SGH 160th Anniversary | Xinmin Weekly Highlights Innovation for the Patients at Shanghai General Hospital’s Ophthalmology Center

https://mp.weixin.qq.com/s/jUU_DlhPBP07V49gc5b0CQ

Special Coverage by Xinmin Weekly on the Ophthalmology Center:

"The Path of Innovation for the Patients at Shanghai General Hospital's Ophthalmology Center"

Shanghai General Hospital's Ophthalmology Department is a renowned "golden brand" in the field. For patients, the department represents not only an authoritative destination for resolving complex medical conditions but also a trusted partner in maintaining everyday eye health.

Founded in 1946 by Professor Zhao Dongsheng, celebrated as the "Eye of the East," the department has grown into a pioneering institution in retinal disease surgery in China. Recognized as a leading clinical discipline in Shanghai since the 1990s, the Ophthalmology Center was approved in 2019 as a National Clinical Research Center for Eye Diseases, making it one of the largest integrated ophthalmology centers in the country.

According to Professor Sun Xiaodong, Director of the Ophthalmology Center, "Innovation is embedded in the DNA of Shanghai General Hospital’s Ophthalmology Center." Over the past 70 years, generations of experts have achieved groundbreaking milestones, such as performing China’s first retinal detachment surgery, pioneering the use of scleral buckling with Dacron bands, and developing vitreous cutting surgery, as well as inventing domestically produced intraocular gas and heavy water solutions. In recent years, the department has further advanced in areas such as precision myopia control, gene therapy, and smart ophthalmology systems.

At its core, the department’s mission is "for the people." With shifting patterns in eye diseases influenced by lifestyle changes, Shanghai General Hospital remains a leader in diagnosing and treating complex retinal detachment, diabetic retinopathy, macular diseases, hereditary eye conditions, cataracts, pathologic myopia, and pediatric ophthalmology. The department has also made significant contributions to juvenile myopia prevention, a critical area affecting public health and the quality of life of future generations.

The widely recognized slogan, “The stars in the sky, the eyes of Shanghai General Hospital,” encapsulates the trust patients place in the department and inspires continuous innovation and excellence among its staff.

For Complex Eye Diseases, Pursuing "China's Solution"

The history of Shanghai General Hospital’s Ophthalmology Department is replete with milestones. Professor Zhao Dongsheng, its founder and a pioneer in retinal detachment surgery in China, laid the foundation for the hospital's leading position in retinal disease treatment.

In the 1940s, when retinal detachment surgeries were unavailable in China, Professor Zhao returned from Austria to establish these procedures at Gongji Hospital (the predecessor of Shanghai General Hospital). By introducing retinal detachment surgery, Professor Zhao transformed the hospital into the first surgical treatment base for retinal diseases in China. In 1986, the hospital further strengthened its leadership by founding the Shanghai Eye Institute, becoming the first institution in China to research proliferative membranes in retinal detachment, preceding international studies by four years.

Professor Zhao's groundbreaking "Zhao's Membrane Grading Method" became a hallmark of the hospital's ophthalmology practices, earning him the 1978 National Science Conference Award.

In the 1980s, Professor Zhang Xi and his team achieved further breakthroughs, particularly in vitreous surgery. Faced with the lack of imported C3F8 gas, essential for retinal surgeries, Professor Zhang spearheaded a collaborative effort with the Shanghai Institute of Organic Chemistry to develop ultra-pure domestic C3F8 gas. The resulting innovation not only lowered costs but also improved surgical success rates, boosting retinal detachment recovery from 70% to 98.6%.

In the 1990s, Professor Xu Xun, the current academic leader, introduced new approaches to treating diabetic retinopathy and established a model combining prevention and treatment. This approach has since been adopted nationwide, influencing clinical guidelines issued by the National Health Commission. Professor Xu's leadership also led to the inclusion of retinal diseases as a key focus in China’s National Eye Health Plan in 2022.

Myopia Prevention and Control: The "Shanghai General Standard" Becomes a National Benchmark

Adolescents represent the future of the nation, and myopia prevention among this group has become a national strategy. Data show that the number of people with myopia in China is still rapidly increasing, with the problem being particularly acute among children and adolescents, posing a significant public health issue.

Shanghai took the lead nationwide in initiating myopia prevention and control for children and adolescents. Starting in 2011, the Shanghai Municipal Health Commission and the Municipal Education Commission launched a three-year program to establish refractive development archives for children and adolescents across the city, with the Shanghai Eye Disease Prevention and Treatment Center responsible for implementation. For nearly two decades, the teams led by Professor Xu Xun and Professor Zou Haidong, Deputy Director of the Ophthalmology Center at Shanghai General Hospital, have conducted extensive research on myopia prevention and control in adolescents, working tirelessly to transform Shanghai's local standards into national ones.

In 2011, under the leadership of Professor Zou Haidong, a pioneering medical-education integrated platform for adolescent eye disease prevention was established. This platform created a database for children’s refractive development archives, covering over 3 million children and adolescents in Shanghai and conducting nearly 10 million screenings. Through this, an effective early prevention model was developed, encompassing large-scale myopia screening, referral, intervention, follow-up, archiving, health education, and dynamic management through informatization.

In October 2019, the first Shanghai municipal standard in the field of eye health, Specifications for Refractive Error Screening in Primary and Secondary School Students, drafted by Professor Zou, was officially promulgated. In January 2020, it was further approved as a national health industry standard, significantly advancing the national strategy for myopia prevention in children.

Shanghai General Hospital’s clinical research on myopia prevention has also attracted significant attention. In 2022, a team led by Professors Xu Xun and He Xiangui conducted a randomized controlled trial evaluating the effects of outdoor activities and light intensity on the progression of myopia in children. The findings, published in the prestigious journal Ophthalmology, provided new insights into the protective role of outdoor activities, linking it to the duration and intensity of light exposure. The study proposed quantitative relationships that are now being applied in the field of myopia prevention, yielding promising results.

The Ophthalmology Department at Shanghai General Hospital has actively engaged in public welfare activities, creating the impactful “Bright Eyes, Clear Vision” volunteer program. Initiatives such as “Eye Protection Lessons on the First Day of School” and themed campaigns for National Eye Care Day, World Vision Health Day, and International Volunteer Day have garnered widespread social recognition. Professor Zou and his team have also conducted over 800 charitable surgeries and nearly 200 professional lectures in remote regions, including Tibet, Xinjiang, southern Sichuan, and Guizhou, making substantial contributions to underserved communities.

Leading the Era of Gene Therapy in Ophthalmology

Stepping into the newly inaugurated Ophthalmology building at Shanghai General Hospital in 2023, patients are greeted with a state-of-the-art environment that embodies modernity and innovation. The hospital has become a hub for the development and application of new technologies and treatments.

In July 2023, the hospital established the nation’s first Rare Eye Disease Diagnosis and Treatment Center, also the first Gene Therapy Clinical Research Center for Eye Diseases in China. The center has launched clinical trials for genetic therapies targeting various hereditary retinal diseases, filling gaps in domestic research.

Recognizing that genetic mutations in Chinese patients differ from those abroad, the hospital’s Ophthalmology team has focused on identifying local mutation hotspots and developing precise treatment strategies tailored to these unique needs. In 2021, the team completed China’s first clinical trial for Leber Congenital Amaurosis (LCA) gene therapy, with results showing significant vision improvements for participating patients.

Gene therapy has also shown potential for other conditions, such as age-related macular degeneration (AMD). Professor Sun Xiaodong’s team has completed phase II clinical trials for AMD gene therapy, demonstrating promising safety and efficacy, with annualized rescue treatment rates significantly lower than those of similar foreign products.

Looking forward, the hospital aims to establish a seamless “closed-loop” innovation chain, encompassing disease diagnosis, clinical research, independent drug development, and clinical application. By focusing on creating affordable and effective gene therapies tailored to Chinese patients, the hospital’s Ophthalmology Department continues to pursue its mission: bringing lasting light to those living in darkness.

Source: Issue 38, Xinmin Weekly, 2024

Reporter: Wu Xue

Editor: Public Relations and Spiritual Civilization Office, Shishi Cai

Translator: International Cooperation and Exchange Department, Yuhan Wang