This year Texas’ largest ophthalmology practice has made its work with a partnering but independent, non-profit research institute physical. Nestled beneath Spec’s on N. Central Expressway are Texas Retina Associates and Retina Foundation of the Southwest, the ophthalmological duo that works on advances such as the “bionic eye,” or ARGUS II, clinical trials.
“Having this private and non-for profit collaborative relationship is unique really anywhere in the country,” said Jeff Brockette, CEO of Texas Retina Associates, or TRA.
Established in 1966 and based in Dallas, TRA has 13 offices going as far south as Waco, as far west as Lubbock, and as far north as Wichita Falls. The practice’s sub-specialized physician team has participated in more than 75 national clinical trials over the past 20 years.
Brockette, who has been with TRA for 15 years, said he has seen research develop from not being able to help much to one that has been able to provide new treatments that can actually improve vision. “We’re the ones helping develop the drugs that I might be taking when I turn 70, and the drugs that my parents are taking today.”
The research programs have grown significantly over the last few years for a variety of reasons. One of which is the demand of the aging population as well as the pharmaceutical companies taking note of progress. TRA has been part of the trials for essentially all of the current treatments for macular degeneration used worldwide, Brockette said.
Now located next door is The Retina Foundation of the Southwest, or RFSW, which was established in 1982 by TRA physicians and has grown to staff 28 people as well as volunteer physicians who are able to treat patients at no cost as they are supported by research grants. Many physicians who work at TRA also volunteer at RFSW, Brockette said.
While the move is new, the collaboration isn’t. TRA physicians and RFSW scientists have worked together for more than 30 years on treatments for retina conditions such as age-related macular degeneration, diabetic retinopathy, retinitis pigmentosa, and uveitis which are the leading causes of vision loss.
About three years ago TRA met with RFSW to discuss bringing the two establishments physically together to coordinate the trials. Now, patients who are eligible to participate in trials only have to walk next door to start the process said Karl Csaky, M.D., who came to TRA roughly three years ago from Duke due to the institute’s ability to try new things with ease and work well with patients.
“(Some patients) drive from 70 miles away, and now they don’t have to drive back and forth,” Csaky said. ”I can see a patient, and we can enroll her in a clinical trial the same day. She leaves here knowing that she’s arguably receiving the most advanced care in the world for her macular degeneration. She is benefitting from cutting-edge research for a disease that historically has had no real good treatment in terms of the dry form.”Csaky went on to say he could not have done the above at Duke because of the levels of interference, restrictions, and bureaucracy that go along with large research institutions.
“In our field, there are so many unmet needs, and as a physician, one of the most frustrating things is to have to tell a patient there is nothing we can do,” Csaky said. “Now we have a facility that allows us to push the envelope on our knowledge and understanding of retina diseases, as well as how to treat those conditions in the most efficient manner.”
One of the trials TRA took part in is ARGUS II, an implant in the eye designed to provide a low level of stimulation of vision for patients who are blind. Csaky described the device as a small telescope that fits on a glass, has an electrical signal transmitted that then transmits that circle onto the surface of the retina, which is still functioning, and then goes back to the brain.
In addition to this trial, the institutes have:
- Discovered that DHA in mother’s milk is necessary for infant eye and brain development. Enhanced formula containing DHA is now sold worldwide.
- Proved that cataracts should be removed in infants to enable normal visual development
- Discovered the function of the gene that causes Stargardt disease (juvenile macular degeneration)
- Discovered that blue light can cause damage to the eyes and lead to macular degeneration
- Pioneered improvements in visual testing for retinitis pigmentosa and allied retinal degenerations
- Developed an inexpensive distance stereoacuity test, the Randot test, for children as young as three years of age to monitor kids with intermittent exotropia (when one eye drifts out). Changes in distance stereoacuity over time may signal deterioration and the need for surgical correction to re-align the eyes.