‘As A Doctor, You Will Never Forget’

Transforming laboratory research into real-life therapy for patients is a rare occurrence.

But when it does happen, it’s big. Huge, in fact.

Ask Dr. Audina M. Berrocal, the pediatric retinal surgeon who performed ground-breaking retinal surgery in March on 9-year-old Creed Pettit. Creed lived with severe vision loss caused by a rare inherited retinal disease (IRD) called Leber congenital amaurosis (LCA)* manifested by a mutation in his RPE65 gene. At the time of his treatment, he was the nation’s youngest patient to receive it.

Dr. Berrocal’s surgery at Miami’s Bascom Palmer Eye Institute on the third-grader marked one of those extraordinary times when research goes from clinical to surgical – from bench to bedside.

“It’s one of those honestly amazing moments in medicine,” she said. “Things that you think you are never going to see and here I am, doing it. As a doctor you will never forget.”

Dr. Berrocal, Dr. Byron Lam (who diagnosed Creed at age 2½ with LCA), and a surgical team, removed the vitreous, a gel-like substance attached to the retina’s surface – though Creed’s vitreous was thinner than normal – before administering the medication – LUXTURNA™ – a genetically engineered virus that supplanted Creed’s mutated RPE65 gene with healthy versions of the gene.

“The challenge is to lift the retina with the medication,” she said. “Detaching the retina, especially of a child, is pretty hard to do. We are looking through microscopes and special equipment that makes seeing the retinal layers easier, but it’s still challenging.”

Working with two syringes filled with the medication that is viable for only four hours, Dr. Berrocal said she could not find the right subretinal space to inject the treatment with the first syringe. She then successfully injected LUXTURNA with the second syringe.

“With the first case, everything is new,” she said of the surgery, which took about an hour. “The second eye, everything went smoother, quicker and faster.”

‘Science that revolutionizes medicine’

“It’s extraordinary,” she said. “It makes you feel you are on the brink of a new area of science that is going to revolutionize medicine and eradicate disease. This truly is the brink of an era of gene manipulation and gene therapy.

“To be living this as a physician is really, really unique and special.”

Before the surgery, Dr. Berrocal trained with people from Spark Therapeutics, LUXTURNA’s developer, to learn about the drug’s pharmacology and to train in the knowledge of the surgical process. This genetic treatment came to fruition after decades of research and millions of dollars, followed by approval by the Food and Drug Administration in December.

“The viral vector provides the correct gene that you need,” she said of the medication’s delivery system. “The concept can be used for any gene and I think this is truly the beginning of a revolution of genetic manipulation.”

Soon after the surgery, Creed enjoyed improved vision.

“We never expected it to change so quickly. I don’t think anyone was expecting it.”

“No one believed it,” she said when Creed’s mother, Sarah, reported two days after the surgery that her son’s vision dramatically improved.

No one except Dr. Berrocal.

“The thing is, people do not always believe mothers, but as a mom myself, I will tell you that no one knows a child better than mom. If Creed’s mom is saying that Creed never walked around with such little light before, then it’s true.”

Given her background, Dr. Berrocal being at this point in her career seems a little unsurprising. Her father, Dr. Jose Berrocal, trained with Dr. Charles Schepens, a Belgian ophthalmologist known as the father of modern retina surgery.

Her father became Bascom Palmer’s first trained retina specialist and the first such specialist in Puerto Rico. Dr. Berrocal’s older sister, Dr. Maria H. Berrocal, became a retina specialist and practiced with their father. Both women turned to medical school after graduating with degrees in political science and realizing politics wasn’t for them.

Dr. Berrocal, now 51, has two daughters and one son with her physician husband. She grew up helping her dad in the office, as ophthalmology was part of the family. She is now medical director of Retinopathy of Prematurity Services at Bascom Palmer and professor of Clinical Ophthalmology at the University of Miami.

Asked whether her sister was jealous of her doing breakthrough surgery, Dr. Berrocal laughed and said, “She’s very proud of me.”

Dr. Berrocal’s father always told her she’d end up doing something with kids, and she sealed the deal working under a mentor dealing with pediatrics and retinas in her 2002 fellowship at Bascom Palmer in Vitreoretinal Diseases and Surgery.

“I truly like kids more than I like adults. They’re honest, sincere, concrete. You can never lie to them; if you do, you lose their trust forever.”

Dr. Berrocal respects Creed, listened to him and talked to him as an adult. She said he wasn’t interacting during their first meeting in January. Over time, she won him over by caring about what he wanted and needed, especially the little things. Creed didn’t like having the ID band on his wrist, so she took off the band and he felt better.

“He’s much more comfortable with me now,” she said. “It makes it really special.”  

“They have to feel that they’re part of the process. It’s their body and it’s their eyes. I think empowering kids to be part of the process, taking in their feelings and their emotions, directing the conversation to them – that’s essential to make it work.”

Dr. Berrocal, as with most retinal specialists, is much more used to seeing children lose their vision and become blind.

“One of the most important things for me in this process has been watching a kid regain vision. This was a kid who couldn’t do things. He’s seeing the world in a different way. That is so powerful and so overwhelming. We cannot forget the importance of getting him ready for something so overwhelming.

“Learning to see again is hard emotionally. We have to somehow have these kids talk about it, how different their lives will be. How to guide them through it…We have never reversed the road to blindness before.”

Dr. Berrocal sees Creed for check-ups and more, confiding: “I can’t separate.”

Looks like that won’t be a problem for the surgeon – when she retires she knows Creed will be at the party.

Tell Us Your Story: ‘Do Not Limit Yourself’

I am 22 years old and I have LCA.

My name is Angélica Bretón Morán, I am from Mexico, I am 22 years old and I have Leber congenital amaurosis (LCA). Two years ago I learned that the gene that affects me is the RPGRIP1.

I’ve been reading many sites on the Internet, and I have realized that there are many comments from parents concerned about the development of their children, however there are almost no comments from parents with older children or people with LCA who talk about their development.

My intention is to tell you a little about my story to bring you peace.

LCA diagnosis: Many wrong turns

Angélica holding red roses and standing next to her parents and brother

When I was 2 months old, my mom realized that I did not follow people or toys with my eyes, and that when they did not speak, I cried as if I was alone and my eyes were standing down.

My mother is licensed in special education and specialized in hearing and language; she has many diplomas in different disabilities, including visual disability, so she realized that something was not completely normal.

The doctor told my parents that my eyes had to mature, but the months passed and nothing changed. My mom was certain that my characteristics were those of a blind person.

Finally, the doctors diagnosed that I was blind and there was a rain of bad diagnoses, syndromes that would terribly affect me, or that I would die a premature death, or that I would be like furniture, without the ability to do anything. They also said that maybe I would lose some other sense, that I could never talk, walk, eat ,among many other things Of course all this broke my parents’ hearts.

Other doctors recommended surgery but my mom never agreed and my dad supported her, he trusted in her because my dad did not have the experience with people with disabilities like my mom.

It was a painful road for my parents until a doctor told them “If they force me to give a diagnosis, I would say to you that it is LCA.” I was 2 years old.

My dad searched for information about this new diagnosis on the Internet, and what he found was not nice things, as I see that happens today. In one of the Internet searches, my parents found a writing made by a 22-year-old Italian young lady who was a musician; this for them was something hopeful.

From that moment we were in the group of research families, and for many years that was the diagnosis even though there was nothing that would formally confirm it. However, my parents did not lose details about my development; they were still worried because there was not something completely defined, since the disease was little known.

While my mom stimulated my touch with toys with different textures, placing hands in containers with different seeds, she strengthened my hands and enrolled me in mud classes. I was very afraid of the people, so she enrolled me in ballet classes where I would meet more girls and teachers. I was very little and I liked the music and the stage.

Then I went to kindergarten. It was not easy to find a school where they would admit me, but my parents never agreed that I was in a school for people with disabilities. As I had already been in the Ballet, it was easier for me to adapt to the classroom.

My parents never treated me differently, when I told my mom that when I grew up I wanted to be a pianist and opera singer, she told me that I could reach where I wanted. I liked to hear Charlotte Church and I admired Andrea Bocelli, because he was an example for me.

I have always been shy, I work hard to be sociable. This has been good, even though it has not been easy, but the reality is that we live in this world that will not be especially easy for us. This is achieved gradually and with personal life experiences, but I believe that above all with great patience and understanding of our parents and relatives, then we personally will learn to have it.

To give an example, my mother let my friends go to my house, and she let me go to their homes too. My parents did not make me see that my case was something special, because I could play with dolls, the kitchen, to be a doctor etc., like all the girls; only that when there were obvious things like playing jump on the stairs, the adults had to tell us that this was dangerous, because this is dangerous for any child, do not you think?

Angélica with roses and smiling

When I behaved differently from other children, my parents told me that this was not a good behavior. They explained to me how I should behave, without showing myself. When I waved my hands my mother held them and told me not to do it, she did it kindly but firmly and little by little I stopped doing it.

What made my parents angry was that I pressed my eyes with my fingers, because this was harmful to my eyes, every time they saw me doing it, they rebuked me more strongly; but now I thank them, because my eyes have no harm and in the future if the cure for my gene is found, there will be no injury that prevents me from receiving the treatment.

My parents educated me with a lot of love, but above all with discipline, an orderly and coherent discipline. I had to keep my toys like all children, learn to eat correctly like everyone else, not put my hands in food and just touch it with a finger that my mom called “guide finger”, this as a support because I cannot see the food.

I am weak visually, when I was a girl I could see better than now. Now I see lights and shadows but I cannot distinguish differences between colors as I used to, this has been so progressive that I did not realize until recently.

My disability has never been a secret, but neither has it been something for which I have to be different from others. It is true that you have to adapt some things, this is logical; however you have to look for how to achieve the objectives.

Going back to my life story, I have always studied in regular school; all my life music has been present. I graduated from music training at the Autonomous University of Nuevo Leon (UANL) while studying elementary school. I finished high school and got the second place for qualifications. I entered the technical career in music and finished it with honors while I studied online high school, all this in the UANL. I am currently studying a degree in music with an emphasis in piano at the same university and I have been studying professional singing for five years with a private teacher to become an opera singer.

I think it’s important to mention that I’m not an only child, I’m the oldest of two. My parents, like many of you, were afraid that the second child would have something worse than mine, but they have always had great faith in God and my brother was born. He does not have any disability, but he was asthmatic since he was a child and my parents have faced their situation in the same way they have faced mine … they never treated him differently, nor did they make him see that he had disadvantages. But to achieve something you had to look for how to do it. He is a high-performance swimmer, asthma attacks are becoming less frequent, and he is currently a healthy boy.

All this I tell you so that you know how important it is not to limit yourself. If you limit yourself as parents, you will limit us as children. My brother has been a great support for me in many situations, he has taught me to be the older sister. Our illnesses and the education of my parents, they taught us that neither he nor I have an obligation to take care of each other, we simply do it because we are brother and sister and we love each other

I played with my brother, we made mischief, we laughed late at night until my parents scolded us to sleep, as any pair of siblings can. My parents have never marked differences between us, everyone is accepted with their differences, we all have, but I am not more important than him, nor is he more important than me.

All this we have worked for 23 years as a family, we have been wrong many times, some other times we have felt that our effort has been in vain. We have stumbled like any family, we have asked for help when we consider that it is necessary. We have also tried to help when we think it is appropriate. But above all things, the strength of my parents and my family has been their faith in God, which they have transmitted to me and my brother and this faith has been my reason to continue in difficult times.

Speaking about people with LCA, they may have other disabilities, I have witnessed them myself, or they may not have them as is my case. However, I can tell you that when you treat a person different from the others, that person will behave differently regardless of whether they have a disability or not.

You have to be aware of the limitations, but you also have to find a way around the obstacles, or pass through them, or use them as a catapult, or see them as a feature that makes us unique and special as people, as we all are.

I hope my words help many families, since that is my intention. I invite more adults with LCA to tell their stories and how they have faced life! I think we would give a much more encouraging approach when new parents enter the Internet looking for information about the diagnosis of their children, and why not, for those who are newly diagnosed patients and research the internet on their own.

I have known fathers and mothers with LCA, young people, babies, children, even a child who was cured with genetic therapy because he has RPE65. We met him when he was blind and the second time we saw him, he saw and guided the other children who were still blind. It was amazing! We were all very excited and we could not stop the tears.

Finally I want you to know that I am in the best position to answer your questions in this post from my personal perspective. As I mentioned before, my only intention is to help because I am greatly moved to see your anguish and I feel that it is my duty to be now the 22-year-old girl who brings a hopeful message to those who enter the internet looking for information about LCA.

I would like to know, is there anyone else that has the RPGRIP1 GEN? I do not know anyone else!

God be with each one of you, blessings!

An Amazing Year

This is the seventh in a series following the progress of Creed Pettit, a 9-year-old Florida third-grader, who completed treatment in March with the breakthrough gene-therapy drug called LUXTURNA™, approved as the first gene therapy for RPE65 genetic mutations and as the first-ever genetic therapy in the United States for an inherited disease.

MOUNT DORA, Fla. – Third grade tends to be one of those childhood times we remember with fondness. For Creed Pettit, his third year in elementary school marked the amazing and life-changing experience of dramatically improved vision through a breakthrough genetic therapy

Creed underwent surgery in March for a mutation in his RPE65 gene that caused a rare inherited retinal disease (IRD) called Leber congenital amaurosis (LCA).

Returning to school, the 9-year-old, from the Orlando suburb of Mount Dora, for the first time could see the words written on his classroom white board. Before surgery, he received most of his information up close from a computer monitor on a desk shared with his teacher.

Creed no longer needs special bright light bulbs to see. He navigates around Mount Dora Christian Academy more easily, although he still has help from his buddy, Michael, who’s been a human guiding light at school since they became friends in first grade.

Even more so, Creed is coming into his own, socializing more with classmates and feeling more confident about his classwork.

He is now joyfully celebrating his first summer with much better vision, or as he says, his first summer without LCA.

The young boy is one of the first patients to receive LUXTURNA™, a ground-breaking treatment developed by Spark Therapeutics. The surgery entailed injecting into his retinas a genetically engineered virus containing copies of a normal gene that pumps out a version of an enzyme needed for healthy vision. Dr. Audina Berrocal performed the surgery at Bascom Palmer Eye Institute in Miami.

Creed’s vision before surgery measured 20/200 in his right eye and 20/600 in the left. Now it is 20/40 and 20/100. A person with 20/600 vision sees something 20 feet away that a person with 20/20 vision would see 600 feet away.

Before the school year ended in June, Creed received his first-ever pair of prescription eyeglasses. As a toddler, he wore non-prescription glasses that looked like goggles to help with what doctors incorrectly diagnosed as a lack of depth perception.

Creed in a blue shirt reading a book

His teal-framed glasses mark another milestone in his elementary school years at school, where teachers and staff showed understanding, patience and compassion with their new charge.

“What we did was give him a chance to be normal,” Principal Lori Hadley said. “He’s been a special and unexpected blessing, for sure.”

His first-grade teacher, Marissa Rapp, said Creed becoming part of her class presented a new experience for everyone. She put his desk next to a floor plug, so he could have his light ready to charge and made sure he had extra light in class. She avoided moving furniture, but when she did she would walk with Creed around the classroom to familiarize him with a new setup.

Mrs. Rapp characterized Creed as remarkable. She wasn’t sure whether he would enjoy one of the first events at school – the annual grandparents’ day program – because of the extra noise and more people.

“So, we tried to talk it up and make him excited about it. He had music all week, so he could learn the songs the kids had been working on. Once he got on stage and the music started, he sang and was so excited. He loved it. It was a very special moment to watch him and his grandmother in the front row.”

Back in first grade, Creed didn’t go on the annual field trip to Disney’s Animal Kingdom because it would have been difficult for him to see the animals.

This year, he told Mrs. Rapp all about the animals he saw at the Disney theme park.

“It is amazing to see all the things that he now gets to experience. I am blessed to have been a part of Creed’s journey and am excited to continue to watch him grow.”

Creed and family out for lunch

In second grade, teacher Denita Snider accommodated Creed’s needs with bright lights, an extra storage bin for easy access to his supplies, larger fonts, special wide-lined paper and extra help. She realized Creed was an auditory learner and gave him explicit oral instruction and directions and checked for understanding.

She made sure Creed walked in the front of the line and he often held her hand as the hallways were dark and difficult to navigate.

Mrs. Snider also had Michael Hamburg in her class. Michael is a classmate with a big heart who took it upon himself in first grade to help Creed.

She said Michael is Creed’s buddy when they walked in line, sat at lunch, sat in chapel and went to the restroom.

“He helped Creed pack his backpack, find supplies he couldn’t see, you name it. Michael was always there to help. In fact, Michael was just awarded “Disney’s Dreamer and Doer” award at our awards day ceremony for all he has done for Creed in the last three years.”

Mrs. Snider tutored Creed this past school year, and since surgery he’s gradually learning he can do more things, such as see inside his desk, find stuff in his backpack, see the chair legs and go around them and see faces around him.

“He has been so used to not being able to see the little things we take for granted that he is now learning to really look at all the amazing things around him that he couldn’t see before. A whole new world has opened up for Creed.”

Creed and two friends from school

When third-grade teacher Faye Shyers learned Creed was going to be in her class, she accommodated him with brighter lights, a computer monitor and working closely with him.

“I wanted to make him as independent as he could be,” Mrs. Shyers said.

Before surgery, she said, Creed would stay at his desk and read during breaks in class.

“Since the surgery, he is actually getting up and being one of the guys.”

Mrs. Shyers, knowing one of Creed’s wishes after surgery was to see a rainbow, began a project in which each of his 15 classmates created an image of a rainbow, put the pictures together into a book called “Somewhere Over the Rainbow,” and presented it to Creed when he first came back to school.

“He looked at each and every one and made a comment about every one. “‘Oh wow, they put a lot of time into this,’” she recalled Creed saying.

Before the end of the school year, though, Creed’s wish came true. He reveled in seeing two rainbows so far, the latest with his mom and her fiancé from their front yard.

“Wow, that’s pretty,” he told his mom as he pointed to the spectrum in the sky.

Read Creed’s story

Life after LUXTURNA

Future so Bright, Need to Wear Shades!

Beginning to See the Light

Annnnnd We’re Off!

Ready, Set, Scheduled

The Road To Treatment

Living With LCA: Maverick Johnston

A revolutionary genetic treatment could improve the vision of 5-year-old Maverick Johnston, but his mom first wants to know more about the side effects and capabilities of the breakthrough drug called LUXTURNA™, developed by Spark Therapeutics.

Maverick, a kindergartener from Paso Robles, Calif., lives with Leber congenital amaurosis LCA RPE65 and enjoys a great quality of life, said his mom, 35-year-old Laurel Singletary-Johnston.

Laurel worries about LUXTURNA’s™ possible adverse effects, specifically citing any potential cataract development. She will continue to have doctors scan and check Maverick’s vision every six months, but she wants to review information about the drug’s longer-term effects before going forward with the treatment.

“Emotionally and mentally,” she said, “it’s going to have to be my decision. What if we give him this window of what he can potentially see, and then what?…

“In the grand scheme of things, he’s really healthy and that’s really important to me. His quality of life is so amazing, and we really don’t have a lot to complain about,” she said. “It’s scary to go through a procedure that’s so new.”

While she has reservations about LUXTURNA™, Laurel connected with Dr. Aaron Nagiel of Children’s Hospital Los Angeles on Feb. 28 – National Rare Disease Day. She and Maverick consulted with Dr. Nagiel to be on track to potentially receive the gene therapy treatment after evaluating the three-year results of the drug’s clinical trials.

Patients in Spark’s Phase 3 clinical trials are being followed from the time of their initial treatment to 15 years out to determine the efficacy, durability and safety of LUXTURNA™.

Monique da Silva, head of Corporate Communications for Spark Therapeutics, said the data have been presented at multiple medical meetings since November 2017 and that the three-year-safety data were submitted to the Food and Drug Administration in the fall of 2017.

In December 2017, the FDA approved LUXTURNA™ and doctors performed their first surgeries during the week of March 19, including that of 9-year-old Creed Pettit of Mount Dora, Fla., at Miami’s Bascom Palmer Eye Institute. Treatment with LUXTURNA™ entails injecting a human-engineered virus containing copies of a normal gene so that the cells can express a protein the retina needs to convert light into vision-enabling signals sent to the brain.

5-year-old Maverick Johnston holding his dog with a big smile on his face

In California, Maverick is blossoming in kindergarten, and while he rides his bike and can hit a ball off a tee, he’s found his perfect sport: Swimming – spring, summer and fall, two days a week.

“He loves his Speedo,” his mom said. “He is such a good swimmer and there’s a big black line at the bottom that he can follow.”

Laurel and her husband, Jason, a 36-year-old Army retiree working with the National Guard, do not let their son use his level of vision as an excuse not to do something. Maverick uses a headlamp to find toys that fall under the table, flashlights are all over the house, and his home is filled with bright lights.

She feels the family doesn’t have to make a rash decision.

“I don’t feel bad about my decision. You have to trust your mom-gut. Right now, I just feel this is the right decision for my family.”

A rough road to LCA diagnosis

Getting to this point for Maverick, his mom, his dad, and little sister, 3-year-old Dagny, has been more than a rough road.

Laurel had an otherwise uneventful pregnancy with Maverick, but during delivery experienced extreme difficulty. She said it was strange, because they checked out of the hospital fine, but Maverick had a very wide-eyed, blank stare and would not let anyone hold him except her.

His first pediatrician diagnosed Maverick as autistic at 2 months old.

“She told me he had autism and I’m not a doctor, but I knew that was crazy.”

The next doctor told her to get Maverick’s eyes checked. She took him to a well-known ophthalmologist where Maverick did well tracking a toy, until Laurel mentioned that he could track it because it jingled, not because he could see it.

When her son was about 4 months old, she was told: “There’s really nothing we can do but follow his progress to see if anything improves.”

The day before his third birthday, Maverick was diagnosed with nystagmus, or involuntary eye movement, which Laurel also had noticed.

Then the doctor told her that Maverick had a brain tumor, despite already having had an MRI for a sacral dimple.

“Brain tumor?! … I was literally losing my mind,” she said.

A second MRI showed no brain tumor.

In between all of this, she said, “It was every optical diagnosis you could imagine, detached optical nerves, visual maturation delay and 50 other eye diagnoses they tried to give us.”

Maverick at 3 years old saw Dr. Mark Borchert of Children’s Hospital Los Angeles and he recommended an electroretinogram (ERG), which produced the doctor’s suspected diagnosis: LCA, a rare inherited retinal disease (IRD).

Maverick then received a genetic diagnosis of LCA RPE65, but only after his parents paid $3,000 for the test. A neurologist later wrote on Laurel’s behalf to a community non-profit organization in nearby San Luis Obispo called Jack’s Helping Hand, which reimbursed most of the cost.

Even early interventionists had few answers and a visual therapist didn’t seem to challenge Maverick to move him along.  

Laurel asked what she could do and was told: “Wait until he gets into school and see how much he struggles.”

Maverick and family at LegoLand

“It felt like, in a way, we were brushed under the rug. I had to beg for him to have a cane. I had to beg to have someone show him how to use a cane.”

“He’s 65 pounds right now and I still carry him” in crowds because he can’t navigate through movement around him.

“People think he’s playing chicken with them and think he’s a disrespectful little kid when in reality he is so kind and has the best heart. The lack of patience, understanding and compassion among the general public is sad. We’re just trying to enjoy our lives like everyone else.”

Finally, about a year ago, a supervisor of the home-visiting visual therapist intervened and determined Maverick should have begun therapy when he was 2. He received more intensive attention before starting in kindergarten last fall and now receives in-school therapy twice a week.

Through all of this, Maverick has played and learned like other kids.

Then came December 19, 2017, the day the FDA approved LUXTURNA™, the ground-breaking genetic therapy treatment for people with a mutation of their RPE65 gene. It is also the first drug in the United States to treat an inherited disease.

“I never posted one single thing on my Facebook page (about Maverick’s LCA) until that day because I never wanted someone to feel sorry. On that day I posted it because I had something positive to share.”

She didn’t want to hear, “ ‘Oh, my God, I don’t know how you do it.’ My answer is yes you can, you do not have a choice. I was really meant in my heart to be Maverick’s mom; I don’t ever put him in a situation where he can fail. I put him in situations where he can succeed.

“I really hate the judgment and I hate all the things that he has to go through. I wish he could drive and have 100 percent independence like every other kid, but I really believe he’s going to have a happy, fulfilled and successful life.”

Laurel’s advice to other parents of children with LCA is persistence.

“You have to be their advocate. You are the Number One person to advocate for them until you can have peace with what’s happening. Without hope, you have nothing.”

And what has helped Laurel hang on to hope while navigating the maze of doctors and diagnoses, opinions and judgments? One little quote:

“The key to success is playing the hand you were dealt like it was the hand you wanted.”

Life After LUXTURNA: ‘Now He Can See’

This is the sixth in a series following the progress of Creed Pettit, a 9-year-old Florida third-grader, who completed treatment in March with the breakthrough gene-therapy drug called LUXTURNA™, approved as the first gene therapy for RPE65 genetic mutations and as the first-ever genetic therapy in the United States for an inherited disease.

Sarah St. Pierre Pettit’s life has been filled with lots of firsts these days as she watches her little boy literally see his world in a brighter light.

Before retinal surgery with LUXTURNA™, a ground-breaking, gene-therapy treatment, 9-year-old Creed needed very bright lights to see; post-surgery, he can see into a dark box, read books and discern crisper details in standard lighting.

One of the most unexpected differences to Sarah after her son’s surgery is his state of mind.

“I’m surprised at how much more relaxed he is,” the mom from Mount Dora., Fla., said. “That’s the biggest difference to me.”

Creed never was hyperactive, but his sense of relief and calm manifested as an unforeseen result of his revolutionary eye surgery.

“I think he’s relieved because the surgery is over and because now he can see,” she said. “He’s not so nervous about everything.”

Doctors diagnosed Creed with Leber congenital amaurosis (LCA) caused by a mutation in his RPE65 gene when he was nearing 3 years old in 2011 – the same time scientists at Spark Therapeutics worked to research and develop the innovative gene therapy that came to market as LUXTURNA™ in December.

The new drug is an injectable, human-engineered virus with copies of RPE65 to prompt the creation of more RPE65.

Creed’s surgery last month went well, though he had his issues with sticky things, even though he and his mother practiced at home with special tape from the doctor to get him used to the bandage he’d need over his eye afterward. He did well with the first patch because he mostly slept before it came off, 24 hours after surgery. The second wasn’t so easy. Creed didn’t sleep and obsessed about the patch, so taking it off was hard.

“As soon as it was off, he was happy. Everything was good again. He was ready to go.”

Creed in a blue shirt reading a book
Creed reading the menu at his favorite restaurant, Mount Dora Pizza, without a flashlight or extra lamps.

Wednesday marked a milestone after Creed’s surgery, reaching what doctors call the 30-day peak, meaning 30 days after surgery on Creed’s right eye, his vision will have improved as much as it is going to from the treatment.

Creed met with Dr. Christine Kay of Vitreo Retinal Associates in Gainesville, Fla., Thursday to check his vision at this 30-day point. On Monday, which will be about a month from surgery on his left eye, he is scheduled to meet with Dr. Audina Berracol, his surgeon at Miami’s Bascom Palmer Eye Institute.

As Sarah awaits medical word on Creed’s level of vision improvement, she sees signs of great progress every day.

He no longer needs help keeping the handlebars straight when he rides his three-wheeled bicycle.

“He was so excited. He did awesome, looking right at me, smiling, and I’m thinking, oh my god, he’s gotta slow down.”

Creed also climbed onto to the wheel well of a boat trailer to get into a powerboat before settling in on a cushion to read and draw. Would he have ever done that before? “Heck, no,” Sarah said. “No way.”

Since he’s gotten back from Miami, Creed’s also gone to his favorite restaurant, Mount Dora Pizza, where he ate six, count ’em, six, meatballs.

He went back to school at Mount Dora Christian Academy on April 10th.

“He’s doing so good,” his mom said. “He’s right back into chorus. He didn’t want to miss chorus.”

Creed brought his usual lunch – peanut butter and jelly, a bag of cereal, a granola bar and three cookies. He was particularly impressed at lunchtime, though, when he clearly saw for the first time all the food choices in the cafeteria. While he still prefers to bring lunch, he realized students could get two side orders, rather than just one, with their main meal.

That first day back, as she does every school day, Sarah left a note in Creed’s lunch bag, telling him to have an awesome day, not to forget to do eyedrops after lunch and to wash his hands a lot to keep germs out of his eyes.

When she asked him how his first day back was, she said, “Typical Creed. ‘It was good.’”

Then he remembered something any third-grader would want their mom to know: “I saw a kid throw up.”

“A kid who’s sick,” Sarah mused. “This is what I get; I was expecting all these great things.”

The next day when she accompanied her son to school, Creed’s teacher, Mrs. Shyers, handed over a big box filled with all the lamps and bright bulbs that Sarah brought to school for her son to see better in the classroom, long before his surgery.

“He doesn’t need these,” Mrs. Shyers told Creed’s mom.

Read Creed’s story

Future so Bright, Need to Wear Shades!

Beginning to See the Light

Annnnnd We’re Off!

Ready, Set, Scheduled

The Road To Treatment

College Connection: Making A Successful Transition To College

Starting high school or going off to college is not easy; new people, classes and sometimes even a new city makes for a stressful transition. Doing it all with a vision impairment adds some additional complexity. I am going to share with you my experience of moving to college with a vision impairment. Hopefully you can learn from my experiences and apply it to your own life.

Four years ago I knew that I wanted to attend Wilfrid Laurier University. When I received my acceptance letter I immediately started to plan, which proved to be incredibly important. I was able to connect with various people at the university: getting a larger dorm room at no additional cost to accommodate my guide dog, speaking with the Accessible Learning Center to arrange exam accommodations (I write my exams on a computer in a private room), and connecting with professors before classes started.

Jack McCormick and his guide dog Jake, center, at a recent “Eye To Eye” event Jack organized at his college. On the left is Dr. Penny Hartin, CEO of the World Blind Union, the guest speaker at the event.

For someone with vision loss it can be challenging to navigate a new place and college campuses are no different. It is so important to learn the layout of your college before move in day because I am telling you, you won’t have time during frosh week and you will want to know where your classes are before they start. There are a lot of benefits to knowing the layout of your campus beyond being able to find your classes and places to eat.

  1.     If you know where things are better than the people on your floor, then you can help them find their classes. It’s a good way to get to know people and show them that you don’t let your vision loss stand in your way.
  2.     Getting involved with campus organizations is a great way to have some fun and get to know like-minded people. These organizations aren’t going to meet in the same places as your classes. So you need to be able to find them or you are going to miss out on one of the best parts of college life!

“So, Jack, I’ve planned and learned the layout of campus. What about the first day? How do I make friends? I am worried that people will judge me because of my vision impairment.”

  • Remember that all people are nervous during their first days of college. You are not alone!
  • Own your vision impairment, tell people about it and be open to answering questions (you will get some dumb ones). This eliminates any awkwardness that people may have about your vision loss and soon you will find a great group of friends!

I hope this helps as you move away to college!

Jack McCormick is a 21-year-old honors business student at Canada’s Wilfrid Laurier University in Waterloo. Jack was diagnosed in high school with Leber congenital amaurosis due to mutations in the RPE65 gene. He is a Hope in Focus (formally Sofia Sees Hope) ambassador, helping people living with LCA and IRDs. Read his blog at jackdamccormick.wordpress.com

His Future’s So Bright, He’s Gotta Wear Shades

This is the fifth in a series following the progress of Creed Pettit, a 9-year-old Florida third-grader, who completed treatment in March with the breakthrough gene-therapy drug called LUXTURNA™, approved as the first gene therapy for RPE65 genetic mutations and as the first-ever genetic therapy in the United States for an inherited disease.

Life looks a lot brighter for Creed Pettit, the Florida boy who just became one of the first LCA-RPE65 patients to have eye surgery using the brand-new gene therapy treatment LUXTURNA™.

For the very first time, Creed built the entire track of his wooden train set, and he did it in the garage rather than in the house with all the lights on.

“He played with it for over two hours,” said his mom, Sarah St. Pierre Pettit. “He played with it like a kid should play with it.”

Before the surgery, Creed and his mom would have what she called “taught play,” with her little boy doing only what he was taught or told.

“All of a sudden, he was playing with these things, interactive play, putting doors on the train, making the bridges of the train set.”

Even digging into the box with the train-set pieces is a new experience. Before, Creed wouldn’t look in the box because it was dark, and he couldn’t see anything. Now, he’s looking into the box and pulling out curved pieces of track.

Creed is back home in Mount Dora, Fla., from having his second surgery, this time on his left eye, on March 28 at Bascom Palmer Eye Institute in Miami.

He and his family came home to a house decorated by friends with streamers, balloons and a big home-made sign that said, “Welcome Home Creed.”

Creed is one of a handful of the first LCA-RPE65 patients to receive the genetic therapy treatment LUXTURNA™ developed by Spark Therapeutics.

The U.S. Food and Drug Administration granted approval of the revolutionary drug in December. Soon after, preparations began for administering the treatment to the first patients the week of March 19. The surgery entails injecting under the retina a human-engineered virus containing copies of a normal gene, prompting the making of more RPE65.

As Creed came into the operating room last week, he heard “I’ll Be There For You,” coming from the speakers; it’s the theme song from the television show “Friends,” and the same song Creed and his mom – and the whole surgical team – sang while waiting out a short delay before his first eye surgery.

After performing surgery on his right eye on March 21, Dr. Audina M. Berracol found new growth in the eye’s photoreceptor. Creed will return to Miami on Monday for high-resolution scanning, called Optical Coherence Tomography, (OCT) on his left eye.

Back at home using just basic lighting, Creed reads “Diary of a Wimpy Kid.” And he looks down at his food now.

“It’s really, really neat,” Sarah said. “Every day has just shocked me.”

He watched “Peanuts,” one of his favorite shows, and then went on a long walk.

“It’s just so cool to watch him. He has his sunglasses on, he’ll just stare, looking at different trees, touching them.”

No more flashlights, either. Years ago, Creed’s mom outfitted their home with bright lights and lots of flashlights, so he could see things if they dropped under the table.

The third-grader also stopped by his school to see his friends and he kept looking at the designs on the floor and asking people what they were eating.

“It’s a hamburger,” his mom said. “It’s almost like teaching a toddler all these things.”

Speaking of school, after Creed returns from Miami for his follow-up appointment on Monday, he goes back to school Tuesday and plans to wear a new T-shirt, much to his mother’s chagrin.

Sarah wanted to buy Creed something special to celebrate the success of the surgeries and his new-found look on life. She wanted to buy him a watch or something cool at one of the popular stores.

“Look, here’s a neon one,” she said, pointing to a big watch. “Anything you want.”

Instead, he picked out a shirt with words on it, “totally not something I’d ever buy,” Sarah said. The shirt says, “I was going to do my homework, but my hands are full,” and shows an image of two hands holding a game console.

She thinks he picked it out because he could read the letters.

“He’s never gotten in trouble (at school). He thought it was hilarious that it said that.”

Sarah said she was thankful that her mom and her fiancée accompanied her and Creed to Miami and helped keep her calm after waiting nine years for Creed’s treatment come to fruition.

“I think I cried harder on the second one,” Sarah said after this latest surgery.

“Oh my gosh! It’s done! We’re done! We beat this! We never stopped fighting and look where we are now.”

Read Creed’s story

Beginning to See the Light

Annnnnd We’re Off!

Ready, Set, Scheduled

The Road To Treatment

Post-Surgery: Beginning to See the Light

This is the fourth in a series following the progress of Creed Pettit, a 9-year-old Florida third-grader, who completed treatment in March with the breakthrough gene-therapy drug called LUXTURNA™, approved as the first gene therapy for RPE65 genetic mutations and as the first-ever genetic therapy in the United States for an inherited disease.

A rainbow drawn over Creed Pettit’s left eye on Wednesday, March 28, marked the correct eye to receive surgery, but even more so, the arc symbolizes what the third-grader from Mount Dora, Fla., hopes to see after his recovery.

The 9-year-old with LCA-RPE65 underwent his second surgery that afternoon –  this time on his left eye – with the revolutionary genetic therapy drug LUXTURNA™.

Dr. Audina M. Berracol of Miami’s Bascom Palmer Eye Institute performed this surgery on Creed’s eye, as she did a week ago on his right eye.

Creed in a hospital bed with an eye patch on his left eye
Creed, recovering from his second surgery March 28 to reverse his vision loss caused by LCA-RPE65.

Creed’s mom, Sarah St. Pierre Pettit, said in a Tuesday email that her son’s right eye shows distinct improvement since surgery last Wednesday, March 21.

“The doctor already saw new growth in the photoreceptor yesterday (Monday, March 26),” Sarah said about improvements already showing in the right eye. “She was so excited.”

Six days after the first surgery, the boy’s mom wrote, “Creed’s spirits are so high.”

“He keeps saying ‘I did it without light,’ when he reads or eats or draws. It’s so cool,” Sarah said. “I am loving every moment but must admit I’m completely exhausted.”

She said that he is asking so many questions about what things are. “It’s wild.”

In 2011, doctors diagnosed Creed at almost 3 years old with LCA. He later received a confirmed genetic diagnosis of LCA-RPE65. Sarah tried to get him into clinical trials for LUXTURNA™ when he was 3 and 4, but her little boy could not perform tasks required by the study, such as trying to navigate a maze.

Preparation for Creed’s treatment came shortly after LUXTURNA™, developed by Spark Therapeutics, received Food and Drug Administration approval in December and around the time of Creed’s 9th birthday in January.

He had told his mom that after surgery, he couldn’t wait to see a real rainbow and he couldn’t wait to throw his canes in the lake.

Creed 4 days after his first surgery to reduce his vision loss caused by LCA-RPE65. He is smiling at the camera, because he can see the camera.

Since Creed’s first surgery, Sarah has taken photographs of him pointing to her without any lights on and smiling at the camera after being able to see it.

Before the first surgery there had been a few delays, so to help pass the time, Creed and his mom sang “I’ll be there for you,” the theme song from the television show “Friends.”

Sarah said she cried a lot.

Before today’s surgery, Sarah wrote: “The experience was mind-blowing. Our LUXTURNA™ arrived and

we waited for it to be mixed. It felt like an eternity waiting. Mom (Sarah’s mother), Chad (Sarah’s fiancée) and I fasted with Creed.

“The team was amazing. They were so good with Creed and I, explaining everything and allowing me to hold him as we went back and (allowing us to) stand next to him as he went to sleep. It was so hard to leave. Yet I felt this sense of comfort knowing they truly had a love for Creed.”

After Luxturna™ Treatment: ‘Mom, Pop, is that you sitting there?’

Christian Guardino underwent experimental eye surgery five years ago with a revolutionary genetic treatment called LUXTURNA™, forever changing his life by restoring his vision that was lost due to Leber congenital amaurosis-RPE65.

On the heels of government approval of this extraordinary drug, the 18-year-old from Long Island recently had the opportunity to thank Spark Therapeutics, makers of this transformative treatment.

LUXTURNA™ is the first gene therapy for people with Leber congenital amaurosis (LCA), a rare inherited retinal disease (IRD), with an RPE65 gene mutation

The senior from Patchogue-Medford High School recounted his experience of receiving the drug during clinical trials and thanked Spark for their incredible, life-changing work that the Food and Drug Administration approved in December 2017.

Christian’s 2013 surgery involved injecting a human-engineered virus containing copies of a normal gene so that the cells could express a protein needed by the retina to convert light into vision-enabling signals sent to the brain. LUXTURNA™ also is the first treatment of its kind in the United States for any inherited disease.

Before surgery, Christian had difficulty seeing even in very bright light; after surgery, the teen-ager, who also is an accomplished singer, experienced something astonishing as he stalled offstage, preoccupied with the night sky before performing outdoors at Long Island’s Adventureland.

“My eyes were glued to the sky and I was looking at the moon for the first time,” Christian said. “That was pretty cool.”

During his meeting with Spark, Christian also sang three songs.

He offered a true treat, singing a very bluesy version of “Who’s Loving You” by the Jackson 5, the same song he performed for his audition a year ago on “America’s Got Talent,” where host Howie Mandel hit the “Golden Buzzer” button, speeding him forward to live competition.

During that appearance, Christian answered Simon Cowell’s introductory questions with the tentativeness of any 16-year-old on stage before a packed house and millions of television viewers. Seconds before the audition, the camera flashed to audience members in hold-your-breath anticipation. When the music began, Christian brought the microphone to his mouth and belted out a soulful, strong, self-confident performance, belying his youth and bringing the audience to its feet.

Christian, whose musical heart is in soul and the Motown sound, recently said: “There’s just so much truth and meaning in soul and Motown. To have that kind of soul, you have to be really down in life.”

At the meeting with Spark, Christian also sang “Rise Up” by Andra Day and “Don’t Stop Believing” by Journey.

From left, Children’s Hospital of Philadelphia Research Coordinator Kathy Marshall, Dr. Albert Maguire, Christian, Christian’s mom, Beth, Dr. Jean Bennett; at Oct. 2017 FDA Advisory Committee LUXTURNA meeting.

From that meeting, Christian, his mom, Beth, dad, Nino, and younger brother, Nicholas, traveled to Orlando, Fla., where he was one of 10 national champion ambassadors – patients who triumphed over great odds – for the Children’s Miracle Network Hospitals (CMN Hospitals), a national organization raising funds and awareness for 170 children’s hospitals.

He represented Children’s Hospital of Philadelphia (CHOP), as their national champion, at the invitation of LUXTURNA™ developers, Drs. Jean Bennett and Albert Maguire.

After performing there, Hunter Hayes, a Grammy-nominated singer/songwriter, surprised Christian by telling him he was a big fan and inviting him to a future studio session.

The hunt for a genetic diagnosis

Christian’s mother, Beth, noticed that his eyes did not track when was about 3 months old and that he did not make eye contact, rather gravitating to light sources. Doctors suspected some sort of eye disease, including LCA.

His family noticed something else different before he was even 6 months old, when a visual therapist worked with Christian to track the song “Twinkle, twinkle, little star” on video.

“All of a sudden, in his bouncy seat,” Beth said, “He starts humming, ‘Twinkle, twinkle, little star, how I wonder what you are…’ ”

“Is that normal?” she asked the therapist, who looked at her and said, “Noooo!”

He would repeat everything he heard, singing scales and la-la-la-la-la-la-la-la all over the house.

“His musical ability, even as an infant and a toddler, was just off the charts,” Beth said. “I knew it was really something different.”

After having “every test under the sun,” doctors diagnosed Christian with LCA at 9 months old.

“At the time, so little was known about LCA. They didn’t give us much information.”

Doctors told her then that his vision would be stable or slightly improved, which turned out not to be true.

A pediatrician then referred Christian to a geneticist, to no avail.

“That’s one thing that actually surprises me now. Even back in 2000, they were not able to identify his gene.

“There was nothing we could do. We enrolled him in early intervention and had to accept the fact that he was visually impaired. We just did the best with what we had.”

When he was about 10 or 11, Christian started missing things, even in bright light, and when he didn’t recognize a friend at a church barbeque, Beth knew something was not OK.

She found information online and signed up for a family conference in Philadelphia sponsored by the Foundation for Retina Research, which has since melded into the Foundation Fighting Blindness (FFB). 

“We found out during a presentation that he was going to go completely blind,” Beth said. “Here we were, sitting in a roomful of acquaintances, that was kind of hard to hear.  

“It was really, really overwhelming, and I literally had to fight not running out of that room because I was really so completely…,” she paused saying through tears, “It’s emotional.”

Christian was genetically tested at that summer 2012 conference and received results in March 2013. Dr.

Christian in a hospital gown crossing his fingers
Christian in June 2015 at his second-year follow-up at Children’s Hospital of Philadelphia.

Bennett also tested the sample in her lab and was 90 percent sure he had RPE65. 

“We agreed to be part of the research,” Beth said. “Whatever we can do to help get things further along.”

Three months later, Christian underwent surgery.

“The first thing was really when I woke up, I was in a very, very dark room with one little lamp. ‘Dominique, is that you?’ ” Christian asked, referring to Dominque Cross, a CHOP research coordinator sitting in the room.

“I didn’t even know what to think because I’ve never really seen in a dark room. It was hard to get used to because I was used to what I saw before.”

His eyes were treated a week apart.

Beth said, “My husband and I were sitting in the room.” The doctor took off the patch and “his head turned in our direction. ‘Mom, Pop, is that you sitting there?’ ”

The whole room erupted.

Returning to school as an eighth-grader, Christian said, “It was kind of crazy because I could walk down the hall and see someone waving to me, instead of being antisocial. I wasn’t actually antisocial (before) but I seemed antisocial. Now I could see who I was talking to. It was pretty awesome.”

Shortly after surgery, he began performing with Idolmaker USA, a local talent-show company, and then went on to win Amateur Night at the Apollo Theater, marking his entrance into the real world of singing.

Christian’s now a senior and even as he talked, he couldn’t believe he’s so close to graduating.

“I graduate in June and that’s in, like, three months. It’s really just hitting me now.”

But it’s not like Christian doesn’t have plans.

“I just want to follow my career, singing, get in the studio and put out some of my own stuff.”

He recently worked with Sacha Skarbek, a British songwriter and record producer who has written songs for James Blunt and Miley Cyrus and worked with Adele, Lana Del Ray, Tears for Fears and others.

The songwriter chose one of his songs for Christian to record and then donated it to the Vision of Children Foundation, which is making a documentary called “Vision Hero.”

The name of the song and its lyrics are top secret for now, but Christian did say he recorded the song last month in Los Angeles.

Living Without LCA: ‘Andddddd we’re off”

“Andddddd we’re off 💓,” Sarah St. Pierre Pettit wrote Saturday afternoon as she, her son, Creed, and her fiancée, Chad, piled into their SUV. They’re headed south for Miami’s Bascom Palmer Eye Institute where doctors await Creed’s arrival for ground-breaking, gene-therapy eye surgery using LUXTURNA™ to correct his LCA RPE65 gene mutation.

LUXTURNA™, developed by Spark Therapeutics, is a revolutionary genetic treatment in which a human-engineered virus containing copies of a normal gene is injected under the retina. Creed’s surgery will be among the first since the Food and Drug Administration in December approved LUXTURNA™, which also is the first-ever genetic treatment in the United States for any inherited disease.

Emotions have been running high for Creed’s mom, Sarah of Mount Dora, Fla., and they kicked into even higher gear Friday. That’s when Sarah’s mom picked up Creed’s dog, Annie, to stay with her while Creed and company readied for Saturday’s five-hour ride to Miami.

She said it “hit hard,” when her mom picked up Annie, described as a pound dog, not a service dog.

“I lost it,” she wrote in an email. “This is it. 9 years of fighting and it’s finally here. So crazy.”

Sarah’s mom, Mary, will leave the pooch with family and friends and meet up with the family in Miami on Tuesday.

Today, Creed is undergoing pre-op tests and could learn when doctors will perform the surgery. The original dates were Wednesday for Creed’s first eye, and a week later, March 28, for his second. Sarah said Creed is sick of waiting, but he is excited for the surgery.

This morning, Creed asked Sarah’s fiancée, Chad, to bring all of Creed’s canes after the second eye surgery so he can throw them in the bay.

Good luck, buddy!!

Read Creed’s story

Ready, Set, Scheduled. Florida Boy Will Receive Gene Therapy Treatment to Reverse Vision Loss

Curing Blindness: The Road To Treatment With LUXTURNA™