Expert Talk: Dr Subhadra Jalali of LV Prasad Eye Hospital, Hyderabad, India

The following is an interview with Dr Subhadra Jalali, an Ophthalmologist and a Retina Specialist, who heads the Smt. Kanuri Santhamma Retina Vitreous Centre at the L V Prasad Eye Institute in Hyderabad. Dr Jalali is also significantly involved in the scientific work of Retina India as a member of its Scientific Board.

Arun & Rani: Dr Jalali, thank you for taking time from your very busy schedule to respond to our questions.

We have heard about the amazing work that you and your team are involved in at the LV Prasad Eye Institute, with a focus on finding a long term and viable treatment for retinal degenerative diseases. As we all know, retinal ailments have taken a heavy toll of patients all over our country, and have devastating consequences in terms of leading to total blindness.

Dr Jalali: Thank you for giving me this opportunity.

Question: Which form of treatment is your team specifically targeting for treating retinal degenerative diseases? Is it stem cell treatment, gene therapy or artificial retina? What reasons would you attribute to pursuing a specific method?

Dr SJ: All options are open. Scientific evidence and rigor are the key factors targeting treatment major retinal degenerative diseases.

Question: Is your treatment methodology applicable to a wide range of retinal ailments?

Dr SJ: Not necessarily in all cases. It depends on the clinical situation and the actual results of treatment being given.

Question In your experience, what are the most common retinal ailments among Indian patients and what are the important challenges you face in their rehabilitation?

Dr SJ: Common retinal ailments include diabetic retinopathy and other vascular retinal occlusions, rhegmatogenous retinal detachments, trauma to the eye and the retina, congenital ocular anamolies (like coloboma), retinal vasculitis, retinal degenerations including generalised conditions such as Retinitis Pigmentosa, Leber’s Congenital Anaurosis, Rod monochromat, Congenital stationary night blindness, etc., and localized conditions like Staargardts, cone dystrophy, as well as conditions such as Age-related Macular Degeneration, Parafoveal Telengiectesia and Idiopathic Polypoidal Choroidal Vasculopathy (IPCV) and pediatric retinal diseases like Retinopathy of Prematurity and Familial Exudative Vitreoretinopathy (FEVR).

Question By when do you propose to start full fledged clinical trials at your Institute?

Dr SJ: We wait to see the safety results from Phase I of a clinical trial. As and when they go to Phase II or beyond with good scientific evidence, and the rigor of safety with some efficacy demonstrated in phase I, we can begin with the clinical trials.

Editor's note: If you wish to know more about clinical trials and how they are conducted, please click here.

Question: We had heard in the news that last year, there was some breakthrough in your Institute, regarding implementing stem cell treatment for retinitis pigmentosa and there was also news of starting clinical trials for the same. What has happened to that particular development?

Dr SJ: It is an ongoing study in various phases of development. The scientific study is not conclusive yet.

Question Every research requires funding. What are your major sources of funding? How is the Government cooperating in this regard?

Dr SJ: There are multiple sources of funding for us. Major funding comes both from Indian Government, as well as international collaborations from American, European, Australian and Japanese Governments and trusts. We are appreciative of the substantial support from the Indian Government.

Question Could you please describe to us in brief, the exact methodology of your work/research in treating retinal degenerative diseases?

Dr SJ: We are in various phases of scientific study and trials from basic science to animal studies and human trials. All completed work is published/presented at various scientific fora in peer review journals and meetings

Question What problems and shortcomings do you have to overcome, medically, in implementing your work on a full fledged basis?

Dr SJ: Mainly, it is the lack of time due to overwhelming clinical work

Question: Are you satisfied with your current level of work, and what would be your goal in the long term, as far as finding a viable treatment is concerned?

Dr SJ: Yes I am very much satisfied. This is ongoing work, with the long term goal of providing scientific evidence based treatment to my patients.

Question We also heard that your Institute is doing a lot for rehabilitation of visually impaired patients. Could you throw some more light on this aspect?

Dr SJ: We care for low vision and blind patients in all areas of care. This includes social, vocational, educational, government schemes, awareness, advocacy and medical care. (Please click here for more details. )

Question What specific measures do you plan to take in the near future, as far as making more progress in your current research work is concerned?

Dr SJ: I would like to be being involved with various ongoing research areas in retinal treatments, so as to keep abreast with latest technologies and trends on sound scientific foundations.

Question How long do you feel it might take to find full fledged treatment for retinal degenerative diseases?

Dr SJ: I feel it would take about 3- 5 years for a start. I also think we will reach substantial progress in next 10 years where treatments match expectations and needs of the patients.

Question: What are the criteria laid down by your Institute to participate in clinical trials, as and when they take place?

Dr SJ: Our institute follows the following criteria.

1. We need to get ethics committee approval

2. We want to see compliance with all national and international laws and regulations governing clinical trials.

3. The clinical trial should be relevant to the clinical diseases common in our population.

Question In what ways do you think Retina India, as an organization, can collaborate with your Institution?

Dr SJ: Some of the areas in which Retina India can collaborate would be:

1. Provide patient support group activities, which I believe the group is already involved in.

2. Initiate discussions on needs of this group

3. Raise awareness and support for education and integrated schooling of such children with normal sighted children

4. Prepare patient registries to provide data to bring advocacy and awareness for support for research in retinal diseases

5. Raise funds and bring retina to forefront of public opinion. As of now too many people are unaware that they have a critical organ in their vision called RETINA!

Question Finally, is there anything else you would like to share with our readers?

Dr SJ: I am convinced that in the coming decade, we will definitely meet many challenges in achieving the goal of satisfactory and substantial treatment for patients with progressive retinal dystrophies.

Arun & Rani: Thank you very much Doctor, for having spent your precious time with us. We are sure our readers will greatly benefit from this discussion. We wish you and your Institute all success in your endeavor, and fervently hope that there will soon be a full fledged treatment for retinal degenerative diseases.

The interview was conducted by Mr Arun Torgal from Goa and Ms Rani Ramakrishnan from Coimbatore. Ms Shveta Garg from Pune helped in refining the write-up.