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 repeated screening eye exams, where the severity of their disease is staged. Staging guides which of three treatment approaches is called for: laser or cryotherapy, intraocular injections, or surgery, which is indicated for the most advanced disease.

“Deciding which approach to take is not a clear-cut process,” Dr. Eton explains. “We want to understand how decisions are being made and care delivered across a range of NICUs.”

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 analyzing are which modes of ROP treatment are being selected for which patients, 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 ROP. We hope this study will be a useful first step in improving how we care for babies with this vision-threatening disease.”

Benjamin Young, M.D., is in the second year of his surgical retinal fellowship at Kellogg. His latest research project is looking at Stargardt disease, an incurable, largely untreatable inherited retinal disease (IRD) that leads to significant, progressive vision loss.

“We know that patients with Stargardt disease lose their vision as a result of irreversible damage to retinal pigment epithelial cells (RPE), and that the damage begins in the center of the retina and expands out, causing larger and larger blind spots,” explains Dr. Young. “But little is known 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 be common to Stargardt disease, too. “In all three IRDs, RPE degeneration tends to continue along the edge of where the most recent cell death has occurred,” he explains. “This is in contrast to RPE cell death resulting from 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 progression in IRD patients, Dr. Young will look for a common mechanism or process driving this ‘neighbor effect,’ and attempt to describe the rules that govern that process.

“With that information, we plan to develop a computational simulation of the process,” he explains. “Eventually, such a model could be used to predict how a patient’s disease will progress over time.”