Children's Hospital Los Angeles has one of the largest pediatric retina programs in the country and serves as the major referral center for greater Southern California, Nevada, and Arizona. We treat all pediatric retinal conditions and have a full suite of diagnostic and therapeutic modalities in the clinic and operating room. Retinal diseases in children are often vision threatening and highly complex. We pride ourselves on having an excellent team to care for your child and your family throughout their entire journey. Meet our team.
Retinopathy of Prematurity
Retinopathy of prematurity (ROP) is an eye disease that affects the blood vessels in babies who are born premature (early) or babies who weigh less than 1500 grams (roughly 3 pounds) at birth. ROP happens when abnormal blood vessels grow in the retina, the light-sensitive tissue in the back of our eye. In some cases, if left untreated, ROP can lead to retinal detachment and blindness.
A baby’s retina is supposed to finish developing around the due date at 40 weeks (9 months of pregnancy). When a baby is born prematurely, these vessels have not fully developed and sometimes they can grow abnormally. We are able to measure the severity of ROP based on the zone (higher zone means the retina is more fully grown) and stage (higher stage means more severe disease). Based on the zone and stage, our doctors will determine how severe the ROP is and whether treatment is needed. In many cases, the severity of ROP is low and the baby only needs serial eye examinations. If treatment is needed, usually this involves an injection of a medicine into the eye or laser treatment. In very severe cases, a surgery known as a vitrectomy is necessary. With proper management, ROP is highly treatable and outcomes are generally good.
Inherited Retinal Disease and Gene Therapy
Mutations in genes that are important for vision lead to dysfunction and death of our light-sensing cells in the retina, the photoreceptors. In the past, there was no treatment for these conditions and not even a way to detect what genes were mutated. Now we have cutting edge tools to detect mutations causing blinding retinal diseases. Even more exciting is that we can in certain cases perform gene therapy to correct these mutations in patients, giving them back eyesight that they have lost.
In 2017, the FDA approved voretigene neparvovec-rzyl (Luxturna) to treat a specific type of inherited retinal disease. Only about a dozen centers across the USA were selected to provide this highly specialized surgical treatment. CHLA was the first center on the West Coast to deliver this new treatment and since then we have performed a large number of gene therapy surgeries. Our strength lies in CHLA’s world-class expertise in pediatric retina surgery, anesthesiology, pharmacy, and genomic medicine. As a result, we have recently attracted several clinical trials testing new gene therapy approaches.
Pediatric Retinal Disease
Our CHLA team specializes in the medical and surgical management of pediatric retinal disease, including retinopathy of prematurity, retinal detachment, ocular trauma, familial exudative vitreoretinopathy, Coats disease, Norrie disease, X-linked retinoschisis, retinitis pigmentosa, Leber congenital amaurosis, Stickler syndrome, persistent fetal vasculature, and many other disorders. Our state-of-the-art facility has the latest diagnostic and imaging equipment both in the clinic and operating room. This allows us to perform in-depth studies even on young children or those who cannot cooperate with testing. Our surgical suite is fully equipped for all pediatric retina procedures including injections, lasers (green and red), small-gauge vitrectomy, scleral buckling, and ocular endoscopy.