National Eye Institute Director Michael Chiang, MD, talks about the organization’s future plans to address age-related macular degeneration (AMD) treatment and health disparities in the ophthalmology field.
It is well known that age-related macular degeneration has a significant impact on the quality of life of patients. How has National Eye Institute (NEI) research on this condition evolved over time and where is it headed?
Clearly, AMD has made a big difference. If I look back, I completed my residency in 2000. As a resident, you know, what we’re studying is the macular photocoagulation study, or MPS, where we do laser therapy on the retina. You know, within 5 to 10 years, those are replaced by anti-VEGF drugs. I’m really proud that a lot of this work was supported by the National Eye Institute. Now, that’s where we’ve been and where we are now. In terms of where we’re headed, there’s a lot of work on the science and pathogenesis of AMD that will allow us to develop better treatments.One of the problems is that, in the early 2000s, genome-wide association studies [GWAS], one of the first successful GWAS for AMD complement factor h. But the problem is, it’s been over 15 years since then, and we haven’t really had a successful clinical trial yet. So I think I think the way things are going is that we have to move more from genes to mechanisms and pathways to understanding disease. I think this is where we can develop better treatments to help patients in the future.
How is NEI working to address health disparities in ophthalmology, both by more diverse inclusion in clinical trials and by ensuring equitable access to care?
This is a very important topic. One of the things that this pandemic has exposed is that we have a lot of health disparities in this country, and that not everyone has equal access to healthcare. And, you know, from my perspective, I think another way of looking at it is that if these people don’t have access, then the best scientific advancement and the best clinical care that we have in the world is actually Not as useful as it is most needed. So we’re actually trying to address those differences in a number of ways at NEI. One of those is, of course, we pay great attention to the clinical research to make sure we’re recruiting patients that are truly representative of the breadth of the U.S. population. And I think we’re doing a lot of initiatives, both developing them and working with others who are working on those initiatives, to diversify the workforce vision. You know, how can we recruit and train more people from diverse backgrounds that are currently underrepresented in medicine and science, you know, to really strengthen our workforce. The other thing we’re doing is basically a research program to try to address some of these health disparities. For example, we started working with the National Institute on Minority Health and Health Disparities, NIMHD, to plan a workshop to really try to bring together the best people who have not only expertise in eye disease but also methodology With expertise focused on health disparities, how can we work together to address them? I guess what I want to emphasize is that this is not something that the National Eye Institute can do on its own. We must work with the entire community, including ophthalmologists, optometrists, scientists, industry and academia. But we’re really looking forward to addressing that.