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A Semiannual Publication of the Georgia Regents University James & Jean Culver Vision Discovery Institute

SUMMER 2015


SUMMER 2015 VISION

DIRECTORS’ NOTE

How many of us can look back at our lives and say we wouldn’t change a thing? And how many of us would live it all exactly the same way if given the chance?

NO REGRETS

On a recent visit with Dr. James and Mrs. Jean Culver, Jean said something that struck me as truly amazing. She said she and Jim had lived a charmed life and she would love to do it all again the same way (see page 6). I then thought of all the times I had heard their stories of struggling through difficult financial times or multiple moves around the world prompted by career changes or military deployments, and at first, I was confused. Why would she want to live through those tough times again without changing a thing? Looking across the room at Jim and Jean sitting together, I realized why these two “realities” could indeed coexist. The secret was in their nearly lifelong partnership or, if you will, their collaboration through good times and bad. That was the magic behind their charmed life. Likewise, the collaboration and close relationships of our clinicians and scientists forged through the James and Jean Culver Institute have helped to create our own magic. Every day, we collaborate together and with you as our supporters to cure eye disease though patient care, education, and groundbreaking research. Indeed, the Culver VDI is a fitting tribute to Jim and Jean Culver and the stories of their life, some of which we share with you in this publication. We hope you enjoy the latest issue of this newsletter, and we wish you a beautiful summer season. Gratefully, Drs. Sylvia Smith and Julian Nussbaum Co-Directors, Culver VDI

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IN THIS ISSUE SUMMER 2015

GIVING __________________ 4

Vision is published biannually by the Medical College of Georgia Department of Ophthalmology and the Georgia Regents University Division of Communications and Marketing. Please direct comments or questions to Editor Emily Renzi at erenzi@gru.edu or 706-721-3213.

IN BRIEF _________________ 5 CULVER SPOTLIGHT_______ 6 DISCOVERIES_____________10 PROGRAMS______________ 11 FACULTY SPOTLIGHT______ 12 NEW FACES______________ 13

ABOUT THE COVER

FACULTY MEMBERS _______14

Dr. James and Mrs. Jean Culver have traversed the globe advancing vision treatment. Read more on page 6.

NEW GRANTS____________ 15 DON’T MISS______________16

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www.culvervdi.org

SUMMER 2015

VISION


SUMMER 2015 VISION

GIVING

A GROWING LEGACY

Dr. Fleetwood Maddox and wife Dr. Katie Cook Maddox (MCG, ’76)

To support the Culver VDI, contact David Cantrell, Major Gifts Officer, at 706-721-1817 or dcantrell@gru.edu.

“I should tell you that I’m old enough to have taught Dr. Julian Nussbaum when he was a resident,” laughed Dr. Fleetwood Maddox, referring to the Co-Director of the Culver Vision Discovery Institute. But Maddox’s ties to Georgia Regents University and the Medical College of Georgia go back even further than that. The Macon native received his medical degree from MCG in 1957, becoming one of the nation’s first pediatric ophthalmologists, and went on to teach at MCG as well, where he met Nussbaum. He was also on staff at the Eye Center of Central Georgia in Macon, where he practiced for 40 years before retiring in 2005. It was here that his greatest contribution to MCG — one that is ongoing — would begin. Early in his career, Maddox, at a patient’s behest, received funds from the Knights Templar Foundation to support pediatric ophthalmologic surgery. The patient later reached out to him to ask a favor: With his expertise and knowledge of eye care and research in Georgia, would Maddox serve as the ophthalmologist advisor for the Knights Templar Educational Foundation of Georgia? The foundation was established by a $30,000 bequest that was held in trust for about 50 years until the mid-1980s, at which point it had grown

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to about $4 million and was directed to support ophthalmological research, lectures, and libraries at MCG and Emory University. That request from a patient happened 30 years ago, and to date, Maddox has helped bring more than $1 million to the MCG Department of Ophthalmology. Over the years, the gifts have grown from $25,000 annually to $42,000 this year to each institution. At MCG, monies in the past two years have funded a new microsurgery simulator, which teaches ophthalmology residents how to perform delicate eye surgery. The simulator, located in the J. Harold Harrison, M.D. Education Commons, has a plaque stating that it is a gift from the Knights Templar Educational Foundation of Georgia. In his retirement, Maddox enjoys spending time with his wife, Katie, and their 11 grandchildren. He also performs medical mission work in Jamaica. But a highlight of his year is always the annual Knights Templar luncheon, where he and foundation representatives present checks to Emory and his alma mater. Over the past 30 years, much has changed in the field, and that’s a very good thing, said Maddox. “Research has gotten closer to treatment - closer and closer to the patient who needs it — and I think that’s wonderful.”


IN BRIEF

CULVER VDI RETREAT

COMMUNITY INVOLVEMENT

RESEARCH MEETING 5

Highlights of the Culver VDI’s ongoing impact in vision research were in the spotlight during the seventh annual Culver VDI Scientific Retreat on March 11-12. Co-Director Sylvia Smith cited the faculty’s 13 National Eye Institute grants (including R01 and K08 grants, which are among the highest funding levels), two National Institute of Diabetes and Digestive and Kidney Diseases grants, two National Institute of Neurological Disorders and Stroke grants, and 17 awards from non-National Institutes

of Health funding sources, including the American Heart Association and the Department of Defense. The research targets conditions including blindness caused by retinopathy, glaucoma, corneal dystrophy, low vision, and impaired visual perception.

Raising funds for translational vision research and increasing attendance at Culver VDI events are among the goals of the Culver VDI external advisory board. The board met April 22 at a hunting facility on the grounds of Drs. Julian Nussbaum (right) and Stephanie Goei’s home in Grovetown, Georgia, to discuss ways to advance the VDI’s research, clinical, and

educational initiatives. Other plans include adding more Augusta-area members to the board.

Twenty Culver VDI researchers presented recently at the 2015 annual meeting of the Association for Research in Vision and Ophthalmology, one of the foremost events for vision research. Among many highlights, Dr. Mohamed Al-Shabrawey (right) and colleagues John Penn, Lois Smith, Timothy Lyons, and Julia Busik hosted a session on challenges in accurately detecting and measuring lipid metabolites and their role as a potential treatment target

for retinal diseases. Other presentations highlighted the research of Drs. Ruth Caldwell, Yutao Liu, Sylvia Smith, Amany Tawfik, and Ming Zhang.

www.culvervdi.org

SUMMER 2015

VISION


SUMMER 2015 VISION

CULVER SPOTLIGHT

PLAY IT AGAIN Dr. James Culver, for whom the James & Jean Culver Vision Discovery Institute is named, helped revolutionize retinal surgery with his contributions to ophthalmology.

The year was 1952, and Dr. Derrick Vail, Chairman of the Northwestern University Department of Ophthalmology and one of the nation’s foremost ophthalmologists, had just offered young resident-intraining James Culver the opportunity of a lifetime: one of only two residency spots in the country for the discipline. In shock, Culver sat silently while the great man talked on. Then suddenly, like a looming shadow, Vail was in front of him, shouting, “Well, do you want the position or not?”

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Culver, in fact, wasn’t sure. He and his wife, Jean, were still newlyweds. The two had met while Jean was working as a nurse and Culver as an intern at a hospital in Macon, Georgia – Culver’s hometown. After the third time they passed each other in the halls, Culver was smitten, and they married a year later. But as with many young couples struggling on what was then a paltry salary for doctors-in-training, times were hard. And with Chicago’s brutal winters and decidedly nonSouthern bent, the city


Even as Dr. James and Mrs. Jean Culver revel in old memories, they enjoy making new ones as well – including visiting friends Dr. Julian Nussbaum (Culver Vision Center Co-Director) and his wife, Stephanie Goei. The Culvers are pictured here with the couple’s children.

‘WELL, DO YOU WANT THE POSITION OR NOT?’ just wasn’t where the young couple saw themselves staying, particularly with an apartment where the folddown bed took up every bit of living space. But Culver said yes – and Chicago was one of many different cities where the Culvers would find themselves living over the years, thanks to Jim’s “itchy foot,” as Jean describes it. From the Midwest, they would plant themselves in exotic Hawaii, then Miami,

Washington, D.C., Paris, Germany, Japan, Korea, Carmel and Monterey in California, then finally back to Florida, where Culver had served in the U.S. Army Air Forces after earning his degree from the Medical College of Georgia in 1945. Looking back at the hardships, Jean and Jim just laugh. “We’ve had an amazingly charmed life,” said Jean. “I’d love to do it all over again and not change a thing.”


MACON • HAWAII • WASHINGTON, DC • ‘WE’VE HAD AN AMAZINGLY CHARMED LIFE.’ – Jean Culver

• CHICAGO • MIAMI • PARIS • JA


• GERMANY • KOREA • MONTEREY BAY

APAN • CARMEL BAY • FLORIDA •


SUMMER 2015 VISION

DISCOVERIES

RESEARCHER’S STUDIES HIT CLOSE TO HOME

Dr. Pamela Martin is seeking new treatments for blinding retinal diseases.

Dr. Pamela Martin’s interest in vision research could, in a way, be considered genetic. The Harlem, Georgia, native grew up just down the road from where her office and lab are now located on Georgia Regents University’s Health Sciences Campus. She remembers exactly how she felt when as a girl, she received her first pair of glasses, amazed that she could finally see clearly. At the same time, she remembers confusion and disappointment when she asked her parents, “Why can’t glasses fix Aunt Edith’s eyes?” Her dad’s younger sister was born with a condition that resulted in low vision, and later complete blindness. Martin often went along on the long car rides to Macon, Georgia, to take her aunt to and from the Georgia Academy for the Blind, experiences that helped fuel her interest in figuring out “what allows us to see properly . . . why some people can and others can’t – and what things we can do to preserve vision.” Now an Associate Professor with the Culver Vision Discovery Institute, Martin conducts research focused on understanding mechanisms and developing new therapies to prevent and treat blinding retinal diseases, particularly diabetic retinopathy and sickle cell disease, which blind millions of people worldwide – and that are very close to Martin’s heart since they also directly impact several of her family members. Currently, no early treatments exist for sickle cell or diabetic retinopathy, and the available treatments are invasive, often involving monthly injections into the back of the eye, the site of the retina. Because Martin’s

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graduate and postdoctoral work focused on how nutrients and metabolites pass in and out of the eye, she became interested in developing more patientfriendly solutions in the form of oral drug therapies that could piggyback on the existing transport modalities used by these compounds. For example, a $1.875 million National Eye Institute grant is funding Martin’s research into how high oral doses of niacin and similar compounds can target a receptor on the surface of the retina and keep inflammation at bay. This could potentially open a door for an easy preventive therapy for diabetic retinopathy, much in the same way that a heart patient takes a daily aspirin supplement. In addition, a pilot grant from the Culver VDI helped Martin launch a project examining how the multiple sclerosis drug, dimethylfumarate/ monomethylfumarate, can benefit those with sickle cell disease, boosting the production of fetal hemoglobin and helping to alleviate or prevent retinal and other complications of sickle cell disease by reducing oxidative stress and inflammation and preventing the sickling of red blood cells. This discovery has been patented by Martin and her longtime collaborator, Dr. Vadivel Ganapathy. While both therapies are still in the basic research stage, Martin hopes clinical trials will follow soon. “My hope for the future is the same as that of many other basic scientists,” said Martin. “It’s to see something that started at the bench in the lab actually being used in clinic and benefiting patients.”


PROGRAMS

PEERING INTO THE RETINA

Dr. Alan Saul performs electroretinograms to diagnose and track treatment of retinal disease.

ERG’S RESEARCH ROLE Along with his work using ERG to improve how retinal disease is diagnosed, Dr. Alan Saul is also working with photographer Mike Stanley on a research project to determine if retinal disease can be diagnosed early in adolescents at risk for diabetes.

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Dr. Alan Saul places a delicate electrode onto the surface of the eye — so fine that it is difficult to see with the naked eye. Then, with the flip of a switch, the patient looks at a variety of light stimuli – flashes along with spatially and temporally diverse patterns of light, dark, and colored tones. It’s all part of Saul’s daily routine as a visual electrophysiologist and researcher with GRHealth Eye Care and the Culver VDI, where he performs electroretinograms to help diagnose and track treatment of retinal disease. Only major centers offer tests like these, which supplement a physical exam and a patient’s verbal descriptions with valuable information about how the retina is actually working. “An ERG is an objective way to evaluate how people are seeing,” explained Saul. “It can be very sophisticated. You can do a lot of different ERGs to investigate different parts of the retina and find out a lot of information this way.” During an ERG, flashing lights send stimuli to the retina in the back of the eye. The response from the retina is in the form of tiny electrical signals that can be picked up by the fine electrode, which is entirely unobtrusive. Along with diagnosing disease, Saul also tracks the effects of certain drug therapies, which can damage the retina. “An ERG can detect some of the damage before the doctor can physically see it in the eye,” he said. Saul’s basic research involves how the brain

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processes time, which is directly relatable to his clinical work. He’s found that neurons in the visual thalamus and cortex respond to visual stimuli differently: some at the peak of the stimulus, others just before or after. “The way ERGs typically work is that 95 percent of the time, they present a flash — a visual stimulus that is only milliseconds long,” he explained. “But that’s not the way we see naturally. In the natural environment, the world changes slowly.” He is working on ways to improve ERGs and present stimuli that, like the natural world, change more slowly than a brief flash. In the current test, patients stare straight ahead for an extended period without moving their eyes, which can be very uncomfortable. Saul is proposing that the test stimulus could take the form of a movie or cartoon, which would help both adults and children focus more easily on the test — and would also help those with photophobia, or discomfort viewing bright flashes. The slower stimuli could also pick up other features of retinal disease that the current test can’t detect, thus improving how retinal diseases are diagnosed and treated. “Everyone wants to get a better solution, to be better able to predict what’s going to happen to people’s vision,” said Saul. “The ERG is already a very sensitive test, but there are lots of ways to improve it and make it more patient-friendly.”

SUMMER 2015

VISION


SUMMER 2015 VISION

FACULTY SPOTLIGHT

PEDIATRIC OPHTHALMOLOGIST REVELS IN CHILD’S PLAY

Dr. Stephanie Goei has spent 15 years treating children with unusual vision problems.

WORLDWIDE PERSPECTIVE Many children around the world don’t have a clear view of the world around them, said Dr. Stephanie Goei, but that’s something that could be easily fixed with a pair of glasses or a simple surgical procedure. One of Goei’s goals is to perform international outreach to care for and improve the lives of children without access to pediatric ophthalmology. “Just 30 minutes in a clinic could change a child’s life in another country,” said Goei.

Most doctors rely on stethoscopes or tongue depressors to examine their patients. Dr. Stephanie Goei’s tools of choice? Toys. In every imaginable color and shape, toys decorate her office behind the Eye Care Clinic at Georgia Regents Medical Center: orange and green felt finger puppets from Peru; Mickey Mouse in a purple shirt; a Mr. Incredible in his indelible bright-red costume. The toys are invaluable in her work treating infants and young children with eye disorders, who often can’t talk or explain what’s going on with their eyes. Goei relies on visual clues: how a child tilts or turns his head or how his eyes track and follow a colorful toy flying through the air or dancing on a table. As the only pediatric ophthalmologist at GRHealth (a second, Dr. Andrea Prosser, joins the staff this summer), Goei has spent 15 years treating children with unusual eye problems. She loves working with infants in particular, puzzling out what’s going on with their eyesight, then performing intricate surgery or other treatments to fix it. For example, she said, “We do a lot with premature babies to prevent blindness.

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Twenty years ago, these little survivors would be blind, but thanks to early detection and treatment, today they’re not.” Goei splits her time between her medical practice and surgery, from repairing baby cataracts to straightening crossed eyes. But she also focuses on education. This includes educating the families of her patients on their role in their child’s treatment plan. She also teaches ophthalmology residents and reaches out to current and future pediatricians to educate them about certain eye issues, since they will most likely be the first providers to spot any potential signs or symptoms. Once upon a time, Goei never imagined that she’d become an ophthalmologist, much less a pediatric ophthalmologist. But after completing her residency, she realized that at the end of every day, she felt happy – and she still feels that way. “I’m so fortunate that I love what I do,” she said. “There are so many things I enjoy – my family, being at home, and traveling – but I also miss work when I’m not there. A lot of it has to do with having an incredible team. I’m very fortunate, really. It’s never boring, and it’s so much fun.”


WELCOME, FIRST-YEAR RESIDENTS!

FAREWELL, CLASS OF 2015!

DANLIN MAO, MD

TAM BLOOMQUIST, MD

Start date: July 1

Educational Background: BS in premedicine: Pennsylvania State UniversityUniversity Park, 2012

After graduation: Academic and/or private practice in comprehensive ophthalmology

MD: Jefferson Medical College, 2014 Transitional Internship: Reading Hospital School of Health Sciences, expected 2015

AMANDA HENDERSON, MD

Interests: Running, photography, baking, cooking, blogging, yoga

STEVEN GLENN, MD

After graduation: Fellowship in neuro-ophthalmology at Bascom Palmer Eye Institute, followed by an oculoplastics fellowship

Start date: July 1

Educational Background: BS in physiology and developmental biology: Brigham Young University, 2010 MD: Texas A&M Health Science Center College of Medicine, 2014

ABU-BAKAR ZAFAR, MD

Transitional Internship: Spartanburg Regional Medical Center, Expected 2015

After graduation: Corneal/external disease fellowship

Interests: Skiing, snowmobiling, kiteboarding, wakeboarding, photography, cooking

OSEMELU ABURIME, MD Start date: July 1

Educational Background: BS in biology: Morehouse College, 2010 MD: Morehouse School of Medicine, 2014 Transitional Internship: Baptist Health System, expected 2015 Interests: Tutoring, soccer

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SUMMER 2015

VISION


SUMMER 2015 VISION

FACULTY MEMBERS

STEWARDS OF OUR VISION Abiodun Akinwuntan, PhD, MPH, DRS, Allied Health Sciences

Ruth Caldwell, PhD

Mohamed Al-Shabrawey, PhD

William Caldwell, PhD

Oral Biology

Emeritus Faculty

Bill Andrews, MA, CMI, FAMI

Raymond Chong, PhD

Medical Illustration

Physical Therapy

Sally Atherton, PhD

Hannes Devos, PT, PhD

Regents Professor Emeritus

Allied Health Sciences

Babak Baban, PhD

Yanbin Dong, MD, PhD

Oral Biology

Georgia Prevention Center

Manuela Bartoli, PhD

Azza El-Remessy, PhD

Ophthalmology

Pharmacology and Toxicology

David Bogorad, MD

Diego Espinosa-Heidmann, MD

Ophthalmology

Ophthalmology

Wendy Bollag, PhD

Amy Estes, MD

Physiology

Ophthalmology

Kathryn Bollinger, MD

Sumner Fishbein, MD

Ophthalmology

Ophthalmology

Julia Brittain, PhD

Vadivel Ganapathy, PhD

Cellular Biology and Anatomy

Emeritus Faculty

Cellular Biology and Anatomy

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Stephanie Goei, MD

Lakshman Segar, PhD

Ophthalmology

Vascular Biology

Diana Gutsaeva, PhD

Nilkantha Sen, PhD

Ophthalmology

Neuroscience and Regenerative Medicine

Jay Hegde, PhD

Shruti Sharma, PhD

Ophthalmology

Biotechnology and Genomic Medicine

Michael Jensen, MD, CMI

Sylvia Smith, PhD

Medical Illustration

Cellular Biology and Anatomy

Daniel Killingsworth, MD

Amany Tawfik, MD

Ophthalmology

Oral Biology

Mallory Lanier, MHS, OTR/L

Dilip Thomas, MD

Allied Health Sciences

Ophthalmology

Gregory Liou, PhD

Lane Ulrich, MD

Ophthalmology

Ophthalmology

Yutao Liu, MD, PhD

Mitchell Watksy, PhD

Cellular Biology and Anatomy

Cellular Biology and Anatomy

Brendan Marshall, PhD

Zhiyong Yang, PhD

Cellular Biology and Anatomy

Ophthalmology

Pamela Martin, PhD

Ming Zhang, PhD

Biochemistry and Molecular Biology

Cellular Biology and Anatomy

Priya Narayanan Namboothiri, PhD, Allied Health Sciences

Julian Nussbaum, MD Ophthalmology

Albert Pan, PhD Neuroscience and Regenerative Medicine

Tadd Patton, PhD Psychology

Puttur Prasad, PhD Biochemistry and Molecular Biology

John Riffle, MD Ophthalmology

Peter Rosen, MD

We welcome your feedback. If you have suggestions for articles or other comments/ questions about the newsletter, contact Editor Emily Renzi at erenzi@gru.edu or 706-721-3213.

Ophthalmology

Alan Saul, PhD Ophthalmology

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SUMMER 2015

VISION


Non-Profit Organization U.S. Postage

Communications and Marketing 1120 15th Street, TR-101 Augusta, Georgia 30912

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Augusta, GA Permit No. 210

CHANGE SERVICE REQUESTED

Wrong address? Need to update your information? Tell us by email at updateinfo@gru.edu Go online to gru.edu/updateinfo Or call us at 706-721-4001

EVENT LISTINGS The following seminars are held in the Lee Auditoria Center, room 140, from 4 to 5 p.m.:

DISTINGUISHED SEMINAR SERIES

July 21 Topic to be announced Aaron Seitz, PhD University of California, Riverside August 18 Molecular Imaging of Retinal Disease Ashwath Jayagopal, PhD Vanderbilt Eye Institute September 15 Microglia in Retinal Physiology, Aging, and Disease Wai T. Wong, MD, PhD National Eye Institute October 20 Topic to be announced Demetrios G. Vavvas MD, PhD Massachusetts Eye and Ear Infirmary Visit culvervdi.org/seminars for information on future events.

Vision Magazine, Summer 2015