Retina Fellowship

Fellowship in Diagnosis and Management of Vitreoretinal Diseases

Retina Section, Emory Eye Center
Emory University School of Medicine

Chris S. Bergstrom, MD
Blaine Cribbs, MD
Andrew Hendrick
G. Baker Hubbard III, MD
Timothy W. Olsen, MD
Jiong Yan, MD (Fellowship Director)
Steven Yeh

Curriculum

This fellowship consists of training in the surgical and medical management of diseases of the retina and vitreous. The training is provided by the Retina Section of Emory Eye Center at Emory University. The program provides an intensive, broadly based clinical experience in retinal and vitreous disease, with the goal of training the physician to pursue a career in an academic environment.

Training is provided in all major diagnostic and therapeutic techniques in retinal and vitreous disease. Particular emphasis is placed on indirect ophthalmoscopy, fundus biomicroscopy, fluorescein and indocyanine green angiography, ocular coherence tomography and ultrasonography. Extensive experience is provided at Grady Memorial Hospital, the Atlanta Veterans Affairs Hospital, Children’s Hospital of Atlanta, and The Emory Eye Center. Increasing responsibility for scleral buckling and vitrectomy surgery is provided throughout both years. The fellow also acts as an attending physician, providing supervisory and teaching support for the residency program, both in the operating room and in resident outpatient clinics devoted to treating a wide range of retinal and vitreous diseases.

In the first year, the fellow is fully integrated into all aspects of medical and surgical treatment of patients on the vitreoretinal service. For 6 of the 12 months, the first-year fellow will supervise retinal clinics at Grady Memorial Hospital. These are held on Thursday and Friday afternoons. These two half-days per week will consist of working in an attending capacity in supervising retinal and photocoagulation clinics. The remaining time will be devoted to seeing referral patients and participating in surgery at the Emory Clinic with staff vitreoretinal specialists. During this time, proficiency with ultrasonography, OCT, photography and retinal angiography will be developed. In addition, research projects (which can be continued into the second year) should begin. These may be clinical, medical or surgical research, or laboratory projects.

During the second year, there is a greater emphasis on surgical proficiency. The fellow will scrub with each of the retinal staff members and will serve as an attending physician to the residents for surgery at Grady Memorial Hospital and the Atlanta VA Medical Center.

The clinical activities of the Section are as follows:

1. Retinal Detachment Surgery

Adult and pediatric patients with retinal detachments are seen on referral on the private service, as well as at the Grady Memorial Hospital and VA Medical Center. The fellow makes retinal drawings and submits these to the staff physician for evaluation. Progressive surgical responsibility is granted as the fellow's skills develop. The fellow is to supervise resident staff clinic surgery performed by the senior resident on the retina service at Grady Memorial Hospital and VA Hospital. A staff physician will assist with the formulation of the surgical approach in each case.

2. Vitrectomy Surgery
Adult and pediatric vitrectomy surgery is a major clinical and research interest of the Retina Section staff. Approximately twenty to thirty cases are performed for posterior segment disorders weekly. The second-year fellow is the primary surgeon at the Atlanta VA Medical Center each Thursday morning, staffed by Dr. Yan.

3. Photocoagulation
An extensive program of photocoagulation in the treatment of diabetic retinopathy, retinopathy of prematurity and macular disorders is an ongoing part of the retina work at Emory University. Multiple types of laser are used including slit-lamp delivery of red, yellow, and green wavelengths, indirect diode laser, photodynamic therapy, and transpupillary thermotherapy. Patients from the Grady Memorial Hospital (both adult ophthalmology clinic and neonatal intensive care unit) and the VA Medical Center provide an extensive experience in photocoagulation. Intravitreal injection of emerging therapeutic agents plays and increasingly important role at all facilities.

4. Angiography and Ocular Coherence Tomography
Fluorescein angiograms are performed by ophthalmic photographers at The Emory Eye Center, the Atlanta VA, and at the Grady Memorial Hospital. Pediatric FAs are performed at Children’s Healthcare of Atlanta using the RetCam. Indocyanine green angiography is performed at the Emory Clinic. The retina fellow is encouraged to learn the techniques of retinal photography. Primary responsibility for reading fluorescein angiograms done at Grady will be assigned to the fellow so that he/she may interpret these studies in consultation with members of the Retina staff. OCT is performed at The Emory Eye Center and the Atlanta VA. Fellows learn to interpret OCT and help teach these skills to residents in the Flourescein Angiogram/OCT conference.

5. Emory Retina Clinic
The fellow sees private patients with Retina staff members during their office hours. These patients all have complete diagnostic ophthalmologic examinations with concentration on the retinal diagnostic procedures. Residents work along with members of the Retina Section at all times, and the fellow is responsible for some supervision and training of the residents, together with the attending staff.

6. Grady & V.A. Retina Clinics
During each week, members of the resident staff collect interesting and difficult patients in the field of retinal disease for presentation at the retina clinics at the Grady Memorial Hospital and at the VA Hospital. The fellow sees these patients and decides on their management in consultation with the Retina Staff physician. A major portion of these retina clinics is devoted to the care of diabetic retinopathy, especially at the Grady Memorial Hospital, which is the largest outpatient clinic caring for diabetics in the United States.

7. Electrophysiology and Ultrasound
An active laboratory program is ongoing in both ultrasound and electrophysiology. Two full-time technologists are present. Standard A- and B-scan techniques are utilized in addition to high resolution anterior segment techniques in the Ultrasound Laboratory. The Electrophysiology Laboratory is a computerized facility offering VEP, electroretinography, electrooculography, dark adaptation and color vision testing facilities.

8. Retina Conference
All fellows, faculty and researchers with an interest in retinal disease meet every Thursday morning at 7AM for a weekly conference. Interesting cases, ongoing research projects and pertinent journal articles are discussed.

9. Fluorescein/OCT conference
A monthly fluorescein conference is held on Thursdays at 7AM. Interesting fluorescein angiograms and OCT images are presented to the residents by the fellows with input by the members of attending retina staff.

10. Annual Conference Attendance
The first year fellow attends the annual meeting of the Association for Research in Vision and Ophthalmology. Second year fellows attend the annual meeting of the American Academy of Ophthalmology and the annual meeting of the American Society of Retina Specialists. Attendance to either ARVO, ASRS or the AAO is predicated on the acceptance of a research presentation of the fellow's choice.

11. Collaborative Clinical Studies
The Emory Retina Service has participated in almost every NIH sponsored clinical trial evaluating retinal disease. Current ongoing NIH studies include: the Complications of AMD Treatment Trials (CATT), the Age-Related Eye Disease Study (II), and Studies of the ocular Complications of AIDS. In addition, there are many ongoing industry-sponsored studies.

12. Subspecialty Experience
The Emory Retina Fellowship provides extensive experience in all vitreoretinal subspecialties. Each fellow will rotate with faculty members who have specific interests and expertise in uveitis, inherited retinal disease, pediatric retina, and intraocular tumors. Ample opportunity is provided for fellows to develop their own subspecialty interest and to perform clinical research in these areas.

The fellow will receive a secondary appointment as an Associate in the Emory University School of Medicine.

The deadline for applications is August 29 of the year prior to the July 7 starting date for a fellowship.

EMORY UNIVERSITY IS AN AFFIRMATIVE ACTION EQUAL OPPORTUNITY EMPLOYER.

Last updated: 08/21/2014

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