Advancing Ophthalmology Research at the Karalis Johnson Retina Center
The Roger and Angie Karalis Johnson Retina Center at South Lake Union is the realization of the vision of Angie Karalis Johnson. Angie worked with her late husband Roger for many years as office manager of their very successful Seattle ophthalmology practice. She saw many patients who lost vision from retinal degenerative diseases during this time despite having the best care available. Angie’s vision is a world where this does not happen. The UW Medicine Department of Ophthalmology is deeply grateful for this gift made by Angie Karalis Johnson and her vision to find a cure for all types of retinal diseases.
The Center is both a state-of-the-art clinical facility and a leading research center in vision science with internationally renowned faculty. By putting our clinical facilities in direct proximity to our research laboratories, we can accelerate research while at the same time offering our patients access to advances not yet available in the broader community.
The Karalis Johnson Retina Center supports four pillars of research in its mission to eradicate retinal blindness: advanced optics imaging, computational ophthalmology, accelerating the therapeutic pipeline, and vision restoration research.
Advanced Imaging. The retina is the only visible component of the central nervous system outside of the human brain. This tissue-paper thin structure is essential to normal vision. Visualization of the retina has been central to diagnosing retinal disease for over a century, but advances in digital optics and imaging allow the unprecedented ability to detect and characterize the retinal disease.
Research Associate Professor Ram Sabesan, PhD, and his lab use adaptive optics imaging borrowed from astronomy to fully correct the optics of the eye and image the retina at the level of single cells. George and Martina Kren, Endowed Chair of Ophthalmology Ricky Wang, PhD, and his lab developed the now widely-used technique of optical coherence tomography angiography. These two technologies are together advancing our ability to image the retina to single-cell resolution.
Computational Ophthalmology. The availability of huge datasets such as the American Academy of Ophthalmology’s IRIS registry allows C. Dan and Irene Hunter Endowed Professor Aaron Lee, MD, and Klorfine Family Endowed Chair Cecilia Lee, MD, to determine real-world outcomes of treatments and identify risk factors and trends in disease on an unparalleled scale. Combined with machine learning approaches, we anticipate that personalized precision retinal medicine will become a reality – finding the best possible treatment options for patients based on analysis of millions of similar cases.
Accelerating the therapeutic pipeline includes the work of Gordon and Joan Bergy Professor Jennifer Chao, MD, PhD. This lab can take blood samples from patients affected by retinal diseases to create patient-specific stem cells, which can grow into small copies of the retina in the laboratory. These cells can then be tested with available drugs or nutritional supplements to look for agents that might slow or stop regeneration. Such interventions can then be tested in the clinic with the sensitive imaging techniques of the first pillar to identify promising treatments. This technique also has the potential for transplantation – repairing damaged tissues with the patient’s cells.
The work of Dr. Kathryn Pepple, Associate Professor of Ophthalmology, also accelerates the therapeutic pipeline by characterizing animal models of ocular inflammatory disease, which can be used for drug development.
Vision restoration describes methods to reintroduce light sensitivity to retinas blind from degeneration. Gene therapy approaches pioneered by Bishop Professor Jay Neitz, PhD, and Ray Hill Chair Maureen Neitz, PhD, has been shown to correct color blindness and have the potential to correct other forms of blindness. Research from the Bucey Chair Russell Van Gelder, MD, PhD’s laboratory uses small molecules to ‘reanimate’ the remaining cells in the degenerated retina to restore light responsiveness.
The clinical care at the Retina Center is state-of-the-art. We have outstanding retina and uveitis specialists from the UW Medicine Eye Institute and an exceptional group of optometrists and low-vision specialists. All treatments for retinal and ocular inflammatory diseases are offered at the center, including macular degeneration, management of hereditary retinal degeneration, treatment of diabetic retinopathy, and management of other retinal problems, including vascular diseases, retinal detachments, and uveitis. The Center is equipped with the latest diagnostic and therapeutic equipment.
The retina is the sensor of the eye that converts focused light into electrical neural impulses that communicate to the brain. Most blindness in the US is due to diseases of the retina. Three leading causes of blindness include age-related macular degeneration (the leading cause of blindness in the US), diabetic retinopathy (the most frequent cause of vision loss in working-age adults), and hereditary or inherited retinal degeneration (the most common inherited cause of blindness).
At the Retina Center, patients with retinal degenerative diseases may have the opportunity to participate in clinical research during their visit. In this way, patients will be on the front line of available treatments and have access to the latest clinical trials before they are approved for use by the general public.
Our patients serve as our partners in research, contributing to the science that will help other people with debilitating eye conditions. With information derived from advanced imaging and other tests, researchers at the UW Medicine Eye Institute will be able to make faster progress in advancing vision-saving research on several fronts, including stem cell therapy, gene therapy, and chemical reanimation therapy, all of which may have the potential to slow or halt retinal degeneration — and even, perhaps, to restore vision.