Pediatric Research

Improving Pediatric Eye Care with Groundbreaking Clinical Research

 

The Duke Pediatric Ophthalmology and Strabismus division has long had an interest in clinical research.  Our faculty have been active participants and principal investigators in pivotal trials such as CRYO-ROP, ETROP, IATS, and a host of Pediatric Eye Disease Investigator (PEDIG) studies.  

The Duke pediatric ophthalmology faculty have held leadership roles in the American Association for Pediatric Ophthalmology and Strabismus (AAPOS).   Edward Buckley, MD and Sharon Freedman, MD have each been President of the organization and Board of Director members, as well as held various other leadership roles within the association.   All of our faculty actively participate on various AAPOS committees and task forces, as well as presenting our work regularly at the annual meeting in the form of posters, platform talks, and workshops (often with trainees we have mentored).  

Our faculty have also been active in the American Academy of Ophthalmology (AAO) in a variety of roles, including program development, expert breakfast and workshop presentations, committee work, as well as scientific presentations.  Together with collaborators in other divisions, we have studied and published widely on many pediatric ophthalmology topics.

David Wallace, MD is the current Chair of the PEDIG group, while Laura Enyedi, MD has served on the Executive Committee, and Dr. Freedman joined the committee in 2016.  

We have a broad portfolio of research in many different areas of pediatric ophthalmology. 

Strabismus and Amblyopia

Through active participation in PEDIG studies, our faculty group continues to answer important clinical questions related to the evaluation and surgical treatment of strabismus and amblyopia.

Retinopathy of Prematurity (ROP)

Duke pediatric ophthalmology faculty Sharon Freedman, MD and David Wallace, MD pioneered the use of semi-automated computer-based quantitative analysis of retinal blood vessels to assess the posterior pole retinal blood vessels changes that are harbingers of severe, treatment-requiring ROP.  Grace Prakalapakorn, MD has joined this investigation which has resulted in numerous publications in high impact journals.

David Wallace, MD designed and is leading a PEDIG dose-finding study of bevacizumab for severe ROP in infants; this study will help to establish the optimate dose of this relatively new treatment for type I ROP.

We are continuing to study the application of a portable, affordable, hand-held, non-contact retinal fundus camera as a tool in the hands of non-ophthalmologist imagers, to identify eyes with severe ROP requiring an ophthalmologist’s examination to determine need for possible treatment.  This work has implications for global screening and treatment of ROP abroad, as well as in the United States.

A multi-diciplinary group of faculty from Pediatrics and the Vitreoretinal Division are studying the use of handheld Spectral Domain Optical Coherence Tomography (SDOCT) to image the macular and retinal development, both normal and abnormal, in prematurely born infants with and without ROP.

Pediatric Neuro-ophthalmology

Mays El-Dairi, MD dual trained in pediatrics and neuro-ophthalmology is leading the investigation of OCT to study the optic nerve in healthy children and in optic nerve diseases.

Pediatric glaucoma

Sharon Freedman, MD, an international leader in pediatric glaucoma has studied many aspects of evaluation, medical and surgical management of children with glaucoma, together with many residents and fellows in the division over the past two decades, and in the application of OCT to evaluating the optic nerve in children.

We have studied the monitoring of intraocular pressure in children with known and suspected glaucoma, applying rebound tonometry to this endeavor.  Ongoing projects involve long-term home-based monitoring of intraocular pressure fluctuations in children with known and suspected glaucoma using an Icare Lending Library, evaluating SDOCT of the optic nerve in normal and glaucomatous eyes of children, and study of newer surgical technique to treat selected types of childhood glaucoma.

Pediatric retinal disease (other than ROP)

Duke ophthalmology faculty, Cynthia Toth, MD and her colleague, Lejla Vajzovic, MD have revolutionized the evaluation and treatment of children with a variety of retinal diseases, using novel applications of hand-held non-contact spectral domain optical coherence tomography (SDOCT) in the eyes of premature infants and children with a variety of retinal diseases.