Ocular Imaging Program, their project, based at Children’s Hospital of Wisconsin, seeks to identify the differences between normal variations in the infant eye and those associated with ROP, so that treatment can be administered to the right patients at the optimal time.

“The results of this study have the potential to change the way doctors around the world treat retinopathy of prematurity, by providing pioneering data about the developing eye of a premature child and suggesting an indicator for the most successful time in an infant’s development to treat ROP,” Dr. Costakos said.

Central to the team’s approach is a collaboration with Bioptigen, Inc., a manufacturer of optical coherence tomography (OCT) systems. With MCW, the company received a small business grant from the National Institutes of Health (NIH) to develop a hand-held probe specifically suited to taking high-quality images of the eyes of infants in neonatal intensive care.

“Bioptigen is dedicated to serving the pediatric clinical and research ophthalmologist,” said Eric Buckland, President and CEO of Bioptigen. “Drs. Costakos and Carroll are leaders in understanding retinal development and risks to the neonatal eye. We are proud that MCW has chosen us to be partners and collaborators on this project.”

The images, which can be acquired in seconds as part of a routine patient exam, may enable detection of the earliest signs of change in the infant’s eye, long before a doctor could see it with standard clinical tools, and data from the team’s pilot studies supports this suggestion. The technology will also help the investigators establish the first ever database of infant retinal anatomy to more accurately determine the early signs of ROP.

To make the screening available to more patients, the team will access MCW’s mobile translational research unit through the Clinical and Translational Science Institute (CTSI) of Southeast Wisconsin. This will allow Dr. Costakos to screen children at multiple area neonatal intensive care units.

“The Eye Institute is poised to make a significant advancement in this field because we are one of only a few hospitals in the world with imaging technology sophisticated enough to examine the eyes of these premature children,” Dr. Carroll said. “We envision this as a vital first step to creating a regional screening program for ROP. With the mobile resources of the CTSI, we can pilot a program where the portable OCT technology is delivered to where it is needed most – area neonatal intensive care units.”

The Russell J. and Betty Jane Shaw Fund was specifically created to support medical research for childhood diseases, making this project an intuitive fit. Russell J. Shaw was a Milwaukee-area businessman, and Betty was a volunteer to many local charitable organizations.

“This project provides Wisconsin with access to cutting-edge diagnostic technology that will improve the future quality of life for children in this state and beyond,” said Jeannie Fenceroy, senior program officer and administrator of the Shaw Fund.

Because this study is novel in its approach and with emerging technology, it will likely generate the evidence requisite for applying to the NIH for a grant to expand the line of research.

“Private philanthropy provides the capital needed for the preliminary studies that can lead to large grants from government or national foundations,” said Joseph E. Kerschner, MD, Dean of the Medical School and Executive Vice President. “The generosity of Greater Milwaukee Foundation’s Russell J. and Betty Jane Shaw Fund will be felt by many local families with premature children, and the positive repercussions of this research may one day be felt nationwide.”

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Page Updated 10/28/2013