Retina Research at the Hawaii Macula and Retina Institute
HMRI consistently participates in the latest multi-centered national and international clinical trials for the development of new treatments for retinal diseases such as macular degeneration, diabetic retinopathy, and retinal vein occlusions. The doctors at HMRI, Dr. Lai, Dr. Wee, and Dr. Kokame, have all taken on the role of Principal Investigator for clinical trials. HMRI has now participated in over 50 multi-centered clinical trials. Clinical trials run at HMRI have led to approval by the FDA of revolutionary new treatments for retinal diseases. One example is the MARINA study, which led to the first intravitreal injections of antiangiogenic medications, such as ranibizumab, and helped to lead to the approval by the FDA of Lucentis for wet or exudative macular degeneration. Other pivotal national clinical trials performed at HMRI leading to FDA approval of medications include the RISE study, which led to the approval of Lucentis for diabetic macular edema, the VIEW1 study which led to the approval of aflibercept (Eylea) for exudative macular degeneration, and the VISTA trial which led to the approval of aflibercept (Eylea) for diabetic macular edema.
Dr. Kokame has also designed and run unique clinical trials studying treatment options for polypoidal choroidal vasculopathy (PCV), a subtype of exudative macular degeneration, which has created new knowledge in better understanding this disease and how to manage this disease. PCV is underdiagnosed in the United States, due to lack of access to and lack of education in indocyanine green angiography. More recently, research done at HMRI has shown that PCV is less responsive to our usual medications for exudative macular degeneration, and has unique characteristics in different ethnicities. PCV research here at HMRI has led to presentations at numerous national meetings such as the American Academy of Ophthalmology, Macula Society, Retina Society, and American Society of Retina Specialists. Dr. Kokame has been an invited speaker at some of the most prestigious meetings such as American Ophthalmological Society, Aspen Retinal Detachment Society, Pan-American Association of Ophthalmology, World Ophthalmology Congress, and many other invited lectures all over the world, including the Pettit Lecture at the Jules Stein Eye Institute in 2014.
HMRI has been pioneering new surgical techniques to help improve retinal surgeries for both the patient and surgeon. These range from scleral fixation of dislocated posterior chamber intraocular lenses to various management options for macular holes. Because of this surgical expertise, HMRI was the first site in the Asia-Pacific region to perform the “Bionic Eye” surgery for the previously inoperable disease, Retinitis Pigmentosa.
As a result of research and clinical explorations, HMRI has authored over 85 peer-reviewed publications to major ophthalmology journals as well as book chapters. The hope is that through these publications, HMRI will help to advance the field of retinal disease management and surgery by its unique contributions.
Some of HMRI’s major accomplishments:
- Help a blind patient with retinitis pigmentosa see again
- Cure a disease that was untreatable for over 100 years
- Advance vitreoretinal surgery to diseases which previously were not approachable with surgery
- Contribute to the greatest advance in the history of the treatment of the western world’s most common cause of vision loss, exudative macular degeneration
- Pioneer new surgical techniques in the management of complications of the most common surgical procedure performed in the United States, cataract surgery.
- Helped to unlock the secrets of a newly recognized cause of leaking and bleeding in the central vision area of the eye (macula) that is much more common in patients of Asian descent
- Create awareness of new, key information on the disease polypoidal choroidal vasculopathy