A specialized optical equipment setup in a medical office.

Keeping Patients Safe

To protect eye patients during the COVID-19 pandemic, UCSF Ophthalmology has implemented stringent safety measures. Innovative solutions are taking shape as clinical teams maximize precautions.

A specialized optical equipment setup in a medical office.
Protective plexiglass shields have been installed on all the examination slit-lamp microscopes.

UCSF vision clinics have reopened for nonurgent patient care needs after adopting new policies and practices to protect both patients and practitioners.

“UCSF Ophthalmology is honored to be a trusted health partner during this crisis,” says M. Reza Vagefi, MD, medical director for the Department of Ophthalmology. “Our teams are making every effort to contain the spread of COVID-19 and to ensure that patients continue to receive the very best vision care.”

 

Precautions at All Eye Clinics

All UCSF vision clinics at the Department of Ophthalmology and Francis I. Proctor Foundation for Research in Ophthalmology follow the safety guidelines of the US Centers for Disease Control and Prevention.

Many new protocols are in place to reduce the risks of viral transmission. Patients can expect prescreening and rescreening for COVID-19, shorter appointments and waiting times, limits on nonessential visitors, and requirements for masks.

Protective plexiglass shields have been installed on every slit-lamp microscope, creating a physical barrier during face-to-face eye exams. UCSF’s Matthew Russell, MD, and his father-in-law, Lorne Dubin, kindly fabricated, installed, and donated the innovative shields.

The premises and all instruments undergo disinfection or sterilization each morning, between patients, and at night. All exam room surfaces, including chairs, chin rests, and door handles, are cleaned and disinfected.

 

A healthcare worker checking a patient’s temperature in a car.
Monitoring the eye pressure of a glaucoma patient

Drive-Through Testing

UCSF glaucoma specialists are minimizing contact with drive-through tests to monitor eye pressure, also called intraocular pressure. The brief procedure involves gently touching a disposable, single-use tonometer tip to the surface of the eye while the patient remains inside his or her vehicle.

 

Telehealth Rising

Telehealth refers to medical triage, diagnosis, and care provided remotely. Pioneered for those living far from medical help, this touchless method reduces transmission risks. Clinicians now meet with patients via video, email, and phone to adjust medication, consult on upcoming surgeries, examine the external eye, and check vision. Brief clinical tests are paired with remote appointments to review test results and go over treatment plans.

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A young girl drinking from a small cup, wearing earrings and a pink garment.

Early Detection to Halt Spread of COVID-19

A young girl drinking from a small cup, wearing earrings and a pink garment.
Researchers added COVID-19 surveillance to clinical trials treating children in Burkina Faso. This young participant is taking her dose of azithromycin.

Underfunded health clinics, lack of running water, and other public health deficits leave millions of people in sub-Saharan Africa vulnerable to COVID-19. In response, the Proctor Foundation is leveraging two clinical trials underway in Burkina Faso to look for early signs of COVID-19 outbreaks. Led by Catie Oldenburg, MPH, ScD, the trials examine the impact of azithromycin on child mortality and involve 50,000 infants and young children.

Orange badge with a virus symbol and text 'Responding to COVID-19'.

Health workers are now tracking COVID-19 symptoms and influenza-like illnesses in participating clinics. This “syndromic surveillance” method was used to detect an increase in influenza-like illness in New York prior to the first major rise in COVID-19 cases, at a time when the number of lab-confirmed flu cases was declining. With this “early warning system,” the Proctor Foundation aims to empower local governments and health organizations to respond as quickly as possible to stem the spread of the virus.

News, Patient Care /
Healthcare worker wearing a face shield and mask.

ACTION Against COVID-19

Orange badge with a virus symbol and text 'Responding to COVID-19'.

Clinical Study of Azithromycin

Premier research teams worldwide are racing to halt the devastation of this novel coronavirus. The Francis I. Proctor Foundation for Research in Ophthalmology quickly joined the fight, using its 20 years of experience with the antibiotic azithromycin to search for solutions.

Two decades ago, That Man May See helped to launch the Proctor Foundation’s research to eliminate the blinding disease trachoma in Ethiopia. The seed-funded pilot study examined the impact of azithromycin on infants and young children. Findings proved that the antibiotic drastically reduced prevalence of the eye disease and saved children’s lives.

 

Leaping into Action

Now, Catie Oldenburg, ScD, MPH, and Thuy Doan, MD, PhD, lead a clinical trial for COVID-19. They have leveraged Proctor Foundation’s deep azithromycin expertise to swiftly initiate a well-designed, nationwide, randomized clinical trial, with support from the Bill & Melinda Gates Foundation. Planning for such rigorous studies often takes months and even years, but the team is already enrolling patients, following a markedly compressed planning period.

The clinical trial is called Azithromycin for COVID-19 Treatment in Outpatients Nationwide (ACTION). The research team, which also includes Ben Arnold, PhD; Travis Porco, PhD; and Tom Lietman, MD; hopes to recruit at least 2,300 patients by the end of the year.

The trial will help researchers understand the potential effect of a single dose of the antibiotic in halting progression of COVID-19 in patients who are not hospitalized. Azithromycin is an antibiotic used to treat many common bacterial infections, and it may have antiviral and anti-inflammatory properties.

The Proctor team collaborates with the Stanford Clinical Virology Lab to recruit newly diagnosed COVID-19 patients. This lab has been performing a high volume of California tests for the virus, known as SARS-CoV-2. COVID-19 patients nationwide are encouraged to participate, and more virology labs will be recruited as well.

 

Inside the Trial

Each participating patient will be sent a single dose of the azithromycin or a look-alike placebo. Because the study is conducted completely via mail and email, patients with proof of a positive SARS-CoV-2 test can enroll from anywhere in the United States within seven days of their positive test result. Participants will then complete five short online questionnaires over the subsequent three weeks.  In addition, Dr. Doan and her lab team will analyze biosamples taken at home by interested participants. Their analysis will provide insight into the precise effects of the azithromycin.

 

Changing Science, Changing World

In the face of this pandemic, the Proctor team is experiencing synergy like never before.

“There’s a level of cooperation across disciplines that was unusual before,” says Dr. Oldenburg. “I feel that the way researchers are working together during the pandemic is going to change how we do science forever.”

Evidence generated by the ACTION trial will serve as a blueprint for future trials. “We don’t think this is the last coronavirus epidemic that we’re going to see,” says Dr. Oldenburg. “What we learn now will allow us to jumpstart effective research practices during future epidemics.”

Dr. Oldenburg stresses the importance of patients stepping forward to participate in gold-standard clinical trials like this one. “To understand and properly evaluate drug treatments,” she says, “the best thing we can do is to conduct and volunteer to take part in randomized controlled trials.”

Five headshots of medical professionals on a blue background.

 

Join the Trial

If you or someone you know tests positive for COVID-19, please consider enrolling in the ACTION study within three days of diagnosis. Learn more: Website: proctor.ucsf.edu/action-trial
Email: Actiontrial@ucsf.edu
Phone: 415.326.3761

Clinical Research, News, Patient Care, Research, Trials /
A woman with short, wavy hair in a black shirt, smiling at the camera.

That Man May See Leadership Transition

Kathleen Rydar
Kathleen Rydar

After serving as President of That Man May See for the past 16 years, Kathleen Rydar is retiring, effective April 30, and passing the torch on to Deborah Chesky.

Through the Future of Vision campaign, Kathleen ensured that UCSF Ophthalmology would succeed in supporting the new Wayne and Gladys Valley Center for Vision at Mission Bay, a state-of-the art facility that will form the hub of one of the most diverse and productive vision research programs in the world, one of the most successful and innovative teaching programs, and one of the premier clinical care programs in the nation.Kathleen’s passion and from-the-heart altruism has been felt throughout the Bay Area and beyond. In 2005, she was presented with the Hank Rosso Outstanding Fundraising Professional award by the Bay Area Association for Fundraising Professionals. During the span of her tenure, Kathleen has brought in well over $200 million to support the mission of the Department of Ophthalmology and Francis I. Proctor Foundation at UCSF.

Deborah Chesky
Deborah Chesky

Kathleen’s parting gift has been her central role in the recruitment of Deborah, a truly worthy successor as President of That Man May See. With a strong professional history in both health care and philanthropic development in research universities, Deborah started her career as a social work director at Albany Memorial Hospital and then Bellevue Woman’s Hospital in Niskayuna, New York.

She transitioned to Vice President of Marketing and Corporate Development at Bellevue. Deborah moved from philanthropy in health care to research, health, and higher education, ultimately serving as the Senior Advancement Officer for Foundation Relations at Rensselaer Polytechnic Institute in Troy, New York.

Deborah has had an extremely successful tenure at Rensselaer, with productive relationships among many in the sphere of UCSF Ophthalmology—the Bill & Melinda Gates Foundation, the Alfred P. Sloan Foundation, Pew Charitable Trust, Howard Hughes Medical Institute, and the Gordon and Betty Moore Foundation, to name but a few. Deborah is personally committed to issues of health and vision, and the faculty is delighted that she has chosen to bring her skill set to ophthalmology and vision at UCSF, to lead That Man May See’s fulfillment of its mission to save and restore sight in actionable ways.

That Man May See will celebrate its 50th anniversary in 2021. Through Deborah’s passion and commitment, she will continue in its vision to advance the work of a world-class faculty of clinician researchers and basic scientists by engaging the philanthropic community to support research, patient care, and training the next generation of leaders in ophthalmology.

News /
A man focused on scientific work under dim lighting.

Ophthalmology Department’s Max Nachury, PhD, Receives ARVO’s 2020 Cogan Award

The laboratory research of UCSF Ophthalmology’s Maxence Nachury, PhD, promises to bring great insight to an understanding of photoreceptor degeneration and potential treatment strategies.

The Association for Research in Vision and Ophthalmology (ARVO) has named Dr. Nachury as recipient of its 2020 Cogan Award.

Dr. Nachury studies the primary cilium, a surface-exposed organelle required for vision, olfaction, and developmental signaling. He has published widely in Cell, Science, PNAS, Nature Genetics, Nature Materials and Nature Cell Biology.

The Cogan Award recognizes a “young researcher 45 years of age or younger at the time of application deadline, and who has made important and worthwhile contributions to research in ophthalmology or visual science that are directly related to disorders of the human eye or visual system, and who show substantial promise for future contributions.”

Dr. Nachury’s research is currently funded by the Wayne and Gladys Valley Foundation, Research to Prevent Blindness, That Man May See, National Institute of Health/National Institute of General Medical Sciences, National Institute of Health/National Eye Institute, and the American Diabetes Association.

Faculty Profile, Honors and Awards, News, Research /
Three researchers discussing in a laboratory.

Halting Retinal Sight Loss

Patients with glaucoma and retinal degenerations need better solutions. Researchers deploy advanced tools to find novel ways to save their sight.

 

Protecting Vulnerable Cells

Photo caption above: To halt glaucoma, Dr. Ou, Dr. Dunn, and Dr. Della Santina investigate novel avenues for preventing damage to retinal nerve cells.

Christie Hastings knows firsthand that glaucoma steals sight. By the time she noticed blurring in her visual field, her sight was irreversibly compromised. Innovative avenues that identify glaucoma earlier and treat it more effectively promise to transform outcomes for patients like Christie.

“Patients need more effective strategies,” says glaucoma specialist Yvonne Ou, MD. To advance novel paradigms to halt the disease, Dr. Ou collaborates with two coinvestigators: physiologist Felice Dunn, PhD, and neuroscientist Luca Della Santina, PhD.

The team uses molecular, anatomical, electrophysiological, and modeling techniques to understand how increased eye pressure, common in glaucoma, affects potentially weaker retinal nerve cells and their neighbors. They also explore how retinal circuits mend themselves and continue functioning even when some cells are damaged.

“Learning how to protect the retinal nerve cells most vulnerable to damage is key to stopping glaucoma,” says Dr. Dunn. “We’re excited to pursue this promising direction.”

 

Altering Genes to Save Sight

Retinitis pigmentosa is a major interest for geneticist Douglas Gould, PhD. Dr. Gould and his team explore how “quality control” mechanisms inside retinal cells try to fix or dispose of mutated proteins.

Headshot of Doug Gould, PhD, with a blue background.

Lorie Hirson is losing her sight to retinitis pigmentosa, but she is hopeful that future generations will be spared. “Vision scientists are getting closer to answers that will change our lives,” she says. “We’re proud to support their research.”

Microscopic cross-section of a biological sample.
Dr. Gould’s team of geneticists explores whether faulty formation of the front of the eye can cause glaucoma. This image shows the anterior segment during development.

In this inherited disease, mutations in a particular protein cause the light-sensitive retinal cells to die off. Dr. Gould’s team will test whether altering this cellular process can preserve vision. If so, treatments to alter this process could potentially preserve sight for patients like Lorie.

 

Prenatal Signs of Glaucoma

Children as young as six months can get glaucoma and its companion, high intraocular pressure. Genetic mutations that lead to the formation of defective ocular cells and tissues in the front of the eye may lead to glaucoma in infancy or later in life.

Dr. Gould uses advanced imaging and molecular techniques to investigate how the front of the eye develops. “By understanding genes that contribute to structural defects, we will open new doors to glaucoma prevention and treatment,” says Dr. Gould.

 

Research support provided by the National Institutes of Health, Research to Prevent Blindness, and friends of That Man May See.

Clinical Research, News, Research /
A smiling man in a turquoise shirt standing in a laboratory.

Restore the Retina, Restore Sight

Retinal transplantation will one day allow ophthalmologists to restore sight. To accelerate development of regenerative treatments for blindness, the National Eye Institute has provided funds to five multidisplinary teams nationwide.

 

Retinal specialist Jacque Duncan, MD, leads UCSF research for the initiative, joined by neurobiologist and bio-engineer Deepak Lamba, MD, PhD, and leading scientists at the University of Wisconsin.

To better understand cellular behavior before, during, and after experimental retinal transplantations, Dr. Lamba’s team will use stem cells to develop retinal tissue with many, many cone cells. These are the light-sensitive cells that allow humans to recognize faces and see fine detail in daytime.

“Dr. Duncan’s expertise in patient care, disease progression, and advanced imaging techniques will guide us to look for cellular changes that she has previously recorded from her patients’ retinal cells,” says Dr. Lamba.

The team’s findings will move successful retinal cell transplantations closer to a transformative reality.

 

Photo caption: Dr. Lamba’s team collaborates with clinical researcher Dr. Duncan to advance transplantation of laboratory-grown retinal cells to restore sight.

Clinical Research, News, Research /