Dr Fred Chen is an ophthalmologist and researcher at Lions Eye Institute and Royal Perth Hospital
Q: As an Ophthalmologist and researcher, why did you choose to focus on age-related Macular Degeneration (AMD) as a subject of interest?
FC: AMD affects over a million Australians and it causes 60 per cent of all irreversible blindness in Australia. It is estimated that in 2015 over 130,000 Australians had the wet form of AMD, many of them still in their 60-70s. An average of 7-8 injections to their eye each year is needed to maintain their vision. A similar number of patients have the dry form of AMD, which still has no effective treatment. Although the current injection treatment for wet AMD has allowed many patients to keep their independence, the burden of this type of treatment to patients, relatives and the healthcare system is significant and unsustainable. Better treatment is urgently needed.
Q: Tell us about your current research project.
FC: I lead three research streams:
(a) Characterising retinal degeneration using high resolution retinal imaging devices. To measure the slow progression of these diseases, our group uses specialised cameras that can allow us to see individual retinal cells and measure blood capillary density in patients.
(b) Stem cell research. We are also testing the use of adult stem cells for treatment of macular degeneration. We also derive stem cells from patients’ skin to study the mechanism of their retinal disease and test new treatment.
(c) Translational study of novel therapies through clinical trials. I currently lead five clinical trials that test new treatments in wet and dry AMD, and three observational studies in macular and retinal degeneration.
Q: How is your approach different to other researchers looking at treating AMD with a stem cell-derived retinal patch?
FC: Our approach in developing the retinal patch uses adult neural stem cells derived from the cornea. We hypothesise the addition of blood vessels to the patch will promote survival of the graft in the eye.
Q: What are the potential benefits for patients, and for clinicians?
FC: Replacing damaged retinal cells may potentially cure AMD. Current eye injections for wet AMD cannot be stopped once started. Upcoming dry AMD treatments are also likely to involve indefinite regular eye injections. A single operation to regenerate retinal cells would be a more attractive option for patients in the long term, while reducing the burden of AMD treatments for clinicians and the healthcare system.
Q: How successful have early investigations been? Any challenges?
FC: We have demonstrated that adult stem cells from the human cornea can be grown into retinal cells. These cells are now undergoing laboratory testing to verify their functionality. We are also testing the compatibility of various carrier substrates in the retina for supporting new retina and blood vessels. Our biggest challenge is an engineering obstacle – the delivery of a 5x3mm retinal cell patch of only tens of micrometres thick into the human retina without damaging the surrounding delicate tissue.
Q: What is the next step in the project?
FC: The Merit Award from the WA Health Department has enabled my team to continue testing these cells. Our next step is to obtain further research funding allowing us to optimise the patch, then to find engineering collaborators to develop a surgical device that can deliver this patch safely into the human retina.
Q: How do you unwind after a long day at the hospital or clinic?
FC: Unwind? When I get the chance, I play the piano and spend time with my tolerant family.
Q: Your mother always told you…
FC: Be respectful to everyone and treat them the way I would like to be treated.
Q: Who is your greatest hero in science…
FC: My heroes are my research patients who put up with a lot for the advancement of medicine and my scientists for their tireless efforts. Science is a team effort.
This article originally appeared in AMA(WA) Medicus, September 2016, and is reproduced here with the kind permission of the Editor and Dr Fred Chen.