The two primary components of this fellowship include evaluating clinic adult patients with inherited retinal diseases and participation in laboratory research. The curriculum, rotation and rotation sites will consist of:

• 2 days a week in the inherited retinal disease clinics at UIHC of Ian Han, MD, Stephen Russell, MD, Elliott Sohn, MD, and Edwin Stone, MD, PhD
• 2 days a week in research that may involve any or all of the following according to the fellow’s specific interests and career goals:
  • Laboratory work in the Institute for Vision Research consisting of molecular genetics experimental research and writing the associated papers and grants
  • clinical trials for gene and stem-cell based therapies
  • pre-clinical rat and pig surgeries associated with gene therapy and stem cell transplantation
  • Retinal imaging
  • Phase I-III clinical trials of human retinal gene therapy
• 1 day per week in a relatively independently managed fellow clinic seeing patients needing just-in-time procedures including intravitreal injections
• Further clinical opportunities that may be available (with discretion of the fellowship director) include:
  • Maximum of 12 days for independent clinics that will be in place of fellow or faculty retina physicians.
  • Maximum of 12 days of retinal surgery that will be supervised by a faculty physician. If this option is exercised, we will mitigate impact on the 2 year vitreoretinal surgery fellowship by having the research fellow take a proportional number of days of vitreoretinal surgery fellow call. Otherwise, there is no call associated with the Chung fellowship.

Inherited Retinal Diseases

The surgical and medical retina fellows learn the diagnostic work-up and phenotypes of patients with inherited retinal diseases in clinics of Drs. Ian Han, Elliott Sohn, Stephen Russell and Edwin Stone. As the genetic diagnosis and treatment of these rare diseases are primary missions of the University of Iowa Institute for Vision Research, fellows gain extensive knowledge and experience in the latest treatments for these disorders, including the opportunity to assist in the surgical delivery of human gene and stem cell therapy. Research projects in inherited retinal diseases are required. By the end of this fellowship, graduates of this program will:

• Become proficient in the work-up and diagnosis of patients with inherited retinal diseases including clinically-focused genetic testing
• Understand how psychophysical (e.g. microperimetry and Goldmann perimetry), electrodiagnostic, and multi-modal image testing can aid in assessment and progression of these disorders
• Become proficient in discussing genetic testing results and prognosis with patients and the implications for families
• Be facile with core knowledge on inherited retinal disorders in stonerounds.org, Ryan Retina and other texts, and current literature
• Develop a more precise understanding of genotype-phenotype correlations for inherited retinal diseases
• Learn how clinical diagnostic tests are performed and interpreted utilizing results and interaction with the Carver Nonprofit Genetic Testing Laboratory

Imaging

The technique and interpretation of high-resolution optical coherence tomography, OCT-angiography, autofluorescence, and stereoscopic and wide-field fluorescein angiography for the diagnosis of diseases of the posterior pole of the eye is acquired in coordination with the Photography Service of the Department of Ophthalmology. First-year vitreoretinal and medical retina fellows direct an imaging conference once per week during the academic year. This conference is attended by staff members of the Retina Service as well as by fellows and residents in the Department of Ophthalmology.

Imaging is performed with state of the art devices for OCT, FA/ICG, autofluorescence, ultrawide field photography and OCTA, including:

• Heidelberg Spectralis SD-OCT machines 
• TopCon photography and SD-OCT machines
• Zeiss SD-OCT units with OCT-angiography 
• Zeiss Plex Elite 9000 for ultra-wide swept source OCT and OCT angiography
• ultrawide field photography, FA, and autofluorescence with Optos, Clarus 500 and Clarus 700 units
• Portable OCT using the Bioptigen handheld SD-OCT unit

Macular Disease

The Vitreoretinal Service evaluates over 2000 new patients a year with macular disease, the majority being patients with age-related macular degeneration (AMD) but a wide variety of other macular diseases are also seen. Fellows play an integral part in the evaluation and treatment of all patients. Fellows gain an understanding of the role of genetic research in AMD and macular dystrophies with application to clinic patients through the Carver Lab. In addition, there are numerous studies being carried out including phase I, II, and III trials in AMD with which fellows have the opportunity to be involved with.