Every year, thousands of premature infants are at risk of losing their vision due to retinopathy of prematurity (ROP), an eye disease that affects premature babies by causing abnormal blood vessels to grow in the retina. Most cases are mild and resolve on their own, but severe cases can lead to bleeding, scar tissue, retinal detachment, and ultimately, blindness. ROP has become more common as more babies now survive at younger ages, due to advances in neonatal care. Babies born before 31 weeks’ gestation and weighing less than 3.3 pounds routinely undergo repeated screenings to monitor for ROP. Recognizing the urgent need for expert screening for ROP in communities lacking specialized pediatric ophthalmology services, the U-M Kellogg Eye Center pioneered a remote examination program. “Screening and treatment for ROP are challenging because many hospitals do not have eye specialists on staff or nearby who are trained to provide these services,” says Pediatric Retina Specialist Cagri Besirli, M.D., Ph.D., Associate Professor of Ophthalmology and Visual Sciences. For the past several years, and by leveraging telemedicine technology, the Kellogg team has brought life-changing care to some of Michigan’s most vulnerable patients close to their families and local providers. The program currently operates in partnership with Trinity Health Ann Arbor Hospital in Ypsilanti, Michigan, and UP Health System-Marquette in Marquette, Michigan. “This community outreach allows high-level care to be brought to the patient, instead of the patient coming to us for care,” says Dr. Besirli. “Most importantly, it allows infants to remain close to their families while receiving care.” Ophthalmologists at the Kellogg Eye Center review images, determine screening frequency, refer for treatment as needed, and support and train imaging staff at remote sites. “Most image reviews and recommendations are completed within 6-24 hours,” he says. “Remote monitoring after treatment enables infants to return to their local hospitals and be co-managed by both local and Kellogg specialists. Hundreds of infants have benefited since the program’s inception.” Dr. Besirli notes that the Kellogg team partners with remote hospitals, such as UP Health System-Marquette, to train staff on how to obtain the images. “We also have phone calls with them to review image quality and to explore ways to improve technique,” he says. “Additionally, we have worked with teams of neonatologists and nurse practitioners at their NICUs. Open communication with local staff and 24/7 availability are critical to maintaining high reliability.” The Kellogg Eye Center continues to look for opportunities to bring this technology and expertise to other hospitals. “Any infant meeting ROP screening criteria can be included,” says Dr. Besirli. “Community hospital participation is determined through collaboration, including investment in equipment, staff training, and the appointment of a dedicated ROP coordinator to maintain clear communication.” The Kellogg Eye Center remote ROP physician team includes: Steven Archer, M.D., Ida Lucy Iacobucci Collegiate Professor of Ophthalmology and Visual Sciences; and Pamela Erskine Williams, M.D., Clinical Assistant Professor.Age-related macular degeneration (AMD) is an eye disease that causes irreversible damage to the macula, a region of the retina that controls central vision, and can lead to blurred vision, blind spots, and difficulty with activities like reading, driving, and recognizing faces. In 2025, an estimated 20 million Americans will be living with AMD. Jason Miller, M.D., Ph.D., the James Grosfeld Endowed Professor and Assistant Professor of Ophthalmology and Visual Sciences, devotes his clinical and research focus to AMD. Dr. Miller’s work explores the underlying molecular mechanisms contributing to AMD progression, with the goal of developing innovative strategies to diagnose and treat the disease. By combining his expertise in both clinical ophthalmology and scientific research, he aims to improve outcomes for patients affected by AMD, advance the understanding of retinal diseases, and contribute to the development of more effective treatments. This year, Dr. Miller received a grant from the Foundation Fighting Blindness to study how the eye cells that die in macular degeneration, called the retinal pigment epithelium (RPE), use fat for energy, and how this process might affect AMD. In AMD, fat builds up just outside the RPE cells and triggers RPE cell death. “We are looking at how the RPE deals with extra fat,” he says. “There is a process in RPE, called beta-oxidation, that turns fat into energy. Our goal is to help the RPE burn up the fat for energy, instead of letting the fat build up and form the harmful fat deposits that characterize AMD and trigger RPE degeneration.” Dr. Miller emphasizes the need to learn why RPE cells are slow to break down fats. “If we can discover the underlying reasons, we might be able to help these cells process fats more efficiently,” he says. “We suspect these cells may prefer to use energy sources other than fat, and we want to determine why. We also aim to learn whether impaired fat breakdown directly leads to the harmful fat deposits seen in AMD. Currently, the treatments for dry AMD are minimally effective, so we’re seeking new approaches to treating the disease. Targeting fat in the RPE represents one such alternative approach.”