In this installment of Retina Mentor Moments, John W. Kitchens, MD, sits down with Sonia Mehta, MD, to discuss trends in retina fellowship education and developments in gene therapies for inherited retinal diseases (IRDs).
Dr. Mehta is a board-certified ophthalmologist who practices at Mid Atlantic Retina and Wills Eye Hospital and is an assistant professor of ophthalmology at Sidney Kimmel Medical College at Thomas Jefferson University in Philadelphia, Pennsylvania.
Learning opportunities in retina fellowships
From early on in her career, Dr. Mehta has been interested in medical education, as she co-authored the best-selling medical textbook Step-Up to the USMLE Step 1 when she was in medical school. Now, she oversees the retina curriculum for residents and the retina arm of the International Scholar Program at Wills Eye Hospital.
Outside of developing retina education and training, Dr. Mehta’s research interests include:
- Surgical Topics:1-3
- Outcomes following scleral-sutured intraocular lenses (IOLs)
- Following patients who had good visual outcomes after retinal detachment (RD) repair with proliferative vitreoretinopathy (PVR)
- Silicone oil emulsification in patients with complex retinal diseases
- Reporting on new surgical techniques as a section editor for Block Time in the Retina Times
- Diversity Within Ophthalmology:4
- Authorship trends for women in retina
Both Drs. Mehta and Kitchens highlighted how attending international conferences gives fellows and residents the opportunity to learn different surgical approaches and hear alternative strategies to disease management as physicians face different obstacles to providing care.
Dr. Mehta noted that her favorite retina conferences include:
- American Academy of Ophthalmology’s (AAO) annual meeting
- American Society of Retinal Specialists’ (ASRS) annual meeting
- The Retina Society
- The Macula Society
- Women in Ophthalmology
- VitBuckle Society
To hear more about the importance of women mentors for ophthalmology residents and fellows, watch the full interview!
Areas for improvement in retina fellowship education
As someone who is involved in surgical training for retina fellows, Dr. Mehta noted that many fellows have a well-structured curriculum in terms of the breadth, depth, and volume of surgeries in training, but education around managing pre- and post-operative care could be more of a focus.
She explained that doing general surgery during her internship year taught her how to discuss surgical procedures with patients, and unfortunately, many retina fellows lack direct training on how to build trust with patients and manage treatment expectations during surgical consultations.
Prior to any surgery, Dr. Mehta likes to sit down with patients to review:
- Why they are doing the procedure
- The risks and benefits of the procedure
- The post-operative recovery process visually and how it may cause systemic or physical restrictions (ex., limited head movement or positioning)
Gene therapies for inherited retinal diseases
Dr. Mehta noted that her favorite surgery is macular hole repair, as peeling internal limiting membrane (ILM) is one of her favorite things to do. In contrast, she finds it can be difficult to manage patients with retinitis pigmentosa (RP) because there are currently no US Food and Drug Administration (FDA)-approved treatments for the condition.
Dr. Kitchens remarked that because gene therapies for RP patients are still in development, he focuses on educating patients on how RP could potentially be passed down to their children and gives them hope for advancements in interventions. It is important to ensure that patients with RP or other IRDs have follow-up appointments scheduled so that they do not feel abandoned by their eye doctor after receiving a difficult diagnosis, he added.
Recent developments in gene therapies for IRDs include:5-7
- Phase 3 liMeliGht clinical trial for OCU400 (Ocugen, Inc.)
- Phase 2/3 VISTA clinical trial for AGTC-501 (Beacon Therapeutics)
- Phase 2b RESTORE clinical trial for MCO-010 (Nanoscope Therapeutics Inc.)
Watch the full interview to learn more about advancements in gene therapies for IRDs and retinal diseases.
Conclusion
Though many retina fellowships provide the necessary training for surgical skills, Dr. Mehta noted that interpersonal skills, such as building trust and patient education, and managing pre- and post-operative care are areas where fellows could receive more direct training.
Fortunately, retina fellows are entering the field during an exciting time of technological and medical breakthroughs for conditions that have long been considered untreatable.
