EEF Sight + Sound: Fall 2019

News for Supporters and Friends

2019 FALL EDITION

Transformative Support - Sending Visual Images to the Brain

by Carrie Fogel

This past June, the University of Pittsburgh received the largest single donation in support of research in the Department of Ophthalmology from the Richard King Mellon Foundation. The Richard King Mellon Foundation is a preeminent philanthropic presence in southwestern Pennsylvania, investing in the competitive future and quality of life of the region and supporting work in areas such as the conservation of natural resources, economic development ventures, and academic research, among many others.

In This Issue Understanding the Importance of Hearing for a Healthy Brain

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Remembering Someone We All Admired and Loved Charles Snyder

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Second Annual Survivorship Symposium - Big Success

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Using Our Own Bacteria to Treat Eye Disorders

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Inaugural Wiegand Award Recipients – Bringing Treatments Closer to Patients 6 Furthering Innovation and Research:The Difference one Person Can Make

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Using Technology to Train Surgeons

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Muse Dinner 2019

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his gift will greatly accelerate the Department of Ophthalmology’s progress toward becoming a global enterprise in vision research and patient care and will enable us to recruit and retain the world’s best vision scientists and clinicians and allow our faculty to interact meaningfully with our partners at the Institut de la Vision in Paris and worldwide.

Department Chairman José-Alain Sahel, MD, has identified the area of cortical vision research as a priority because of its potential for large-scale technology transfer from Paris and the creation of complementary research endeavors to make significant and rapid progress in the field, with the goal of making Pittsburgh a leading international center of basic and translational vision research.

Investing in a cortical vision research program is important because of the scale of vision problems and blindness that results from issues with the eyes themselves. Retinal ganglion cell degeneration is one of the leading causes of blindness in the Western World. This condition underlies a variety of conditions that cause blindness, including ocular trauma, glaucoma, diabetic retinopathy, tumors, or optic neuropathies. Since retinal ganglion cells are the only conduits of visual information from the retina to the brain, ganglion cell degeneration leaves the brain devoid of any visual input and, therefore, inevitably leads to complete blindness. The Cortical Vision program that the Richard King Mellon Foundation is now supporting aims to restore visual perception by reintroducing visual information directly into the primary visual cortex of the brain, by using prosthetics (implants) and optogenetic stimulation.

In the context of this exciting new initiative, scientists in the Department of Ophthalmology are already partnering with some of the University of Pittsburgh’s most renowned faculty such as Andrew Schwartz, PhD, to seed and nurture closer collaborations with our Cortical Vision teams. Leading the project will be Ryad Benosman, PhD, recruited from Sorbonne Universite, working on neuronal circuitry, robotic vision, and advanced coding, along with Leah Byrne, PhD, an expert in vector design who was recruited from UC Berkeley in 2017 and Ethan Rossi, PhD, an expert in advanced imaging and adaptive optics, who was recruited from the University of Rochester in 2016 will also be involved. These scientists will collaborate with a strong team of clinical researchers led by José-Alain Sahel, MD, including Kunal Dansingani, MD; Joseph Martel, MD; Gabrielle Bonhomme, MD; and Tarek Shazly, MD. Continued on page 2

Understanding the Importance of Hearing for a Healthy Brain

by Craig Smith

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cientists in the Department of Otolaryngology at the University of Pittsburgh are studying the link between hearing loss and cognitive decline.

Recent epidemiological data indicates that hearing loss is considered the most heavily contributing modifiable risk factor to dementia and Alzheimer’s Disease in humans. Finding correlated, age-related changes may allow for targeted treatment to mediate the negative consequences of these changes. Thanos Tzounopoulos, PhD, is currently working with an animal model to investigate how a reduction in synaptic zinc, a neuromodulator in the brain, maybe a contributor for both impairments in hopes of finding a medicinal treatment.

“We hypothesize that age-dependent pathological reduction in cortical zinc signaling contributes to central hearing loss and cognitive impairment in Alzheimer’s Disease,” states Dr. Tzounopoulos, Endowed Professor and Vice-Chair of Research of Otolaryngology who directs the Pittsburgh Hearing Research Center.

“Our proposed studies will shed light on the specific signaling mechanisms that

mediate age-dependent impaired cortical sound processing and, potentially, impaired cognitive function in Alzheimer’s patients,” says Dr. Tzounopoulos, who has been collaborating with Dr. Amantha Thathiah, Assistant Professor of Neurobiology, an expert in Alzheimer’s Disease.

The World Health Organization (WHO) has identified dementia as a public health priority, with approximately 50 million people suffering from the disease worldwide, and that number is growing. According to a recent study, older patients experiencing moderate to severe hearing loss had a 29 to 57 percent higher risk of experiencing cognitive decline.

“Although we tend to talk about hearing, what we actually are talking about is communication,” says Catherine Palmer, PhD, an associate professor in the Department of Communication Sciences and Disorders and Otolaryngology.

“Communication is what connects people to other people and the ability to feel connected and to participate socially relates to depression and isolation and these both directly impact health.”

Dr. Palmer, who serves as the Director of Audiology and Hearing Aids at the University of Pittsburgh Medical Center, will work with Dr. Tzounopoulos on the clinical side as potential treatments and approaches are developed through the animal model that may help people. As Dr. Palmer explains, “One thing that is very different about our center is that Dr. Tzounopoulos involves the ‘human’ clinicians and researchers from the very beginning of his work to make sure that all the issues that are important to human care are thought about throughout his research.”

Dr. Palmer states “that research like this wouldn’t be possible without continued support from our donors.

The Eye & Ear Foundation funding is essential in this type of investigation. These are the funds that allow preliminary data to be collected so the investigators have a compelling, important story to tell in order to attract grant funding to continue this work and most importantly, move towards treatments that help people.“

Continued from page 1 By working with these teams, and our local, national, and international collaborators, we will accelerate the development and commercialization of innovative products that solve some of the vision sciences most difficult challenges and in doing so, seed further rounds of research and development.

Based on the experience of expert colleagues in Paris and the synergies between the University of Pittsburgh and Carnegie Mellon University, Dr. Sahel and the team working on cortical vision anticipate that several spin-off companies will be created from

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the science and technology developments.

With this transformational support from the Richard King Mellon Foundation, our Department can attract new talent to the region to join this effort. The results of this investment in developing quality research in understanding cortical vision will greatly improve the patient outcomes and will also create an innovation hub for the development of new technologies, new treatments, and new job-creating companies that will have a measurable impact on the regional economy.

According to Dr. Sahel, “understanding how

the brain is processing visual information is one of the key steps toward restoring some sight to patients who suffer from currently untreatable blinding conditions that result from damage to the visual pathway, especially the connections between the eye and the brain. New technologies including braincomputer interfaces, optogenetics, and signal processing will emerge that have the potential to change lives. The quality of the first recruit and of the numerous outstanding applicants is predicting that our goals are within reach.”

Remembering Someone We All Admired and Loved - Charles Snyder

by Lawton Snyder

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n August 18, 2019, the Eye & Ear Foundation lost a wonderful friend and supporter with the passing of Charles “Chuck” Snyder. In 2010, I was introduced to Chuck and his wife, Louella, by Andrew Eller, MD, Professor in the Department of Ophthalmology at the University of Pittsburgh. I was really touched

by Chuck’s passion to make an impact on people suffering from vision loss. Louella’s vision loss had significantly impacted their lives and Chuck’s love of his family was driving his passion to make a difference. The Snyders, along with their children Richard, Sally, and Dennis became supporters, and later donated funds to create the Charles and Louella Snyder Laboratory to support retinal regeneration research.

As the Chairman of the Snyder Associated Companies, Chuck knew that sustained investment in an endeavor reaps the greatest overall benefits. During his annual visits to the Eye and Ear Institute, usually accompanied by his children and grandchildren, to meet with researchers and clinicians, including Dr. Jeffrey Gross, Director of the Charles & Louella Snyder Laboratory for Retinal Regeneration, Chuck did a deep dive into the details of current and future research to broadly assess the opportunities to support research to help with the worst ocular conditions.

“I will really miss Chuck and his visits to the Snyder lab. We always had a nice discussion about the research we were doing; Chuck would ask very direct questions about where we were and where we were headed and he offered encouragement to keep moving things forward. Beyond the science though, Chuck also always asked about, and how we were doing in Pittsburgh. I enjoyed these conversations and will miss them,” states Dr. Gross.

Chuck was very excited that the Snyder Lab would have a new home in the UPMC Vision and Rehabilitation at UPMC Mercy. Following

Richard, Charles, and Sally Snyder visiting the Charles & Louella Snyder Laboratory for Retinal Regeneration with Jeffrey Gross, PhD. their visit this spring, the Snyder family made a commitment to continue supporting the Snyder Lab with equipment which will be needed now and in the new facility. As Dr. José-Alain Sahel, Chairman of the Department of Ophthalmology at the University of Pittsburgh explains, “Chuck and Louella were among the first supporters I met with when I joined the Department of Ophthalmology.

I met them first at their home in Florida and again upon his spring visit together with his son and daughter. They impressed me with their openness, genuine interest in medical progress and constant will to support all efforts that could help fighting blindness. It also became a personal relationship as Chuck was a direct, warm, sincere and generous human being. We miss him a lot.”

What I love about working in this business is meeting the people who make it their purpose to give back to others. When you drive around the streets in Kittanning it is clear to see that Chuck Snyder was one of those people.

“I will really miss Chuck and his visits to the Snyder lab. We always had a nice discussion about the research we were doing; Chuck would ask very direct questions about where we were and where we were headed and he offered encouragement to keep moving things forward. Beyond the science though, Chuck also always asked about, and how we were doing in Pittsburgh. I enjoyed these conversations and will miss them,” - Dr. Jeffrey Gross

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Second Annual Survivorship Symposium Big Success

by Craig Smith

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he Department of Otolaryngology held it’s annual Head and Neck Cancer Survivorship Symposium on August 5-6th at UPMC Shadyside. The symposium included keynote speakers from the University of Pittsburgh School of Medicine, the University of Texas MD Anderson Cancer Center, Georgetown University Medical Center, Medical University of South Carolina, and University of Wisconsin School of Medicine and Public Health, and covered a variety of topics such as challenges of survivorship, self-advocacy in cancer care, contemporary therapy, rehabilitative strategies, strategies for oral health management, and dysphagia.

The Head and Neck Cancer Survivorship Clinic at the University of Pittsburgh Medical Center is a multidisciplinary service provided by the Department of Otolaryngology that allows cancer patients to see several specialists, such as a nurse, a swallowing therapist, a primary care physician, an audiologist, a dentist, and a surgeon, all during one clinic visit under one copay. This model provides consistent, comprehensive follow-up care for the patients and allows doctors to better understand and treat patient needs.

“Over 90% of our cancer survivors report having to deal with a side effect in the past seven days, and over 50% report dealing with three or more,” states Jonas Johnson, MD, FACS, Professor and Chairman of the Department of Otolaryngology. “This “cost of care” has been largely overlooked. Our efforts have brought awareness to these problems and afford opportunities to better understand avoidance, treatment, and prevention.”

During the symposium, a panel discussion was held featuring Marty Griffin, a former local reporter, and head and neck cancer survivor, his wife Kristine Sorensen, and Marci Nilsen, PhD, Assistant Professor of Otolaryngology and Co-Director of the Head and Neck Cancer Survivorship Clinic.

“In my life I’ve never been around folks like this, from the doctors who perform the surgery, to the nurses at Hillman [Cancer Center], to the people at the survivorship clinic, and I’ve never seen something like that,” says Griffin, who was diagnosed with head and neck cancer in 2018 after discovering a lump on his throat.

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Survivorship

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Cancer at

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University of Pittsburgh Medical Center is a multidisciplinary service provided by the Department of Otolaryngology that allows cancer patients to see several specialists, such as a nurse, a swallowing therapist, a primary care physician, an audiologist, a dentist, and a surgeon, all during one clinic visit under one copay.

Wanting to use his platform as a public figure for good, Griffin chronicled his cancer journey online and became an unofficial spokesperson, advocating for people to get vaccinated against the human papillomavirus (HPV), which precipitated his own cancer.

“He really wanted to be public about it and in retrospect, it was the best thing we ever did,” says Sorenson, who is also a local news reporter for KDKA. “It feels so good to be able to help people and give all of this a bigger purpose.”

Serving a bigger purpose is at the center of the Survivorship clinic, as researchers and clinicians work together to advance care for patients who often face uphill battles even after surviving their initial cancer diagnosis and treatment.

Marty Griffin, Kristine Sorrenson, and Marci Nilsen, PhD during the Head and Neck Cancer Survivorship Symposium panel discussion.

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“We need funding to continue to both aid in optimizing patient care, but also evaluating new approaches to care, which we mainly do through research,” says Nilsen, who helped plan and moderated the symposium. “Once we identify the issues, we can test ways to mitigate these changes.”

Using Our Own Bacteria to Treat Eye Disorders

by Craig Smith

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hile some people associate the word ‘bacteria’ with disease or infection, Anthony St. Leger, PhD is seeing it in a different light: as a means to better eye treatment.

Dr. St. Leger and his team have been investigating how the eye microbiome, a collection of microbes such as fungi, bacteria, and viruses, work together with the immune system to keep your eye healthy.

“What we found is that bacteria live on your eye. And those bacteria actually stimulate an immune response that protects the eye from infection,” stated Dr. St. Leger.

“We also know that bacteria stay on the eye indefinitely, so we are harnessing that characteristic and hoping we can genetically modify microbes to act as a long term drug delivery vehicles.”

Dr. St. Leger, who is classically trained as an immunologist, hopes that if this novel drug delivery system is developed, it will give

Lab photo, from the left: Dana Previte, Kate Carroll, Heather Buresch, Hongmin Yun, MD PhD, Ben Treat, and Anthony St. Leger, PhD (not pictured Yannis Riggas). doctors an alternative treatment plan other than simply prescribing antibiotics, which he says may disrupt bacteria that are keeping the eye healthy.

“I think antibiotics are definitely important medical treatments and save lives, but I also think in some cases like pink eye, for instance, which is a self-limiting infection and likely caused by a virus, antibiotics are not as helpful.”

A picture of the bacteria found underneath the mouse eyelid. It was possible to image it using a fluorescent microscope and a method called fluorescent in situ hybridization (FISH). Dr. St. Leger’s team used a piece of DNA that was complementary to the DNA found in our bacteria of interest (Corynebacterium mastitidis). There was a fluorescent probe attached to our piece of DNA, so when it bound to the bacteria, it would light up when we imaged it using a fluorescent microscope.

It is widely known that excessive or inappropriate use of antibiotics can be detrimental to the microbiome, so the goal is to develop a more ‘organic’ treatment using the body’s own bacteria to treat disorders such as Dry Eye Disease, which affects roughly 4 million people in the United States annually. Dr. St. Leger is confident that with additional support needed to propel the study forward that a viable treatment could be available in the coming years.

For Dr. St. Leger, who now heads the research lab previously led by Dr. Robert Hendricks, being recruited back to the University of Pittsburgh in late 2017 brought his story full circle, having studied under. Dr. Hendricks as a student.

“I was originally drawn to Bob’s [Hendricks] lab because he was such a great immunologist. And while I was working in his lab I became more interested in eye research, which spurred my interest in going to the National Eye Institute to study ocular immunology for my post-doctoral training,” says Dr. St. Leger. “So it was really amazing to take over Bob’s lab when I was recruited back to Pittsburgh.”

While still at the NIH, Dr. St. Leger began receiving correspondence from Dr. Hendricks talking about recent changes and the exciting future of the department under Chairman José-Alain Sahel, MD, who had recently been recruited from Paris. It was this excitement that partially convinced Dr. St. Leger to return to Pittsburgh, and he hasn’t been disappointed.

“I think the transition with Dr. Sahel has been really exciting because of the type of faculty he has recruited and the exciting projects everyone is working on. I think these are things that could really shift the story in ocular research”

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Inaugural Wiegand Award Recipients – Bringing Treatments Closer to Patients

by Craig Smith

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hanks to a generous gift from Bruce and Barbara Wiegand, the Departments of Ophthalmology and Otolaryngology at the University of Pittsburgh School of Medicine have a new source of funding. The Bruce and Barbara Wiegand Entrepreneurial Research Award was established to provide seed funding for projects in the precommercialization stage of development with the added opportunity that any future revenue that comes from the technology would provide returns to the Eye & Ear Foundation. On September 23rd members of the Foundation held an appreciation dinner for the Wiegands, providing the couple with the opportunity to meet the award recipients and hear first-hand about the research their funds support.

One of the inaugural winners of the Wiegand Award is a project led by Robert Shanks, PhD, Jes Klarlund, PhD, Deepinder Dhaliwal, MD, Kira Lothrop, MS and Eric Romanowski, MS titled, “Extending the Uses of Biological Drugs to Eye Diseases.”

The study focuses on using biologics to find more efficient treatments for the eye compared to traditional eye drops, the majority of which are washed away during the blinking process. “Biologics have been revolutionary in treating problems throughout the body, but they currently cannot be used on the surface of the eye because of the tears and the act of blinking,” says Dr. Shanks, lead researcher on the project.

“Dr. Klarlund and I have developed an approach to deliver drugs successfully to the surface of the eye using what we call ‘anchors’.” These ‘anchors’ are small peptides or molecules that we can attach biologics to and allow the medicine to remain in contact with the eye for hours or even days rather than a few seconds. While

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currently focused on using this anchor system to develop new treatments for the eye, Dr. Shanks believes this system could eventually be used to treat other parts of the body as well and acknowledges that the Wiegand award will help propel them forward towards a viable treatment. “We are incredibly grateful to the Wiegand family for supporting us. It’s going to be a huge benefit for us and will allow us to perform the efficacy studies essential to getting this treatment to patients.” explains Dr. Shanks.

The second winner is an ongoing research project to develop a drug treatment for tinnitus, led by Thanos Tzounopoulos, PhD, and Peter Wipf, PhD, a Distinguished Professor in the Department of Chemistry at the University of Pittsburgh. “We are very excited about the potential to help individuals who suffer from tinnitus,” stated Dr. Tzounopoulos, Endowed Professor and Vice-Chair of Research of Otolaryngology who directs the Pittsburgh Hearing Research Center.

Although tinnitus affects between 15 to 20 percent of the population – and a much higher percentage among military personnel – there is currently no FDA-approved drug for treatment, and current treatment of the disability is limited to symptom management. Together, Dr. Tzounopoulos and Dr. Wipf have developed a novel, highly potent and selective potassium channel activator, which cures tinnitus in mice, that they see as a first in class clinical drug candidate for the prevention and treatment of tinnitus in humans. Along with previous and ongoing funds from the Department of Defense, the funding from this award will help researchers to move the project from preclinical development to Phase 1 clinical trials. “We are grateful to the Wiegands. They have created a novel path to facilitate the transition of basic research findings from the lab to the clinic,” stated Dr. Tzounopoulos.

Barbara and Bruce Wiegand (center) met the inaugural Wiegand Award recipients at a celebratory dinner, along with Department Chairmen José-Alain Sahel(far left) and Jonas Johnson (far right) and from left Ajay Kumar, PhD, Jes Klarlund, PhD, Thanos Tzounopoulos, PhD, and Robert Shanks, PhD

Furthering Innovation and Research: The Difference one Person Can Make

by Heather Chronis Danek

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hen new residents of Pittsburgh discuss their favorite things that they have discovered in the Steel City, it usually includes the Carnegie Museums of Pittsburgh, the Steelers and Heinz Field, Lawrenceville’s thriving restaurant scene, or the Cathedral of Learning. For Travis Abbott whose career at Google brought him to the city, his favorite discovery was Stella Lee, MD, of the Department of Otolaryngology at the University of Pittsburgh – his Rhinologist.

“I was new to Pittsburgh and really struggling with the change in the environmental factors from moving from the Midwest. It was affecting my day to day work at Google and I was not really enjoying Pittsburgh at all,” says Mr. Abbott. Referred to Dr. Lee for an

Stella Lee, MD evaluation, Mr. Abbott soon learned that he would need surgery to treat his chronic rhinosinusitis (CRS) with polyps and be treated with further advanced medical therapy. “While this was not an optimal way to begin life in a new city, I was thankful to have Dr. Lee in my corner. From my office visits to my surgery, she was my champion every step of the way,” he stated.

Mr. Abbott honored Dr. Lee’s dedication to her rhinology research with a donation to the Sinonasal Research Fund to help her and her team further their understanding of CRS pathogenesis via endotyping studies, develop novel therapeutic drug delivery systems as well as create an olfactometer to objectively measure smell. As an employee of Google,

he was able to apply for a corporate donation match which helped his gift to the Eye & Ear Foundation go even further to help Dr. Lee’s research.

“One of the most interesting and inspiring aspects of my work is the ability to develop innovative ways to tackle difficult problems.

Generous and engaged patients like Travis Abbott are integral to the progress we can make in understanding complex diseases like CRS and develop more effective therapeutics. I am incredibly grateful for his support and Google’s recognition of the importance of philanthropy to further research,” states Dr. Lee.

Using Technology to Train Surgeons

by Craig Smith

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phthalmology residents at the University of Pittsburgh have an exciting new hi-tech teaching tool!

Thanks to contributions from the Joseph Horne Trust and generous donors to the residents’ education fund, the Department of Ophthalmology was recently able to purchase a VR Magic Eyesi® Surgical Simulator, a high-end virtual reality simulator for intraocular surgery training. This $250,000 state-of-the-art training tool will allow the next generation of ocular surgeons enhanced training opportunities outside those found in a traditional surgical training laboratory.

“The traditional model of training for surgery was to bring residents to the operating room, have them watch faculty, and then bit by bit start doing first steps on live patients. This was supplemented over the years by a surgical training lab,” explains Evan “Jake” Waxman, MD, PhD, Associate Professor of Ophthalmology and the Director of the UPMC Eye Center Mercy.

“Even though we have quite a good surgical training lab here at the University of Pittsburgh,

there is an activation barrier to only training in the lab, whether it’s the cost of materials, or the time setting up and cleaning the lab, etc. The VR Magic is going to decrease the activation barrier for our residents. It is something they will be able to do in their spare time,” states Dr. Waxman.

The surgical simulator, aside from its ease of use, also offers residents and medical students the opportunity to train in an interesting, interactive way. According to Dr. Waxman, the simulator uses, ‘video-game-like’ programs that will allow users to practice certain hands training and muscle memory skills that are beneficial in surgical training. This additional training will better prepare residents as they move from the training laboratory to the operating room. A recent study in the U.K. showed that complication rates in cataract surgery being done by first and second-year residents decreased by 38% after training with the Eyesi Surgical Simulator.

Dr. Waxman and Dr. Ian Conner, Assistant Professor of Ophthalmology and Chief of the Glaucoma Service, both agree that the

simulator will serve as a tool for additional training, and not a replacement of the traditional surgical training laboratory, where residents perform vital, hands-on training using real and synthetic tissue matter.

“I think it’s likely that as we look at the exercises built into the VR Magic, we are going to go back to our surgical training laboratory and apply some of the principals learned in the surgical simulator,” adds Dr. Waxman, while stressing how important donations are to expanding the training capabilities within the Department. “We couldn’t get equipment like this without the generosity of the donors to the Eye & Ear Foundation.”

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The Eye & Ear Foundation of Pittsburgh is a nonprofit 501 (C)(3) organization. Our mission is to support the research and academic efforts of the Departments of Ophthalmology and Otolaryngology at the University of Pittsburgh. Donations to support our research initiatives can be made online at eyeandear.org or by returning the enclosed envelope. For more information on the Foundation, our research, or the articles in this newsletter, please contact Katherine Troy, Director of Operations, at katherine@eyeandear.org or 412-864-1300.

Congratulations to the 2019 Albert C. Muse Prize recipient for Excellence in Research and Advancement of Care in Otolaryngology

Congratulations to the 2019 Albert C. Muse Award recipient for Excellence in Innovation and Service in Otolaryngology

muse Dinner 2019

Lloyd B. Minor, MD

Eugene N. Myers, MD, FACS, FRCS Edin (Hon)

Carl and Elizabeth Naumann Dean of the Stanford University School of Medicine

Distinguished Professor and Emeritus Chair

Professor of Otolaryngology—Head & Neck Surgery

University of Pittsburgh School of Medicine

Professor of Bioengineering and of Neurobiology

Ceremony Monday, November 4, 2019

For more details, please contact the Eye & Ear Foundation at 412-864-1300.