Principal Investigators:

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Prof. Wai Ching Lam, Clinical Professor

 

Dr. Amy C.Y. Lo, Associate Professor

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Overview

Retinopathy of prematurity(ROP) is the leading cause of preventable childhood blinding disease globally. Low birth weight and prematurity are strongly associated with an increased risk of the disease. Infant born prematurely have incompletely vascularized retina with a peripheral avascular zone. ROP development is thought to be a biphasic pathologic neovascularization process involving an aberrant production of vascular endothelial growth factor (VEGF). With this understanding, the treatment for advanced ROP has moved from the destructive retinal laser ablation to the use of the anti-VEGF injection. This paradigm shift of management approach has resulted remarkable improvement of the outcome of the ROP infant especially the more advanced cases.

Despite the improvement treatment outcome, there are still gaps in the understanding and management of this condition.

Our combined team of clinician and basic scientist are active in the pursuit of research in this field, focusing on improvement of understanding of the pathophysiology of the disease, diagnosis, surgical management, and investigating alternate treatment approach such as nutritional supplement.

From the clinical perspective
Professor Lam has the clinical researches:

  • Investigating alternate diagnostic protocol for early and more accurate diagnosis of ROP

  • Established the pediatric widefield fluorescein angiography for improved diagnosis and monitoring of ROP and other pediatric retinal diseases (only facility in Hong Kong)

  • Participate in international multi-center clinical trial for the use of anti-VEGF treatment of ROP

  • Provide world class surgical expertise and developing improve surgical techniques to tackle the management of complicated stage 4 and 5 ROP

 

 

Our basic research team led by Associate Professor Dr. Amy Lo has

  • Established oxygen-induced retinopathy (OIR), an animal model of ROP – first and only one in Hong Kong

  • Identified therapeutic potential of aldose reductase inhibition in the treatment of ROP

  • Reported the beneficial effects of lutein in promoting vascular regrowth in OIR

  • Investigated vascular pathophysiology and neuronal dysfunction in gestational diabetes-associated retinopathy of prematurity

Clinical trials

Open-label, randomized, two-arm, controlled study to assess the efficacy, safety, and tolerability of intravitreal (IVT) aflibercept compared to laser photocoagulation in patients with retinopathy of prematurity (ROP) 2019.

Publications

  1. Tsang JKW, Wolf SA, Pompoes IM, Joussen AM, Lam WC, Yang D, Lo ACY. Potential Effects of Nutraceuticals in Retinopathy of Prematurity. Life. 2021;11(2):79. doi: 10.3390/life11020079

  2. Chiu HH, Wan MJ, Kertes PJ, Muni RH, Lam WC. Visual outcomes after treatment in pediatric patients with Coats’ disease. Can J Ophthalmol. 2019; 54(6):647-652. doi:10.1016/j.jcjo.2019.02.004

  3. Bata BM, Chiu HC, Mireskandari K, Ali A, Lam WC, Wan M. Long-term visual and anatomic outcomes following early surgery for Persistent Fetal Vasculature: A single-center, 20 year review. JAAPOS. 2019 Dec;23(6), 327.e1-327.e5.

  4. Sharma A, Ali A, Henderson RH, Patel CK, VandenHoven C, Lam WC. Accuracy of scleral transillumination techniques to identify infant ciliary body for sclerotomy and intravitreal injections.

  5. Tsang JKW, Liu J, Lo ACY: Vascular and Neuronal Protection in the Developing Retina: Potential Therapeutic Targets for Retinopathy of Prematurity. Int J Mol Sci. 2019 Sep 3;20(17). pii: E4321. doi: 10.3390/ijms20174321. Review. PMID: 31484463.

  6. Alabduljalil T, Westall CA, Reginald A, Farsiu S, Chiu SJ, Arshavsky A, Toth CA, Lam WC. Demonstration of anatomical development of the human macula within first 5 years of life using handheld OCT. Int Ophthalmol. 2019 July; 39(7):1533-1542. doi: 10.1007/s10792-018-0966-3.

  7. Gan NY, Lam WC. Special Consideration for pediatric vitreoretinal surgery. Taiwan J Ophthalmology. 2018 Oct-Dec,8 (4): 237-242.

  8. Gan NY, Lam WC. Retinal Detachment in the pediatric population. Taiwan J Ophthalmology. 2018 Oct-Dec;8(4): 222-236.

  9. Fu Z, Meng SS, Burnim SB, Smith LE, Lo AC: Lutein facilitates physiological revascularization in a mouse model of retinopathy of prematurity. Clin Exp Ophthalmol. 2017 Jul;45(5):529-538. doi: 10.1111/ceo.12908. Epub 2017 Jan 29. PMID: 28002872.

  10. Fu Z, Nian S, Li SY, Wong D, Chung SK, Lo AC: Deficiency of aldose reductase attenuates inner retinal neuronal changes in a mouse model of retinopathy of prematurity. Graefes Arch Clin Exp Ophthalmol. 2015 Sep;253(9):1503-13. doi: 10.1007/s00417-015-3024-0. PMID: 25921391.

  11. Liu J, Lai CHY, Lo ACY: Therapeutic strategies for retinopathy of prematurity. H K J Ophthalmol. 2015 19(1):8-15

  12. Lo ACY, Lai AKW, Fu ZJ: Stem cell therapy for retinopathy of prematurity. Anat Physiol. 2013;3:126. doi: 10.4172/2161-0940.1000126. Review.

  13. Fu ZJ, Li SY, Kociok N, Wong D, Chung SK, Lo AC: Aldose reductase deficiency reduced vascular changes in neonatal mouse retina in oxygen-induced retinopathy. Invest Ophthalmol Vis Sci 2012 Aug 20;53(9):5698-712. doi: 10.1167/iovs.12-10122. PMID: 22836764.

  14. Cheung CS, Butty Z, Tehrani NN, Lam WC. Computer-assisted imaging analysis of temporal retinal vessel width and tortuosity in retinopathy of prematurity for the assessment of disease severity and treatment outcome. J AAPOS. 2011 Aug;15(4):374-80.

  15. Kohly RP, Muni RH, Kertes PJ, Lam WC. Management of pediatric choroidal neovascular membranes with intravitreal ant-VEGF agents: a retrospective consecutive case series. Can J Ophthalmol.2011Feb;46(1):46-50.

  16. Robitaille JM, Zheng B, Wallack K, Beis MJ, Tatlidil C, Yang J, Sheidow TG, Siebert L, Levin AV, Lam WC, Arthur BW, Lyons CJ, Jaakkola E, Tsilou E, William CA, Weaver RG jr, Shield CL, Guernsey DL. The role of Frizzled-4 mutation in familial exudative vitreo-retinopathy and Coats disease. Br J Ophthalmol. Nov 21 2010.

  17. Adam RS, Kertes P, Lam WC. Observations on the management of Coats' disease: less is more. Br J Ophthalmol. 2007 Mar;91(3):303-6. Epub 2006 Oct 4.

 

Book

Wu WC, Lam WC: A Quick Guide to Pediatric Retina/ Springer. 2021 (Editors)

 

Devenyi RG, Lam WC:  Paediatric Retinal Disease.  The Hospital for Sick Children Paediatric Ophthalmology Atlas, AV Levin, editor, 2006.

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ROP Laser treatment

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ROP screening Orbis Vietnam