From Reactive to Proactive in Retinal Disease Care | NYU Langone Health

Why It Matters

By targeting the gut microbiome and adding pharmacologic protection to surgery, NYU Langone aims to shift retinal care from treating late‑stage disease to preventing it, setting a precedent for proactive, system‑wide health management.

Key Takeaways

• NYU Langone adopts cross‑disciplinary model for retinal disease research.
• Gut microbiome identified as modifiable target to prevent retinal degeneration.
• Retinal imaging offers a “keyhole” view into systemic vascular health.
• Current surgeries lack therapies to protect cells and prevent scar tissue.
• Oral repurposed drugs aim to shift care from reactive to proactive.

Summary

The video outlines NYU Langone Health’s new cross‑disciplinary strategy for tackling retinal diseases, merging ophthalmology, basic science, AI, data analytics, and microbiome research under one roof. Dr. Dimmitra Scondra, vice chair of research, emphasizes that the eye provides a unique, non‑invasive window into systemic vascular and metabolic health, enabling earlier detection of disease processes. Key insights include the discovery that gut microbiome balance directly influences retinal degeneration, offering a modifiable lever unlike immutable factors such as age or genetics. By leveraging diet, targeted compounds, or repurposed drugs like metformin, clinicians could intervene before pathology becomes irreversible. The team also highlights the limitations of current surgical techniques, which lack adjunctive therapies to protect retinal cells or prevent proliferative scar tissue after detachment. Scondra cites concrete examples: using high‑resolution retinal imaging to monitor microvascular changes, collaborating with immunologists and AI specialists to mine large clinical datasets, and developing an oral formulation of an existing drug to curb cell death and scar formation. She envisions integrating gene‑therapy pipelines and novel therapeutics into routine practice, turning retinal care from a reactive to a proactive discipline. If successful, this model could reshape ophthalmic care by enabling risk stratification, early intervention, and reduced surgical re‑operations, ultimately lowering healthcare costs and improving patient outcomes across systemic diseases that manifest in the eye.

Original Description

Dimitra Skondra, MD, PhD, vice chair of research in ophthalmology at NYU Langone Health, is leading a new era of retinal disease care — one focused on prevention, early intervention, and personalized treatment strategies.

In this video, Dr. Skondra discusses her research into modifiable risk factors for age-related macular degeneration (AMD) and other retinal diseases, including groundbreaking work linking gut microbiome health to AMD and retinopathy of prematurity. She also shares how advanced retinal imaging is being used to detect early signs of neurologic and cardiovascular disease — before symptoms appear.

Key topics covered:

How gut dysbiosis contributes to AMD and retinal disease risk

The role of repurposed medications like metformin in AMD prevention

Using the eye as a window into systemic and neurologic health

Integrating genetics, microbiome data, imaging, and AI for personalized care

Expanding clinical trials, including gene therapy for AMD

Dr. Skondra's research program integrates multiomics data — genetic, microbiome, imaging, and clinical — with AI analytics to identify targeted prevention strategies and move retinal disease care from reactive to proactive.

"The goal is to move from reactive to proactive and stop the problem before it happens." — Dimitra Skondra, MD, PhD

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Learn more about Dr. Skondra and her research at NYU Langone Health:

https://nyulangone.org/doctors/1063652469/dimitra-skondra

Read the full Physician Focus feature:

https://physicianfocus.nyulangone.org/from-reactive-to-proactive-in-retinal-disease-care/