OSU Ophthalmology Annual Report - 2012-13

Table of Contents INNOVATIVE LEADERS

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Faculty Residents Fellows

PIONEERING DISCOVERIES

Research Faculty Highlighted Research Select Grants & Publications

CENTERS OF EXCELLENCE

Anterior Segment Glaucoma

Neuro-Ophthalmology & Oculoplastics

Pediatric Ophthalmology Vitreoretinal

Caring Experts Right Where You Live

BUCKEYE BENEFACTORS When faced with a difficult diagnosis, you want to make sure that you have access to the experts.

Fortunately for eye patients in Central Ohio, the experts are not far. At The Ohio State University Havener Eye Institute, we are specially trained to care for your toughest eye care challenges.

Not just experts, compassionate experts...

We know that it is individuals that create a culture of caring. We are fortunate and proud to have a unique group of staff, residents, fellows, and faculty who create a positive, compassionate, caring environment. It is this environment that has our Chairman - Thomas Mauger, MD Administrator - Robert LaFollette, MBA Outreach Committee Alan Letson, MD

Rebecca Kuennen, MD

Andrea Sawchyn, MD

Cate Jordan, MD Research Manager - Laura Sladoje Program Coordinator - Christina Stetson Outreach Intern - Megan Rossman OPHTHALMOLOGY OUTREACH (614) 293-8760 • eye@osumc.edu • eye.osu.edu

patients reporting a 96% satisfaction rate.

There are many unknowns about the future of healthcare. One thing, however, is certain. The quality of training and level of care demonstrated by everyone at the Havener Eye Institute will allow us to meet the challenges that face us all—right here in Central Ohio.

OHIO STATE IS YOUR BEST CHOICE FOR EXPERT EYE CARE

Columbus Monthly lists 18 of our ophthalmologists among CENTRAL OHIO’S BEST DOCTORS. Ohio State’s EYE AND EAR INSTITUTE provides a full range of eye care in one convenient location.

OUR EXPERTS TRAIN ophthalmologists who provide care in central Ohio and across the state.

OHIO STATE’S EYE SPECIALISTS PROVIDE AN UNPARALLELED LEVEL OF EXPERTISE. Any vision problems you may experience, from routine to specialized, can be treated by the experts at Ohio State’s Havener Eye Institute.

STATE-OF-THE-ART MEDICAL AND SURGICAL CARE for major eye diseases such as glaucoma, retinal detachments, diabetic retinopathy, macular degeneration and cataracts.

Our physicians are SPECIALTY TRAINED IN THE LATEST EYE CARE TECHNIQUES, including corneal transplant, advanced ocular imaging and laser vision correction.

Ohio State’s clinical trials give our patients ACCESS TO THE LATEST EYE TREATMENTS. When eye disorders are the result of another medical condition, our PHYSICIAN TEAMS COLLABORATE WITH YOUR DOCTOR and other medical specialists to make sure all of your care needs are addressed.

INNOVATIVE LEADERS | Faculty

THOMAS MAUGER, MD CHAIRMAN Dr. Mauger is a Professor and Chairman of the Department of Ophthalmology and Visual Science. He is focused on seeing patients, conducting research, working with students, residents and fellows, and traveling to developing countries to save sight, whenever possible.

Dr. Mauger has authored or contributed to nine books, 60 articles, and has given scientific presentations worldwide. He oversees numerous research projects focused on ocular surface disease, responses of the cornea to ophthalmic medications, corneal preservation solution analysis, and corneal changes as a result of laser surgery.

Dr. Mauger has made a commitment to providing ophthalmic care to underserved populations both in developing countries and here in Columbus. He has been instrumental in obtaining needed exam equipment for the Columbus Free Clinic, and he volunteers there with other faculty, residents and resident alumni on nearly a weekly basis to provide eye care for those who don’t have health insurance.

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DON L. BREMER, MD is the Interim Chairman of the Ophthalmology Department at Nationwide Children’s Hospital and an Associate Professor of Ophthalmology at The Ohio State University College of Medicine. His clinical interests include strabismus (when eyes are not properly aligned with each other), amblyopia (lazy eye), and retinopathy of prematurity (an eye disease that affects prematurely-born infants.)

CYBIL CASSADY, MD is a Clinical Assistant Professor of Ophthalmology at The Ohio State University College of Medicine and is a member of the Medical Staff at Nationwide Children’s Hospital. She has expanded her clinical interests to include strabismus, amblyopia, and retinopathy of prematurity.

DAVID CASTELLANO, MD is very commited to education and technology which has motivated him to develop a web-based teaching program: StudyAide. com. Originally, he created this unique teaching program for ophthalmology, but it can be adapted for any subject. He remains very active clinically and performs surgeries two days a week. He continues to refine LASIK nomograms to further improve refractive outcomes as compared to national data. He plans to place the nomograms and outcomes analysis tools online for other surgeons to use.

COLLEEN CEBULLA, MD, PHD is a dedicated physician and Assistant Professor with a passion for pushing the boundaries of medicine.

In the clinic, she provides state-ofthe-art retinal and ocular oncology care for patients. She is very active in clinical trials and her research in ocular melanoma and retinal detachments delves into the underlying mechanisms and promises to bring about earlier diagnosis, more targeted treatment methods, and fewer side effects.

THE OHIO STATE UNIVERSITY | WEXNER MEDICAL CENTER | HAVENER EYE INSTITUTE

SUSIE CHANG, MD is very dedicated to her patients and providing them the best care possible. This includes her involvement in conducting clinical research which allows her to offer patients the latest advances. She has been a co-investigator in several trials evaluating new retinal treatment options, often in the last stage before becoming the standard of care.

FREDERICK DAVIDORF, MD is a well-recognized expert in the field of ophthalmology, especially for his work in ocular melanoma. He has been on faculty at The Ohio State University for over 40 years and is beloved by patients, students, residents, and fellows for his extensive knowledge and easy-going manner. He has published over 200 journal articles, authored 2 textbooks and numerous book chapters.

GLORIA FLEMING, MD is a dynamic clinician and faculty member in the glaucoma division. Her energy and enthusiasm for the future keeps her actively involved in the clinical and surgical training of residents and fellows in glaucoma. She also precepts and serves as a mentor to medical students interested in Ophthalmology. An advocate for patient education, she serves as a Councilor to the Glaucoma Research Foundation.

RICHARD GOLDEN, MD is on faculty at OSU and Nationwide Children’s Hospital. and has a very active clinical practice. His primary focus is strabismus, amblyopia, pediatric cataracts and retinopathy of prematurity (ROP). He recently performed clinical research in a new and innovative treatment for orbital dermoid cysts. A dermoid is an overgrowth of normal, noncancerous tissue in an abnormal location.

ANDREW HENDERSHOT, MD is an enthusiastic educator and physician, who recently expanded his clinical care area to include Bucyrus, OH and Galion, OH. He is currently collaborating with the Neurology Department on a study of patients with partial seizures taking Pregabalin. He gives many educational lectures and also serves as the Assistant Residency Program Director.

DAVID HIRSH, MD specializes in neuro-ophthalmology.

He co-directs the neuroophthalmology lecture series to the ophthalmology residents.

He also conducts neuroophthalmology lectures to neurology residents. He also gives an annual lecture to ophthalmology technicians on neuro-ophthalmic topics. He recently began giving an annual medical students lecture on neuro-ophthalmology for their revised curriculum.

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INNOVATIVE LEADERS | Faculty

SHELLY JAIN, MD is a favorite among patients for her softspoken, energetic manner and her expertise. She provides outstanding patient care in both the clinic and operating room.

She loves educating future physicians and frequently staffs the residents’ clinics at the Columbus and Dayton VA Medical Centers, and the Doan Inmate Clinic.

She is working to create more targeted therapy for patients with glaucoma and is the principal investigator for a clinical trial on prostaglandins (eyedrops that lower eye pressure for patients with glaucoma).

STEVEN KATZ, MD has a very busy practice covering all neuro-ophthalmic and oculoplastic conditions. He has written 37 peerreviewed journal articles and 13 book chapters. He is an article reviewer for numerous journals.

He is a clinical and scientific advisor to the Chief of Space Medicine at NASA Johnson Space Center. He has been a principal investigator on dozens of NIH and Industry sponsored clinical trials.

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REBECCA KUENNEN, MD balances an active clinical practice with her many responsibilities as the Anterior Segment Division Director. She is a co-investigator on both national and multidepartmental clinical trials.

She lectures to residents and medical students, organizes the department’s morbidity and mortality conferences, and precepts students, residents, and fellows both in the clinic and in the operating room.

JULIE LANGE, MD is a Clinical Assistant Professor of Ophthalmology at The Ohio State University and a member of the Medical Staff at Nationwide Children’s Hospital.

She is very interested in all aspects of pediatric eye care but has special interest in amblyopia, strabismus, pediatric cataracts, and low vision. She also enjoys working with other departments as a team for patients with multidisciplinary concerns.

L. CAROL LAXSON, MD, PhD specializes in diabetic retinopathy, age-related macular degeneration, and retinal vascular diseases. She maintains an active clinic in medical retina practice, is very involved in teaching residents and mentors residents and fellows. She also serves on the OSU Office of Responsible Research’s Institutional Review Board (IRB), where she evaluates research projects involving human subjects.

RICHARD LEMBACH, MD, with over 35 years in the Department, has pioneered research in extendedwear contact lens, refractive surgery, and corneal crosslinking. He has served as a medical consultant for many companies.

He has received the Senior Teaching Award from the American Academy of Ophthalmology and is an elected member of the Cornea Society. Currently, he is the Medical Director of the Central Ohio Lions Eye Bank.

THE OHIO STATE UNIVERSITY | WEXNER MEDICAL CENTER | HAVENER EYE INSTITUTE

ALAN LETSON, MD is a recognized expert in the field of retina. He serves as the Retina Division Director, the Residency Program Director, and the Medical Student Clerkship Director. He has authored many articles on retinal diseases and serves as a peer reviewer of manuscripts for ophthalmic journals. An active advocate for clinical trials, he has been the Principal Investigator for many national studies, including AREDS2, RIDE, GSK and a Co-Principal investigator for HARBOR, CATT, ACCORDION, DRCR-N.

MARY LOU MCGREGOR, MD is a pediatric ophthalmologist through Nationwide Children’s Hospital (NCH) and the past president of the NCH Medical Staff. Her clinical interests include pediatric cataracts, strabismus, low vision and retinopathy of prematurity (ROP). She has been an investigator in several multicenter NIH grants, including the CRYO-ROP study, STOP-ROP and the ETROP study. She is also the director of the Multidisciplinary Low Vision Clinic.

W. RANDALL MCLAUGHLIN, OD serves as the primary visual consultant for the OSU Department of Athletics. He contributed to research of the intercollegiate usage and impact resistance of football helmet face shields which was published in the Journal of the American Optometric Association. He provides contact lens education to residents and assists in the Resident Contact Lens Clinic.

JULIE MEIER, MD staffs resident clinics and surgeries at the Columbus VA Hospital. She also assisted with completion of peer reviews of both OSU faculty and rotating residents. She initiated work on an application for the iPhone involving ophthalmology resident flash cards and review material. She may expand the service to also include a webbased mock exam designed to prepare residents for the ophthalmology board exam.

JOHN MELNYK, OD has been instrumental in the opening of the eye care clinic at OSU CarePoint East Medical Center. He actively encouraged collaborations with the Departments of Endocrinology, Family Medicine, and General Internal Medicine. He trains Optometry students at the OSU College of Optometry Clinic and coordinates the Ophthalmology/ Optometry service at the CarePoint East Community Day.

CHANTELLE MUNDY, OD has a very busy optometry clinic and is also dedicated to providing optometric services for underprivileged populations both internationally and locally. She gives back to the community by educating and providing vision screening to elementary school students. Her enthusiasm for education continues through her willingness to promote ocular medicine.

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INNOVATIVE LEADERS | Faculty & Residents

MATTHEW OHR, MD utilizes his dualfellowship training to diagnose and manage vitreoretinal and corneal diseases. He specializes in retinal detachment surgery, age-related macular degeneration (AMD), retinal vascular occlusive disease, and diabetic retinopathy, and the surgical repair of dislocated lenses. He has a particular interest in imaging modalities of the retina including optical coherence tomography. In 2010, he received The Cleveland Clinic’s Cole Eye Institute Teaching Award Recognition before joining the faculty at the Havener Eye Institute.

CATE OLSON JORDAN, MD joined the Department in 2012 as a pediatric ophthalmology specialist.

She sees patients at Nationwide Children’s Hospital. Her clinical interests include amblyopia, strabismus, pediatric cataracts and retinopathy of prematurity (ROP).

She is excited to continue her relationship with the Havener Eye Institute where she had an amazing training experience.

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DAVID ROGERS, MD is a faculty member at both The Ohio State University and at Nationwide Children’s Hospital. His clinical interests include pediatric and adult strabismus, pediatric cataract, glaucoma and low vision. He has a strong interest in clinical research especially telemedicine for retinopathy of prematurity (ROP), pediatric vision screening, pediatric cataract, and outcomes in strabismus surgery.

GARY ROGERS, MD is the Chairman Emeritus of the Ophthalmology Department at Nationwide Children’s Hospital as well as OSU faculty emeritus. His clinical and research interests include pediatric and adult strabismus, fMRI, amblyopia and retinopathy of prematurity. Dr. Rogers has been the principal investigator for several important multicenter NIH grants, including the CRYOROP study, and the ETROP study. He is a past President of the Medical Staff at Nationwide Children’s Hospital and the Ohio Ophthalmological Society.

ANDREA SAWCHYN, MD specializes in the care of patients with cataracts, ocular hypertension, and all forms of glaucoma.

She serves as the Glaucoma Division Director and is actively involved in medical education, staffing multiple resident clinics and resident surgeries. She has contributed to several publications and is the lead author on multiple book chapters in the Wills Eye Institute 5-Minute Ophthalmology Consult text.

AMIT TANDON, MD primarily performs cataract and refractive surgery. He also travels to Galion, OH and Bucyrus, OH twice a month to provide patient care in underserved areas. He has developed strong relationships with the community there along with the hospital leadership. He was recently named the director for outreach services in this area.

THE OHIO STATE UNIVERSITY | WEXNER MEDICAL CENTER | HAVENER EYE INSTITUTE

MICHAEL WELLS, MD is very active clinically and surgically, but still manages to regularly mentor medical students, residents, and fellows, staff resident clinics and the operating room, and give formal lectures. He is a coinvestigator on several clinical trials in retina. His passion for teaching and furthering the field of retina is only surpassed by his exceptional care and thorough treatment of his patients.

Second Year Residents Third Year Residents

PAUL WEBER, MD has had a long and distinguished career. A world-renown leader in the field of glaucoma, he has made significant contributions toward the treatment and prevention of the disease. He has served as the principal investigator on some of the most influential National Institute of Health studies in ophthalmology. Since joining the faculty, Dr. Weber has served as the Glaucoma Division Director, Department Chairman, and Vice Dean of Education for the OSU College of Medicine. He has made a name for himself, both as a physician and an educator, garnering many teaching and clinical awards over the years.

First Year Residents

Residents

Danielle Coury, MD

Nhu-Y Dao, MD

Krysta Goslin, MD

Naina Gupta, MD

Dimos Mantopoulos, MD

Craig Miller, MD

J. Bradley Allen, MD

Elaine Binkley, MD

Sarah Hilkert, MD

Mark Hill, MD

Allison Hinko, MD

Julia Reid, MD

Lindsay Adam, MD

Megan Chambers, MD

Abbe Craven, MD

Sarah Escott, MD

Ellen Miller, MD

John Welling, MD

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PIONEERING DISCOVERIES | Research Faculty

An Eye on Research Research inspires and propels us toward future discoveries and our patients toward better treatments. Researchers at the OSU Havener Eye Institute are fueled by a passion for pushing the scientific envelope and helping to create a better world.

Targeting Retinal Scarring

OCT & Adaptive Optics

Genetics of Ocular Cancer

Colleen Cebulla, MD, PhD

Guoqiang Li, PhD

Mohamed AbdelRahman, MD, PhD

Patients develop scar tissue in the light sensitive layer in the back of the eye (retina), due to a variety of conditions. One common cause of scarring is from a retinal detachment, but they can also form from other ocular conditions, like macular degeneration, diabetes, and ocular trauma. Depending on the location of the scarring, this condition known as proliferative vitreoretinopathy (PVR) can interfere with vision.

Dr. Cebulla is focused on understanding how PVR develops and targeting the critical proteins that promote the scarring process. Dr. Cebulla believes that if we knew the target proteins, we could develop better medications to prevent or reduce the scarring as well as to try to promote the healing of damaged retinal tissue.

By comparing the proteins that are increased or involved in a PVR retina with a normal retina in animal models, she is working to identify these proteins before conducting similar studies with human PVR retina. When she has identified the target proteins involved in scarring and regeneration, medications that inhibit these proteins can then be tested and, if successful, will lead to clinical trials.

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The value of high-quality imaging as the conduit to earlier diagnosis and faster treatment is well known. Using a machine available in almost any ophthalmologist’s office, Dr. Li and Thomas Mauger, MD are on a mission to improve the quality of ocular imaging of the eye—personalized to each patient through adaptive optics.

Optical coherence tomography (OCT) machines are a key diagnostic tool in many eyecare offices. Utilizing light to capture an “optical ultrasound”, OCTs are used to diagnose a wide variety of eye conditions.

By correcting a patient’s refractive error using adaptive optics—mimicking a glasses prescription—they can improve the OCT resolution and help capture very fine details of the different parts of the eye; including the cornea, anterior segment, the retina, and eventually the vitreous humor (the gel-like substance that gives the eye its shape). Dr. Li’s team has already built an OCT system with better resolution than what is commercially available, allowing them to see more detailed features for different layers of the retina and provide diagnosis from a cellular level.

Uveal (eye) melanoma is a rare cancer, but the most common primary eye tumor in the adult. The ocular oncology research group studies several aspects of this rare cancer.

Dr. Abdel-Rahman is the lead researcher who works with Drs. Frederick Davidorf and Colleen Cebulla— two world experts in ocular oncology.

The group has recently identified a new hereditary cancer predisposition syndrome caused by the BAP1 gene mutation.

The group are also studying three different aspects of the genetics of ocular melanoma. First, by finding genetic markers that can identify patients with an aggressive form of the disease this will allow researchers to follow these patients more carefully.

Second, they will pre-select patients who will better respond to newly discovered treatments thereby decreasing the toxicity of the medication.

Finally, by identifying genetic markers in a small subset of patients, researchers will know if they are predisposed to ocular melanoma and other tumors which will help in the early management of not only the patient, but other at-risk family members.

THE OHIO STATE UNIVERSITY | WEXNER MEDICAL CENTER | HAVENER EYE INSTITUTE

New IOP Monitoring for Glaucoma

Nanobubble AMD Drug Delivery

Glaucoma & Cornea Biomechanics

Cynthia Roberts, PhD

Ronald Xu, PhD

Jun Liu, PhD

A new contact lens sensor that measures pressure inside the eye (IOP) is being tested at OSU by Gloria Fleming, MD and Dr. Roberts. Glaucoma, which causes damage to the optic nerve through increased pressure in the eye, is nearly symptomless. Since patients cannot recognize the damage until it is irreversible, the constant monitoring of IOP is crucial.

Currently, most IOP measurements are taken using a Goldman applanation tonometer or a Dynamic Contour Tonometer (DCT). Goldmann measures IOP by the force required to flatten (applanate) the cornea. DCT uses the principle of contour matching instead of applanation. Unfortunately, these common monitoring techniques do not take into account a patient’s positioning changes (the effect of sitting versus standing versus laying down on IOP) or ocular pulse amplitude (changes in IOP caused by heartbeats).

The new contact lens sensor is a type of DCT that allows researchers to take constant measurements of patients both sitting and laying down. In a pilot study, researchers found that contact lens DCT was just as accurate as a traditional DCT. In addition, the lens’ mobile nature and constant contact with the surface of the eye has opened the door to exciting research opportunities. Now that the DCT contact lens has been validated, multiple studies are being planned in glaucoma and neuro-ophthalmology that promise to change our understanding and treatment of ocular disease.

Dr. Xu, Alan Letson, MD, and Cynthia Roberts, PhD are using some of the world’s smallest particles, nanobubbles, to deliver much-needed medication to patients with Age-Related Macular Degeneration (AMD), one of the world’s most common blinding diseases.

For patients with AMD, anti-VEGF medication slows the growth of abnormal blood vessels in the back of the eye (retina) and helps restore vision.

Intraocular injections of anti-VEGF medication have been used to combat AMD for many years. However, the anti-VEGF medication quickly leaves the eye after injection. Since a high concentration is needed for proper treatment, more injections are necessary to maintain proper levels in the eye. Each additional injection multiplies the risks of local and systemic adverse reactions.

The new, drug-loaded nanobubbles will allow medication to accumulate in the retina for a longer period of time, until activated selectively using ultrasound. The nanobubbles are dyed a fluorescent yellow, which makes them visible to imaging and to be guided and released when they are in place.

The biodegradable nanobubbles keep the medication from disbursing before reaching the target area, reducing the number of injections needed.

Despite the prevalence of glaucoma, the mechanisms behind this potentially blinding condition are still largely unknown. Understanding the interaction between the intraocular pressure and the biomechanical properties (softness, pliability, stiffness) is critical to earlier diagnosis, new treatments and to eventually finding a cure. Keratoconus (a thinning of the cornea causing visual distortions) is another condition that could be better understood through a study of the biomechanics involved.

Dr. Liu is closely collaborating with Thomas Mauger, MD and Paul Weber, MD to better understand the role ocular biomechanics play in these diseases. Applying quantitative ultrasound techniques, they are able to noninvasively characterize ocular biomechanics in these conditions.

Most ultrasound imaging is qualitative, sensitive enough to detect tissue anomalies, but lacking the ability to analyze their exact properties and the interplay between these properties and disease. Quantitative ultrasound imaging techniques provide specific numbers related to tissue features and lead to increased specificity and understanding of image findings as they relate to disease states. With this sensitive, non-invasive imaging, Dr. Liu, Dr. Mauger, and Dr. Weber are closer than ever to understanding glaucoma and keratoconus, how to diagnose them earlier and then develop novel ways to treat them.

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PIONEERING DISCOVERIES | Collaborative Research / Grants & Publications

Research Partnerships OSU Havener Eye Institute has a long history of using a multi-disciplinary approach to caring for patients.

By pairing our researchers with our clinicians and consulting specialists from across the medical center, the Havener Eye Institute is able to offer patients a more thorough approach to their eyecare.

ENDOCRINOLOGY

Retina specialists manage the care of patients involved in a national federally funded clinical trial of over 8,000 patients that focuses on the treatment strategies for patients with cardiac or diabetic risk factors. Diabetic retinopathy is a common eye condition in diabetic patients that can result in blindness if not proactively diagnosed and managed.

CARDIOLOGY

We collaborate on a clinical trial for patients who suffer from critical limb ischemia or restricted blood supply due to a disease of the blood vessel. Patients are infused with bone marrow in hopes to improve the blood flow in their body.

Patients who have a history of or develop blood vessel growth in the back of the eye are not eligible to participate in this study. Ophthalmologic evaluation is an important safety aspect.

NEUROLOGY

Alzheimer’s A new and promising treatment for early stage Alzheimer’s disease has the potential to cause ocular side effects. As such, our ophthalmology investigator serves an important role in managing the care of the patients while receiving this drug. This involves extensive assessments and imaging by an experienced cornea and retina trained ophthalmologist to appropriately evaluate, manage and treat these patients.

Multiple Sclerosis Our ophthalmologists collaborate on multiple studies each year with the Neurology MS Research team.

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Optic neuritis or inflammation of the optic nerve is common in patients with MS and ongoing management of these patients is an important component to their clinical cares as well as the focus of ongoing research in the area of MS and Neuro-Opthalmology.

PSYCHIATRY

The investigational drug to treat manic depression has demonstrated a potential to cause cataracts in some patients. Careful monitoring of patients to evaluate for cataract or other vision related symptoms and treating ocular side effects will help to reduce the likelihood of any long term issues while the patient is receiving this treatment. Data regarding the incidence of cataract and the degree of severity is an important safety and research question as this drug continues to be explored for future treatment options.

OPTOMETRY

Our glaucoma specialist participates as a co-investigator in a grant for which the goal is to determine if a certain class of cells within the human retina is affected by glaucoma. By using a flickering light test to measure pupil responses to different colored lights of patients with and without glaucoma we can determine if the function of this type of cell is different in patients with glaucoma.

ONCOLOGY

Our anterior segment and retina divisions are collaborating with several oncology clinical trial areas, including: Lung Cancer Hematology OB/GYN Cutaneous Melanoma Rectal Cancer Thyroid Cancer Brain Cancer Our specialists screen potential clinical trial patients to confirm that they do not have any ocular disease that may affect their treatment or cause an increase in the potential for significant vision issues. We also provide ongoing evaluation of oncology clinical trial patients to monitor any visual changes or ocular side effects that may develop and assist in the treatment and resolution of such events.

THE OHIO STATE UNIVERSITY | WEXNER MEDICAL CENTER | HAVENER EYE INSTITUTE

Select Publications & Grants SELECT GRANTS

Cebulla (PI). Genetic polymorphisms in retinal detachment with proliferative vitreoretinopathy. NIH/NEI. Roberts (PI), Fleming, Small, Weber. Interaction of ocular pulse amplitude (OPA) and the difference between intracranial pressure (ICP) and intraocular pressure (IOP) as a mechanism for glaucomatous damage. Columbus Foundation.

Chang (PI), Cebulla, Ohr, Davidorf, Letson, Wells. A Comparative Effectiveness Study of Intravitreal Aflibercept, Bevacizumab and Ranibizumab for Diabetic Macular Edema (Protocol T). Jaeb/NEI. Christoforidis (PI), Chang, Davidorf, Letson. A Phase III, DoubleMasked, randomized, Active Treatment-Controlled Study of the Efficacy of .5mg and 2.0mg Ranibizumab Administered Monthly or on an As-Needed Basis In Patients With Subfoveal Neovascular Age-Related Macular Degeneration. (HARBOR). Genentech.

Davidorf (PI). Modulation of Angiogenesis in Ocular Disease. Patti Blow Foundation.

Davidorf (PI), Chang, Letson, Abdel-Rahman, Cebulla. Comparison Of Age-Related Macular Degeneration Treatments Trials (CATT): Lucentis-Avastin Trial. U Penn/NEI. Katz (PI), Criden. A Multicenter, Double-blind Randomized Placebocontrolled Study of Weight Reduction and/or Low Sodium Diet plus Acetazolamide vs Diet plus Placebo in Subjects with idiopathic Intracranial Hypertension with Mild Visual Loss. Rochester/NEI. Letson (PI), Cebulla, Chang, Davidorf. Age-Related Eye Disease Study (AREDS2): A Multi-Center, Randomized Trial of Lutein, Zeaxanthin, And Omega-3 Long-Chain Polyunsaturated Fatty Acids (Docosahexaenoic Acid [Dha] And Eicosapentaenoic Acid [Epa]) In Age-Related Macular Degeneration. Emmes/NEI. Letson (PI), Chang, Davidorf. A Phase III, Double-Masked, Multicenter, Randomized, Sham Injection-Controlled Study of the Efficacy and Safety of Ranibizumab Injection in Subjects with Clinically Significant Macular Edema with Center Involvement Secondary to Diabetes Mellitus (RIDE). Genentech.

Li (PI). Electro-optic adaptive eyeglass for correction of presbyopia.

NIH/NEI. Li (PI). Parallel en-face optical coherence microscopy with adaptive focus. NCRR. Liu (PI), Roberts. Corneoscleral Biomechanics and Intraocular Pressure: Corneal Biomedical. NIH/NEI. Mauger (PI), Kuennen, Hendershot. Effect of corneal preservation time on long term graft success cornea preservation time study (CPTS). Jaeb/NEI.

SELECT PUBLICATIONS

Abdel-Rahman MH, Cebulla CM, Verma V, Christopher BN, Carson WE, Olencki T, Davidorf FH. “Monosomy 3 status of uveal melanoma metastases is associated with rapidly progressive tumors and short survival.” Exp. Eye Research. July 2012.

Cebulla CM, Minning C, Pratt C, Lubow M. “Charles Bonnet syndrome and Terson’s syndrome from subarachnoid hemorrhage: good news from bad news.” Graefes Arch Clin Exp Ophthalmol. Mar 2013.

Cebulla CM, Zelinka CP, Scott MA, Lubow M, Bingham A, Rasiah S, Mahmoud AM, Fischer AJ. “A chick model of retinal detachment: cone rich and novel.” PLoS One. Sept 2012.

Christoforidis JB, Wassenaar PA, Christoforidis GA, Ho VY, Knopp MV, Schmalbrock PM. “Retrobulbar vasculature using 7-T magnetic resonance imaging with dedicated eye surface coil.” Graefes Arch Clin Exp Ophthalmol. Jan 2013.

Cebulla CM, Flynn HW. “Calcification of combined hamartoma of the retina and retina and retinal pigment epithelium over 15 years.”

Graefes Arch Clin Exp Ophthalmol. May 2013.

Buzzacco DM, Lubow M, Davidorf FH, Cebulla CM. “Atypical cat scratch disease with vitritis, serous macular detachment, neuroretinitis, and retrobulbar optic neuritis.” Graefes Arch Clin Exp Ophthalmol. Mar 2013.

Clark SA, Lubow M, Ray-Chaudhury A, Davidorf FH, AbdelRahman MH, Cebulla CM. “Optic disc edema from remote uveal melanoma.” JAMA Ophthalmol. Jan 2013.

Markakis GA, Roberts CJ, Harris JW, Lembach RG. “Comparison of Topographic Technologies in Anterior Surface Mapping of Keratoconus using Two Display Algorithms and Six Corneal Topography Devices.” Int J Kerat Ect Cor Dis 2012.

Smadja D, Santhiago MR, Mello GR, Roberts CJ, Dupps WJ Jr, Krueger RR. “Response of the posterior corneal surface to myopic laser in situ keratomileusis with different ablation depths.” J Cataract Refract Surg. July 2012.

Farria-Correia F, Ambrósio R, Roberts CJ. “Scheimpflug-based tomography and biomechanical assessment in Pressure-induced Stromal Keratopathy.” J Refract Surg. May 2013.

Czyz CN, Clark CM, Justice JD, Pokabla MJ, Weber PA. “Delayed Topiramate-induced Bilateral Angle-Closure Glaucoma.” J Glaucoma. Apr 2013.

Mitra K, Melvin J, Chang S, Park K, Yilmaz A, Melvin S, Xu RX. “Indocyanine-green-loaded microballoons for biliary imaging in cholecystectomy.” J Biomed Opt. Nov 2012.

Chang S, Guo J, Sun J, Zhu S, Yan Y, Zhu Y, Li M, Wang Z, Xu RX. “Targeted microbubbles for ultrasound mediated gene transfection and apoptosis induction in ovarian cancer cells.” Ultrason Sonochem.

Jan 2013.

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CENTERS OF EXCELLENCE | Subspecialties

Cornea Cataracts and other anterior segment (front of the eye) conditions are the leading cause of vision loss worldwide. As widespread as these conditions are, they are also largely reversible with proper treatment. Since the surface of the eye is a primary source of visual distortion, a healthy anterior segment is crucial to clear vision.

A cataract is a clouding of the lens inside of the eye, which interferes with clear vision. Statistics show that more people will develop cataracts than any other eye condition. Other anterior segment conditions include, corneal dystrophies, corneal abrasions, and keratoconus, refractive errors (presbyopia, myopia, hyperopia, and astigmatism), and low vision.

The Division has concluded their participation in a corneal crosslinking study for patients with keratoconus, but are looking for new opportunities to continue researching this exciting area of treatment. They are also involved in testing new devices that depress the surface of the eye using a puff of air to quantify the movement and properties of the cornea.

The Cornea Division at the Havener Eye Institute treats a wide range of diseases and disorders affecting the front surface of the eye, as well as providing refractive surgery (LASIK) and optometry services. The Cornea faculty includes Department Chairman Thomas Mauger, MD, Division Director Rebecca Kuennen, MD, Andrew Hendershot, MD, Richard Lembach, MD, David Castellano, MD, Julie Meier, MD, Amit Tandon, MD, Sarah Huffman, OD, W. Randy McLaughlin, OD, John Melnyk, OD, and Chantelle Mundy, OD.

The division participates in several collaborations with College of Medicine departments within The Ohio State University. These collaborations include clinical trials with the Comprehensive Cancer Center, Psychiatry and Obstetrics & Gynecology. Many of the new drugs currently being evaluated in clinical trials have the potential to produce changes in the eye causing decreased or loss of vision so patients need to be evaluated in the clinic. Our physicians are invaluable in screening and following the eye health of these patients enrolled in various types of clinical trials.

There are many opportunities for research in the field. Dr. Mauger is currently involved in a large federally funded grant involving over 40 sites across the country that is looking at preservation time of donor corneas.

Dr. Guoqiang Li, a research faculty member for both Ophthalmology and Biomedical Engineering, serves as the primary investigator on several federally funded grants developing and testing devices involving adaptive lenses for patients with presbyopia and ocular coherence topography (an imaging device that maps the thickness of back of the eye).

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Education is a very important part of the mission of the cornea division from teaching residents, fellows and medical students to actively staffing resident clinics and surgeries at the Columbus VA and Dayton VA. This extends from mentoring residents to supporting the education and training of fellows each year. Dr. Evan Pike completed his cornea fellowship this past year.

Additionally our anterior segment physicians are very active in mission work and Drs. Mauger, Kuennen, Tandon as well as fellows and residents have traveled to Ghana, Nicaragua, India, Peru, and Ethiopia to participate in global outreach initiatives to provide comprehensive eye care and surgeries to underserved populations.

Corneal conditions affect patients of all ages and backgrounds. At Ohio State, our large number of experienced faculty are well-equipped to care for a diverse population and improve the lives of patients in Central Ohio and beyond.

THE OHIO STATE UNIVERSITY | WEXNER MEDICAL CENTER | HAVENER EYE INSTITUTE

Glaucoma It has been called the silent thief of sight because of its nearly symptomless onset. Often people with glaucoma are not aware of it until they have lost a significant amount of vision. It is estimated that 2.2 million Americans have glaucoma, but only half know that they have it and are receiving treatment to halt its progression.

When light enters the eye, it is translated into electrical signals and transmitted to the brain via the optic nerve.

Glaucoma is thought to be caused by increased pressure inside of the eye which damages the optic nerve and causes irretrievable vision loss. While researchers are still searching for a cure to glaucoma, they have found ways to halt its progression by keeping intraocular pressure (IOP) within normal limits.

The Glaucoma Division, lead by Andrea Sawchyn, MD, includes Gloria Fleming, MD, Shelly Jain, MD, Annette Terebuh, MD, and Paul Weber, MD. They are glaucoma specialists and researchers who utilize the latest treatment and surgical techniques, but continue to search for better treatment options for patients.

Glaucoma is treated by maintaining normal IOP levels, thus accurate IOP measurement is a critical step in providing quality care. Currently, IOP is mea-

sured through the cornea (the clear front of the eye). This technique relies on the assumption that the cornea is identical in all people. However, numerous studies have demonstrated that individual corneas vary in thickness, curvature, and biomechanical properties (the “hardness” or “softness”). These differences can potentially influence the accuracy of IOP measurement.

Collaboration with our biomedical faculty, including Drs. Cynthia Roberts and Jun Liu, has resulted in ongoing translational research projects aimed at solving the limitations of current IOP measurement techniques.

A new contact lens IOP sensor is being researched which promises to change the way that glaucoma specialists monitor IOP. The contact lens sensor is a type of dynamic contour tonometer (DCT) which more accurately assesses IOP by eliminating measurement errors caused by the shape, thickness, or elasticity of the cornea. In addition, the contact lens sensor has been able to take constant IOP measurements allowing researchers to obtain dynamic readings of the natural fluctuations in IOP cause by heartbeats (ocular pulse amplitude), as well as impact of position changes (i.e. sitting vs. standing) on IOP. In addition, Ohio State has provided decades of involvement in the National Institutes of Health-funded Ocular Hypertension Treatment Study (OHTS). OHTS has proven to be one of the most impactful ophthalmic studies.

It has already had a major impact on the management of glaucoma and the prevention of blindness in thousands of patients. The findings from this multicentered clinical trial have resulted in major research spin-offs that will further elucidate the mechanisms of glaucoma damage and result in an even greater preservation of sight in the future.

Researchers are also working to identify changes to the eye caused by a common glaucoma treatment, prostaglandin analog eye drops (PGAs). PGAs are known to lower IOP, but laboratory studies have shown that they also can soften the cornea. Although not dangerous to the eye, this softening may result in falsely low IOP readings.

In the education arena, all of the faculty have been actively involved in training residents and medical students in the latest treatment options, as well as expanding research, for glaucoma. The Glaucoma Fellowship is directed by nationally renown Dr. Weber, who was recently awarded a Lifetime Achievement Award by OSU Medical Center for his many contributions to education.

The continued generous contributions of state-of-the-art diagnostic equipment from grateful patients like Jerry Colp have allowed the Division to stay at the very forefront of patient care and research—saving sight and giving hope.

With all of the advancements that are being made and patients seeing unprecedented results, we are hopeful that a cure for this potentially blinding condition will not be far behind.

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CENTERS OF EXCELLENCE | Subspecialties

Neuro-Ophthalmology & Oculoplastics When patients develop rare nervous system, autoimmune system, or brain conditions that affect their vision, they turn to Neuro-Ophthalmology and Oculoplastics experts. At Ohio State our fellowshiptrained faculty specialize in a wide variety of unusual conditions in order to provide the most effective therapeutic and surgical options for patients.

Many neuro-ophthalmic and oculoplastic patients have chronic and systemic conditions which affect their vision. Idiopathic Intracranial Hypertension (also known as Pseudotumor Cerebri) is a condition where increased pressure inside of the skull results in swelling of the optic nerve causing headaches and vision loss. Neuro-ophthalmologists and oculoplastic specialists also treat visual side-effects caused by autoimmune conditions (like myasthenia gravis, thyroid eye disease), eye muscle diseases and disorders, hereditary and trauma induced facial abnormalities, and other rare ocular and neurological conditions.

At Ohio State’s Neuro-ophthalmic & Oculoplastics Division’s geographic faculty include Steven Katz, MD and David Hirsh, MD. Our community faculty are Susan Benes, MD, John Burns, MD, Jill Foster, MD, Kenneth Cahill, MD, and Cameron Nabavi, MD. They practice many specialized treatments and surgeries including therapeutic and cosmetic botulinum toxin, cosmetic tissue fillers, blepharoplasty surgery, surgical and medical treatment for ptosis, eyelid reconstruction, bioengineered tissue grafts, anophthalmic socket reconstruction, and more.

Neuro-ophthalmology and Oculoplastics are active members of the Comprehensive Skull Base Center at the James Cancer Hospital. The group is dedicated to advancing the care of patients with complex head and neck cancer. With more aggressive tumor removals, the multidisciplinary recon-

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struction of these patients is increasingly challenging, but promises better survival and functionality.

Research is an integral part for the Division. The Idiopathic Intracranial Hypertension (IIH) Treatment Trial is a National Eye Institute study that provides an invaluable resource for patients with this chronic condition. The multi-center study hopes to determine if weight reduction and low sodium diet alone or combined with acetazolamide will benefit patients with IIH. The Pseudotumor Cerebri Center of Excellence is a multi-disciplinary group dedicated to the care of patients with idiopathic and secondary intracranial hypertension. The group also focuses on clinical and basic science research to provide better understanding of the underlying etiology as well as more targeted treatment options. The Division is working toward a tissue bank to collect blood and cerebrospinal fluid from patients for long-term studies will further knowledge of this disease.

The China Eye Project is a collaborative effort to develop artificial vision with Professor Quishi Ren, Chairman of the Department of Biomedical Engineering at Peking University in Beijing.

The goal of the project is to stimulate the optic nerve and create artificial vision in patients with retinitis pigmentosa. Dr. Katz developed the Shanghai orbitotomy, a new surgical approach to the lateral optic nerve for implantation of a microelectrode needed for artificial vision.

Other clinical trials include pharmaceutical interventions in patients with multiple sclerosis and Huntington’s Disease, lacrimal outflow system imaging, botulinum toxin efficacy, new techniques of tissue filler delivery, minimally invasive facial surgery, facial anatomy, and treatment of orbital lymphangiomas, and ocular toxicity with new chemotherapeutic agents.

Additionally, Dr. Katz is a reviewer for both the journal, Eye, and Columbus Foundation grants, a scientific advisor to the Intracranial Hypertension Research Foundation, and an advisor to the Chief of Space Medicine at NASA. The Division has a rigorous two-year Fellowship in Neuro-ophthalmology, Orbital Disease, and Oculoplastics.

Faculty are actively involved in resident training by overseeing the hospital ward and emergency room consult service and conducting a cadaver dissection lab so residents can gain experience with surgical approaches to the eyelid and orbit. Drs. Benes, Burns, Cahill, and Foster are instrumental in overseeing resident clinics and the neuro-ophthalmology and oculoplastics resident lecture series.

At Ohio State, furthering understanding and treatment options for patients with rare and chronic conditions is not just subspecialty, it’s a calling and an opportunity to provide hope to those in greatest need.

THE OHIO STATE UNIVERSITY | WEXNER MEDICAL CENTER | HAVENER EYE INSTITUTE

Pediatric Ophthalmology Vision is always important, but it is especially precious in children—who are seeing everything for the first time. The Pediatric Ophthalmology Division faculty is devoted to helping children affected by strabismus, amblyopia, double vision, and other conditions that interfere with their visual development.

Common childhood eye conditions include strabismus (misalignment of the eyes), amblyopia (a form of visual loss due to a lack of stimulation of the vision part of the brain commonly referred to as “lazy eye”), glaucoma (increased eye pressure leading to vision loss), ptosis (dropping eyelid), retinopathy of prematurity (abnormal growth of blood vessels in the back of the eye in premature infants), double vision, and refractive errors (farsighted, nearsighted, and astigmatic).

Our pediatric ophthalmology division faculty members are fellowship-trained and dual-appointed at Nationwide Children’s Hospital (NCH) and OSU. Faculty include Division Chief Don Bremer , MD, Gary Rogers, MD, Mary Lou McGregor, MD, Cybil Cassady, MD, Richard Golden, MD, David Rogers MD, Julie Lange MD, and Cate Jordan.

The Pediatric Division has several busy subspecialty clinics. The Low Vision Clinic assesses children so that an educational plan and recommendations for low vision aids can be made. The Oculoplastics Clinic provides reconstruction for patients with traumatic injuries and congenital and acquired abnormalities involving the periorbital structures and orbit. The Pseudotumor Cerebri clinic is our newest subspecialty clinic devoted to managing children with intracranial hypertension due to both primary and secondary causes. This clinic works closely with the neurology and neurosurgery departments at NCH. Advances in technology are improving the level of care for NCH patients. The

Electrophysiology Lab, under the direction of Julie Racine, PhD., uses state of the art technology to evaluate visual and neurologic pathways involved with vision. Having a portable Ocular Coherence Topography (OCT) machine allows us to provide care both in the clinic, at the bedside, and in the operating room. This equipment not only enhances patient care, it also opens up new avenues for pediatric research.

Our faculty remains committed to research that improves our understanding of pediatric eye diseases and their diagnosis and treatment. We are actively involved with the Pediatric Eye Disease Investigator Group (PEDIG), several multicenter clinical trials, and numerous investigator initiated studies.

We currently have research funding through the NIH, The Ohio Lions Eye Research Foundation, and Eye Care for Kids. In addition to numerous publications in 2013, we are pleased to have been selected to present some of our research at the annual meeting of The American Association for Pediatric Ophthalmology and Strabismus (AAPOS) in California in 2014. In association with PEDIG, we are involved with studies dealing with amblyopia, strabismus, convergence insufficiency, and cataract surgery. PEDIG has recently completed enrollment of a multicentered clinical trial aimed at treating amblyopia utilizing levodopa (a drug developed to treat Parkinson’s disease). Preliminary work done at NCH was responsible for the pilot data that allowed this protocol to be developed.

One of our most exciting new endeavors is led by Dr. Golden who is utilizing laser refractive surgery in treating difficult cases of amblyopia in children resulting from extreme refractive error. Through the generous support of the Ohio Lions Eye Research Foundation we are able to continue our departmental research in areas that involve how systemic diseases such as diabetes mellitus and cystic fibrosis affect the corneal endothelium.

Our initial results are very promising and show that the cornea may act as a biomarker for early systemic disease in these patients and may be a marker for treatment efficacy. We are also analyzing the demographics, presentation, diagnosis, and management of children with pseudotumor cerebri. The department has been involved in drug studies of Travaprost looking at safety and efficacy in children. Other department research continues in areas involving retinopathy of prematurity, cerebral venous sinus thrombosis, and how electronic medical records affect the delivery of health care.

In addition to clinical eye care, the division supports teaching programs that ensure delivery of the highest quality pediatric care. The pediatric ophthalmology resident clinic is staffed by one first-year and two second-year OSU ophthalmology residents, a part-time optometrist, and is supervised by the full-time faculty of the department of ophthalmology.

We are proud of the strides we are making in research, education, and patient care with the purpose of helping children reach their full vision potential.

CENTERS OF EXCELLENCE | Subspecialties

Retina Division Retinal diseases and disorders are among the most wide-spread and prevalent conditions that affect eye patients. Age related macular degeneration (AMD) can distort vision making life extremely challenging, diabetic eye disease requires monitoring to prevent progression, and a retinal detachment can change someone’s life in an instant.

The Retina physicians at the Havener Eye Institute are dedicated to providing patients with the best possible visual outcome. They are all fellowshiptrained to handle any retinal condition including AMD, retinal detachments, diabetic retinopathy, retinal vein occlusions (RVO), eye tumors, ocular inflammatory diseases, and many other disorders that affect the back of the eye.

The Retina Division includes seven specialized physicians; Colleen Cebulla, MD, PhD, Susie Chang, MD, Frederick Davidorf, MD, L. Carol Laxson, MD, PhD, Alan Letson, MD, Matthew Ohr, MD, and Michael Wells, MD. They care for thousands of patients yearly and interpret imaging procedures, administer eye injections for wet AMD and other causes, and

perform complex retinal surgical procedures.

Research is a major focus in the Retina Division—from basic to clinical trials to collaborative intradepartmental research. The Division actively participates in national clinical trials sponsored by the National Institutes of Health/National Eye Institute (NIH/ NEI) as well as industry sponsored clinical trials. AMD trials include AREDS2, CATT, Genentech HARBOR and GlaxoSmithKline studies. Diabetic retinopathy trials include multiple DRCR network studies as well as Genentech RIDE. The RVO Vibrant study was sponsored by Regeneron.

Collaboration with departments and schools across The Ohio State University campus has resulted in multiple clinical trials between The James Cancer Institute, Cardiology,

Neurology, Endocrinology, and other departments. Individual retina faculty have pioneered research in complex retinal diseases. Dr. Cebulla’s NIH funded research in retinal detachments promises to identify genetic markers in a severe complication— Proliferative Vitreoretinopathy (PVR).

Dr. Davidorf and Dr. Abdel-Rahman, an ophthalmology researcher, have conducted extensive research in ocular melanoma molecular genetics, supported through the Patti Blow Research fund, and have made significant breakthroughs in the field.

Education and teaching are a priority with Dr. Letson leading the Retina Division and serving as the Residency Program Director. The Division is committed to training future ophthalmologists and mentors residents in their first and second year retina rotations, conducts weekly retina lectures, and also serves as preceptors for resident research projects. The Division’s teaching activities include supporting two retina surgical fellowship trainees each year, hosting imaging conferences, and being active in the medical student Curriculum of the College of Medicine.

From caring for individual patients to clinical trials that lead to more effective treatments to teaching the next generation of care givers—The OSU Retina Division physicians are improving the lives of patients, every day.

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BUCKEYEBENEFACTORS GIFTS OF $100 OR MORE MADE FROM 01/01/13 to 12/31/13 $1,500,000 and above Ann La Fontaine* $150,000 - $250,000 Warner & Patti Blow $50,000 - $149,999 Dr. Marilyn J. Huheey Dr. John & Linda Pajka $10,000 - $49,999 Dr. Glenn & Carmen Himes John L. Marakas Richard Murphey Sarah Slack* $5,000 - $9,999 Louis Bloomberg* Phyllis Ann Havener Drs. Jack & Candace Hendershot Dr. Charles F. Libell Drs. Thomas Mauger & Carol Laxson Dr. Carl & Joan Minning Dr. James L. Moses Dr. Mitchel & Pamela Opremcak Dr. Leonard D. Quick Dr. Carl Shin Dr. David Stinchcomb Dr. Paul & Lesley Weber $2500 - $4,999 Ted Donley & Dr. Colleen Cebulla Dr. Hank & Suzanne Croci Dr. Mark Gersman Michael & Jean Griffith Ruby L. Grill* Sara Kamal Jeff Wakefield & Dr. Ann Koval Dr. Charles Leone Dr. Alan & Susan Letson Dr. Garret & Kristina Mouser Drs. Jeffrey & Mary Oehler Dr. Dale & Bonnie Solze Dr. Amit & Sarah Tandon $1000 - $2499 Dr. Doug Baker Dr. William S. Banks David Laing & Pamela Bertram Paul T Cevasco Harry Esbenshade, III

$1000 - $2499 John & Elizabeth Felker Dr. David & Joan George Carolyn Greshemer Michael & Joyce Hallet Amy R. Hogan Drs. Sonu & Shelly Jain Dr. Steven & Stacey Katz John Kauffman* Dr. Carol Kollarits Bob & Danette LaFollette Irene Levine James Magnuson Timothy & Mary McNemar Dr. Steven Meadows Dr. Karl Pappa Trish Rebish Elizabeth Reese* Dr. Cynthia Roberts Donald Schriver Doug & Laura Sladoje Dr. Jonathan Walker $500 - $999 John Alberini Peggy Andrew Bellows Dr. Louis Chorich Richie Cohen-Smith Cookie Criden Dr. Frederick Davidorf Dr. Sarah Escott Gene & Ruth Fisher Mildred A. Glover John L. Havener Steve Juenger Kacy Kern Dr. Rebecca Kuennen Dr. Donald Lewis Dr. Guoqiang Li Dr. Robert A. Lytle Dr. Alfred & Hon. Cheryl Nicely Dr. Stephen Orr Richard Poffenbaugh Paul Ritter Dr. Mac Ronning Marilyn Sayre George & Tina Skestos Dr. Michael Stone Dr. Emanuel & Amy Tanne Marjorie Ward Dr. Michael B. Wells Roy Whipple Lisa Williamson George & Janet Wintringer

$100 - $499 Dr. Mohamed Abdel-Rahman Julie Amling Norma Amsterdam Judy Appel John Ballard Lois Bean Shelly Biggs Dr. Elaine Binkley Frances Black Dr. John Bockoven Dr. John Burns Dr. Kristen & Charles Burwick Dr. Dominic Buzzacco Dr. Megan Chambers Dr. Susie Chang Julie Chicoine Drs. Adam & Leah Cloud Debra Cole Dr. Dennis Corbett Albert Covelli Dr. Mary-Abigail Craven Dr. Marc* & Natasha Criden Sue Ellen Dailey Roxanna Damron Dr. Matthew Dangel Dr. Elliot Davidoff Dr. Aaron Davis Elma Davis Howard Davis Dr. Thomas Dingle Dr. Todd Dowling Dr. Mark Drabkin Michael Emmelhainz Catherine Fenderson Ken Fisher Dr. Gloria Fleming Margery Forry Mary Jayne Fox Dr. Elena Geraymovych Marjorie & Eli Goldach Dr. Richard Golden Alicia Green Beverly Gruber Dr. Deborah Grzybowski Arthur Hannel Monica Hanson Dr. James Harris Ann Havener-Estabrook Virginia Helfrich Dr. Andrew & Cadi Hendershot Audrey Henry Kent Hess Virginia Hess Dr. Randall Hieber

*Indicates Deceased

$100 - $499 (Cont.)

Dr. David Hirsh Mark & Andrea Inman Dr. Cate Jordan Marilyn King Rhonda Kitzler Dr. Bodo Knudsen Joanne Krackow William Kuhlman Barbara Landolfi Judith Lang Dr. Julie Lange Dr. Jonathan Lass Stella Lawrence Debra Leibowitz Dr. Richard Lembach Paul Little Nancy Matt Dr. Jeffrey McAdoo Dr. W. Randy McLaughlin Dr. John Melnyk James Meyer Theodore Minge Lora Moore James Murphy Timothy Nagy Fred & Cheryl Nicely Tim Nietfeld Dr. Philip O’Donnell Christina Padrutt Dr. George & Ruth Paulson Christopher Peele Dr. Baird Pfahl Jeana Piper Dr. Alan Rehmar Joyce Resin Judith Richards Dr. Paul Richards Jill Salerno Michael Sauer Scott Savage Grier Schaffer Kevin Shively Jennifer Slate Robert & Helenor Smith William Speer Graham & Christina Stetson Michael Steyer Dr. Scott Strickler Phyllis Tashman Donna Taylor Dr. William Terrell Francine Wahrman Dr. Brian Weeks James Weinstein Dr. Jeffrey Wincko

We appreciate your generous support. Thank you!

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