A BI-ANNUAL PUBLICATION OF THE GEORGIA REGENTS UNIVERSITY JAMES & JEAN CULVER VISION DISCOVERY INSTITUTE FALL 2013
Culver VDI Co-Directors Julian Nussbaum, MD Sylvia Smith, PhD
Comings and Goings, and Coming Back Again! These past months have been busy for the James and Jean Culver Vision Discovery Institute. Among our newest members, Dr. Mitchell Watsky joined Georgia Regents University as the Dean of the Graduate School, bringing his vision science laboratory and corneal research work to the Culver Vision Discovery Institute. We are thrilled Watsky has joined us while becoming an active member of the Culver VDI. Around the globe and back again, Dr. Lane Ulrich spent several weeks on a mission trip to Africa. He cared for patients suffering from a variety of potentially blinding disorders and brought much-needed medical and surgical therapy to an underserved population. Coming back to us again was Dr. David B. Birnbaum of Nashville, Tenn., whose generous gift will support student and resident travel, research, educational seminars, and more. Birnbaum is a 1990 alumnus of our ophthalmology residency program. We hope you enjoy this issue of the Culver VDI Vision!
THIS ISSUE 3. 4.
From a Patient’s Perspective and New Grants
Culver VDI co-directors
Julian Nussbaum, M.D.
On the cover: Dr. Mitchell Watsky
Development The Heart of the Giver
An almost 30-year career in ophthalmology has inspired an alumnus to come full circle. Dr. David B. Birnbaum, who graduated from the Medical College of Georgia in 1986, recently donated $50,000 to the Department of Ophthalmology, prompting the Eye Care Center resident room to be named in his honor. “I had a great time in Augusta and it was the perfect time in my life,” says Birnbaum. “I went to medical school, internship, and residency at the Medical College of Georgia.” He cites faculty including Drs. John Davis, Keith Green, Robert Harbour, David Hull, Malcolm Luxenburg, and Robert Summerer as mentors, noting, “They were all excellent teachers as well as clinical faculty.” He was inspired by his fellow residents, as well. “All of the residents were very good friends,” says Birnbaum. “The residents were helpful to everyone, wanting for each person to do well.” One of his most memorable rotations was in the Charlie Norwood Department of Veterans Affairs Medical Center, observing, “They allowed the residents to have more responsibility in patient care.” After completing his training, he served in the U.S. Air Force, completing a three-and-a-half-year commitment, then staying on another 18 months, earning a Meritorious Service Medal.
“I ended up staying five years total because I liked it so much.” Next, he embarked on a 16-year career with the Premier Medical Group in Clarksville, Tenn. “I did over 5,000 cataract surgeries and had a lot of happy patients,” says Birnbaum. “I did a full range of procedures, including laser surgery for glaucoma and diabetic retinopathy, eyelid plastic surgery, strabismus surgery, and minor procedures.” He considers his gift to MCG “a way to show my appreciation, to do something that made me feel good and to thank those at MCG. “One of the residents told me after a recognition meeting of my donation that he was happy I gave,” says Birnbaum. “I told him I was happier than he was.”
This plaque above will reside in the resident room at Georgia Regents Medical Center.
Dr. Lane Ulrich, an Associate Professor in the Culver Vision Discovery Institute, recently volunteered at The Lighthouse for Christ Eye Centre in Mombasa, Kenya, treating patients and performing surgery. He was accompanied by his family, including son Colin, 14, and daughter Lydia, 16. Ulrichâ€™s wife Debra was born and raised in the region.
The Ophthalmology Residency Program welcomed three new residents: Drs. David Gay, Mark Stephens, and Michael Westafer. A costume party was held in their honor at the home of Drs. Julian Nussbaum and Stephanie Goei.
Resident Tournament Bowl The second annual resident-faculty bowling tournament was held at Brunswick Lanes where faculty and residents dueled for a trophy. Dr. Dilip Thomas bowled the highest score. Dr. David Gay, scored the highest for the residents.
The Eye of the Beholder
Have you ever fumbled around for your keys in low light? Perhaps you found your cell phone and pens, but not your keys? How is it that the brain determines what we feel is what we see? These senses of sight and touch and how the brain interprets their meanings are being researched at Georgia Regents University to help those with visual impairments. Dr. Jay Hegdé, Associate Professor in the Department of Ophthalmology Culver Vision Discovery Institute and Brain and Behavior Discovery Institute, has received a National Institutes of Health grant to glean more information. “This grant explores the way the brain interprets what we see and what we touch, multisensory perception,“ says Hegdé. “For instance, Braille is a case where people with visual impairments use their hands to either augment or compensate for what their eyes can’t see. Essentially, they are using their fingertips as seeing eyes.” Hegdé, a brain researcher who sees the brain as the last true frontier, explains that the brain is hungry for any information to make sense of “what is out there.” He hopes to teach those with visual impairments to translate what they feel with their fingertips into data other people gather visually. “The brain essentially avails itself of whatever it can sense and combines it, even in a healthy brain,” says Hegdé. “The brain doesn’t have compartments. It makes use of whatever source of information that it can get a hold of in order to do to carry out the basic functions of life. For instance, the brain may be faced with the
problem of deciding whether to combine the touch information from your left or right hand with what the eyes are seeing at a given moment. It uses synchronicity to make determinations – it looks at whether what is in the left hand or the right hand is synced with what the eyes see.” He is exploring the parameters of both healthy patients and patients with various visual deficits, hoping to harness the innate abilities of the brain to compensate for vision impairment.
His inspiration came in the smallest of packages. “Something happened when one of our goddaughters was diagnosed with retinoblastoma (cancer of the eye),” says Hegdé. “For a while, the only options for her seemed to be turning her blind to save her life or risking her life to save her sight.” Tough choices came and went. But eventually, surgeons were able to remove the diseased part of her eye, and it turned out she had a very mild form of the disease. Her vision is impaired, necessitating rehabilitation, but her future is bright. “Because of what she means to us, and to me personally, I feel like really nothing I do makes any sense except in light of what it means for her, or patients like her, especially children like her,” says Hegdé. “If all I do is help my little goddaughter Susie and children like her, I will take it, I will take it any day of the week, and twice on Sunday.”
Pro g ram Update Optimizing Participation in Daily Living Activities
Imagine being unable to determine if a stove is on or off ... unable to read a computer screen ... unable to separate lights from darks before washing clothes. Dr. Mariana D’Amico, Associate Professor of Occupational Therapy and Director of the GRU Low Vision Rehabilitation Center, has devoted her career to addressing these and other potential challenges for those with low vision. The center, which opened in February 2012, helps those with low vision sustain their daily living activities. The patients—approximately 70 and counting—are referred from the GRU Ophthalmology Clinic to learn techniques to help them with activities including cooking, reading, and self-care. The clinic’s adaptive equipment enables them to practice while supervised and instructed by D’Amico. “Basically, we look at adaptive equipment and techniques that the client and I determine would be beneficial based on their evaluation,” says D’Amico. “One example would be using high-contrast markings or textured dots to identify ‘medium’ and ‘off’ on stove knobs.” She also teaches patients how to optimize lighting conditions during daily activities. D’Amico involves family and caregivers as well, discussing things such as home modifications.
“My goal is to educate the patients and their family or caregivers so they can sustain and maintain a quality of life in their homes and communities,” says D’Amico. D’Amico operates the clinic single-handedly but draws on a wide network of support, including ophthalmologists, related specialists, and campus resources such as a driving simulation lab.
To contact the GRU Low Vision Rehab Center, call 706-721-3641.
Dean Sets Sights on Corneal Advances Fast Facts Watsky earned his doctorate in physiology at the Medical College of Wisconsin and completed a postdoctoral fellowship in physiology and biophysics at the Mayo Foundation in Rochester, Minn. He received the Silver Fellow Award from the Association for Research in Vision and Ophthalmology in 2010. Dr. Mitchell Watsky joined Georgia Regents University June 1 as Dean of The Graduate School and Professor of Cellular Biology and Anatomy.
Transformational Research Currently researching wound-healing in corneas, Watsky began something transformational nearly 20 years ago—helping create an artificial cornea. “It started out as an idea between my primary collaborator on the project, Dr. May Griffith, who is now at the Swedish institute Linköping University,” says Watsky. The research, originally funded by Procter & Gamble Co., was intended to find non-animal alternatives for toxicology testing. Watsky and Griffith designed a test-tube cornea with tissue entirely derived of human cells. “The idea was to be able to use it for experimental purposes,” says Watsky. “The test-tube cells were used to study [things such as] wound-healing and toxicology studies.”
The test-tube cornea is now in clinical trials to be used on humans as an alternative to donor eye tissue. “If you need a cornea transplant in the United States, you get it from a human donor,” says
Watsky. “In the United States, there isn’t really a problem with tissue availability, but worldwide, it is a very big problem.”
Research at Georgia Regents University
Watsky’s current research, funded by the National Institutes of Health, builds on his finding that the cornea can make vitamin D. “The main source of vitamin D through the body is via sunlight exposure to the skin, and the only two parts of the body that are exposed to sunlight are your skin and your eyes,” he says. “It’s been that a number of different tissues, tissues that everybody originally thought not to be involved in vitamin D metabolism, can make vitamin D, or at least activate it. So, we wanted to know if that was true in the eye. We’ve now determined that the cornea can indeed make vitamin D, and now we are examining the physiological significance.” Watsky also studies how bioactive lipids affect corneal wound-healing and corneal fibrosis. These studies have expanded to look at other fibrotic disorders of the body, including systemic fibrosis, or scleroderma. Watsky has discovered that these lipids interact with ion channels of certain cell types to promote fibrosis. His goal is to reverse this process.
From the Patient’s Perspective
NIH-R01: “Mechanism of Retinal Microvascular Dysfunction During Diabetic Retinopathy.”
Dr. Mohamed Al-Shabrawey
NIH-R21 (High Risk, High Impact): “Role of Temporal Congruity in VisualHaptic Cross-Modal Object Recognition and Learning.”
Dr. Jay Hegdé Do You See IWhat Do You See What See?I See? Do you see things that you know are not real? I see many things I know are not real, namely ground covered with snow, rooms covered in chicken wire, and trees with rhinestone flowers and stars! I was delighted to read in a book, “The Complete Guide to Saving and Maximizing Your Sight” by Lylas G. Mogk, MD, that my illusions have a name — Charles Bonnett Syndrome and is common in people with low vision.
NIH-R01: “Genetic and Chemical Screens for Factors Regulating Retinal Regeneration.”
Dr. Jeff Mumm
NIH-R01: “Cellular Mechanisms of Retinopathy: Role of Arginase.”
Drs. William and Ruth Caldwell
-Marjorie Wood, 2001 Culver VDI Donor Visually Impared Person Milledgeville, Ga.
Meet our new members
Amy Estes, MD Department of Ophthalmology
Julia Brittain, PhD Department of Cellular Biology & Anatomy
Mitchell Watsky, PhD, FARVO Cellular Biology & Anatomy The Graduate School
Nilkantha (Neel) Sen, PhD Institute of Molecular Medicine & Genetics
Peter Rosen, MD Department of Ophthalmology
Tadd Patton, PhD Department of Psychology
Y. Albert Pan, PhD
Institute of Molecular Medicine & Genetics
Wendy Bollag, PhD Physiology
Sylvia Smith, PhD Celluar Biology and Anatomy, Ophthalmology
Kathryn Bollinger, MD Ophthalmology
Julian Nussbaum, MD Ophthalmology
Anthony Ahmed PhD Psychiatry and Health Behavior
Abiodun Akinwuntan, PhD, MPH, DRS Allied Health Sciences Mohamed Al-Shabrawey, PhD Oral Biology
Ruth Caldwell, PhD Cellular Biology and Anatomy
William Caldwell, PhD Pharmacology and Toxicology
Raymond Chong, PhD Physical Therapy Mariana Dâ€™Amico, EdD, OTR/L, BCP Allied Health Sciences
Bill Andrews, MA, CMI, FAMI Medical Illustration
Hannes Devos, PhD Physical Therapy Allied Health
Sally Atherton, PhD ARVO
Azza El-Remessy, PhD Pharmacology and Toxicology, Experimental Therapeutics, Ophthalmology
Babak Baban, PhD Oral Biology Manuela Bartoli, PhD Ophthalmology
David Bogorad, MD Ophthalmology
Diego Espinosa-Heidmann, MD Ophthalmology Amy Estes, MD Ophthalmology
Vadivel Ganapathy, PhD Biochemistry and Molecular Biology
Puttur Prasad, PhD Biochemistry and Molecular Biology
Â´ PhD Jay Hedge, Ophthalmology
John Riffle, MD Ophthalmology
Stephanie Goei, MD Ophthalmology
Michael Jensen, MS, CMI Medical Illustration
Daniel Killingsworth, MD Ophthalmology
Gregory Liou, PhD Ophthalmology
Brendan Marshall, PhD Cellular Biology and Anatomy Pamela Martin, PhD Biochemistry and Molecular Biology Jeffrey Mumm, PhD Cellular Biology and Anatomy
Alan Saul, PhD Ophthalmology Lakshman Segar, PhD Experimental Therapeutics Shruti Sharma, PhD Center for Biotechnology and Genomic Medicine Amany Tawfik, MD Cellular Biology and Anatomy Dilip Thomas, MD Ophthalmology Lane Ulrich, MD Ophthalmology Mitchell Watsky, PhD Cellular Biology and Anatomy
Priya Narayanan, PhD Cellular Biology and Anatomy
Zhiyong Yang, PhD Ophthalmology
Tadd Patton, PhD Psychology
Ming Zhang, PhD Cellular Biology and Anatomy
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DISTINGUISHED SEMINAR SERIES
Jan. 23, 2014 Room BC-140
Guest Lecturer, Henry F. Edelhauser, PhD. Feb. 27-28, 2014 St. Paulâ€™s Episcopal Church
Culver VDI Retreat,
Guest lecturrs, Jay Neitz, PhD, and Maureen Neitz, PhD
March 18, 2014 Room CB-1801
Guest Lecturer, Timothy Kern, PhD June 17, 2014 Room-CB 1801
Using Optical Coherence Tomography Imaging to Change Ophthalmic Clinical Care and Surgery, Cynthia Toth, MD