Optogenetics

• The final common pathway to sight loss in IRD is loss of the primary neurons of the retina (the photoreceptors). Optogenetics is a technique which renders the secondary and tertiary neurons light-sensitive, thereby restoring function by converting them into novel photoreceptors. This is achieved through the introduction of genetic sequences which code light sensitive proteins, or opsins. We are investigating the ability of microbial and animal opsins to restore vision in models of retinal degeneration.
• The optogenetics program is supported by the NHMRC & Macula Disease Foundation Australia. 

Retinal explant project

• We have developed protocols for harvesting and storing living donor human retinal explants collected during emergency surgery for retinal detachment repair. These explants have been used for proof-of-concept testing of gene therapy vectors. This model is also being utilised as a potential source of retinal progenitor cells. 
• This work is supported by the Sydney Eye Hospital Foundation and the Foundation Fighting Blindness.

Retinal bioglue

• Retinal detachment carries a lifetime risk of 1 in 200 (rising to 1 in 20 with high myopia) and is the commonest reason for emergency eye surgery. Retinal detachment is caused by retinal tears, which are normally treated intraoperatively using LASER or cryo (freezing) therapy to provide a seal at the edge of the tear. However, this seal takes 1 week to form and necessitates the use of gases or oil in the eye to prevent intraocular fluid from redetaching the retina following surgery. Furthermore, 10-15% of cases experience recurrent detachment, which is thought to be primarily driven by the formation of scar tissue (proliferative vitreoretinopathy). Together with Dr Jing Jing You (SMS) we are developing novel bioglues to seal retinal tears intraoperatively: these have the potential to revolutionise management by negating the requirement for intraocular gas or oil. Furthermore, it could prevent the cellular migration from tears which is believed to cause recurrent retinal detachment.

• Dr Jing Jing You
• Dr Lay Khoon Too
• Dr Dario Protti

Visual Function in Retinal Disease 

• We use psychophysical techniques, including selective perimetry, threshold versus intensity testing, colour vision assessment and dark adaptation to explore clinical phenotypes and to design appropriate tests for characterising and monitoring function in patients with retinal disease. 
• We also seek to explain clinical observations through hypothesis driven psychophysical testing. Results are correlated with advanced imaging modalities such as optical coherence tomography. Ultimately, we hope to predict function based upon structure. 
• This work is supported by the Foundation Fighting Blindness and the Global Ophthalmology Awards program. 

Sub-retinal injection randomised controlled trial

• Sub-retinal injection is a surgical approach used to deliver novel therapies – such as gene and cell therapy – to the retina. We have recently completed a randomised controlled trial which investigated the optimal method of delivering treatment via sub-retinal injection (ACTRN12619001121156). 

LensOne Phase I Trial

• Dislocation of implanted lenses during or following cataract surgery can occur in 0.2-3% of cases and may require the insertion of secondary intraocular lenses. The latter are frequently associated with slow recovery and uncorrected refractive error. The lens one device is a novel platform which functionally replaces the lens capsule (ACTRN12623000305628) which is designed to facilitate faster recovery and which is compatible with most types of implantable intraocular lenses. 

Fight Inherited Retinal Blindness!

• This is a new Save Sight Registry module directed at tracking the natural history – and uniquely – treatment outcomes following retinal gene therapy (voretigene neparvovec/Luxturna) in patients with inherited retinal disease.

• Dr Ainal Adlin 
• Dr Christian Engelbrecht
• Dr Lay Khoon Too
• Ms Catherine Le