Physicians, researchers and staff at the Joan and Irwin Jacobs Retina Center (JRC), directed by William R. Freeman, M.D., UCSD Professor of Ophthalmology and Co-Director of the Retina Division, administer treatments, conduct clinical testing and laboratory research projects seeking solutions for people who suffer from retina problems. Dr. Freeman’s team also develops new treatments and diagnostic devices for debilitating disorders such as age related macular degeneration (AMD), diabetic retinopathy, tumors, inherited diseases, retinal detachment, macular holes and other retinal diseases.

New Devices. Dirk-Uwe G. Bartsch, Ph.D., Director of the Retinal Imaging Laboratories and Associate Professor of Ophthalmology, and Dr. Freeman have improved scanning laser instruments to further the capability to view the retina and ultimately picture individual cells within the eye. Currently, they are working on a scanning device that takes an image of the retina illustrating tiny slices which shows abnormal materials within or under the retina thus making a map. Over the past year, doctors Bartsch and Freeman helped to develop the OCT-SLO (Optical Coherence Tomography – Scanning Laser Ophthalmoscopy), one of only two in the world, which observes the blood supply in the retina to detect abnormal vessels such as tumors or melanoma. This non-invasive scan helps doctors predict tumor growth and assess the treatment by demonstrating patterns of abnormalities or changes with a 3 dimensional picture therefore saving the patient from having a biopsy. This new technology also detects AMD, monitors its progression and response to therapy in ways not previously possible.

New Treatments. Gabriel A. Silva, Ph.D., Director of the Retinal Neural Engineering Laboratories and Assistant Professor of Ophthalmology and Bioengineering, works with the JRC team to bring an engineering background to develop practical ways to treat retinal disorders. Dr. Silva is working to regenerate retinal tissue that has been damaged in patients with AMD and hereditary diseases like retinitis pigmentosa. He utilizes self-assembling gels, which consist of signaling molecules that allow stem cells and related cells to be directed to and repopulate damaged areas. Dr. Silva is in the process of identifying the correct signals, in other words telling the stem cells “what to do”.

New Drugs. Lingyun Cheng, M.D., Co-Director of the Ocular Pharmacology Laboratory, has been working over 10 years with Dr. Freeman to develop new drugs and delivery systems which can be applied to or within the eye to treat retinal disease. They have teamed up with Karl Y. Hostetler, M.D. at the UCSD Moores Cancer Center, members of the UCSD School of Engineering and the UCSD Department of Chemistry, most especially Michael J. Sailor, Ph.D. Most recently, they have developed drugs in the form of crystals which are injected into the eye and release slowly, the way sugar dissolves in iced tea. They are also working on nano-technology to control drug release within the eye using silicon wafers (much like computer chips) with channels the size of molecules that would change color as the drug dissipates, thus showing the doctors what is happening within the eye. Dr. Freeman and this group recently won the UCSD Technology Transfer Award for the most innovative patented invention at UCSD.

New Genes. Dr. Freeman is also collaborating with David S. Williams, Ph.D., UCSD Professor of Pharmacology and Neuroscience, on retinal diseases. Dr. Williams has made important inroads into gene therapy for Usher syndrome which affects hearing and causes progressive vision loss through retinitis pigmentosa. In the future, the team hopes to be treating these patients with the gene therapy agents. Dr. Williams’ group has made important discoveries concerning genes involved in AMD and are pursuing ways to treat this and other retinal diseases.

Clinical Trials. At the clinical trials and treatment center on the first floor, Dr. Freeman and his group study new treatments for retinal disease in collaboration with a number of organizations both business and governmental such as: the Food and Drug Administration, Genentech, Heidelberg Engineering, OTI Instruments, Bausch & Lomb, the National Eye Institute and Allergan. The clinical research unit in the JRC is equipped with the latest diagnostic instruments, scanners, cameras and equipment, some of which are available nowhere else. Some visual acuity testing and exam rooms allow absolute darkness to accommodate various types of testing. There are also rooms that are protected from all electromagnetic interference for extremely specialized testing. Patients are carefully followed and their vision function tested by the Director of clinical trials, Denie Cochran, and coordinators Nicole Reagan, Alona Mask, Tiara Kemper and Luzandra Magaña along with other technicians and staff. The clinical trial center includes a team of U.S. and International retina specialists including Iryna Falkenstein, M.D., Joshua Hedaya, M.D., Igor Kozak, M.D., Byungro Lee, M.D., Francesca Mojana, M.D., Nitin Nigam, M.D., and Ajay M. Tammewar, M.D. Clinical trials are currently being performed for diabetic retinopathy, retinal vein occlusions, macular edema, retinal scarring, uveitis, ocular melanomas, as well as wet and dry AMD. Two drugs are currently under investigation. Retisert is a long acting drug that treats retinal vein occlusions and lessens the swelling of the retina. This drug is injected or surgically sewn into the retina then dissolves very slowly over a year’s time. RhuFab has shown improvement in wet AMD patients.

Dr. Freeman and his team at the Joan and Irwin Jacobs Retina Center, along with his collaborators, have published over 600 scientific articles and 350 articles in the U.S. National Library of Medicine at the National Institutes of Health. If you would like to speak to someone further about the Jacobs Retina Center, please call 858-534-6290 for appointments and for clinical trials call 858-822-3170.