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  • IRIS Registry Data Analysis

  • Research to Prevent Blindness and American Academy of Ophthalmology Award for IRIS Registry Research

    Research to Prevent Blindness funded four IRIS® Registry research grants in 2024 in a program co-sponsored by the Academy. 

    The grants support use of the database and its analytic capabilities to further population-based research in ophthalmology and blindness prevention. You can find and submit the grant application online. The deadline to apply is Jan. 31, 2024.

    RPB and the Academy recently announced the four studies that were selected for IRIS Registry Research awards for 2023.

    2023

    • Eric Crowell, MD, assistant professor of Ophthalmology, Dell Medical School at the University of Texas at Austin
      Crowell will use IRIS Registry data to evaluate whether race and socioeconomic status affect rates of visual impairment and blindness in patients with uveitis, a condition that causes 10 percent of blindness in the US. Additional goals include identifying optimal treatments for vision recovery in these patients, as well as identifying the ocular comorbidities that affect outcomes. Dr. Crowell hopes the research will lead to more effective disease management, a decline in overall blindness and improved treatment access for high-risk patients.
    • Mary Ellen Hoehn, MD, professor of Ophthalmology, the University of Tennessee Health Science Center
      Hoehn will analyze IRIS Registry data to evaluate the outcomes of strabismus surgery in patients with strabismic amblyopia. Dr. Hoehn hopes to better understand the factors that contribute to visual recovery and the best timing for surgery. There is currently no well-established guidance to help surgeons determine the timing and benefit of surgery in these patients. Dr. Hoehn believes this analysis could lead to a prospective clinical study.
    • Ang Li, MD, assistant professor of Ophthalmology, Cleveland Clinic Cole Eye Institute
      Goniotomy, a surgery to lower eye pressure in patients with glaucoma, is becoming more common, but information on the long-term outcome of this surgical procedure in large, diverse populations is sparse. Dr. Li will evaluate data from the IRIS Registry to better understand the effectiveness of this procedure in the real world, identifying factors associated with success and failure so clinicians have more guidance on the ideal candidates for goniotomy.
    • Matthew Starr, MD, assistant professor of Ophthalmology, Mayo Clinic
      Starr will conduct the first big data analysis of patients with endophthalmitis from pars plana vitrectomy. The largest meta-analysis to date involved just 199 cases from the literature. He hopes to establish the frequency and risk factors associated with endophthalmitis following pars plana vitrectomy, providing critical insight into how this vision-threatening infection can be avoided.

    2022

    • Mary Elizabeth Hartnett, MD, distinguished professor of ophthalmology and visual sciences, University of Utah Health
      Dr. Hartnett will use IRIS Registry data to determine if women in the United States bear a greater burden of blindness and vision loss, as well as other potential disparities in visual impairment. Big data will allow the study of differences in age-adjusted blindness and/or vision loss in children and adults based on gender and ophthalmology disease categories in a way that has not been studied before. Dr. Hartnett notes that identifying health care disparities is the first step in addressing them.
    • Kyle Kovacs, MD, assistant professor of ophthalmology, Weill Cornell Medicine
      Dr. Kovacs will evaluate outcomes in patients who had secondary intraocular lens placement to determine complication rates at more than three months after surgery. Because some techniques used for secondary intraocular lens implantation are relatively new, surgeons need to better understand the long-term, real-world risks so they can counsel patients on their best option for refractive rehabilitation.
    • Adrienne Scott, MD, associate professor, the Johns Hopkins University School of Medicine
      Dr. Scott will use big data to explore a possible protective effect of sickle cell trait in patients with both diabetic retinopathy and sickle cell disease. Dr. Scott hopes to better clarify this association and provide ophthalmologists with important information to consider when screening, monitoring, and treating patients who have diabetes and sickle cell disease/trait.
    • Victoria Tseng, MD, PhD, assistant professor, David Geffen School of Medicine at UCLA
      Dr. Tseng will investigate racial/ethnic differences in the incidence, treatment patterns, and visual outcomes in patients with neovascular glaucoma, a condition that must be treated early to avoid vision loss. Dr. Tseng hopes to gain insight that will help reduce disparities in care, maximize visual outcomes, and prevent permanent disability.

    2021

    • Ta Chen Peter Chang, MD, Bascom Palmer Eye Institute
      Childhood glaucoma surgery: Does it prevent blindness? An IRIS Registry analysis
      Childhood glaucoma is an important cause of preventable childhood blindness worldwide and accounts for approximately 20% of bilateral blindness. Childhood glaucoma affects approximately 1200 children per year (12,000 children/decade). With an annual cost of care of $21,442 per child, the management of childhood glaucoma imposes significant economic burden. While the treatment of childhood glaucoma is mostly surgical, the surgical outcome remains uncertain and limited to studies with modest sample sizes. We assert that analysis of a larger cohort is needed to assess the IOP and visual outcomes of childhood glaucoma surgery, and such an analysis on a relatively uncommon group of patients is only feasible with a large national data registry, such as the Intelligent Research In Sight (IRIS) Registry. The results of this study will provide physicians the means to select surgical procedures more judiciously and to optimize the treatment algorithm in childhood glaucoma.
    • Jennifer Patnaik, PhD, Colorado School of Public Health, University of Colorado, Denver
      Epidemiology, treatment and outcomes of Acanthamoeba keratitis
      Acanthamoeba keratitis (AK) is a very rare, but potentially blinding disease in which amoebae invade the cornea. It is primarily unilateral and is linked with the use of contact lenses (85% of infections in the United States), exposure to contaminated water, or after eye trauma. The incidence has been estimated to be approximately 1-2 cases per million contact lens users. Outbreaks associated with specific cleansing solutions have been described. The clinical presentation of AK varies, which along with its rarity, can cause delayed or mis-diagnosis. Early recognition and diagnosis are essential for effective treatment. Treatment includes various topical antiamoebic agents, sometimes followed by penetrating keratoplasty (i.e. corneal transplant) in medically-resistant cases. To date, there is no single effective chemotherapeutic treatment, and the role and timing of penetrating keratoplasty remain poorly defined. Providing informative data on this condition will help improve diagnosis and clinical management of infected patients.
    • Andrew Williams, MD, University of Pittsburgh, Department of Ophthalmology
      Loss to follow up among glaucoma patients: Prevalence, risk factors and clinical outcomes
      Patients with glaucoma who do not return for follow up care are likely to receive less treatment over time and have poorer visual outcomes that patients who continue regular follow up. Long term monitoring and management of the chronic course of this disease likely reduces the risk of permanent vision loss. However, many patients with glaucoma do not return for follow up, and past studies have been conducted only in a few academic medical centers. Greater understanding of the rate of loss to follow up and the clinical outcomes upon return to care will help to address barriers in optimal management of this lifelong condition.
    • Nakul Shekhawat, MD, MPH, Wilmer Eye Institute, Johns Hopkins University
      Visual outcomes and practice patterns for Herpes Zoster Ophthalmicus in the U.S.
      HZO is associated with significant ocular morbidity and can be sight-threatening, requiring a chronic regimen of corticosteroid eyedrops, glaucoma medications or oral antiviral medications.  Complications from HZO, such as progression of cataract formation, glaucoma, corneal scarring or corneal endothelial failure, can also warrant surgery, including keratoplasty.  The overall public health burden of HZO in the United States is not well understood. This information would provide valuable insights to practicing ophthalmologists to help them understand which patient characteristics are associated with better or worse visual outcome with corticosteroid, glaucoma and oral antiviral medications, and with different surgical treatments.  The study could also provide insight into differences in groups stratified by age, which is relevant for the age recommendations for timing of Shingles vaccination.

    2020

    • Prethy Rao, MD, assistant professor, Emory University
      Most adults who undergo a pars plana vitrectomy will later develop cataracts, but what about children? Dr. Rao will use the IRIS Registry to evaluate the rate at which children require cataract surgery following vitrectomy. This real-world evidence will help ophthalmologists counsel patients and their families regarding future expectations, as well as help coordinate future care among different subspecialties.
    • Adam Rothman, MD, assistant professor, Bascom Palmer Eye Institute, University of Miami
      Evidence shows that cataract surgery alone can significantly reduce intraocular pressure, but which patients best respond to this intervention? Dr. Rothman will leverage the IRIS Registry to conduct a large-scale, population-based study to help understand the IOP-lowering effect of cataract surgery based on a patient’s age, race/ethnicities, co-morbidities, whether they have glaucoma, etc. This research will provide ophthalmologists with critical insight into the best surgical options for their patients with glaucoma or those at-risk of glaucoma.
    • Karen Armbrust, MD, ophthalmologist, University of Minnesota
      As a rare disease, there are a lot of unknowns about how best to diagnose and treat scleritis. Dr. Armbrust will use the IRIS Registry to evaluate which treatment options are most effective in patients with different types of scleritis. This research will also help ophthalmologists determine which patients are at higher risk for worse outcomes from this potentially devastating disease and require more treatment and closer monitoring.
    • Fasika Woreta, MD, assistant professor, Wilmer Eye Institute, Johns Hopkins University
      Cystoid macular edema (CME) is the most common complication following cataract surgery. However, the rate of CME varies widely across clinical studies. Dr. Woreta will use the IRIS Registry to quantify the real-world rate of CME, to identify factors associated with the development of vision loss due to CME, as well as best practices for treating this condition.

    2019

    • Rishi Singh, MD, Cole Eye Institute, Cleveland Clinic, assistant professor of ophthalmology, Lerner College of Medicine. Even though there are effective treatments for diabetic macular edema, there remains a disparity in outcomes among minority populations. What can ophthalmologists do to help close that gap? Dr. Singh will use IRIS Registry data to better understand differences in the selection and frequency of treatment among patients of different races, socioeconomic status, and education levels, as well as how visual outcomes differ among those groups.
    • Thomas M. Lietman, MD, professor, University of California, San Francisco School of Medicine. Viral conjunctivitis is the most common cause of pink eye. It’s also very contagious. Dr. Lietman will use IRIS Registry data to better detect, track, and predict pink eye epidemics in the United States.
    • Jennifer Elizabeth Thorne, M.D., Ph.D., professor, Wilmer Eye Institute, Johns Hopkins Bloomberg School of Public Health. Uveitis can often complicate cataract surgery. Dr. Thorne will investigate whether uveitis patients have worse surgical and visual outcomes compared with cataract patients without uveitis. She will use IRIS Registry data to understand the factors that contribute to better and worse visual outcomes in people who have uveitis, including whether it’s beneficial to use corticosteroids to prevent surgical complications.
    • Subhash Aryal, Ph.D., associate professor, biostatistics & epidemiology, UNT Health Science Center. What causes central serous chorioretinopathy and what’s the best treatment? Current research is based on studies that are too small or poorly constructed to provide good answers. While most people regain their vision without treatment, about 5 percent suffer permanent vision loss. Dr. Aryal will use IRIS Registry data to learn which of the three main treatment options offer the best results for this blinding condition.

    2018

    • Xueya Cai, Ph.D., research associate professor, University of Rochester School of Medicine & Dentistry. Nearsightedness and farsightedness in children and young adults is on the rise. Dr. Cai will use the IRIS Registry database to examine what might be behind the increase. Dr. Cai will also look for new factors that could influence how these vision problems progress.
    • Sapna Gangaputra, MD, MPH, assistant professor, Vanderbilt University School of Medicine. Pediatric uveitis is a rare disease in the United States. It would be difficult and expensive to conduct a clinical trial to answer key questions about this potentially blinding disease. Dr. Gangaputra will use the IRIS Registry to learn how best to treat children with uveitis.
    • Jay Stewart, MD, professor, University of California, San Francisco School of Medicine. Dr. Stewart will use the IRIS Registry to examine whether a common diabetes medication, metformin, can reduce the incidence or slowdown the progression of age-related macular degeneration (AMD). Because inflammation is believed to play a role in AMD, the anti-inflammatory effects of metformin may be beneficial.
    • Elizabeth Vanner, Ph.D., scientist/biostatistician, University of Miami Miller School of Medicine. Ophthalmologists and their patients had hoped the landmark Tube Versus Trabeculectomy trial would settle the question of which surgical option is preferred for glaucoma: trabeculectomy or tubes and shunts. Dr. Vanner will use the IRIS Registry to gain more insight into the best treatment.

    How it Works 

    • Research to Prevent Blindness will fund four studies. Each grant is worth $35,000, with the selected investigators receiving $10,000 each for their institution for direct research funds.
    • Grant recipients will visit the Academy office in San Francisco to learn about IRIS Registry data. This Academy training will be of tremendous value to recipients as they work collaboratively, ask questions and learn alongside and from other awardees, discovering interpretations and analyses of the data. The training will also be useful afterwards, when they continue to work on their own projects.
    • Based on the study design, IRIS Registry staff will provide a subset of data for the grant recipient’s analysis. IRIS Registry staff are available for phone questions, conference calls and support after the training session and throughout the two-year award period.

    Eligibility Requirements 

    • Applicants should be employed by a research institution and must have relevant analytics experience (statistical background, experience with big-data analytics, knowledge of SAS or other statistical program).
    • The research question should be clinically significant and align with the Academy’s mission to protect sight and empower lives.

    Application Process

    Requirements

    • Summary of investigator’s relevant experience (statistical background, experience with big data analytics, knowledge of SAS or other statistical program)
    • Research question / hypothesis
    • Specific aims, background / rationale, and clinical significance
    • Alignment with Academy’s mission: protect sight and empower lives
    • IRIS Registry data elements and time period needed for analysis

    How to apply

    Fill out the brief questionnaire and submit before Jan. 31.

    Evaluation criteria

    • Significance: Does the project address an important problem or a critical barrier to progress in the field?
    • Investigator: Is the candidate well suited to the project and does the candidate have appropriate experience and training?
    • Innovation: Is this a unique research question for the IRIS Registry?
    • Approach: Are the overall strategy, methodology and analyses well-reasoned, and is the project feasible?
    • Environment: Are the institutional support and other resources available to the investigators adequate for the project proposed?

    Timeline

    The IRIS Registry Analytics Committee will review applications and select a slate of potential nominees for Research to Prevent Blindness to review and approve. Selected investigators will be notified in July 2024 with studies to begin shortly afterwards.

    For questions or more information about the RPB and Academy grant, contact 415.561.8592.