DOVS research is carried out by the clinicians, clinician researchers, clinician scientists and basic scientists within the Department. They perform this research at their base hospitals and associated hospital research institutes as well as KEI (Figure 13).
The Department produces a large number of peer-reviewed publications, grants, and presentations, some of which are detailed in appendices to this report. What distinguishes this group of researchers is the large number of publications, presentations and grant dollars (over $67M in the last 10 years, Figure 14), arguably the largest of any academic ophthalmology department in the country. The other distinquishing feature is the breadth of research topics thoughout the Department. These span basic research, translational work and clinical research to population research and clinical trials. As can be seen in Figure 15, our residents, fellows, and faculty have authored more than 1400 publications in the last 8 academic years, with impressive growth seen in the last two years.
Research in the Department can be broadly divided into two broad categories: discovery science/basic and translational research (Table 1), conducted at the Donald K. Johnson Eye Institute, Lunenfeld-Tanenbaum Institute, SickKids Research Institute, and the Sunnybrook Research Institute; and clinical research (Table 2), conducted at the Hospital for Sick Children, KEI, Mount Sinai Hospital, Sunnybrook Health Sciences Centre, St. Michael’s Hospital, Toronto Western Hospital, and Trillium Health Sciences Centre. Figure 13 provides a schematic of our research sites.
Table 1. Major directions in basic and translational research.
Cellular interactions and signaling pathways that control ganglion cell survival and regeneration.
Retinal development, connectivity, and photoreceptor protection and transplantation.
The role of extracellular proteins in the developing and regenerating CNS.
Neural cell reprogramming, with a focus on retinal cells and glial cells.
Role of neuron-vascular interactions in retinal and brain disease, injury, and cancer.
Developmental signaling in brain tumour initiation.
Lymphatic circulation in the eye and its role in aqueous humor drainage, and the entry of cerebrospinal fluid into the optic nerve via the glymphatic system.
Mechanisms controlling retinal injury responses.
Development of the visual system, particularly the formation of the network between the eye and the brain in normal conditions and in eye diseases.
Design new treatment and drug delivery strategies.
Identify pathogenic mechanisms that contribute to neurological disorders with next generation sequencing, proteomics, electrophysiology and imaging.
How to expand diagnostics in retinal imaging.
Understanding brain mechanisms that cause abnormal eye movement.
Exploiting eye movement for vision rehabilitation.
Genetic characterization of inherited retinal disorders
Principles of tumor suppressor genes and the regulation of activity of the retinoblastoma gene and protein.
Endothelial to mesenchymal transition of the corneal endothelium and migration of the corneal endothelium.
Table 2. Major directions in clinical research.
Ocular regenerative medicine
Cytokine profile of ocular diseases
Treatment of neurotrophic keratopathy with minimally invasive corneal neurotization
Corneal crosslinking
Inherited eye diseases and therapeutic modalities, including gene therapy.
Cataract surgery research
Optimal perioperative management
Ophthalmic surgical instrument development and innovation
Understanding low vision and low vision rehabilitation
Microinvasive glaucoma surgery
Health human resources in ophthalmology
Provision of eyecare
Surgical outcomes with corneal transplantation and keratoprostheses
Intravitreal therapeutics in retinal disease
Mechanisms of age-related macular degeneration
Tele-ophthalmology
Therapy to treat inherited retinal diseases
Novel therapeutic approaches for children with retinaobalstoma.
Approaches aimed at achieving optimal care and outcomes for childhood cancer patients globally
Novel treatments for Fuch’s endothelial dystrophy.
In 2018, the position of vice-chair, research was split into two positions — a vice-chair clinical research and a vice-chair, basic science and translation research. This was done to ensure better input, assessment, and oversight of research activities in the Department. As well, a research committee was organized at KEI, with representation from each hospital department and subspecialty to drive translational research.
Residents and fellow are actively engaged in research, with dedicated blocks of time along with research infrastructure and support, and access to funding. Residents have had a significant number of peer-reviewed publications since 2012 and numerous research awards.
The strength and diversity of the DOVS research program was appreciated by the external reviewers in 2011 and 2017. In particular, the reviewers commended efforts to bring researchers and clinicians together. Recent successes include the Vision Science Research Program (VSRP), a partnership between the University Health Network (UHN) and the University of Toronto, which provides an opportunity for researchers to collaborate and funds graduate students. As well, reviewers highlighted as “very successful” a recent study conducted at KEI on corneal crosslinking.
There are currently 8 faculty members in the DOVS that hold endowed university-hospital named chairs, including the recently established the Dixon Chair at Sunnybrook. Increasing the number of endowed chairs in a priority and the Chair is working closely with the Temerty TFOM’s advancement team to drive fundraising that will support more research and endowed chairs. The goal is to grow this number considerably over the next 5-10 years in order to solidify the Department’s standing as a global leader in ophthalmic research.
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