FALL 2016 Chairman’s

NEWSLET TER

Duke Ophthalmology: Dedicated to Curing Eye Disease Worldwide

CONTENTS MESSAGE FROM THE CHAIR Welcome to the first issue of Duke Eye Center’s Chairman’s newsletter. This new bi-annual communication will provide updates and important information about our department. Each issue will include topics such as: »» New faculty »» Awards, honors and accomplishments »» Events »» Publications

1 Message from the Chair 4 Recent publications 5 Events 6 New faculty 7 Supporting DEC

I am particularly excited to share announcements about US News and World Report rankings, our presence at the recent American Academy of Ophthalmology (AAO), and research efforts by Duke Eye Center faculty that are changing the way eye diseases are diagnosed and managed. Duke Ophthalmology is now ranked #6 in the US News and World Report, an increase from #8 last year. This accomplishment a testament to the excellence that we offer in research, teaching and patient care, and that our reputation among our peers and colleagues remains high. Thank you for your commitment to the field of ophthalmology and making Duke one of the best of the best. At the recent American Academy of Ophthalmology (AAO) meeting, the largest annual gathering of ophthalmologists, Duke Eye Center faculty participated in over 50 presentations, posters and labs as part of the scientific sessions. In addition, we tried something new this year! Duke Eye Center had a booth in the exhibit hall where we held educational presentations and recorded content for future CME. There are so many great things going on at Duke Eye Center, having a booth allowed us to maximize our time with our ophthalmology colleagues. Be sure to check our website for recordings of the presentations from our booth that will be available December.

DUKE EYE CENTER ALUMNI DEREK DELMONTE, MD, JESSICA CHOW, MD AND EDWARD BUCKLEY, MD

We enjoyed seeing many of our alumni at the annual Duke Eye Center Alumni Reception held during AAO. It was great to stay in touch and connect with one another. Our faculty continue to led groundbreaking clinical trials and research to find treatments for eye disease and develop new ways to image the eye to improve diagnosis, management and surgery, just to name a few. We have so many great accomplishments to share. Thank you all for what you to do to make Duke Eye Center a world leader in ophthalmology. Sincerely, Edward G. Buckley, MD

SCOTT COUSINS, MD PRESENTS “FIVE TIPS TO KNOW BEFORE DOING CATARACT EXTRACTION ON YOUR RETINA PATIENTS” TO A GROUP OF AAO ATTENDEES.

Chairman, Department of Ophthalmology Vice Dean for Education, Duke School of Medicine Vice Chancellor Duke-NUS Affairs James P. and Heather Gills Professor of Ophthalmology Professor of Pediatrics

To receive notification of the CME availability, please register with Clinical Practice Today.

DUKE EYE CENTER LEADS EFFORT FOR HUMIRA INDICATION FOR UVEITIS Patients suffering from noninfectious uveitis, can get effective treatment from a corticosteroid alternative that has previously been approved for treatment of arthritis and Crohn’s disease, according to a study led by Glenn Jaffe, MD, professor or ophthalmology at Duke Eye Center. The Food & Drug Administration recently approved the additional use of adalimumab (sold as Humira) for patients with noninfectious uveitis. Corticosteroids have traditionally been the only FDA-approved treatment for these diseases, although some doctors had prescribed adalimumab off-label. In a study published in the New England Journal of Medicine (NEJM) September 8, 2016, Jaffe and colleagues found that in 217 adults with who had active, non-infectious intermediate or posterior uveitis, or panuveitis median time to treatment failure was 24 weeks in the adalimumab group and 13 weeks in the placebo group. Patients in the adalimumab group were also significantly less likely to experience treatment failure during the duration of the study (80 weeks) and they were at lower risk of treatment failure due to each of the four signs. Jaffe said the study’s results are significant not only because they indicate adalimumab delays treatment failure, but also because the investigation considered several signs as causes for treatment failure. “It is the active inflammation, caused by the body’s immune system reacting against itself, that can potential permanently decrease the patient’s vision and cause unwanted symptoms such as eye pain and floaters in the field of vision,” said Jaffe. “The hope is that by delaying or eliminating recurrences, the symptoms will be minimized or eliminated,” he continued. AbbVie, the pharmaceutical company that manufactures and markets adalimumab as Humira, sponsored the study. Dr. Jaffe served as a consultant for AbbVie, and other study authors also report financial relationships with the company. Further author disclosures are available in the study’s manuscript. Adalimumab in Patients with Active Noninfectious Uveitis. Glenn J. Jaffe, M.D., Andrew D. Dick, M.B., B.S., M.D., Antoine P. Brézin, M.D., Ph.D., et al. N Engl J Med 2016; 375:932-943September 8, 2016DOI: 10.1056/NEJMoa1509852 This is an excerpt from a press release issued by Duke Health Office of News and Communications, read the full release. Look for more about this and other uveitis treatment developments in the next Vision Magazine.

DUKE EYE CENTER RESEARCH LANDS THREE PAPERS IN SPECIAL ISSUE OF IOVS TO MARK 25TH ANNIVERSARY OF OCT We are honored to announce that researchers and ophthalmologists at Duke University publish three studies in Investigative Ophthalmology and Vision Sciences (IOVS) special issue to celebrate the 25th anniversary of optical coherence tomography (OCT). Duke has a rich history of leaders in research and implementation of OCT, since its beginning 25 years ago. These invited papers are just proof of our commitment develop new knowledge and skills to enhance patient care. »» Optical Coherence Tomography for Retinal Surgery: Perioperative Analysis to Real-Time Four-Dimensional Image-Guided Surgery Oscar M. Carrasco-Zevallos; Brenton Keller; Christian Viehland; Liangbo Shen; Michael I. Seider; Joseph A. Izatt; Cynthia A. Toth »» Impact of Microscope-Integrated OCT on Ophthalmology Resident Performance of Anterior Segment Surgical Maneuvers in Model Eyes Bozho Todorich; Christine Shieh; Philip J. DeSouza; Oscar M. Carrasco-Zevallos; David L. Cunefare; Sandra S. Stinnett; Joseph A. Izatt; Sina Farsiu; Privthi Mruthyunjaya; Anthony N. Kuo; Cynthia A. Toth Cynthia Toth, MD, professor of ophthalmology and biomedical engineering and Joe Izatt, PhD »» Posterior Eye Shape Measurement With Retinal OCT Compared to MRI Anthony N. Kuo; Pavan K. Verkicharla; Ryan P. McNabb; Carol Y. Cheung; Saima Hilal; Sina Farsiu; Christopher Chen; Tien Y. Wong; M. Kamran Ikram; Ching Y. Cheng; Terri L. Young; Seang M. Saw; Joseph A. Izatt

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SMALLEST, LIGHTEST HANDHELD PROBE FOR OPTICAL COHERENCE TOMOGRAPHY PROVIDES INSIGHT INTO CHILDREN’S RETINAS Engineers and physicians at Duke University have developed the smallest, lightest handheld device capable of capturing images of a retina using optical coherence tomography (OCT) technology. The new probe will allow researchers to gather detailed structural information about the eyes of infants and toddlers for the first time.

Diagnostic tools that examine and image the retina have been well-designed for adults, but are exceedingly difficult to use in infants and young children who can’t hold the required position or focus for long enough periods of time.

“Before now, it hasn’t been possible to measure the impact of injury or diseases on their photoreceptors—the cells in the eye in which light is first converted into nerve signals,” said Cynthia Toth, professor of ophthalmology and biomedical engineering at Duke University.

While handheld devices based on OCT and other technologies have been developed before, they are far from ideal. Some weigh several pounds, making holding them still over a child’s eye tiresome and difficult, and none provide a high enough resolution to see individual photoreceptors. CYNTHIA TOTH | PROFESSOR OF OPHTHALMOLOGY AND BIOMEDICAL ENGINEERING AT DUKE UNIVERSITY.

In a paper, published online on August 1, 2016, in Nature Photonics, researchers and ophthalmologists from Duke University present a new option. Their handheld device is about the size of a pack of cigarettes, weighs no more than a few slices of bread and is capable of gathering detailed information about the retina’s cellular structure. “This paper demonstrates the first time researchers have been able to directly measure the density of photoreceptors called cones in infants,” said Joseph Izatt, the Michael J. Fitzpatrick Professor of Engineering at Duke and a pioneer of OCT technology. “As such, it opens the door to new research that will be key in future diagnosis and care of hereditary diseases.” Without the ability to gather this sort of information, there is little to no data about how a child’s retina develops, as it matures by the age of 10. This limits our knowledge of how diseases affect a child’s vision early in life and makes diagnosis of these diseases more difficult. In the paper, a collaborative research group led by Izatt, Sina Farsiu, professor of ophthalmology and biomedical engineering at Duke, and Toth, detail the developments that made their new handheld device possible.

A LOOK AT A CLINICIAN USING THE NEW HANDHELD DEVICE. PREVIOUS TECHNOLOGIES WEIGHED SEVERAL POUNDS, WERE DIFFICULT TO HOLD IN PLACE FOR LONG PERIODS OF TIME AND DID NOT HAVE NEARLY THE RESOLUTION DEMONSTRATED BY THE NEW DEVICE.

With the prototype being used by clinicians at Duke Health, the amount of information being gained from children’s scans could eventually create a database to give a much better picture of how the retina matures with age. The group is already working on the next generation of the design after getting feedback from clinicians on what can be improved. This work was supported by the National Institutes of Health (R21-EY021321 and R01-EY023039) and the Hartwell Foundation. “In vivo cellular-resolution retinal imaging in infants and children using an ultracompact handheld probe.” Francesco LaRocca, Derek Nankivil, Theodore DuBose, Cynthia A. Toth, Sina Farsiu and Joseph A. Izatt. Nature Photonics, 2016. DOI: 10.1038/NPHOTON.2016.141. This is an excerpt from a press release issued by Pratt School of Engineering, read the full press release.

DUKE RETINA SURGEONS NAMED TOP IN THE NATION Duke Eye Center retina faculty recognized by Ocular Surgery News (OSN) Retina 150. The OSN Retina 150 is a select group of retina specialists the editors and publisher have identified as leading innovators in the field of medical and surgical retina. Among those recognized: Scott Cousins, MD Sharon Fekrat, MD Glenn Jaffe, MD Tamer Mahmoud, MD PhD and Cynthia Toth, MD. >> See the full list 3

UPCOMING EVENTS LEADERS IN OPHTHALMOLOGY SPEAK AT DUKE

Science Visiting Professor January 12, 2017 Albert Eye Research Institute Auditorium

David J. Calkins, PhD

»» Recent Guest Lectures “From Bench to Bedside and Beyond: Development of a Translational Medicine Program in Ocular Surface and Immunological Diseases” Victor Perez, MD

Professor of Ophthalmology Microbiology and Immunology Walter G. Ross Chair in Ophthalmic Research Director Ocular Surface Center Bascom Palmer Eye Institute University of Miami Miller School of Medicine “The Changing Practice of Ophthalmology in the Community” Reginald E. Ishman, MD

The Denis M. O’Day Professor of Ophthalmology and Visual Sciences, Vice-Chairman and Director for Research, The Vanderbilt Eye Institute Director, Vanderbilt Vision Research Center, Vanderbilt University Medical Center, Nashville, TN Joseph M. Research Bryan Lecture February 2, 2017 Albert Eye Research Institute Auditorium

Department of Ophthalmology University Eye Specialists PC Warsaw, New York

Alan B. Scott, MD

“Shotgun Lipidomics for Cell Biology and Molecular Medicine” Andrej Shevchenko, PhD

Max Planck Institute of Molecular Cell Biology and Genetics Dresden, Germany

»» Kourosh Alexander Dastgheib, MD Pioneer Award in Ocular Innovation Lecture Established by Duke Eye Center Alumni, Kourosh Alexander Dastgheib, the Dastgheib Pioneer Award in Ocular Innovation Lecturer is awarded annually to someone who has made a major contribution in the field of Ophthalmology focused on something that has proved useful in real life. The Social Entrepreneurship: From “El Dispensario to Fundacion Barraquer” Award Recipient and Presenter:

Suttler Health (Brown and Toland Physicians), San Francisco, CA “Injection Treatment of Strabismus” Controversies in Cataracts and Cornea Conference February 4, 2017 Trent Semans Center Duke University Advanced Pediatric Retina Symposium March 24-25, 2017 Duke Eye Center Advanced Vitreous Surgery Course (AVS) April 21-22, 2017 Durham Convention Center www.regonline.com/avs2017

Elena Barraquer Compte, MD

Centro De Oftalmologia Barraquer, Barcelona, Spain

»» Medical Alumni Grand Rounds Juan Batlle, MD

Chairman of Ophthalmology Elias Santana, Santo Domingo, Dominican Republic

For more information or to register: »» dukeeyecenter.duke.edu/cme »» 919-684-6593 »» walla023@mc.duke.edu

DUKE EYE CENTER IN NATIONAL GEOGRAPHIC

PHOTO: NATIONAL GEOGRAPHIC

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National Geographic’s September cover story “Why There’s New Hope About Ending Blindness” featured new advances in eye care that are helping people around the world. It included an image of Lejla Vajzovic, MD performing surgery on a patient who received an Argus II device.

NEW FACULTY Divakar Gupta, MD GLAUCOMA

Dr. Gupta joined Duke Eye Center in August 2016 as assistant professor of ophthalmology in the glaucoma division following the completion of his fellowship at Duke. Miguel Materin, MD OCULAR ONCOLOGY, RETINA

Ocular oncologist Miguel Materin, MD joined Duke Eye Center as Professor of Ophthalmology and Director of Ophthalmic Oncology in September 2016. He joins Duke from Yale University School of Medicine where he was an Associate Professor of Ophthalmology & Visual Science.

AAO AWARDS AND RECOGNITION We are proud of our fellows, faculty and staff who were honored during the meeting. »» Leon Herndon, MD received the 2016 American Academy of Ophthalmology Secretariat Award. (Note: Dr. Herndon is designing an international glaucoma fellows’ course to be held at AAO 2017). »» Michael P. Kelly, FOPS was elected the 21st president of the Ophthalmic Photographers Society »» Scott Walter, MD Duke Eye Center fourth year vitreoretinal fellow together with his teammate Yi Jiang, a first year vitreoretinal surgery fellow at University of Illinois-Chicago won the Retinal Jeopary Compettion supported by Genetech. Walter and Jiang were one of 19 teams that competed. They will be awarded a plaque and a copy of Lawrence Yannuzzi’s Retinal Atlas, when the new edition comes out this December.

Alessandro Iannaccone, MD RETINA

Dr. Iannaccone joined Duke Eye Center in September 2016. Prior to his appointment at Duke, Dr. Iannaccone was an associate professor of ophthalmology at the Hamilton Eye Institute in Memphis, TN, where he served as the founding Director of Retinal degenerations and Ophthalmic Genetics Services and the Lion’s Visual Function Diagnostic Lab. Nathan Cheung, OD PEDIATRICS

Dr. Cheung joined Duke Eye Center in October, 2016. He completed optometry school at the University of California, Berkeley and recently finished residency at Cincinnati Children’s Hospital Medical Center. Dr. Cheung focuses solely on pediatric eye care. Charlene James, OD COMPREHENSIVE

Dr. James joined Duke Eye Center in October, 2016. Before coming to Duke, she practiced at a MyEyeDr location in Raleigh, NC and prior to that, she was at Boling Vision Center, an OD/MD practice in Elkhart, IN. She will be working in the comprehensive clinic.

NEW LABORATORY SPACE FACILITATES HIGH IMPACT RESEARCH When the Hudson Building at Duke Eye Center opened in June 2015, faculty offices moved from Albert Eye Research Institute (AERI) to the fourth floor of the Hudson building. The move opened the 3rd floor of AERI to become the research space for which it had been originally planned. Scott Cousins, MD, Vice Chair for Research was given the opportunity to design a research space for the future that defines “bench to bedside.” The entire third floor of AERI has transformed into an open concept laboratory where the bench doesn’t belong to one scientist, but is a collaboration station. Moving scientist’s desks away from the bench encourages interaction, which is “how great things are developed, discovered and ultimately leads to patient care” said Cousins. The new area allows more scientists to work in smaller space and facilitates knowledge building, technology invention, development and commercialization. “At the end of the day, if we haven’t gotten a drug to market to help patients, we haven’t done our job,” said Cousins. With the evolution of the lab space, it facilitates getting sight-saving therapies to market. 5

NEWSLET TER Duke Eye Center Office of Marketing and Communications »» 2351 Erwin Rd. Durham, NC 27705 »» 919-668-1345 »» dukeeyecenter.duke.edu

SUPPORTING DUKE EYE CENTER Duke Eye Center’s physicians, faculty, and researchers are dedicated to curing eye diseases worldwide through excellence in research, teaching, and patient care. For 50 years, philanthropy has played an important part in enabling and sustaining this vital work. You may direct your gift in the way that is most meaningful to you, including supporting the work of your physician. To discuss your contribution or for more information about giving please contact: Jillian Ream Director of Development for Duke Eye Center 919.385.3197 jillian.ream@duke.edu You may also make a donation using our secure website: gifts.duke.edu/dukeeye

»» RESEARCH Duke Eye Center is recognized as one of the world’s leading ophthalmic research centers and is part of one of the nation’s top universities.

»» EDUCATION Duke Ophthalmology trains medical students, residents, and fellows to become the next generation of leading clinicians and scientists devoted to vision research and eye care.

»» CARE

Innovative research aligned with quality patient care makes possible state-of-the-art diagnosis and treatment. There are many ways to make a gift to Duke Eye Center.