Kellogg’s Latest Heed Fellows Since 1947, funding from either the Heed Ophthalmic Foundation or the Society of Heed Fellows has provided postgraduate fellowships to promising clinical investigators. Numerous Heed Fellows can be found among current Kellogg faculty and alumni, including two current retina fellows appointed for 2021-2022: Emily Eton, M.D., is a first-year vitreoretinal surgery fellow at Kellogg. Among her current research pursuits is a study of the treatment of retinopathy of prematurity (ROP), a disorder of abnormal retinal blood vessel growth that occurs in babies born prematurely. Care for a premature baby begins in a hospital’s neonatal intensive care unit (NICU). There, babies with ROP undergo
Heed Fellows: Benjamin Young, M.D., and Emily Eton, M.D.
repeated screening eye exams, where the severity of their disease is staged. Staging guides which of three treatment approaches
“We know that patients with Stargardt disease lose their
is called for: laser or cryotherapy, intraocular injections, or
vision as a result of irreversible damage to retinal pigment
surgery, which is indicated for the most advanced disease.
epithelial cells (RPE), and that the damage begins in the center
“Deciding which approach to take is not a clear-cut process,” Dr. Eton explains. “We want to understand how
of the retina and expands out, causing larger and larger blind
decisions are being made and care delivered across a range
spots,” explains Dr. Young. “But little is known
To assess ROP care, Dr. Eton is studying information from the Vermont Oxford Network (VON), a group of more than 1,400 medical centers that contribute a wide range of NICU clinical data for research. Dr. Eton is comparing data from different types of NICUs, segmenting them by region of the country and by
“
hospital type — academic versus community health systems. Among the trends she is analyz-
about exactly how this happens over time.” In previous research in choroideremia and age-related macular degeneration, Dr. Young noticed a pattern of RPE cell death that seems to
DECIDING WHICH APPROACH
too. “In all three IRDs, RPE degeneration tends to continue
WE WANT TO UNDERSTAND HOW DECISIONS
along the edge of where the most recent cell death has occurred,”
ARE BEING MADE AND CARE DELIVERED
he explains. “This is in contrast
ACROSS A RANGE OF NICUS.
to RPE cell death resulting from
ing are which modes of ROP treatment are being selected for which patients,
— Emily Eton, M.D.
whether ROP babies are being transferred long distances to academic centers, and whether certain types of NICUs tend to treat the more advanced cases that require surgery. “NICU doctors need decision-support tools for treating
a retinal injury, which eventually stops.” “In other words, in these inherited diseases, RPE cells seem more likely to die once neighboring cells have died.” Examining imaging of disease progres-
sion in IRD patients, Dr. Young will look for a com-
ROP. We hope this study will be a useful first step in improving
mon mechanism or process driving this ‘neighbor effect,’ and
how we care for babies with this vision-threatening disease.”
attempt to describe the rules that govern that process.
Benjamin Young, M.D., is in the second year of his surgi-
“With that information, we plan to develop a computa-
cal retinal fellowship at Kellogg. His latest research project is
tional simulation of the process,” he explains. “Eventually, such
looking at Stargardt disease, an incurable, largely untreatable
a model could be used to predict how a patient’s disease will
inherited retinal disease (IRD) that leads to significant, progres-
progress over time.”
sive vision loss. 30
be common to Stargardt disease
TO TAKE IS NOT A CLEAR-CUT PROCESS,
“
of NICUs.”
