Retina Update: Now director of National Eye Institute, Dr. Michael Chiang comes full circle

Michael F. Chiang, MD, shown at the Casey Eye Institute, is two months into his term as director of the National Eye Institute. (Image courtesy of Oregon Health and Science University.)

A self-described physician originally trained as an engineer, Michael F. Chiang, MD, has taken over as the third permanent director of the National Eye Institute after 10 years as associate director of the Casey Eye Institute at Oregon Health and Science University. Now that he oversees the largest eye research organization in the world—its 2020 fiscal year budget is $835 million—Dr. Chiang is in a unique position to set the course for science in ophthalmology.

It seems like a natural progression for someone who’s witnessed the translation of research from the bench to the clinic. He’s one of the early investigators of telemedicine, biometrics and artificial intelligence—phrases that resonate much more today than they did when his work started 20 years ago.

Work on telemedicine for ROP 

“I was basically a clinician-scientist who was building and evaluating telemedicine systems for retinopathy of prematurity diagnosis, and over the years we evolved that to things like artificial intelligence and big data and electronic health records, and I’ve gotten to see how that research is really starting to make a difference in the lives of people,” Dr. Chiang tells Retina Specialist in an exclusive interview. 

That research translated to the clinic in the form of a training system for neonatal intensive care unit nurses to take retinal photos to screen infants for ROP. “Gradually more and more people have begun to be early adopters of telemedicine for ROP, and then gradually now we’ve developed policy statements showing that it’s within the acceptable standard of care to do that if you’re really careful, and then insurance companies have begun to reimburse for that,” he says. “So it’s really been amazing to me to see that cycle of how clinical needs drive research, drives early adoption, and drives policy and clinical care.” 

Dr. Chiang started at NEI last November, but, in a way, going to the NEI’s headquarters in Bethesda, Md., brings him full circle. A little over 20 years ago while he was a resident at Johns Hopkins University in Baltimore, he had an opportunity to meet with then-NEI director Carl Kupfer, MD, the first to hold that post before he retired in 2000. “He invited me to his office in Bethesda and I spent the afternoon there, and he gave me some advice that really affected the course of my career,” Dr. Chiang recalls. 

A formative impact

A resident meeting with a giant of eye research must have had an impact. “I’ve gotten to know program directors at the NEI over the years that have really had, in many ways, a formative impact on the direction of my research through things like giving me advice and introducing me to collaborators,” Dr. Chiang says.

Research into retinal disorders may figure prominently in the direction of NEI, not only because of Dr. Chiang’s own work in ROP. He credits his predecessor at NEI, Paul A. Sieving, MD, PhD, now a professor at the University of California Davis School of Medicine, for his work in inherited retinal degenerations. 

“Within the past few years it’s really been amazing to see how advances in gene therapy and technologies like CRISPR can deliver treatments for patients in the operating room,” Dr. Chiang says. 

“It’s been inspiring for me to see how there are patients that I’m seeing today who would’ve gone blind a generation ago if it weren’t for those advances in science and technology,” Dr. Chiang adds. “There’s never been a more exciting time to be doing something like this because of all of those advances in areas such as genetics, immunology, neuroscience, medical imaging and technology.”

Lessons from Casey Eye

Dr. Chiang is a pediatric ophthalmologist who, because he’s done so much work in ROP, admits to having been mistaken for a retina specialist earlier in his career. He also credits two renowned retina specialists he worked with at Casey Eye—David J. Wilson, MD, director at Casey Eye, who’s done extensive work in ocular oncology, and Andreas K. Lauer, MD, chair of ophthalmology and a leading researcher in age-related macular degeneration—for helping him to prepare for the NEI job. “I got to see how as an administrator I could build teams of people who were able to accomplish things on a larger scale by working together,” says Dr. Chiang. 

That perspective has helped him form both short- and long-term goals for the NEI. In the short term, he sees supporting the National Institutes of Health staff and research community through the COVID-19 pandemic. “In the longer term,” he says, “my goal is basically to develop plans where we can make those scientific advances that are ultimately going to lead to eliminating preventable causes of blindness and improving quality of life for people around this country,” he says. 

Dr. Chiang also says he’ll continue to see patients, albeit “on a smaller scale.”

“As a researcher, and as somebody who now leads an institute and is going to be closely involved with things like policymaking, I think it’s important to have that contact with patients,” Dr. Chiang explains. “It always reminds me of why we do what we do." RS

— Richard Mark Kirkner