2021 U-M Kellogg Eye Center Annual Report

UNIVERSITY OF MICHIGAN W.K. KELLOGG EYE CENTER

2021

University of Michigan Kellogg Eye Center Annual Report 2021

4 Innovative Patient Care

8

14

21

Advancing Eye Care for Patients and Populations

Advances from the Bench to the Bedside

4

NIH-Funded Pilot Program Addresses Disparities in Glaucoma Care

14

Finding New Pathways for the Treatment of Choroideremia

29

2

Vitreoretinal Lymphoma: from Symptoms to Diagnosis to Treatment

5

Kellogg Offers Multiple Options for Limbal Stem Cell Deficiency

7

17

6

Collaborating to Deliver Specialized Care

COVID-19 Transmission Risk in Cornea Transplantation

Mapping the Genetic Landscape of Nanophthalmos

15

18

8

In it Together

Clinical Research Update: Patient Perspectives

Lipid Droplets May Protect Against AMD

10

Finding a Personalized Solution for Dry Eye

11

Prioritizing Communication for Patient Safety

12

Kellogg Leads International Team Linking Family’s Symptoms to Rare, Inherited Syndrome

Training the Leaders and Best 19

Michigan Medicine to Establish Neural Engineering Training Program

24 Kellogg Addresses Technician Shortage with Ongoing Training Program 27

International Partnerships 16

Training Eye Disease Researchers in India

21

Kellogg Researcher Launches Firstof-its-Kind Study of Health and Aging in Kenya

25 New Pediatric Ophthalmology Fellowship in Ghana Philanthropy 31

29 Guarding Photoreceptor Metabolism to Prevent Vision Loss in Inherited Retinal Diseases

22 Innovation in Action 23 State-of-the-Science Microscope Gives Kellogg Researchers New Edge 23 Toward a Therapeutic Target for Proliferative Vitreoretinopathy 26 Next-Generation Tools to Treat Abnormal New Ocular Blood Vessels Kellogg Updates

32 Eyes on the Future

1

The Chair’s Perspective

33 Big Data, Collaboration, and Impact

13

Leading on the National Stage

34

35 2021 First-Year Residents

U-M Learners Produce Online Newsletter

28 Genetically-Modified Occludin Shown to Protect Against Diabetes-Related Vision Loss

A Visionary Legacy

20 A New Regulator of Retinal Angiogenesis Discovered

Recognizing Distinguished Alumni: Richard Gutow, M.D., and Gary Gutow, M.D.

36 2021 Graduating Residents and Graduating Clinical Fellows

Faculty Honors and Awards

37

3

Steno North American Fellowship

38 W.K. Kellogg Eye Center Faculty

11

Marshall Parks Lecture at AAO

40 New Faculty Members

19

Endocrine Society Award

41 Faculty Honors and Recognition

Alumni Highlights

30 Kellogg’s Latest Heed Fellows Front cover from top left: Jason Miller, M.D., Ph.D., Angela Elam, M.D., Lev Prasov, M.D., Ph.D., Emily Eton, M.D., Yannis Paulus, M.D., Manjool Shah, M.D., Abigail Fahim, M.D., Ph.D., Andreia Goncalves, Ph.D.,

Kellogg's leadership team from top left: David Antonetti, Ph.D., Jill Bixler, M.D., Wayne Cornblath, M.D., Sherry Day, O.D., FAAO, Angela Elam, M.D., Christopher Gappy, M.D., Catherine Huebner, COA, B.S., Thiran Jayasundera, M.D., Denise John, M.D., FRCSC, Shannon Joseph, M.D., M.Sc, Ariane Kaplan, M.D., Shahzad Mian, M.D., Paula Anne Newman-Casey, M.D., M.S., Perry Schechtman, B.S., M.P.P., Roni Shtein, M.D., M.S., Joshua Stein, M.D., M.S., Jennifer Weizer, M.D., Maria Woodward, M.D., M.S.

• Our development of groundbreaking new biomedical tools, such as a minimally-invasive ‘nanoneedle’ platform for painless, sustained intraocular drug delivery, and photo-mediated ultrasound- a potentially safer, more precise method of removing tiny retinal blood vessels.

• The grant-funded work of Kellogg’s basic, clinical and translational researchers to identify new therapeutic targets for conditions including choroideremia, nanophthalmos, inherited retinal degenerations, and proliferative vitreoretinopathy.

• Faculty dedicated to eliminating disparities in visual health, including the development and implementation of a personal-

The Chair’s Perspective Dear Friends and Colleagues, “She made it clear they would not stop until they figured it out.”

That’s how a patient profiled in this report recounts the relentless determination of his Kellogg opththalmologist and her colleagues from across Michigan Medicine to decode his perplexing symptoms in order to provide life-saving treatment.

ized intervention among residents of Detroit.

• Kellogg’s sustained commitment to training tomorrow’s ophthalmology leaders in wide-ranging areas such as a new neural engineering training program in Ann Arbor, an NIHfunded program to train eye disease researchers in India, and a pediatric ophthalmology fellowship in Ghana.

• Kellogg alumni and supporters who are critical partners in our success, providing expertise, wisdom and resources for our efforts.

Throughout the challenges of this past year and a half,

Every day our Kellogg physicians, residents, fellows and staff

the resiliency, tenacity, and hard work of everyone at Kellogg

work to earn our reputation as a team that never backs down

has been central to our continuing success. We are grateful for

from ophthalmology’s challenges.

the opportunity we have every day to improve the lives of our

In this year’s Annual Report, we share stories that highlight how our guiding principles of innovation, teamwork, inclusion,

patients, communities, and our Kellogg teammates. We thank you for your encouragement and support.

caring, and integrity direct our care and shape our commitment to creating tomorrow’s new treatments, including: • Expanded treatment options, from living donor corneal limbal stem cell transplants to over 50 active clinical trials and more.

Paul P. Lee, M.D., J.D. F. Bruce Fralick Professor and Chair, Ophthalmology and Visual Sciences Director, W.K. Kellogg Eye Center 1

Vitreoretinal Lymphoma: from Symptoms to Diagnosis to Treatment lymph nodes, or a malignancy such as primary vitreoretinal lymphoma.”

Earlier chest imaging had revealed a suspicious lymph node on the lung, which could have been consistent with either diagnosis. After consulting thoracic and rheumatology specialists at the Ann Arbor VA, it was determined his pulmonary node was highly calcified and therefore unlikely to produce a diagnostic sample if it were to be biopsied.

“This meant that in order to make a diagnosis, we would instead need to proceed with a biopsy of vitreous fluid from Mr. Johnson’s eye,” she continues. “Given the small size and volume of the posterior segment of the eye, it can be challenging

Rajesh Rao, M.D., and Therese Sassalos, M.D., with Kenneth Johnson before his surgery

“

to get a large enough sample of cells to analyze.”

Dr. Sassalos turned to a colleague at Kellogg with extensive clinical and research experience in complex vitreo-

COMPLEX CASES LIKE

retinal cases. Retinal and vitreous surgeon Rajesh Rao, M.D., per-

MR. JOHNSON’S REINFORCE THE VALUE

formed a diagnostic vitrectomy,

OF MULTIDISCIPLINARY COLLABORATION,

wasn’t right when, in May 2020, the Ann Arbor resident began

IS WILLING TO BE PART OF THAT TEAM,

experiencing a cluster of uncomfortable symptoms, including jaw pain, earache, and large black and white

THROUGH IT ALL, HIS ATTITUDE HAS BEEN TRULY INSPIRING.

spots in his vision. “I’ve had floaters before, but none like these,” he says.

— Therese Sassalos, M.D.

“There was a whole solar system of spots in my left eye.”

Johnson phoned a nurse at the Veterans Administration Ann Arbor Healthcare System, who recommended

positive for lymphoma.

“Vitreoretinal lymphoma is rare, and its consequences are serious,” Dr. Rao explains. “To be absolutely sure, we needed to go the extra mile.”

Much of that extra mile happened behind the scenes in the pathology lab at

Kellogg and the U-M Department of Pathol-

ogy. In addition to traditional analysis, which

was overseen by Victor Elner, M.D., Ph.D., an ophthalmic

he visit the emergency room. The VA team performed a battery

pathologist specializing in rare ocular conditions, genetic testing

of tests, ruling out cardiovascular disease and other issues.

was performed by a team led by Noah Brown, M.D., Medical

To address the symptoms impacting his vision, they called upon Therese Sassalos, M.D. As a specialist in inflammatory

Director of the U-M Molecular Diagnostics Laboratory.

“Genetic testing analyzes the DNA in the sample for muta-

and infectious eye conditions, Dr. Sassalos practices at the

tions and biomarkers linked to this particular type of cancer,”

Kellogg Eye Center and leads a dedicated uveitis clinic at the

explains Dr. Rao. “It is a more sensitive and specific analysis,

Ann Arbor VA.

and can be an important adjunct approach to enhance our

“Examining Mr. Johnson suggested a diagnosis of uveitis,” Dr. Sassalos recalls. “A complete systemic laboratory and

2

from the left eye. The cells tested

AND THE IMPORTANCE OF A PATIENT WHO

“

Kenneth Johnson knew something

removing nearly all of the vitreous

ability to detect this hard-to-diagnose cancer.”

In order to analyze the DNA, Dr. Rao and Dr. Brown

radiologic evaluation ruled out an infectious cause. That left

needed to harness a fundamental tool of molecular diagnos-

two other possible diagnostic categories: an autoimmune condi-

tics — polymerase chain reaction (PCR) testing. PCR is used to

tion like sarcoidosis, which can impact the eyes, lungs and

make thousands of exact copies of DNA molecules from one

small sample, creating a specimen large enough to analyze.

A gold standard for testing liquid and solid tumor samples, it had not been routinely used before to detect cancer from samples with the gel-like consistency of vitreous.

“Michigan Medicine may be the only center in the U.S. routinely supplementing anatomic with molecular diagnostic testing to analyze diluted and undiluted vitreoretinal samples for lymphoma,” Dr. Rao says. “Some of the top ocular oncologists, retina surgeons, hospitals and labs across the country are now sending vitreous samples here for PCR testing.”

With a definitive diagnosis of intraocular lymphoma, Johnson’s care team expanded to plan and manage his treat-

Hakan Demirci, M.D., Kenneth Johnson and Medical Assistant Bradley Arras

ment. Drs. Sassalos and Rao were joined by Hakan Demirci, M.D., Kellogg’s Director of Ocular Oncology.

This type of lymphoma can start in the retina and spread

and posterior chambers of the eye,” he continues. “Very few

to the central nervous system, or vice versa. Initial brain and

centers perform this type of ‘liquid biopsy’ to diagnose and

spinal cord testing found no evidence of disease. Dr. Demirci

monitor treatment effectiveness.”

began treating Johnson’s eyes directly with chemotherapy injections, which lessens side effects elsewhere in the body.

After the diagnosis, Dr. Rao performed a vitrectomy in the right eye, which also had indications of disease.

“The tumor cells circulate in the vitreous,” Dr. Demirci

The journey from symptoms to diagnosis to treatment has not been easy for Kenneth Johnson, and he faces a difficult road ahead. But he is quick to credit the team from Kellogg, U-M and the VA for their persistence and professionalism. “From the start, Dr. Sassalos made it clear she wouldn’t stop until we had

explains. “The vitrectomies removed the majority of those

answers,” he recalls. “She and all of the doctors and staff who

cells, and we hope the chemotherapy will eradicate any

came together on my behalf made good on that commitment.”

remaining cancer.” U-M colleagues in the Neuro-oncology

“Complex cases like Mr. Johnson’s reinforce the value of

program will monitor Johnson’s central nervous system as

multidisciplinary collaboration, and the importance of a patient

treatment progresses.

who is willing to be part of that team,” says Dr. Sassalos.

“Another thing that helps set Kellogg apart is our ability to assess disease activity by sampling fluid from both anterior

“Through it all, his attitude has been truly inspiring. He reminds all of us why we do what we do.”

Steno North American Fellowship Thomas Gardner, M.D., M.S.,

U-M Professor of Ophthalmology and

their counterparts in Steno Diabetes Centers across Denmark.

Their joint project brings together Dr. Gardner’s recent

Visual Sciences, Internal Medicine,

research on the impact of neural dysfunction on the retina and

and Molecular & Integrative Physiol-

Dr. Larsen’s studies of the role of vascular dysfunction. “The fel-

ogy, was awarded a fellowship to

lowship allows us to pursue our shared hypothesis that diabetes

collaborate with fellow retinal research-

disrupts the entire retinal neurovascular unit,” he explains.

er Dr. Michael Larsen at the University of Copenhagen, Denmark.

Also in 2021, Dr. Gardner received a Distinguished Clinical and Translational Research Mentor Award from the

The Steno North American

Michigan Institute for Clinical & Health Research. The award rec-

Fellowship program, made possible

ognizes his leadership of the Michigan Vision Clinician-Scientist

by a grant from the Novo Nordisk Foundation, fosters transat-

Development Program, a mentored training program at Kellogg

lantic collaboration in diabetes research between investigators

funded by an NIH K12 training grant. “I am honored by the

from three North American partner institutions – the University of

award,” he says, “but I’m sure I learn more from these talented

Michigan, Harvard University and the University of Toronto, and

young investigators than they learn from me.”

3

“

OUR GOAL IS TO DEMONSTRATE

THE POTENTIAL OF A COMMUNITY-BASED,

FAITH-TAILORED PROGRAM TO OVERCOME BARRIERS TO CARE FOR THOSE AT

“

HIGH RISK FOR GLAUCOMA. — Angela Elam, M.D.

NIH-Funded Pilot Program Addresses Disparities in Glaucoma Care

of the following criteria: (1) have a personal or family history of glaucoma; (2) are age 40 or older; or (3) have not received an eye exam in more than 2 years.

The input of church and community leaders will also be sought, along with the Detroit Health Department (DHD), to

Glaucoma is the leading cause of irreversible blindness in Black

guide the recruitment of the community health workers (CHWs)

Americans, who face six times the risk of developing glaucoma

to administer the intervention. CHWs will receive 126 hours of

than their white counterparts. Because Black Americans are

training in motivational interviewing and glaucoma education,

also less likely to see an eye doctor or receive preventive care,

conducted by the Michigan Community Health Worker Alliance,

their glaucoma is four times more likely to go undiagnosed and

in conjunction with the DHD.

untreated.

Angela Elam, M.D., a glaucoma clinician and health servic-

The intervention will consist of a series of discussions with an assigned CHW. During the first session, the CHW will use

es researcher at Kellogg, is preparing to launch the Community

a web-based application to generate glaucoma educational

Based Treatment for Glaucoma program (ComBaT Glaucoma).

materials tailored to the participants. Church leaders will assist

This personalized, multi-level intervention funded by the NIH

Dr. Elam with creating the faith-based messaging.

aims to increase eye care utilization among Black residents of Detroit who are at high risk for glaucoma.

To overcome gaps in health awareness and barriers to care commonly observed in the Black community, ComBaT

Based on the participant’s specific barriers to care, the CHW will generate a written action plan to increase eye care utilization. The patient will also be referred to an eye care provider.

“Research shows that trust is a significant barrier to eye

Glaucoma will rely on engagement methods that have proven

care utilization in Black Americans,” Dr. Elam explains,

effective in interventions for conditions like diabetes and

“and that seeing a physician of the same race or ethnicity has

cancer, but that, to date, have not been routinely employed

a positive effect on patient satisfaction. So we are partnering

for glaucoma.

with Dr. Otis Ferguson, a native of Detroit and an ophthalmolo-

“A tailored approach has been shown to yield greater engagement and better outcomes than a one-size-fits-all model,” explains Dr. Elam. “Every step of the way, we will be partnering

gist who has practiced in the city for over 20 years, to provide eye care for those who do not already have an eye doctor.”

CHWs will conduct follow-up assessments by phone to

with trusted local influencers to reflect the characteristics and

monitor progress, reinforce education and revisit individual

needs of the community.”

barriers to care, and the percentage of eye care utilization in

Potential program participants will be identified in partnership with Detroit’s Historic King Solomon Missionary Baptist

4

The goal is to recruit participants who meet one or more

the group will be calculated.

“Our goal is to demonstrate the potential of a community-

Church (HKSC). HKSC is an established community hub,

based, faith-tailored program to overcome barriers to care for

interfacing with thousands of local residents, both members

those at high risk for glaucoma,” Dr. Elam says. “We hope that

and non-members, through a host of worship, social and health

our pilot will be shown to be effective, sustainable and scalable

programs and events.

for other real-world community settings.”

Kellogg Offers Multiple Options for Limbal Stem Cell Deficiency The corneal epithelial cells that protect the surface of the eye are continuously shed throughout the day. If these cells are not replenished, the health and clarity of the cornea — and the vision — are threatened.

The only cells capable of generating replacement epithelial cells are limbal stem cells, located between the cornea and the sclera. Circumstances that can lead to the loss of limbal stem cells or limbal stem cell deficiency (LSCD) include genetic diseases such as aniridia, inflammatory

Shahzad Mian, M.D., and Nambi Nallasamy, M.D., review tissue samples

conditions such as Stevens-Johnson syndrome, or trauma to the cornea from a thermal or chemical burn.

Limbal stem cell transplantation is the only intervention to counteract LSCD. “But each patient’s situation is unique, and

a small number of the patient’s own cells,” explains Kellogg

there is more than one transplant strategy to consider,” explains

corneal transplant surgeon Nambi Nallasamy, M.D. “The impact on the unaffected eye is negligible, and systemic

Kellogg corneal transplant surgeon Shahzad Mian, M.D.

immunosuppression is not needed.”

“Kellogg has one of the few programs in the region protect the long-term vision of patients with LSCD.” When LSCD affects both eyes, the established treatment is a keratolimbal allograft, or KLAL graft — the transplantation of limbal tissue from a deceased donor into each eye.

“

Recipients must tolerate extended

While SLET is proven to be safe and effective, the procedure is not performed as often in the U.S. as it is in other countries. Outside the U.S., instances of LSCD impacting one eye tend to

KELLOGG HAS ONE OF THE FEW

PROGRAMS IN THE REGION ABLE TO

OFFER MULTIPLE TRANSPLANT OPTIONS

systemic immunosuppression therapy following transplantation.

Although KLAL has been available for decades, only high volume corneal

TO PROTECT THE LONG-TERM VISION

“

able to offer multiple transplant options to

OF PATIENTS WITH LSCD. — Shahzad Mian, M.D.

transplant centers like Kellogg have the surgical expertise to perform it.

For patients with bilateral LSCD who are not good candidates for allograft transplan-

arise from chemical injuries or accidents, which are far less prevalent in the U.S. Recognizing the significant potential of SLET, Drs. Mian and Nallasamy are at the forefront of exploring next-generation applications for the procedure. In particular, they are pursuing allogeneic SLET — transplanting limbal stem cells from either deceased or living-related donors.

“We are undertaking research with our

eye bank partner Eversight to determine an

tation, the best option may be keratoprosthesis, a synthetic corneal transplant. For nearly 20 years, Kellogg has

effective protocol to obtain limbal stem cells from deceased

been the only center in Michigan to offer this treatment option,

donors and prepare them for transplantation,” says Dr. Mian.

which does not require post-transplant systemic immunosup-

This may decrease the immunosuppressive burden on patients

pression.

treated for bilateral LSCD. The introduction of deceased and

When only one eye has LCSD, it is possible to transplant

living-donor SLET will further expand the options available to

corneal limbal stem cells from the patient’s unaffected eye, a

treat patients with LSCD at Kellogg. Dr. Nallasamy performed

procedure called simple limbal epithelial transplantation, or

the first living-related SLET surgery at Kellogg in November

SLET. “The main advantage of SLET is that it requires only

2021.

5

Collaborating to Deliver Specialized Care

“Our treatment plans often reflect the input of our colleagues in neurology, neurosurgery, and neuroradiology,” says Dr. Deveney. “And we regularly collaborate with neurosurgery regarding the care of patients with brain tumors that impact the visual pathways.”

Kellogg continues to expand its subspecialty services and

“Patients benefit from having their care coordinated by a

leverage technology to connect providers across disciplines in

team that includes both neurology-trained and ophthalmology-

order to provide exceptional, coordinated care for patients

trained neuro-ophthalmologists,” adds Dr. Khanna. “We rely

with the most complex eye health challenges.

on that complementary expertise to evaluate and treat patients

In response to growing patient needs, Kellogg’s neuro-ophthalmology service has expanded to five neuro-ophthalmology specialists, with Sangeeta Khanna, M.D., and Tatiana Deveney, M.D., joining Wayne Cornblath, M.D., Lindsey De Lott, M.D., M.S., and Jonathan Trobe, M.D.

referred to us with the most complex symptoms.”

“

Oculoplastics Kellogg is one of the few centers in the Midwest with a dedicated pediatric oculoplastics service. Hakan Demirci,

PATIENTS BENEFIT FROM HAVING

THEIR CARE COORDINATED BY A TEAM THAT

As one of the few neuroophthalmology programs in the region, many patients are referred

INCLUDES BOTH NEUROLOGY-TRAINED AND OPHTHALMOLOGY-TRAINED NEURO-OPHTHALMOLOGISTS.

to Kellogg with complex conditions such as intracranial hypertension,

— Sangeeta Khanna, M.D.

ischemic optic neuropathy, eye movement disorders, optic neuritis related to infections and neuro-immunologic disorders and double vision resulting from myasthenia gravis or brain tumors.

Whether an eye problem arises from a known neuro-

Christine Nelson, M.D., F.A.C.S., care for both children and adults.

Kellogg is also known for providing the highest level of specialized care for the full range of defects and injuries to the eyelids and sockets, including ptosis and other eyelid malpositions, lacrimal disorders and conditions affecting the orbit, such as benign and malignant tumors, and no-

tably, thyroid eye disease (TED). Victor Elner,

M.D., Ph.D., and Shannon Joseph, M.D., M.Sc.,

focus on adult patients as part of our oculoplastics team, in addition to our other oculoplastic surgeons.

logical event or is the first symptom of a neurological disease,

Virtual multidisciplinary care conferences guide TED

the right team of Kellogg specialists will collaborate to deliver

treatment planning. Attendees include specialists in oculoplas-

outstanding, patient-focused care.

tics, strabismus, and neuro-ophthalmology, thyroid surgeons

Sangeeta Khanna, M.D., and Tatiana Deveney, M.D. 6

M.D., Denise Kim, M.D., and

“

Neuro-Ophthalmology

Denise Kim, M.D.

from general surgery and otolaryngology, and colleagues from

benefit from teprotumumab; at U-M these complex patients are

adult and pediatric endocrinology, nuclear medicine, and

supported by a team involving ophthalmologists, endocrinolo-

neuroradiology.

gists, thyroid surgeons, and nuclear medicine specialists,”

Cross-disciplinary dialog is especially important in the era of teprotumumab (Tepezza), the first and only FDA-approved

says Dr. Kim, who coordinates the conferences. “Our patients appreciate that so many providers are involved in their care.”

treatment specific for TED. Originally formulated as a cancer

An ongoing series of virtual multi-disciplinary teaching

treatment, the drug was translated for use in TED by Kellogg

conferences is also helping Kellogg providers share best practices

endocrinologist Terry Smith, M.D.

in the diagnosis and treatment of orbital disorders with col-

“Patients with moderate to severe Thyroid Eye Disease can

leagues in the departments of plastic surgery and otolaryngology.

COVID-19 Transmission Risk in Cornea Transplantation In 2020, researchers studying COVID-19 transmission identified the virus in conjunctival swabs and tears collected from infected This finding prompted a study led by Kellogg cornea transplant surgeon Shahzad Mian, M.D., in conjunction with Eversight Eye Bank and Wayne State University to address COVID-19 related concerns that could impact cornea transplantation. The study was funded by the Eye Bank Association of America (EBAA)

“

through a program targeting issues arising from the spread of COVID-19.

“Since COVID-19 patients

WITH MORE THAN 5 MILLION

PEOPLE WORLDWIDE LOSING THEIR

SIGHT FROM CORNEAL DISEASE, WE NEED

it’s policy of not transplanting

TO DO ALL WE CAN TO ENCOURAGE CORNEA

cornea tissue that comes from

“

patients.

donors with any of these 3 char-

DONATION AND MAXIMIZE THE GLOBAL

hold much of the virus in the upper respiratory tract, we were not surprised

acteristics. The addition of both donor screening and postmor-

SUPPLY OF DONOR TISSUE.

that the virus could also contaminate

— Shahzad Mian, M.D.

the outer layers of the eye, via coughing, sneezing or hand-to-eye contact,” says Dr. Mian, Kellogg’s Vice Chair for Clinical Sciences and Learning. “Our study focused on the consequences of that finding for cornea transplantation.”

Dr. Mian’s team analyzed postmortem ocular tissue samples

tem nasopharyngeal PCR testing for COVID-19 might enable the use of corneas from donors in these subgroups. “With more than 5 million

people worldwide losing their sight from

corneal disease, we need to do all we can to

encourage cornea donation and maximize the global supply of donor tissue.”

from three donor subgroups whose tissues were disqualified

Despite the pandemic, Dr. Mian reinforces the safety of

from surgical use: 1) intended cornea donors who died from

cornea transplantation. “Even though cornea tissue can contain

COVID-19; 2) potential donors who were asymptomatic but

the virus, there have been no cases of transmission through

tested positive at time of corneal recovery; and 3) potential do-

corneal transplantation,” he says. “In the rare instances where

nors who exhibited symptoms prior to death but tested negative

a donor who was positive for COVID-19 was inadvertently

for the virus.

transplanted it has not resulted in infection. Nonetheless,

Approximately 13 percent of the ocular tissue samples

additional research is needed.”

tested positive for COVID-19. The EBAA has thus continued 7

In it Together Two pairs of family members—one linked by blood, one by marriage—look to Kellogg for urgent glaucoma treatment

Glaucoma has been called the silent thief of sight. It can be inherited or result from other diseases, trauma, aging, or many other causes. Glaucoma can present at birth or develop late in life. Glaucoma’s hallmark characteristic, elevated intraocular pressure, can be manageable for years, and then spike rapidly At a high-volume referral center like Kellogg, our glaucoma experts expect to encounter these variations. But it’s not every day that they come along in pairs.

Tierra and Makayla

Tierra Richardson, 25, and her sister Makayla Miller, 17, both of Grand

“

Rapids, Michigan, share an inherited form of glaucoma. Makayla’s glaucoma was discovered at birth,

MIDDLE OF THE SEMESTER MADE ME

ANXIOUS. BUT I WAS INTRIGUED WHEN

DR. SHAH DESCRIBED THE MIGS OPTION. BEING INVOLVED IN THE DECISION MADE

and surgery was performed on one of her eyes as an infant. Tierra was

ME FEEL MORE COMFORTABLE.

diagnosed at age six and underwent her

— Makayla Miller

first operation at age 16.

In the ensuing years, both sisters’ intraocular pressures were watched closely, first by their local ophthalmologist, then by a Kellogg team led by glaucoma specialist Manjool Shah, M.D. “My glaucoma was well-monitored near home,” says

Elevated pressure was jeopardizing both of Tierra’s eyes. Dr. Shah performed cyclophotocoagulation on the eye that had undergone a prior surgery. The procedure applies laser energy to the part of the eye that produces intraocular fluid. That essentially ‘turns down the faucet,’ lowering eye pressure.

Her other eye was a candidate for micro-

invasive glaucoma surgery, or MIGS. “We chose

to implant the XEN® gel stent, a flexible tube the size of an eyelash,” Dr. Shah explains. Kellogg was among the first U.S.

Tierra. “But I chose to travel to Kellogg for access to more

centers to implant this stent when it first earned FDA approval

options to keep my eye pressure down. I encouraged my mom,

in 2017.

who has lost much of her vision to glaucoma, to allow me to bring Makayla to Kellogg too.”

At an evaluation in the spring of 2020, both Makayla

“At the time, I was a full-time college student,” Tierra recalls. “The thought of surgery in the middle of the semester made me anxious. But I was intrigued

and Tierra registered dangerously high intraocular pressures.

when Dr. Shah described the MIGS

“Both patients required prompt interventions,” recalls Dr. Shah.

option. Being involved in the decision

“Because of the distance they traveled, and despite the fact that

made me feel more comfortable.”

Kellogg was operating at limited capacity due to the pandemic,

Throughout the day, the sisters

we scheduled their procedures right away, arranging to operate

worried about each other. But Dr. Shah

on both sisters on the same day.”

kept each updated on the other’s prog-

Glaucoma had already cost Makayla virtually all of the vision in one eye. Dr. Shah recommended that a drainage tube be implanted to manage the pressure in the other eye.

8

Makayla Miller and her sister Tierra Richardson

THE THOUGHT OF SURGERY IN THE

“

and unpredictably.

ress. “We felt better knowing we were in it together,” says Makayla.

Charles and Sallie

Charles and Sallie Sanislow’s ties to the University of Michigan and the Kellogg Eye Center date back decades. Charles, age 90, a retired vascular surgeon, and Sallie, age 85, a retired nurse, both received their medical training at U-M, and both had been patients of Kellogg’s Founding Director, Professor Emeritus Paul Lichter, M.D., M.S. In recent years, an ophthalmologist near their home in Midland, Michigan, oversaw their eye care. But early in spring 2021, the Sanislows experienced different — but equally troubling — consequences of glaucoma. After consulting with their local ophthalmologist, they decided to return to Kellogg, this time under the care of glaucoma specialist Joshua

“

Stein, M.D., M.S. “The Sanislows’ each have difficultto-manage glaucoma, but it developed in two different ways,” explains Dr. Stein.

HAVING PRACTICED A DEMANDING

“Within months of each other, for different reasons, both needed swift

Sallie and Charles Sanislow

TYPE OF SURGERY FOR MANY YEARS,

interventions to stabilize their intra-

I KNOW THE IMPORTANCE OF REALLY

ocular pressures. These cases show just how unpredictable glaucoma

At Kellogg, retinal and uveitis

LISTENING TO A PATIENT’S CONCERNS,

Retinal scarring from an earlier condition left Charles with limited vision in his right eye. As Dr. Stein ex-

“

can be.”

specialists K. Thiran Jayasundera,

IN OUR EXPERIENCE, DR. STEIN IS

M.D., M.S., and Mark Johnson,

TRULY A PHYSICIAN’S PHYSICIAN.

M.D., collaborated with Dr. Stein

— Charles Sanislow

plained, both eyes contribute to depth perception, even when the vision in one eye is limited.

“To preserve that depth perception, I was open to whatever could be done to maintain the remaining vision in that eye,” says Charles.

Dr. Stein performed

to determine the origin of Sallie’s inflammation and map a path to treat it. “Conditions like Sallie’s require detective work,” says Dr. Stein. “To treat

the flare-up effectively, we needed to under-

stand what was causing it.”

Once the inflammation was controlled, Dr. Stein performed a laser trabeculoplasty to stabilize her eye pressure.

laser trabeculoplasty in

“I was impressed by how the doctors and staff worked

April and more laser in

together, how much time they spent with me, and how mindful

June, successfully stabilizing

everyone was — especially Dr. Stein — of our time and travel,”

the pressure in the eye. Not

Sallie recalls.

long after the second proce-

Charles agrees. “Having practiced a demanding type of

dure, Charles again reached

surgery for many years, I know the importance of really

out to Dr. Stein, this time

listening to a patient’s concerns,” he adds. “In our experience,

with an urgent concern

Dr. Stein is truly a physician’s physician.”

about Sallie.

Sallie was experiencing a serious flare-up of uveitis, inflammation in the eye.

Since their procedures, both patient pairs are doing well.

And all have made a lasting impression on their providers.

“Tierra and Makayla are inspiring,” Dr. Shah says. “They

“When it comes to glaucoma, uveitis is a double threat,”

are so supportive of each other, and both are amazingly resilient

explains Dr. Stein. “Both the inflammation and the cortico-

and committed to doing what it takes to manage their glauco-

steroids used to treat it can inhibit the eye’s ability to drain

ma.” “I would describe Charles and Sallie Sanislow exactly the

fluid, accelerating glaucoma.”

same way,” adds Dr. Stein.

9

“

WE OFFER MULTIPLE TREATMENT

OPTIONS FOR PATIENTS WITH ANY

COMBINATION OF SEVERE SYMPTOMS.

“

— Roni Shtein, M.D., M.S.

Roni Shtein, M.D., demonstrates corneal staining technique with Sheila Gilbert, COA

Finding a Personalized Solution for Dry Eye According to the American Academy of Ophthalmology (AAO), approximately 20 million Americans, and nearly 350 million people worldwide, suffer from inadequate lubrication of the eye, or dry eye disease.

Many factors can contribute to dry eye. It is a frequent

Serum tears — Eye drops made from the serum of a patient’s

own blood contain growth factors and nutrients shown to be effective in decreasing symptom severity. Kellogg has developed the protocols used by a U-M blood draw station and a local compounding pharmacy to formulate these ‘customized tears.’

A mail order option through an outside vendor is available to patients out of the area.

medication side effect, a comorbidity of some systemic diseases

Scleral contact lenses — Contact lenses scaled to fit over the

and, most commonly, simply a consequence of growing older.

white of the eye can keep moisture in and cushion the surface

It is mildly uncomfortable for some patients, excruciating for

of the eye. Kellogg also offers the Prosthetic Rehabilitation of

others. Yet despite diminishing the quality of life of so many,

the Ocular Surface Ecosystem (PROSE), a customized scleral

dry eye remains, as EyeNet® magazine states, “notoriously

lens that bathes the eye with artificial tears.

underappreciated, misdiagnosed, and undertreated.”

In the Cornea Clinic at Kellogg, improving the lives of patients with dry eye disease is a top priority. Patients are frequently referred to Kellogg when the established first-line treatment — lubricating eye drops — falls short. Patients with

10

Some Innovative Treatment Modalities Offered:

Intense pulsed light treatment (IPL) — For dry eye

caused by meibomian gland dysfunction, IPL treatment to the eyelids can reduce inflammation and improve meibomian gland function.

the most complex, hard-to-manage conditions are often seen

Research — The cornea specialists at Kellogg are also involved

by dry eye specialist Roni Shtein, M.D., M.S.

in research to improve treatment of dry eye or chronic symp-

“Ocular surface dryness is at its most acute when it is

toms. For example, Kellogg is currently recruiting patients as

associated with ocular surface damage or scarring, when it

part of a multi-center clinical trial of an eye drop for treating

is accompanied by visual abnormalities or diminished vision,

chronic eye pain or dry eye-like symptoms in a post-surgical

or when it occurs with a component of centralized pain,”

population. The eventual goal of the treatment will be to treat

Dr. Shtein explains. “We offer multiple treatment options for

patients with chronic pain/symptoms, regardless of the underly-

patients with any combination of these severe symptoms.”

ing ocular conditions.

Prioritizing Communication for Patient Safety The key to providing safe care in any healthcare organization is good communication. It’s a simple idea, but not always an easy one to implement, especially when juggling the many competing demands of a busy clinic.

To create time and space for a focused dialog on safety, Kellogg leadership instituted an annual ‘safety morning.’ Once a year, time is reserved on the calendar, during which no clinic appointments or procedures are scheduled.

“Faculty and staff are empowered to use that window of

“

Jennifer Weizer, M.D., with Glaucoma team (left to right — Melissa Collins, Erin Bonilla, Becky Elliot, Danielle Little, Rhonda Davis, Tyler Rice, and Kari Bacha)

PRIORITIZING OPPORTUNITIES LIKE

participate. Safety committee mem-

SAFETY MORNINGS AND SAFETY HUDDLES

uninterrupted time to review safety

bers spent time in each clinic discussion, noting the topics covered

ILLUSTRATES KELLOGG’S COMMITMENT

protocols, discuss issues specific to

TO LISTENING, LEARNING AND

their clinics, and suggest possible

CONTINUOUS IMPROVEMENT.

“

process improvements,” explains

and looking for common areas to share potential improvements.

After faculty and staff voiced a desire to keep the dialog going

— Jennifer Weizer, M.D.

Jennifer Weizer, M.D., chair of Kellogg’s safety committee.

Safety morning begins with a department-wide review of fundamental

throughout the year, clinics initiated quarterly safety “huddles” to talk in depth about pressing issues.

“Prioritizing opportunities like safety

mornings and safety huddles illustrates

safety principles. That discussion is followed by

Kellogg’s commitment to listening, learning and

breakout sessions within each clinic to discuss everyday

continuous improvement,” Dr. Weizer says. “Those are the

issues and concerns that can impact safety.

Due to COVID-19 precautions, 2021 safety morning

keys to maintaining our outstanding safety record.”

sessions took place both in-person and virtually so all could

Marshall Parks Lecture at AAO Monte A. Del Monte, M.D., Skillman Professor

mologist selected by a committee representing

of Pediatric Ophthalmology and Professor of

the AAO, the American Association of Pediatric

Pediatrics and Communicable Diseases, present-

Ophthalmology and Strabismus (AAPOS) and

ed the 22nd annual Marshall M. Parks Lecture at

the Costenbader Pediatric Ophthalmology

the 2021 meeting of the American Academy of

Society.

Ophthalmology (AAO), held in November. His

“As a former fellow of Dr. Parks, I was

lecture was titled “The Role of the Conjunctiva

excited to honor my mentor and second father

in Strabismus and Strabismus Surgery.”

figure for the pivotal role he played in the de-

Each year’s presenter is an internationallyrecognized pediatric ophthalmologist or strabis-

velopment of my career and of the entire field,” says Dr. Del Monte.

11

Kellogg Leads International Team Linking Family’s Symptoms to Rare, Inherited Syndrome Stan Gibson has struggled his whole life with an unusual collection of symptoms — symptoms that plagued his father and grandfather before him.

All developed glaucoma as young children, and all battled similar rheumatologic, dermatologic and musculoskeletal problems.

The condition seemed to be passed down only to males, and symptoms seemed to present in early childhood. Based on that pattern, Stan Gibson and his wife Eryn initially thought their daughter was not at risk, and that the disorder had bypassed their sons, who reached adolescence without developing symptoms.

The first indication that that was not the case came when, at age three, their daughter Rachel was diagnosed with glaucoma. At the time, the family lived in California, where Rachel underwent multiple corrective procedures.

Rachel’s eye problems per-

“

sisted after the family relocated

Left to right — Samuel, Stan, Rachel, Rulon, Eryn, Ammon, Adam, Lauren, Spencer. Photo courtesy of the Gibson family.

one eye slipped into the sclera,

DEVELOP EFFECTIVE TREATMENTS.

National Institutes of Health (NIH), where Dr. Prasov completed a clinical fellowship, all of the protein-coding DNA from affected and unaffected

“

— Lev Prasov, M.D., Ph.D.

Brenda Bohnsack, M.D., Ph.D., performed a complex reconstructive procedure that saved her vision. Dr. Bohnsack is now head of ophthalmology at the Lurie Children’s Hospital of Chicago.

Impressed by the level of care his daughter received, Stan

members of the extended Gibson family was sequenced.

This whole exome sequencing revealed a never-before observed misspelling in the gene

DDX58. Stan, Rachel and Adam all share this

mutation.

A search of a public database of reported patient informa-

Gibson soon began seeing Kellogg glaucoma surgeon Sayoko

tion linked to genetic variants led to the identification of another

Moroi, M.D., Ph.D., and cornea and refractive surgeon Shahzad

family in Belém, Brazil, with a similar set of clinical findings

Mian, M.D., to manage his ongoing eye problems. After el-

and the same DDX58 variant.

evated eye pressure caused an initial cornea transplant to fail, Gibson underwent a second transplant procedure at Kellogg.

The mysterious condition struck the family again when, at age 13, their son Adam experienced sudden and dramatic vision loss. Dr. Bohnsack performed an emergency procedure

“We concluded that the disease is Singleton-Merten syndrome type II,” says Dr. Prasov, “an extremely rare, autosomaldominant condition with only three previously documented families.”

Further genetic, clinical and epidemiological research

to normalize his eye pressure, restoring most of Adam’s vision,

followed to better understand the syndrome. An international

save a small peripheral loss.

team led by Dr. Prasov included specialists from Kellogg and six

At that point, ophthalmic geneticist Lev Prasov, M.D.,

12

In collaboration with colleagues at the National Eye Institute of the

US PREVENT SOME OF ITS MORE SEVERE CONSEQUENCES, AND EVENTUALLY

where pediatric glaucoma surgeon

shared by Stan, Rachel and Adam.

THAT DRIVE THIS SYNDROME MAY HELP

to Michigan. When the iris of she was referred to Kellogg,

of the seemingly random symptoms

UNDERSTANDING ALL THE FACTORS

other departments at U-M, academic medical centers in Boston,

Ph.D., along with Dr. Bohnsack and glaucoma geneticist

Chicago and Columbus in the U.S., Belém and Sao Paulo in

Julia Richards, Ph.D., began looking for the genetic origins

Brazil, and seven different units of the NIH.

In addition to the most prominent symptoms — pediatric-

for families with inherited ophthalmic conditions. “Understand-

onset glaucoma and a psoriasis-like skin rash, other symptoms

ing all the factors that drive this syndrome may help us prevent

include arthritis, spontaneous tendon ruptures, and aortic,

some of its more severe consequences, and eventually develop

skeletal and dental calcifications. The team described how the

effective treatments.”

DDX58 variant triggers an inflammatory cascade in the body responsible for many of the symptoms.

The tendency to develop calcifications explained some of

The Gibsons came to Kellogg for sight-saving care. In the process, a family mystery was finally solved.

“If it wasn’t for the Kellogg Eye Center, two of our kids

the puzzling symptoms experienced by Stan, Rachel and Adam

would be blind,” says Eryn Gibson. “Because of the commu-

Gibson. All three endured dental problems caused by retaining

nication between these doctors, this condition is now better

baby teeth long after they are normally lost. Also likely due to

understood. Their curiosity led to answers, and helped us feel

a calcium buildup, Adam suffered a carotid artery rupture at

like we were finally being heard and cared about. After genera-

age 21.

tions of unanswered questions and enormous health challenges,

“This work highlights how a genetic diagnosis can have a big impact on clinical practice and patient outcomes,” says

someone took this seriously and had access to the resources to find answers. We are grateful beyond words.”

Dr. Prasov, who now leads a multidisciplinary clinic to care

Leading on the National Stage Nurturing leaders is in Kellogg’s DNA. In addition to providing world-class patient care and pursuing new research frontiers, we encourage and prepare our faculty members to actively participate in national ophthalmology organizations.

The following list is not meant to be comprehensive, but rather a snapshot of Kellogg faculty involvement. Kellogg faculty and alumni contribute to the boards and committees of the most influential associations in ophthalmology, working with colleagues to help keep the field moving forward.

Kari Branham M.S., C.G.C.

Paul Lee, M.D., J.D.

President, NAEVR/AEVR President, AUPO Chair, AAO Board Task force on Disparities in Visual Health Shahzad Mian, M.D.

Board of Directors, Eversight Eye Bank Senior Medical Director, Eversight Eye Bank Board of Directors, Eye Bank Association of America Board of Directors, Cornea Society Vice Chair, Medical Advisory Board, Eye Bank Association of America Christine C. Nelson, M.D.

Foundation Fighting Blindness Clinical Consortium, Genetics Review Committee, Chair National Society of Genetic Counselors Ophthalmology and Hearing Loss Special Interest Group, Co-Chair

Board of Directors, World Association of Eye Hospitals Trustee, American Society of Ophthalmic Plastic and Reconstructive Surgery Foundation

Monte Del Monte, M.D.

Board of Directors, American Glaucoma Society

Past-President, Costenbader Pediatric Ophthalmology Society Joshua Ehrlich, M.D., M.P.H.

Chair, AGS CARES Co-Chair, Advisory Board, Center for Vision and Population Health at Prevent Blindness Lancet Global Health Commission on Global Eye Health

Paula Anne Newman-Casey, M.D., M.S. Ariane Kaplan, M.D.

AUPO Directors of Medical Student Education Council Joshua Stein, M.D., M.S

Board of Directors of AGS; Chair of patient care committee Maria Woodward, M.D., M.S.

Board of Directors, Pan-American Ophthalmological Foundation

Council Leadership, Subspecialty/Specialized Section, Section Nominating Committee, American Academy of Ophthalmology Board of Directors, Cornea Society Dermatologic and Ophthalmic Drugs Advisory Committee, U.S. Food and Drug Administration

Mark Johnson, M.D.

David Zacks, M.D., Ph.D.

Thomas Gardner, M.D., M.S.

National Advisory Eye Council of the National Eye Institute K. Thiran Jayasundera, M.D., M.S., F.A.C.S.

President, The Macula Society Chair, AAO Retina Subspecialty Day

Secretary, The Retina Society

13

“

MY GOAL IS TO LAY THE

GROUNDWORK FOR NEW THERAPIES FOR CHOROIDEREMIA AND OTHER DISEASES

IMPACTED BY THE DEGENERATION OF THE

“

Finding New Pathways for the Treatment of Choroideremia

BLOOD SUPPLY TO THE OUTER RETINA. — Abigail Fahim, M.D., Ph.D.

Many blinding retinal diseases, including inherited diseases like choroideremia and age-related macular degeneration (AMD), share a common characteristic: the degeneration and death of the choroid, the layer of blood vessels and tissue between the retina and the sclera that supplies blood to the outer retina.

Kellogg Assistant Professor Abigail Fahim, M.D., Ph.D., has been awarded a National Institutes of Health Mentored

“With the guidance of my ‘dream team’ of mentors,” she says, “my goal is to lay the groundwork for new therapies for choroideremia and other diseases impacted by the degeneration of the blood supply to the outer retina.”

Clinical Scientist Research Career Development (K-08) award to explore the role that dysfunction in the retinal pigment epithelium (RPE) plays in choroidal death.

“We know that choroideremia is caused by a genetic mutation that disrupts a process called membrane trafficking, essential to the health of RPE cells as well as the neighboring choroid and photoreceptors” she explains. “But many fundamental questions about how that happens remain unanswered.”

Several innovations make Dr. Fahim’s research approach unique, including the use of a gene-edited, human stem cell-derived RPE model she developed. Past research in choroideremia has relied on mouse models, which provide an incomplete profile of the human disease.

Building on her experience in the genetics and molecular mechanisms of inherited retinal diseases, Dr. Fahim will be supported by a team of five mentors located at U-M and abroad, who will lend their expertise in study design and data analysis to maximize the project’s translational impact.

14

K08 Award

Dr. Fahim’s K-08 Mentor and Advisor Team: Yoichi Osawa, Ph.D., Professor of Medicine; Professor and Associate Chair of Innovation, Department of Pharmacology Debra A. Thompson, Ph.D., Professor of Ophthalmology and Visual Sciences; Professor of Biochemistry Jack Parent, M.D., Professor of Neurology; Director, Neurodevelopment and Regeneration Laboratory David Antonetti, Ph.D., Professor of Ophthalmology and Visual Sciences; Professor of Integrative Physiology Robin Ali, Ph.D., Professor of Human Molecular Genetics; Deputy Director, Biomedical Research Centre and Head of the Centre for Cell and Gene Therapy, King’s College London; Visiting Professor, Kellogg Eye Center

Clinical Research Update: Patient Perspectives After a year during which COVID-19 restrictions curtailed many aspects of its day-to-day operations, the Kellogg Clinical Research Center (KCRC) is once again humming with activity.

KCRC research coordinators currently manage 54 sponsor-initiated clinical studies involving 15 faculty members. Another 13 studies will begin within the next year, with three more faculty investigators.

“While we had to do things differently during the pandemic, we never lost our focus on providing exceptional service and support to our investigators and sponsors, and especially

“

Callie Gordon, COA, OSC, Clinical Research Coordinator, with Brandon Gibbons

OF COURSE, I HOPE

I’LL EVENTUALLY BENEFIT FROM

letter from Kellogg, notifying him

TREATMENTS THAT COME OUT OF

that he met the initial criteria to be considered for a study.

to our valued research volunteers,”

CLINICAL RESEARCH. BUT IN THE

says KCRC Medical Director Grant

MEANTIME, I’M GLAD TO PLAY SOME

Two recent study participants

“

Comer, M.D., M.S.

SMALL ROLE IN THE PROCESS.

typify the selflessness and commitment that make research volunteers so special.

— Brandon Gibbons

Both live with rare, genetic eye conditions that cause progressive vision loss; and for

a leading institution with access to the latest advances, including experimental treatments. My wife and I discussed it and decided to look into it.”

KCRC Clinical Research Coordinator

a comprehensive initial screening, and has

Brandon Gibbons, 27, began seeing an ophthalat age 13. He and his parents first traveled to the Kellogg Eye

much thought,” he admits. “But I came to Kellogg to connect with

Stephanie Wietholter walked Fries through

which there are no effective treatments. mologist close to his home in Florida after being diagnosed

“At first, I didn’t give it

remained his primary point of contact.

“Because many trials require frequent and lengthy visits,

Center in 2008. He returned to Kellogg regularly until starting

we get to know our volunteers very well,” she says. “That’s

college in 2012.

one of the best parts of what we do – building relationships

Curious about any new advances that may have been available, Brandon again traveled from his home in Florida to the

with wonderful patients like Brice and their families.”

“From my first trip to Kellogg through my time in the study,

Kellogg Eye Center in 2017. During his examination, he learned

everyone has gone out of their way to help and encourage me

about a clinical trial and decided to participate.

and my family,” says Fries. “It has made a lasting impression

Gibbons works as an ophthalmic technician, and is studying for a graduate degree in pharmacology. “I’ve always been fasci-

on us.”

Both volunteers know that their participation in these stud-

nated by science and research, and I’ve always been impressed

ies will not directly improve their vision. Yet both agree that the

with the high degree of professionalism and skill I encounter at

experience is one they would recommend to others.

Kellogg,” he says. “So stepping up to participate in a clinical study was not a difficult decision for me.”

Clinical Research Coordinator Callie Gordon is Gibbons’

“I knew from the start that this experience is about helping people down the road, not myself,” Brandon Gibbons says.

“Of course, I hope I’ll eventually benefit from treatments that

primary contact at the KCRC. “All of our trial participants are

come out of clinical research. But in the meantime, I’m glad to

terrific, but Brandon was especially engaged and motivated,”

play some small role in the process.”

she says. “It’s not every day that a patient already ‘speaks our language.’”

Brice Fries, 37, began traveling to Kellogg from his home in northern Ohio in 2011 for annual exams to monitor his

Brice Fries agrees. “Because I had such a high level of trust in my Kellogg care team, I had no reservations about volunteering. It’s especially important for people like us, with conditions that are currently untreatable, to get involved.”

condition. He first learned about clinical trial possibilities in 15

Training Eye Disease Researchers in India Blindness and vision impairment combined are the number one cause of disability among India’s elderly — a growing segment

Kellogg professor David Musch, Ph.D., M.P.H., is the Pro-

of the country’s population. Both in India and in the U.S., poor

gram Director/Principal Investigator on the grant, and is joined

vision in old age is linked to increased risk of falls, dementia,

by co-investigator Joshua Ehrlich, M.D., M.P.H. “Kellogg and

depression, disability, loss of independence, longer and more Non-communicable disease accounts for more than nine in ten cases of vision loss in older Indians, and the majority of those cases are avoidable.

The large and growing burden of preventable eye disease in India is compounded by a shortage of population health research expertise

the AECS have a long and productive history of close collaboration and educational exchanges,” Dr.

“

in the country — a critical barrier to developing effective, evidence-

Musch says. “This award reflects the shared commitment of Aravind and Kellogg to pursue research that will reduce and one day eliminate vision loss.”

A needs assessment survey

SPECIAL EMPHASIS WILL BE PLACED

helped guide the development of the

ON THE TOOLS NEEDED TO CONDUCT

program’s curriculum. Post-grad-

LIFE-COURSE STUDIES, TO UNDERSTAND THE IMPACT OF VARIOUS EARLY- AND MID-LIFE

based interventions to stem the tide of vision-related disability.

“

frequent hospitalizations, and mortality.

EXPOSURES ON LATE-LIFE VISION.

The Kellogg Eye Center has pro-

— David Musch, Ph.D., M.P.H.

posed an ambitious training program to build clinical-epidemiological research capacity in India. The program is a partnership with the Aravind Eye Care System (AECS) located in southern India. AECS is the world’s largest

uate training tracks designed for early- and mid-career AECS faculty will establish a firm foundation in study design, research ethics and statistical analysis. “Special emphasis will be placed on the tools needed to conduct life-course studies,” explains Dr. Musch, “to understand the impact of various early- and mid-life exposures on

late-life vision.”

In addition to preparing India’s next generation

eye care system, and the training program leverages a diverse

of clinical-epidemiological eye researchers, the program will

array of research resources across the University of Michigan.

also bolster the mentoring and teaching skills of AECS faculty

The consortium has been awarded an International

leaders, in anticipation of all training activities transitioning to

Research Training Grant (D43) from the Fogarty International

David Musch, Ph.D., M.P.H., and Joshua Ehrlich, M.D., M.P.H.

16

Center of the National Institutes of Health (NIH).

AECS by the end of the 5-year grant period.

Aravind Srinivasan (Chief Medical Officer, Aravind Eye Hospital, Chennai, India) and Mr. Israel Gnanaraj (Hospital Architect)

“

MY HOPE IS THAT A BETTER

UNDERSTANDING THE GENETIC AND

MOLECULAR MECHANISMS OF SMALL EYES AND HYPEROPIA WILL POINT TO NEW

“

Lev Prasov, M.D., Ph.D., and Erika Ward, B.S., review a pedigree of a large family with nanophthalmos

THERAPEUTIC TARGETS FOR THESE DISEASES. — Lev Prasov, M.D., Ph.D.

Mapping the Genetic Landscape of Nanophthalmos Nanophthalmos is characterized by a small eye and severe

This grant will be used to catalog the genetic determinants

farsightedness (high hyperopia). The condition can lead to a

of nanophthalmos and high hyperopia, including describing

range of complications, from angle closure glaucoma to retinal

the mechanism by which MYRF disrupts RPE structure and

and choroidal detachments.

function.

How nanophthalmos develops is not completely under-

A team of mentors and collaborators led by Dr. Sally

stood. But an important piece of the puzzle was revealed in

Camper will support Dr. Prasov, providing instruction and

2019, when Kellogg physician-scientist Lev Prasov, M.D., Ph.D.

supervision in developmental and medical genetics, RPE biology,

first linked the gene myelin regulatory factor (MYRF) to familial

genomics and bioinformatics.

nanophthalmos. Using animal models, he also uncovered a role

“My hope is that a better understanding the genetic and

for MYRF in retinal pigment epithelial (RPE) development, find-

molecular mechanisms of small eyes and hyperopia will point

ing that its disruption led to retinal degeneration in mice.

to new therapeutic targets for these diseases,” he says. “The

Dr. Prasov has been awarded a Mentored Clinical Scientist Research Career Development (K-08) award from the National

findings may also shed useful light on the other end of the spectrum, namely, myopia that results from too large an eye.”

Institutes of Health to build on that work.

“In a study of families with nanophthalmos, we found that known genes, including MYRF, were implicated in only

Dr. Prasov’s K-08 Mentor and Advisor Team:

20 percent of cases,” says Dr. Prasov. “But we hypothesize that

Sally Camper, Ph.D., Professor of Internal Medicine

the other 80 percent of cases may be explained by other, yet

Jun Li, Ph.D., Professor of Human Genetics

to be identified genes, that may be targets or interacting partners

David Zacks, M.D., Ph.D., Professor of Ophthalmology

of MYRF, whose primary function is to control expression of

and Visual Sciences

other genes.”

Robert B. Hufnagel, M.D., Ph.D., Director, Ophthalmic

Genomics Laboratory

K08 Award

17

“

OUR HOPE IS THAT SHEDDING

NEW LIGHT ON THE ACTIVITIES OF LD

IN THE RPE WILL POINT US TO FUTURE

“

THERAPEUTIC TARGETS FOR AMD. — Jason Miller, M.D., Ph.D.

Lipid Droplets May Protect Against AMD Many cells in the body rely on lipids for a variety of purposes.

just ‘temporary storage’ for the RPE’s daily incoming lipid load,

They are building blocks of cell membranes, and play key roles

LD serve as versatile, dynamic regulatory hubs for lipid traffick-

in cell signaling, energy storage and transport. In the light-sen-

ing and metabolism.”

sitive retina, two layers of cells — the retinal pigment epithelium

Miller will use a combination of imaging, biochemical

(RPE) and the photoreceptors — exchange lipids as part of the

assays, bio-energetic cell profiling and lipidomics to more fully

process of turning light into an electrical signal that the brain

describe RPE LD biology. Experiments will be performed on

interprets as vision.

a combination of human adult RPE cultures and RPE cultures

Buildup of lipid in the RPE occurs naturally with age.

But excessive lipid deposits outside the RPE form lipid-rich lesions — drusen and reticular pseudodrusen — which are early

derived from induced pluripotent stem cells.

“Our hope is that shedding new light on the activities of LD in the RPE will point us to future therapeutic targets for AMD.”

signs of age-related macular degeneration (AMD). AMD is the leading cause of irreversible blindness in the developed world.

As the RPE is a heavy consumer and producer of lipid, it temporarily stores some incoming lipid in structures called lipid droplets (LD). But little is known about what role LD may play in tasks like lipid metabolism, or whether or how LD might be employed to protect against the lipid-accumulations of drusen and reticular pseudodrusen seen in AMD. Jason Miller, M.D., Ph.D., has been awarded a National Institutes of Health Mentored Clinical Scientist Research Career Development (K-08) award to begin filling in these gaps in understanding.

“Our premise is that, until now, science has been underestimating the role of lipid droplets as a protective mechanism in the RPE,” asserts Dr. Miller. “We hypothesize that rather than

18

K08 Award

Dr. Miller’s K-08 Mentor and Advisor Team: Subramanium Pennathur, M.D., Professor and Chief of Nephrology; Director, O’Brien Kidney Translational Center; Director, Molecular Phenotyping and Metabolomics Core, Nutrition and Obesity Center Ormond MacDougald, Ph.D., Professor of Molecular and Integrative Physiology; Professor of Endocrinology Debra Thompson, Ph.D., Professor of Ophthalmology and Visual Sciences; Professor of Biochemistry Sami Barmada, M.D., Ph.D., Professor of Neurology

Michigan Medicine to Establish Neural Engineering Training Program James Weiland, Ph.D., Professor of Ophthalmology and Visual Sciences and Professor of Biomedical Engineering, led a successful cross-campus effort to establish a Neural Engineering Training Program (NETP) at the University of Michigan.

Funding for this new graduate training program will be provided by an institutional research training grant (T32) from the National Institute of Neurological Disorders & Stroke (NINDS).

The grant will support advanced training for predoctoral students whose research seeks to advance new applications of technology leading to the development of clinical devices for the treatment of complex neurological disorders.

Kate Kish, doctoral student in Biomedical Engineering, with James Weiland, Ph.D.

From neuromodulation systems that treat epilepsy, movement disorders and pain, to neural prostheses that restore lost

workshop will be conducted in collaboration with the existing

function to eyes and limbs, neurotechnology is transforming

Kellogg Vision Research Training Program.

medicine. “To create the next generation of devices and implants

“Ophthalmology is among the fields with the most to gain

that will truly change lives, we need better human/machine

from supporting the next generation of neural engineering lead-

interfaces, novel new materials, and a fuller realization of the

ers,” says Dr. Weiland, who also directs the U-M BioElectronic

potential of artificial intelligence,” says Dr. Weiland, who will

Vision Lab (BEVL). His lab is at the forefront of creating and

serve as NETP director. “For all of that, we need highly trained

translating technological solutions for visual dysfunction, in-

neural engineers capable of leading interdisciplinary teams to

cluding bioelectronic retinal prostheses and wearable visual aids

keep up with the pace of discovery.”

for the blind.

Kellogg Eye Center is one of eight University of Michigan

The NETP, which launched in July 2021, will initially

entities collaborating to deliver a targeted curriculum, mentor-

support up to four graduate student slots and will sponsor a

ship and student-led initiatives. To ensure that rigorous ana-

number of training and networking opportunities for trainees

lytical techniques are learned and applied, a statistics training

from more than 30 U-M labs.

Endocrine Society Award Terry Smith, M.D., has been awarded the 2022 Gerald D.

Aurbach Award for Outstanding Translational Research from the Endocrine Society. Dr. Smith, the Frederick G.L. Huetwell Professor Emeritus of Ophthalmology and Visual Sciences at Kellogg, and Professor Emeritus of Internal Medicine at the U-M Medical School, is the only endocrinologist in the U.S. with a full-time primary faculty appointment in ophthalmology at an academic eye center. His pioneering work in Graves’ disease and related autoimmune conditions has culminated in the creation of teprotumumab — the first FDA-approved therapy to treat thyroid eye disease.

19

Andreia Goncalves, Ph.D., with David Antonetti, Ph.D., study immunostained retina

A New Regulator of Retinal Angiogenesis Discovered Blood vessel growth (angiogenesis) has been shown to be an important factor in diseases from diabetes to cancer. Under-

Heme is recognized primarily as a component of hemoglo-

standing how the process is regulated, especially in the brain

bin in red blood cells that carry oxygen. However, heme also

and retina, may yield new treatments for many eye and other

contributes to a wide range of functions in other cells,

Funded by a Stein Innovation Award from Research to Prevent Blindness (RPB), David Antonetti, Ph.D., is advancing a novel hypothesis that sheds new and important light on neural-angiogenesis.

When looking for genes uniquely expressed in the blood vessels of

including the regulation of gene expression and

“

the retina and brain, Dr. Antonetti and post-doctoral research fellow Andreia Goncalves, Ph.D., were in-

the production of energy by mitochondria.

Studies performed by Dr. Goncalves revealed that by reducing heme content in retinal endothelial cells, the blood

THESE AND ADDITIONAL STUDIES

vessel cells grew markedly faster.

PROVIDE STRONG EVIDENCE THAT A

By adding heme back to the cells, this process was reversed.

VARIATION IN HEME CONTENT IN RETINAL

“These and additional stud-

AND BRAIN ENDOTHELIAL CELLS ACTS LIKE

“

central nervous system diseases.

ies provide strong evidence that a variation in heme content in retinal

A RHEOSTAT, SIGNALING BLOOD VESSELS

trigued to find FLVCR2. A mutated

WHETHER, HOW, AND HOW MUCH TO GROW.

form of FLVCR2 is known to drive

— David Antonetti, Ph.D.

the development of Fowler Syndrome, a rare and deadly prenatal disorder that halts the growth of blood vessels but only those in the brain and the retina, with no impact on angiogenesis elsewhere in the embryo.

Since the FLCVR2 gene codes for a transporter of heme,

and brain endothelial cells acts like a rheostat,” explains Antonetti, “signaling blood vessels whether, how, and how much to grow.”

Further studies are planned in the Antonetti lab to explore the link between

FLVCR2, endothelial heme content and brain/

retinal angiogenesis. This has the potential to

profoundly impact the identification and development of new

Drs. Antonetti and Goncalves employed various gene editing

therapeutic targets for a number of blinding eye diseases and

and analysis tools in cell culture and animal models to explore

neurological disorders.

a novel hypothesis: that heme contributes to the control of blood 20

vessel growth.

Joshua Ehrlich, M.D., M.P.H., with Felix Agoi (Field Manager, Aga Khan University, Mombasa, Kenya)

Kellogg Researcher Launches First-of-its-Kind Study of Health and Aging in Kenya A U-M population research team led by Joshua Ehrlich, M.D.,

population and individual aging trends to form a clearer picture

M.P.H., is embarking on a study of population trends and

of Kenya’s age-related health risk factors.”

age-related health issues in Kenya.

LOSHAK will be the newest study in the growing inter-

Ehrlich, a co-director of the Jerome Jacobson

national network of studies based on the U-M Health and

International Program at the Kellogg Eye Center, is a clinician-scientist whose research portfolio addresses global challenges in vision impairment and population health.

The Longitudinal Study of Health and Aging in Kenya (LOSHAK) will follow a cohort

Retirement Study (HRS), which has been gathering

“

and studying aging-related data in the U.S. since 1992. The HRS and the global network of HRS-based studies are overseen by the U-M Institute for Social Research, the

CROSS-NATIONAL COMPARISONS

world’s largest academic social science

WITH DATA FROM OTHER HRS-BASED STUDIES

survey and research organization, where Dr. Ehrlich is a Research

WILL HELP US BETTER UNDERSTAND HEALTH

Assistant Professor.

country. Factors to be tracked

AND AGING ACROSS THE GLOBE, PROVIDING

training, software and data process-

include the impact of vision

INSIGHTS FOR THE U.S. AND OUR CITIZENS.

in the Sub-Saharan African

impairment on health and wellbeing, Alzheimers disease and

“

of adults aged 45 and older

— Joshua Ehrlich, M.D., M.P.H.

related dementias, mental health, air pollution and climate change, and factors influencing late-life economic well-being.

“Today, Kenya’s population is relatively

LOSHAK will utilize interviewer ing developed for the HRS. Recruiting participants will be aided by a local research platform already established in coastal Kenya.

“Ultimately, LOSHAK will provide comprehensive population-based measures of

health and economic well-being from mid- to

late-life,” Dr. Ehrlich explains. “Cross-national

young,” says Dr. Ehrlich. “But it faces a steep aging curve

comparisons with data from other HRS-based studies will help

over the next 30 years. There is a major gap in population-level

us better understand health and aging across the globe, provid-

data on aging in Sub-Saharan Africa. This study will track both

ing insights for the U.S. and our citizens.”

21

Innovation in Action A number of innovations born at Kellogg are now realizing their clinical potential, thanks to domestic and international patents and licensing agreements entered into over the past year.

In its impressive first year of availability, the Michigan Retinal Degeneration Questionnaire (MRDQ), developed by a team led by Kellogg Associate Professor K. Thiran Jayasundera, M.D., M.S., has already been licensed for two commercial and two institutional research applications.

The MRDQ is a patient-reported outcome tool

Guan Xu, Ph.D.

for Inherited Retinal Degenerations (IRDs). Patient responses to the MRDQ generate qualitative and qualitative measurements of central vision, color vision,

Engineering, and Paul Carson, Ph.D., Professor Emeritus of

contrast sensitivity, scotopic function, photopic peripheral

Radiology and Biomedical Engineering, for a method of

vision, mesopic peripheral vision, and photosensitivity.

performing Photoacoustic Physio-Chemical Tissue Analysis.

The non-invasive technology uses the properties of

“To incorporate the MRDQ into two multi-center clinical

both light (photo) and sound (acoustic) waves

trials, one of the institutional licensees is translating tering it in 33 centers around the world,” notes Dr. Jayasundera. “The commercial licensees will be utilizing the MRDQ as part of clinical trials to evaluate new targeted therapies for IRDs.” Photo-Mediated Ultrasound Therapy (PUT), a patent-pending method and apparatus for removing microscopic blood vessels, has been licensed to a start-up company founded by its co-inventors, Kellogg’s Yannis Paulus, M.D.,

“

to generate a precise and nuanced image of tissue, and can be used to access hard-toreach areas like the inside of the eye.

WHILE OTHER MINIMALLY-

INVASIVE IMAGING TECHNOLOGIES

tural characteristics of intraocular

SHOW THE STRUCTURAL CHARACTERISTICS

OF INTRAOCULAR TISSUE, THIS TECHNOLOGY ALSO REVEALS MOLECULAR AND CHEMICAL PROPERTIES ESSENTIAL TO DIAGNOSIS AND TARGETED TREATMENT.

Xueding Wang, Ph.D., U-M Professor of Biomedical Engineering, and

— Guan Xu, Ph.D.

Xinmai Yang, Ph.D., Associate Professor of Mechanical Engineering at the University of Kansas.

“PUT uses synchronized nanosecond laser pulses and

tissue, this technology also reveals molecular and chemical properties essential to diagnosis and targeted treatment,” Dr. Xu explains.

Dr. Xu and Hakan Demirci, M.D., U-M Professor of Ophthalmology and Visual Sciences and Director of Ocular Oncology, have been granted a patent for their specific application of Photoacoustic Imaging to

Diagnose Intraocular Tumors. “By illuminat-

ing an intraocular tumor with a pulsed light

source, the resulting heat and expansion of the tumor tissue

ultrasound bursts to remove micro-vessels with greater precision

produce waves in ultrasonic frequencies,” explains Dr. Xu.

and less risk to surrounding tissues than previous methods,”

“We then use an ultrasound system to generate an image with

explains Dr. Paulus. For more on PUT, please see page 26.

high spatial resolution. The image contains diagnostic infor-

A patent has been granted to Guan Xu, Ph.D., Assistant Professor of Ophthalmology and Biomedical Engineering, and his U-M colleagues Cheri Deng, Ph.D., Professor, Biomedical

22

“While other minimally-invasive imaging technologies show the struc-

“

the MRDQ into 10 languages and adminis-

mation such as the tissue components in the tumor and the architecture formed by the components.”

“Our grant detailed how this microscope will advance the work of more than 30 investigators in ophthalmology and diabetes, with 15 primary investigators occupying the majority of its operational time,” says Stephen Lentz, Ph.D., Imaging Laboratory Director of the MDRC Morphology and Image Analysis Core.

David Antonetti, Ph.D., the principal investigator on the S10 grant, partnered with Dr. Lentz to catalog the specific needs

Stephen Lentz, Ph.D.

of a wide range of researchers, and to detail the institutional

State-of-the-Science Microscope Gives Kellogg Researchers New Edge National Institutes of Health (NIH)-funded investigators in the

support that U-M will provide.

“The integrated software of the Stellaris 8 offers significant improvements over imaging systems previously available,” says Dr. Antonetti. “For Kellogg investigators, it opens new windows into diseases like diabetic retinopathy, macular degeneration and glaucoma.”

For example, multiple images can

Kellogg Eye Center Vision Research Core and the Michigan

be rapidly acquired and “tiled” to-

Diabetes Research Center (MDRC) now have access to the latest

gether into a composite image, making

advancements in confocal microscopy, thanks to an acquisition

it possible to capture changes over an

made possible by a NIH Shared Instrument (S10) grant.

entire tissue segment or organ structure.

The Leica Stellaris 8 was installed in the imaging facility

“By imaging the whole retina, we

in the Brehm tower shared by Kellogg and the MDRC in June

can analyze global vascular changes

2021. It is one of only a handful of microscopes of its caliber

across a large swath of retinal cells,”

found anywhere in the region.

Dr. Antonetti explains (see photo,

The S10 grant is designed to enhance the work of NIHfunded scientists by helping to fund instruments that are too

right).

This new tool makes it possible to

costly for an individual investigator. An institution must dem-

think about our work in new ways, and

onstrate that the equipment will meet the needs at least three

answer questions we couldn’t even ask before,” says Dr. Lentz.

NIH-funded principal investigators who will share it.

“It is already moving our research in new directions.”

Toward a Therapeutic Target for Proliferative Vitreoretinopathy The biggest challenge faced

His latest effort focuses on pyruvate kinase isozyme M2

by a surgeon repairing a

(PKM2), an enzyme expressed in various tissue and tumor

detached retina is proliferative

cells throughout the body, including the cells of the retina.

vitreoretinopathy (PVR), the for-

“In PVR, PKM2 appears to drive a reprogramming of the

mation of fibrotic membranes

metabolism of RPE cells that results in fibrotic retinal membranes,”

on the surface of the retina.

Dr. Wubben explains. “We hope a better understanding of how

PVR increases the risk of both

PKM2 drives this metabolic reprogramming will help us develop

failed RD repair surgery and

new therapeutics to prevent PVR and vision loss in patients af-

poor visual outcomes from the

flicted with this blinding surgical complication.”

procedure. Currently, there are

The project has earned a Career Development Award

no medications to prevent or

from Research to Prevent Blindness (RPB). The award supports the

treat PVR.

independent research of promising junior faculty from the coun-

As a vitreoretinal surgeon and a researcher focused on

try’s top academic ophthalmology programs.

drug design and development, Thomas Wubben, M.D., Ph.D, is driven to pursue novel interventions for PVR.

RPB Award

23

Kellogg Addresses Technician Shortage with Ongoing Training Program “We need more technicians!” It’s a plea heard from ophthalmology practices across the country and in the corridors of Kellogg Eye Center and its community clinic sites. According to the American Academy of Ophthalmology and the U.S. Bureau of Labor Statistics, there are only about 60,000 ophthalmic technicians to assist the country’s 19,000 practicing ophthalmologists.

Kellogg addressed the need for technicians by developing its own competitive technician training program in 2012. The program has graduated an average of two classes per year, each with three to nine students, since 2013.

“

The program attracts applicants from Some are looking to gain clinical experience before further medical training, some are transitioning from other allied health areas, and some are entering healthcare for the first time.

The 12-week program combines classroom

THE STRONG SUPPORT OF

David Beck with trainer Karen Ward, COT, OSC, Allied Health Supervisor and Stephanie Wietholter, M.S., COA

FACULTY AND LEADERSHIP MADE

THE PROGRAM POSSIBLE, THAT SUPPORT

CONTINUES TO BE THE KEY TO ITS SUCCESS.

and clinical instruction.

Coursework is designed

“

many different backgrounds.

— Karen Ward Director of Technical Education

to build the comprehension and hands-on skills required for certification by the Joint Commission on Allied Health Personnel in Ophthalmology (JCAHPO).

“The early weeks are weighted toward classroom instruction, introducing students of all backgrounds to the basics of ophthalmology,” says Karen Ward, Director of Technical Education at Kellogg, who has guided the training since 2018. “Students then transition to practical experience, rotating through subspecialty clinics, working with experienced technicians to learn the latest skills, including facilitating video and virtual visits” To date, the program has graduated 74 technicians. “Several

Timothy Costello, CRA, COA (background) and Rachel Wishart with Cathy Huebner, B.S., COA

have gone on to leadership positions at Kellogg,” says Clinical Administrator Catherine Huebner, “making contributions in our clinics, ophthalmic imaging unit, and clinical research.”

“The strong support of faculty and leadership made the program possible,” she adds. “We continue to make changes

please contact:

each year to enhance the skills of our graduates, including more

Catherine Huebner cathhueb@med.umich.edu

exposure to imaging and other testing that has become critical to

Karen Ward karmward@med.umich.edu

eye care.”

24

For more information about the program,

New Pediatric Ophthalmology Fellowship in Ghana Faculty from the Kellogg Center for International Ophthalmology have partnered with medical educators in Ghana to establish a pediatric ophthalmology fellowship — the first such program of it’s kind in Ghana.

The need is great. Currently, four pediatric ophthalmologists and one pediatric-oriented general ophthalmologist serve the entire country — a physician-to-patient ratio of 1 to 1 million.

The origins of the program date back to 2015, when

“With the help of our Kellogg family, we are addressing the urgent need for pediatric ophthalmology specialists in Ghana.” — Dr. Vera Essuman

Ghanaian ophthalmologist Vera Adobea Essuman first visited Kellogg. Dr. Essuman was accompanying her

“The key to all of our international alliances

husband, also a Ghanaian doctor, who

has been designing programs that keep doc-

geriatrics at U-M. Here, Dr. Essuman, a faculty member of the Ghana College of Physicians and Surgeons (GCPS), observed clinical activity, training and research in pediatric ophthalmology.

Driven by Dr. Essuman and

“

Kellogg colleagues Monte Del Monte, M.D., Jonathan Trobe,

tors caring for patients in their home countries for subspeciality training,” explains Dr. Del Monte. “Until now, ophthal-

UNTIL NOW, OPHTHALMOLOGISTS

mologists interested in specializing in

INTERESTED IN SPECIALIZING IN PEDIATRIC

for formal fellowship training. Too

pediatric care had to leave the region many don’t return to their home

CARE HAD TO LEAVE THE REGION FOR FORMAL

countries.”

FELLOWSHIP TRAINING. TOO MANY DON’T

M.D., and Grace Wang, M.D., Ph.D., a partnership was formed to

“

traveled to Ann Arbor for training in

The first year of the two-year curriculum is spent training with

RETURN TO THEIR HOME COUNTRIES.

establish a formal pediatric ophthal-

local attending physicians and access-

— Monte Del Monte, M.D.

mology fellowship in Ghana patterned after those in the U.S. Work began in 2018 with an exploratory grant from Global REACH (Research, Education, And Collaboration in Health), a U-M

ing educational materials and recorded lectures and grand rounds from Kellogg.

Year two is spent in pediatric rotations outside of Ghana, for example, with India’s

Aravind Eye Care System, or in Nepal, where

“hands on” surgical training is possible. The fel-

Medical School program that pilots sustainable teaching and

low will then spend 3 months at the Kellogg Eye Center on an

clinical interventions to reduce health disparities in developing

International Council of Ophthalmology fellowship to observe

countries.

how clinical and surgical care is performed here, before complet-

Dr. Wang spearheaded the grant proposal. “Growing up in China, I experienced firsthand the effects of limited access

ing fellowship training.

The program launched in January

to healthcare,” she says. “At Kellogg, I’m part of a team plant-

2020 with one fellow, Dr. Vera Beyuo,

ing the seeds to improve eye care in this disadvantaged and

only to be paused within weeks due to

deserving part of the world.”

the COVID-19 pandemic. Dr. Beyuo

The program is modeled after successful pediatric fellow-

restarted in 2021. A second fellow is ex-

ships launched by Dr. Del Monte in China and India. It is

pected to begin in 2022. “I am excited to

offered through Ghana’s two teaching hospitals, where U-M

apply the excellent training I’m receiving

has already established training and research collaborations in

to caring for Ghana’s youngest patients,”

obstetrics/gynecology, pediatrics, emergency medicine, family

says Dr. Beyuo.

medicine and otolaryngology. Dr. Essuman serves as fellowship director.

25

Next-Generation Tools to Treat Abnormal New Ocular Blood Vessels Yannis M. Paulus, M.D., has been awarded two grants to advance two novel technologies, each with the potential to revolutionize the treatment of a range of vision-threatening conditions.

A Nanoneedle Array for Long-Term, Sustained Intraocular Drug Delivery National Institutes of Health/

National Eye Institute Research Project Grant (NEI R01) Photo-Mediated Ultrasound Therapy to Remove

The development of new blood vessels, or neovascularization,

Microscopic Blood Vessels Alcon Research Institute

is a major cause of blindness worldwide. It occurs in conditions

Young Investigator Grant

ranging from diabetes and macular degeneration to corneal diseases. Current treatments are suboptimal in that they can

Choroidal neovascularization, the development of new blood

involve frequent, often monthly, injections inside the eye, which

vessels in the choroid, is the leading cause of vision loss due

carry risks of infection, among other effects.

to wet age-related macular degeneration (AMD).

Recent attempts to design systems to deliver drugs through the corneal barrier, notably biodegradable ‘microneedles’, have proven problematic.

(anti-VEGF therapy) and laser photocoagulation. Both have

Dr. Paulus is collaborating with Dr. Chi Hwan Lee in the

considerable shortcomings.

Weldon School of Biomedical Engineering at Purdue University

Anti-VEGF therapy can result in serious complications like

to develop a novel platform technology that delivers long-term,

infection, bleeding, glaucoma, and cataracts. Moreover, despite

sustained intraocular drugs through fully-miniaturized, slowly-

repeated treatments, some patients end up with significant vision

biodegradable silicon ‘nanoneedles’ embedded on a water-

loss or blindness.

soluble contact lens.

“Nanotechnology makes so many improvements possible,”

The current method of photocoagulation delivers a high dose of short duration laser energy. At that intensity, it can

explains Dr. Paulus. “Our nanoneedles are more than 30 times

damage surrounding healthy cells, leading to serious side effects

smaller than microneedles, and they degrade more than ten

like retinal atrophy and loss of peripheral and night vision.

times more slowly, providing longer-lasting therapy. And the

Dr. Paulus is part of a multidisciplinary team of researchers,

best part is that this is as simple as putting in a contact lens.

including Drs. Xueding Wang and Xinmai Yang, that developed

The contact lens dissolves within 30 seconds, leaving nanonee-

and patented a novel non-invasive alternative — photo-mediated

dles embedded in the peripheral cornea for long-term, sustained

ultrasound therapy, or PUT.

drug delivery.”

The R01 grant (overseen by NEI Bioengineering and

“PUT delivers synchronized nanosecond laser pulses and ultrasound bursts at unprecedented speed and significantly lower

Technology Program Director Tony Gover, Ph.D.) will be used

laser intensity,” explains Dr. Paulus. “That combination allows

to evaluate nanoneedle platforms of different sizes, shapes,

us to target micro vessels with a degree of precision not achieved

aspect ratios and porosities, and to compare the safety, efficacy,

with conventional photocoagulation, and with far less risk of

and side effects of silicon nanoneedles to the current anti-

damage to surrounding tissues.”

vascular endothelial growth factor and laser therapies.

“Our goal is a minimally-invasive platform for painless, sustained intraocular drug delivery,” Dr. Paulus says. “This idea has broad applications beyond corneal neovascularization,

26

Two main treatments are currently used: frequent (often monthly) injections of anti-vascular endothelial growth factor

He will use the Alcon grant for studies comparing the effectiveness of PUT and anti-VEGF therapy — a vital next step in moving PUT closer to clinical application.

“PUT also has the potential to transform how we care for

including the treatment of diabetic retinopathy, macular

patients with other neovascular, oncologic, and dermatologic

degeneration, infections, dry eyes, and glaucoma.”

conditions.”

U-M Learners Produce Online Newsletter Ophthalmology literature made accessible In late 2019, David Portney and Dena Ballouz, both U-M

Ajay Kolli, M.P.H., David Portney, M.D., and Dena Ballouz, M.D.

Medical School Class of 2021, hit a wall familiar to anyone who has walked the path from medical school to ophthalmology schools in the U.S. and Canada share the content development

specialization.

“It’s a tough field to learn about, let alone master,” explains Portney, now an intern gearing up for his first year of residency

duties.

With a team of volunteers, publication expanded from

at Kellogg. “There are so many subspecialties and so much

bi-weekly to weekly. An editorial “cadence” was established to

research, and the med school curriculum barely scratches the

manage the workflow, and a training protocol was developed

surface.”

to help team members outline and write a summary from a published manuscript. The Lens recently added a podcast

“David and I were both involved with Kellogg faculty

featuring interviews with attendings and fellows. And the three

research, so we were very motivated to learn more,” says

co-founders transitioned from writing to editing, with

Ballouz, who is also an intern who will be starting residency

Kolli serving as editor-in-chief.

training at Kellogg in 2022. “But with so much highand only a beginner’s knowledge base, it’s a steep learning curve.”

With their mutual enthusiasm, Portney and Ballouz hatched an idea: Why not create an email newsletter of easy-to-digest summaries of current research and topics in oph-

“

thalmology, prepared especially for medical students?

The first issue of The Lens was

In true Kellogg evidence-based style, the team even fielded and published (in the Journal of Surgical Education) research on The Lens. “Our study — the first

WE HOPE WE’RE MAKING

we know of to assess the efficacy

OPHTHALMOLOGY MORE ACCESSIBLE,

of a newsletter as an educational tool — demonstrated that The Lens

WHAT DREW US TO THE FIELD — ALL THE

improved readers’ knowledge, and

INNOVATION AND TECHNOLOGY — IS ALSO

“

impact research coming out all the time,

WHAT CAN MAKE IT INTIMIDATING.

published online in January 2020.

— Dena Ballouz, M.D.

Initially, the plan was to provide ‘quick hits you want to know’ to interested U-M medical students.

One early subscriber was fellow U-M classmate Ajay Kolli. Kolli, who detoured to Harvard to add an M.P.H. to his M.D., is scheduled to graduate medical school in 2022. “I found it so engaging and useful, I reached out to David and Dena to get involved,” he says.

“Timing is everything,” says Ballouz. “The launch coincided with the COVID-19 pandemic, when so many people were looking for easy-to-use remote learning resources.”

With Kolli on board, the team reached out to connections

that the longer they subscribed, the more they retained,” Kolli says.

“People have asked what qualifies a bunch of medical students with little background in the field to curate and summarize current literature in ophthalmology,” says Portney. “I say ‘Why not?’ We’re trained to absorb concepts

quickly and think critically. Plus, our faculty

are easily accessible if we have any questions or

concerns.”

“We hope we’re making ophthalmology more accessible,” adds Ballouz. “What drew us to the field — all the innovation and technology — is also what can make it intimidating.”

No longer just for medical students, The Lens is expanding its audience to include residents, faculty and practicing ophthalmologists.

at other schools for both readers and volunteers to help produce the newsletter. Today, more than 30 medical students from 25

Visit lensophthalmology.com to subscribe 27

Genetically-Modified Occludin Shown to Protect Against Diabetes-Related Vision Loss Andreia Goncalves, Ph.D., a post-doctoral fellow working in the lab of David Antonetti, Ph.D., has demonstrated that triggering a single mutation in a specific protein building block of retinal blood vessels can help guard against the devastating visual consequences of diabetes.

These consequential findings were published in July 2021 in the journal Diabetes.

Diabetic retinopathy (DR) is one of the leading causes of vision loss and blindness. A hallmark of DR is vascular permeability, or leaks in the blood vessels of the retina.

One of the mechanisms that drive vascular permeability is the action of one protein — vascular endothelial growth factor (VEGF), on another — occludin, a tight junction protein that binds cell membranes together to form nonpermeable barriers.

28

Trainee Highlights

“We wanted to better understand the role of the neurovascular unit in diabetes — which represents the relationship between retinal neurons and blood vessels.

Specifically, we wanted to find out if we could preserve vision by protecting occludin against the actions of VEGF, and as a result, maintain a proper barrier in the retinal blood vessels,” explains Dr. Goncalves. Her team accomplished that by introducing a genetic mutation in occludin in the retinal blood vessels of mice with diabetes.

“With just one mutation in occludin, its functionality was preserved,” she says. “It provided complete protection against diabetes-induced permeability, and preserved visual acuity and contrast sensitivity. That demonstrates that a proper barrier in the retinal vessels is critical for visual function. It’s a very encouraging finding, emphasizing the importance of the neurovascular unit in diabetes.”

Guarding Photoreceptor Metabolism to Prevent Vision Loss in Inherited Retinal Diseases Warren Pan, M.D., Ph.D., M.Phil., a first-year resident, has received a Career Starter grant from the Knights Templar Eye Foundation. The foundation supports basic and clinical research in pediatric ophthalmology.

Dr. Pan plans to use this award to explore a novel treatment for inherited retinal degenerations (IRDs), a group of diseases that can cause childhood blindness.

Of the more than 280 IRD-causing genetic mutations, only one mutation has an FDA-approved treatment.

Because these inherited retinal degenerative diseases share common characteristics, Dr. Pan is focused on developing a treatment capable of treating any one of these mutations by targeting a common aspect of disease.

“Photoreceptor cells turn light into vision. That’s a lot of work,” Dr. Pan explains. “These cells need a healthy metabolism to consume nutrients, generate energy, and

recycle waste to do their job. We believe that metabolic impairment is central to these mutations causing these photoreceptors to degenerate in IRD.” “If we can treat the metabolic health of these photoreceptors,” he continues, “we can prevent vision loss, regardless of which mutation a child may have.”

For this study, Dr. Pan will use an established mouse model of IRD driven by one of the more common mutations. He will treat the photoreceptor cells with a drug that changes their metabolism. He will then measure photoreceptor metabolism and visual function as the disease progresses.

“Our ultimate goal is to prevent vision loss in children regardless of which mutation they may have been born with,” he says.

Trainee Highlights

29

Kellogg’s Latest Heed Fellows Since 1947, funding from either the Heed Ophthalmic Foundation or the Society of Heed Fellows has provided postgraduate fellowships to promising clinical investigators. Numerous Heed Fellows can be found among current Kellogg faculty and alumni, including two current retina fellows appointed for 2021-2022: Emily Eton, M.D., is a first-year vitreoretinal surgery fellow at Kellogg. Among her current research pursuits is a study of the treatment of retinopathy of prematurity (ROP), a disorder of abnormal retinal blood vessel growth that occurs in babies born prematurely.

Care for a premature baby begins in a hospital’s neonatal intensive care unit (NICU). There, babies with ROP undergo

Heed Fellows: Benjamin Young, M.D., and Emily Eton, M.D.

repeated screening eye exams, where the severity of their disease is staged. Staging guides which of three treatment approaches

“We know that patients with Stargardt disease lose their

is called for: laser or cryotherapy, intraocular injections, or

vision as a result of irreversible damage to retinal pigment

surgery, which is indicated for the most advanced disease.

epithelial cells (RPE), and that the damage begins in the center

“Deciding which approach to take is not a clear-cut process,” Dr. Eton explains. “We want to understand how

of the retina and expands out, causing larger and larger blind

decisions are being made and care delivered across a range

spots,” explains Dr. Young. “But little is known

To assess ROP care, Dr. Eton is studying information from the Vermont Oxford Network (VON), a group of more than 1,400 medical centers that contribute a wide range of NICU clinical data for research.

Dr. Eton is comparing data from different types of NICUs, segmenting them by region of the country and by

“

hospital type — academic versus community health systems.

Among the trends she is analyz-

about exactly how this happens over time.”

In previous research in choroideremia and age-related macular degeneration, Dr. Young noticed a pattern of RPE cell death that seems to

DECIDING WHICH APPROACH

too. “In all three IRDs, RPE degeneration tends to continue

WE WANT TO UNDERSTAND HOW DECISIONS

along the edge of where the most recent cell death has occurred,”

ARE BEING MADE AND CARE DELIVERED

he explains. “This is in contrast

ACROSS A RANGE OF NICUS.

to RPE cell death resulting from

ing are which modes of ROP treatment are being selected for which patients,

— Emily Eton, M.D.

whether ROP babies are being transferred long distances to academic centers, and whether certain types of NICUs tend to treat the more advanced cases that require surgery.

“NICU doctors need decision-support tools for treating

a retinal injury, which eventually stops.”

“In other words, in these inherited diseases, RPE cells seem more likely to die once neighboring cells have died.”

Examining imaging of disease progres-

sion in IRD patients, Dr. Young will look for a com-

ROP. We hope this study will be a useful first step in improving

mon mechanism or process driving this ‘neighbor effect,’ and

how we care for babies with this vision-threatening disease.”

attempt to describe the rules that govern that process.

Benjamin Young, M.D., is in the second year of his surgi-

“With that information, we plan to develop a computa-

cal retinal fellowship at Kellogg. His latest research project is

tional simulation of the process,” he explains. “Eventually, such

looking at Stargardt disease, an incurable, largely untreatable

a model could be used to predict how a patient’s disease will

inherited retinal disease (IRD) that leads to significant, progres-

progress over time.”

sive vision loss.

30

be common to Stargardt disease

TO TAKE IS NOT A CLEAR-CUT PROCESS,

“

of NICUs.”

A Visionary Legacy Paul and Carolyn Lichter make a planned gift to support department chair

Paul R. and Carolyn R. Lichter had met and started dating just months before they found themselves together as first-year students on the

Paul R. Lichter, M.D., and Carolyn R. Lichter have made plans for a generous bequest as part of a lifetime of charitable contributions to U-M

University of Michigan campus in 1956, both studying in the College of Literature, Science, and the Arts.

A Shared Journey

“We go back a long way with the university,” says Paul Lichter, today an active emeritus faculty member.

The Lichters married after earning their undergraduate degrees,

He is the immediate past chair of the Department of

and Paul Lichter went on to complete medical school, a master’s degree, and an ophthalmology residency at U-M. He

Ophthalmology and Visual Sciences, a position he held

“

joined the faculty in 1971 and became chair of the

for 34 years, and the founding director of the W.K. Kellogg Eye Center.

In an act of generosity that celebrates their history and adds to their legacy at U-M, the Lichters have made a planned gift to establish the

Department of Ophthalmology and Visual Sciences in 1978. As chair, he pursued a dream of building a comprehensive eye center to advance patient care, research, and education.

OUR GOAL WITH OUR ESTATE PLAN

Carolyn Lichter played a vital

WAS TO STRIKE A BALANCE, WE WANTED

role in the department’s growth, often

professorship will be held by the

TO BE GENEROUS BOTH TO OUR FAMILY

also became involved with UMMA,

chair of the department, jointly

AND TO OUR COMMUNITY.

partment Chair of Ophthalmology and Visual Sciences. The endowed

with the F. Bruce Fralick Professorship in Ophthalmology.

— Paul Lichter, M.D.

“We wanted to help the department in perpetuity, and having our family's name attached to the chairmanship is particularly meaningful to us,” says Paul Lichter. “It will provide income that enables the chair to pursue a wide range of leadership and research activities.”

The gift is part of the Lichters’ lifetime of charitable contributions to U-M, including annual, capital, and endowment

“

Paul R. and Carolyn R. Lichter De-

hosting and advising on events. She serving as a member of the first docent class and as a member of the Friends of the Museum of Art board.

“I love the arts,” Carolyn Lichter says. “I was a docent at the museum for 18 years. I felt invested, which is one of the reasons I wanted to support the museum

through our estate plan. And we love music,

so we also decided to make a planned gift to UMS.” As they think about the transfer of immense wealth in this country as Baby Boomers age, they hope others will consider bequests to U-M and other charities.

gifts to Kellogg, the Medical School, and the University. They

“Our goal with our estate plan was to strike a balance,”

also have made bequests to the U-M Museum of Art (UMMA)

says Paul Lichter. “We wanted to be generous both to our family

and the University Musical Society (UMS).

and to our community.”

31

Eyes on the Future Foundation provides $1 million grant to expand the impact of the Harry A. and Margaret D. Towsley Ophthalmic Imaging Center

Zion Grant was diagnosed with the rare progressive eye disease Leber congenital amaurosis as an infant. At 6 years old, he was treated at the W.K. Kellogg Eye Center with the first gene

This image of a corneal ulcer by Tim Steffens was recognized in the 2021 American Academy of Ophthalmology and Ophthalmic Photographers’ Society Photographic Competition — one of many awards received by our team

therapy approved by the FDA for any inherited disease. His continues to be a journey of diligence and hope, and his doctors keep a careful watch on his eyesight — with critical help from

says Lynn Towsley White, chair of the board of the Towsley

the team in our Harry A. and Margaret D. Towsley Ophthalmic

Foundation.

Imaging Center.

Today, the imaging center and Kellogg staff are among

Ophthalmic imaging is an essential part of caring for

the top tier of ophthalmic imaging centers nationally,

patients with a wide range of eye conditions, includmacular degeneration, glaucoma, and diabetic retinopathy. Our photographers use sophisticated cameras and imaging equipment to enable ophthalmologists to diagnose eye diseases, create precise treatment and surgical plans, monitor the effectiveness of therapies, and

“

of imaging. Kellogg has grown fourfold in patient volume, expanded imaging services to satellite offices across the state, and increased care to underof this success, and looking ahead

STRONGLY ABOUT THE KELLOGG EYE CENTER,

pursue advances through research and clinical trials.

When the new clinical facilities in the Brehm Tower opened in 2010, the Harry A. and Margaret D.

IS VERY IMPORTANT.

— Lynn Towsley White Chair of the board of the Towsley Foundation

investment in this often under-resourced area of eye care, building on a long history of pioneering ophthalmic photography at the University of Michigan. The grant was used to purchase leading-edge imaging equipment and to make digital images available to clinicians at the point of care. The center was fittingly named in memory of the foundation’s namesakes.

to the needs of future patients, the Towsley Foundation in July voted

AND I BELIEVE PRESERVING EYESIGHT

Towsley Foundation made a visionary

to make a second transformational philanthropic investment. The $1 million grant will fuel the purchase of the latest technology, enable Kellogg to fully integrate images from community office locations into our electronic medical records system, and support ongoing efforts to leverage

big data and artificial intelligence to advance

research and patient care.

Most importantly, this investment will enable Kellogg to measure success by meeting our patients’ needs.

“In ophthalmic imaging, getting the best image requires

Harry A. Towsley, M.D., spent his long career as a professor of

connecting with the patient,” says Tim Steffens, director of

pediatrics and communicable diseases and as a leader within the

ophthalmic imaging and information systems. “We have to

Medical School at U-M. Margaret D. Towsley, a civic leader and

make people comfortable, put them at ease. We must realize

philanthropist, was the first woman to serve on the Ann Arbor

that they are worried about their vision and may not know

City Council.

what’s going to happen next. The Towsley Foundation’s gener-

“My mother and father felt strongly about the Kellogg Eye Center, and I believe preserving eyesight is very important,” 32

served populations. In recognition

MY MOTHER AND FATHER FELT

“

ing many pediatric eye diseases, age-related

winning awards for excellence in the quality

ous partnership will help us continue to ensure that for every patient, what’s next includes the best possible eye care.”

Big Data, Collaboration, and Impact Couple recognizes great potential to advance care for eye conditions— and offers critical support

that even top-tier academic medical centers like the W.K. Kellogg Eye Center see only a small number of cases each year. Improving care for patients with those conditions therefore requires communication and collaboration among

“

WE SEE TREMENDOUS POTENTIAL

TECHNOLOGY, AND SOPHISTICATED

eye centers nationally.

A large repository of rich data from what will eventu-

Jeff and Wendy Eisenshtadt are fueling momentum with a gift to the SOURCE data repository

IN LEVERAGING BIG DATA, INFORMATION ANALYTICS TO POSITIVELY IMPACT

“

Some eye conditions are so uncommon

HEALTH CARE, AND THIS IS A GREAT

ally number about three dozen academic medical centers and health systems from across the

EXAMPLE OF THAT IN ACTION. — Wendy Eisenshtadt

country will make that possible. Led

by Kellogg faculty, the Sight OUtcomes Research Collaborative (SOURCE) repository is uniquely linking clinical data from electronic health records with data from ocular diagnostic tests,

Wendy and Jeff Eisenshtadt of Bloomfield Hills. The couple recently made a philanthropic gift to support SOURCE. “We see tremendous potential in leveraging big data, information technology, and sophisticated analytics to positively impact health care, and this is a great example of that

in action,” Wendy Eisenshtadt says. “We want to

help it gain even more momentum.”

In one project, Lindsey B. De Lott, M.D., M.S., an assistant

environmental and community-level factors, and more to build

professor of ophthalmology and visual sciences as well as

a more complete picture of risk factors and outcomes of care

neurology, will be studying optic neuritis, an uncommon condi-

for patients with ocular diseases. Researchers will use the reposi-

tion that occurs when inflammation in the optic nerve causes

tory, which already includes data on more than 7 million patient

an acute, often severe disruption in vision in one or both eyes.

visits, as well as sophisticated machine learning and artificial

The study will bring together the expertise of clinicians, statisti-

intelligence tools, to identify ways to improve treatments and

cians, data analysts, and others. “It is really powerful to be able

outcomes for eye diseases.

to study data that combines the experiences of centers across “By pooling data across many sites,

the country to understand more about

we are increasing racial, ethnic, and

conditions like this, which are relatively

geographic diversity — and the number

infrequent,” Dr. De Lott says. “The goal

of cases we can study,” says Joshua D.

is to create a tool that will help us deter-

Stein, M.D., M.S., an associate professor

mine how to get these patients the right

of ophthalmology and visual sciences

treatment at the right time.”

and of the School of Public Health’s

Researchers from all of the organiza-

department of health management and

tions submitting data to SOURCE will

policy. “We can then build robust predic-

have access to the repository so that they

tive models that will enable us to identify the most appropriate

can pursue similar efforts — for rare and common conditions,

therapy for a given patient at the most appropriate time, to

Dr. Stein says. “There are many ways we can use this resource to

achieve optimal outcomes.”

move toward more personalized eye care. We’re very grateful for

It is an exciting opportunity to help patients, particularly

the Eisenshtadts’ generosity and for their belief in our mission.”

those who are facing rare, sight-threatening conditions, say 33

Recognizing Our 2021 Distinguished Alumni: Richard Gutow, M.D., and Gary Gutow, M.D.

“

I HAVE ENJOYED MY TIME IN THE

DEPARTMENT AND MY SMALL ROLE

IN WHAT HAS GONE ON OVER THESE

is one of the oldest in the country, it was just at the beginning

“

Though our Department of Ophthalmology and Visual Sciences

NUMBER OF YEARS, AND I THANK

of significant growth when two brothers from Flint, Michigan, completed their residencies here in the 1960s and ’70s. Richard

YOU FOR THIS HONOR.

Gutow, M.D., and Gary Gutow, M.D., are part of a generation

— Richard Gutow, M.D.

that led great advances in the field, including in their chosen subspecialty of retina, and they have been integral to the growth both in size and reputation of the W.K. Kellogg Eye Center.

We were proud to recognize them as our 2021 Distinguished Alumni in September.

lens implantation and the first fluorescein angiogram, and he Richard Gutow, M.D.

was part of a team that performed the first pars plana vitrecto-

The decision to attend medical school at

mies.

the University of Michigan was an easy

“But probably the most interesting and exciting thing to

one, said Richard Gutow, M.D. It was

witness during my 63-year association with the department has

where his father, Isadore Gutow, M.D.,

been the spectacular and dramatic growth in its size and reputa-

graduated in 1925.

tion,” he said. Today, the department has 88 clinical faculty and

During medical school, Richard Gutow worked in the laboratory of Mathew Alpern, Ph.D., a physiologist

18 research faculty.

Dr. Gutow left the faculty in 1981 to join the busy private practice that his brother, Gary Gutow, M.D., had launched

who became internationally known for his research on color

in Nashville, and he practiced there until retiring in 1994. He

vision, which helped him choose ophthalmology.

remains a stalwart supporter of the Kellogg Eye Center, includ-

“I have always been interested in working with my hands

ing philanthropically. He and his wife, Susan, have made gifts to

on small things,” Dr. Gutow said, noting that even today he col-

the Alumni and Faculty Annual Fund and to the Alumni Legacy

lects watches and marine clocks, some of which he has enjoyed

Fund, among other areas. They are also supportive of other or-

taking apart and putting back together. “I also liked that the eye

ganizations at U-M, including the Museum of Art, the University

is amenable to examination — you are able to see what is going

Musical Society, and the Center for the Education of Women.

on and diagnose disease.”

After medical school, he completed an internship at Lenox Hill Hospital in New York City — and returned to our depart-

“I have enjoyed my time in the department and my small role in what has gone on over these number of years,” he said.

“And I thank you for this honor.”

ment to do his residency. He then spent time in private practice in Flint, serving in the military, and training in retinal surgery

Gary Gutow, M.D.

before returning again to join our faculty in 1968 as a leader on

As Gary Gutow, M.D., looks back over

the retinal service. He was one of just seven full-time clinicians.

his career, the highlights that emerge

It was an innovative time in the field. He was fortunate to see many firsts in our department, including technology acquisi-

tients, and his colleagues. Key milestones

tions, he said in accepting his Distinguished Alumni Award. The

include founding and directing the retina

list includes the Goldmann applanation tonometer to measure

division at Vanderbilt University as well

intraocular pressure, the binocular indirect ophthalmoscope for

as starting and growing the first retina-

diagnosing retinal disorders, the xenon arc lamp photocoagulator and the argon laser for treating diabetic retinopathy, and the

34

reflect a devotion to medicine, his pa-

only private practice in Nashville.

“It has been very rewarding to build a practice, to bring

fundus camera for photographing the back of the eye. He also

new treatments to patients, and to have decades-long friendships

witnessed the department’s first cataract surgery with intraocular

in ophthalmology,” he says.

Dr. Gutow became interested in ophthalmology during

ophthalmologists. He also served as chairman of the Depart-

medical school at U-M, where he enjoyed a rotation in the

ment of Ophthalmology at TriStar Centennial Medical Center

department and worked on research with Harold Falls, M.D.,

in Nashville for 13 years. He performed the first argon laser

and Mathew Alpern, Ph.D. He fulfilled his pre-med require-

treatment for retinal disease and first pars plana vitrectomy in

ments and did undergraduate work in English before completing

Nashville. The practice participates in numerous multi-center

his medical degree. He went on to do an internship at Lenox

clinical trials.

Hill Hospital in New York City. He then became a captain in

Throughout his career, he enjoyed serving the ophthalmol-

the U.S. Air Force, serving in Korea and in the Department of

ogy community through many professional organizations. He

Ophthalmology at Letterman General Hospital in San Francisco.

is a founding member of the Schepens International Society as

He recognized that U-M had an up-and-coming ophthal-

well as a member the American Academy of Ophthalmology,

mology program, which drew him back to do his residency.

the American Society of Retinal Specialists, the Aspen Retinal

He completed it in 1973 and stayed on for three months as an

Detachment Society, among other organizations. He served as

instructor on the faculty. It prepared him well for his career, he

president of the Nashville Academy of Ophthalmology and as

says. “What I appreciated most were the people. The faculty

a trustee of the Tennessee Academy of Ophthalmology. He is a

members were talented and accessible, and my fellow residents

longtime member of the U-M Department of Ophthalmology

were first-rate. The residency had a good mix of practical

and Visual Sciences Alumni Advisory Board.

experience and didactic learning.”

His achievements as an alumnus elevate the department

Finding especially the surgical aspects of retinal care

and the Kellogg Eye Center, which he has generously supported

exciting, he went on to do an 18-month fellowship with Charles

philanthropically over the years. He also supports many other

Schepens, M.D., often called the “father of modern retinal

entities and organizations, including the Kathryn and Gary

surgery,” at the Massachusetts Eye and Ear Infirmary and

Gutow Advised Fund at the Community Foundation of Middle

Harvard Medical School. He was awarded a prestigious Heed

Tennessee, the Nashville Public Library Foundation, and the

Scholarship and membership in the Society of Heed Fellows.

Nashville Symphony, among others.

Dr. Gutow then joined the faculty of Vanderbilt University

“I am very grateful and honored to receive this Distin-

and was named the inaugural chief of the Retina Division. In

guished Alumni Award,” he says. “I am deeply proud to be

1978, he went into private practice, establishing Retina-Vitreous

an alumnus of the University of Michigan Department of

Associates, the first private retina practice in Nashville, which

Ophthalmology and Visual Sciences, and I will always treasure

is now known as Tennessee Retina and has grown to 11

this recognition.”

2021 FIRST-YEAR RESIDENTS

Sarah Garnai, M.D. B.S. – Biochemistry, University of Michigan M.D. – Harvard Medical School

Matthew Johnson, M.D. B.S.E. – Biomedical Engineering, University of Southern California M.D. – Wayne State University

Joseph Giacalone, M.D., Ph.D. B.S. – Biochemistry and Biochemical Tech, East Stroudsburg University M.D. – University of Iowa Ph.D. – Interdisciplinary Genetics Program, University of Iowa

Alejandra Maiz, M.D. B.S. – Molecular Genetics, Ohio State University M.D. – University of Illinois at Chicago

Rachana Haliyur, M.D., Ph.D. B.S. – Biochemistry, University of Maryland at Baltimore M.D. – Vanderbilt University Ph.D. – Molecular Physiology and Biophysics, Vanderbilt University

Warren Pan, M.D., M.Phil., Ph.D. B.S. – Economics, Harvard University M.D. – University of Michigan Ph.D. – University of Michigan

Breanna Tracey, M.D. B.S. – Mechanical Engineeering, Lipscomb University M.D. – University of Maryland

35

2021 GRADUATING RESIDENTS

Jara Crear, M.D. Pediatric Fellowship Kellogg Eye Center Ann Arbor, MI

Sana Qureshi, M.D. Cornea Fellowship Mass Eye and Ear Boston, MA

Emily Eton, M.D. Vitreoretinal Fellowship Kellogg Eye Center Ann Arbor, MI

Carin Rojas, M.D. Glaucoma Fellowship Kellogg Eye Center Ann Arbor, MI

Olivia Killeen, M.D. National Clinical Scholar Kellogg Eye Center Ann Arbor, MI

Emily Schehlein, M.D. Glaucoma Fellowship Wilmer Eye Institute Baltimore, MD

Annie Wu, M.D. Glaucoma Fellowship Mass Eye and Ear Boston, MA

2021 GRADUATING CLINICAL FELLOWS

Chistopher Conrady, M.D., Ph.D. Surgical Retina, Uveitis, and Ocular Oncology University of Nebraska Omaha, NE

Jason Miller, M.D., Ph.D. Medical Retina and Uveitis Kellogg Eye Center Ann Arbor, MI

36

Lesley Everett, M.D. Medical Retina Casey Eye Institute Oregon Health Sciences University Portland, OR

John Gorham, M.D. Pediatric Ophthalmology and Strabismus Tufts University Boston, MA

Diana Salazar Vega, M.D. Glaucoma Vision Consultants and Surgeons Falls Church, VA

J. Reeves Ellis Samaha, M.D. Pediatric Ophthalmology and Strabismus University of Florida Gainesville, FL

Lynn Sun, M.D., Ph.D. Glaucoma Casey Eye Institute Oregon Health Sciences University Portland, OR

Alison Teo, M.D. Pediatric Ophthalmology and Strabismus Mary Bridge Children’s Hospital Tacoma, WA

Timothy Soeken, M.D. Corneal and Refractive Surgery Kellogg Eye Center Global Fellowship Ann Arbor, MI

Alumni Highlights Nieraj Jain, M.D. (Fellowship,

2014) joined the faculty of Emory University as an Assistant Professor of Ophthalmology in 2015, following a fellowship in vitreoretinal surgery at Kellogg.

In his first years in practice, Dr. Jain observed a pattern of symptoms and peculiar macular characteristics in a number of his patients. Initially, they seemed to present as pattern dystrophy or macular degeneration. But advanced retinal imaging ruled out those diagnoses.

Dr. Jain found the common thread in patients’ medical records: prolonged use of the drug pentosan polysulfate Maria Woodward, M.D., M.S., has received a Career

sodium (PPS, trade name Elmiron), the only FDA-approved

Advancement award from Research to Prevent Blindness (RPB)

oral medication for interstitial cystitis, or painful bladder

and the Allergan Foundation, to fund continued research into

syndrome. His discovery has led doctors and patients to

improving the diagnosis and management of corneal ulcers.

reevaluate the risk/benefit of PPS, which now comes with

Her current work, through a National Institutes of Health (NIH) R-01 grant, uses morphologic and clinical features to

a new FDA warning label.

Dr. Jain made the first of what promises to be many

risk-stratify patients with corneal ulcers for long-term out-

significant contributions to clinical ophthalmology. He credits

comes. “This RPB award builds upon that research,” Dr.

Kellogg for his great start. “I am so grateful to my mentors

Woodward says. “RPB’s leadership deeply understands the

at Kellogg,” he says. “My retina practice strives to emulate

phases of research. This grant mechanism supports a critical

the Kellogg model – thoughtful, patient-centered care.”

time in my research when our laboratory is expanding and innovating. Our NIH research and the collaborations that are fostered through the existing grant are opening up new pathways of discovery. The RPB grant provides our team the opportunity to continue to collaborate and maintain momentum to expand the scope of our investigations.”

Kellogg Chair Paul Lee, M.D., J.D., agrees. “RPB funding has supported researchers who have been associated with nearly every breakthrough in vision research in the last 60 years. The Career Advancement Award is the latest example of RPB’s forward looking perspective to enhance the success of innovative investigators to obtain their second (and often more difficult to obtain) NIH R0-1 award.”

“There are inflection points in research,” says Dr. Woodward. “These critical ‘aha’ moments are thrilling and

Susan Burden, M.D. (B.S. 1997,

M.D. 2001, Residency, 2005) has been elected the next president of Women in Ophthalmology (WIO).

The WIO is committed to enhancing and improving the professional environment for women in the field.

A comprehensive ophthalmologist, Dr. Burden is Associate Professor of Ophthalmology in the School of Medicine at Wake Forest University in Winston-Salem, NC, and serves as Residency Program Director for the Department of Ophthalmology.

After completing undergraduate studies, medical school

sometimes daunting. I am truly grateful for RPB funding to

and residency at Michigan, Dr. Burden joined the Wake

extend our research in corneal infections using bioinformatics

Forest faculty in 2005. At the time, she was the only female

and deep-learning image analysis. This will let us help clinicians

full time faculty member in ophthalmology.

provide decision support tools to better care for our patients.”

“Coming from Kellogg, that was an unexpected adjustment,” she says. “I learned from so many exceptional mentors

says Dr. Woodward.

and role models (female and male) at Kellogg. They gave me the best possible clinical foundation for my career, and

RBP Award

helped spark my interest in helping other women achieve success through WIO.” 37

UNIVERSITY OF MICHIGAN W.K. KELLOGG EYE CENTER FACULTY

B. Ayres, M.D.

C. Besirli, M.D., Ph.D.

A. Bicket, M.D., M.S.E.

F. Abalem, M.D.

S. Abcouwer, Ph.D.

R. Ali, Ph.D., B.Sc.

D. Antonetti, Ph.D.

S. Archer, M.D.

M. Del Monte, M.D.

K. DeLoss, O.D.

H. Demirci, M.D.

T. Deveney, M.D.

C. Dewey, O.D.

C. Farkash, O.D.

P. Fort, Ph.D.

C. Foster, O.D.

B. Furr, C.O., Ph.D.

P. Gage, Ph.D.

D. John, M.D.

C. Hood, M.D.

B. Hughes, Ph.D.

M. Huvard, M.D.

Diane Jacobi, O.D.

A. Jacobson, M.D.

S. Mian, M.D.

D. Kim, M.D.

Z. Kresch, M.D.

A. Lagina, O.D.

H. Leung, O.D., Ph.D.

P. Lichter, M.D., M.S.

S. Michelson, M.D.

J. Miller, M.D., Ph.D.

S. Moroi, M.D., Ph.D.

K. Mundy, M.D.

D. Musch, Ph.D., M.P.H.

M. Nagashima, Ph.D.

N. Nallasamy, M.D.

C. Nelson, M.D.

R. Rao, M.D.

J. Richards, Ph.D.

A. Robin, M.D.

J. Rosenthal, M.D., M.S.

T. Sassalos, M.D.

T. Seng, O.D.

A. Shah, M.D.

M. Shah, M.D.

J. Trobe, M.D.

G. Wang, M.D., Ph.D.

S. Weidmayer, O.D.

J. Weiland, Ph.D.

A. West, M.D.

D. Wicker, O.D.

P. Williams, M.D.

K. Wong, Ph.D.

S. Day, O.D.

R. Shtein, M.D., M.S.

A. Elam, M.D.

S. Joseph, M.D., M.Sc.

J. Stein, M.D., M.S.

THE DEPARTMENT OF OPHTHALMOLOGY AND VISUAL SCIENCES

J. Bixler, M.D.

B. Boland, O.D.

C. Gappy, M.D.

K. Branham, M.S., C.G.C.

T. Jayasundera, M.D., M.S.

R. Chen, Ph.D.

G. Comer, M.D., M.S.

T. Cooney, M.D.

W. Cornblath, M.D.

L. De Lott, M.D., M.S.

M. Diaz-Coranguez, Ph.D. J. Ehrlich, M.D., M.P.H.

S. Elner, M.D.

V. Elner, M.D., Ph.D.

A. Fahim, M.D., Ph.D.

P. Lee, M.D., J.D.

S. Gagnon, O.D.

T. Gardner, M.D., M.S.

D. Green, Ph.D.

P. Grenier, O.D.

P. Hitchcock, Ph.D.

P. Newman-Casey, M.D., M.S.

V. Jeyaraj, M.D.

M. Johnson, M.D.

H. Kaur, M.D.

N. Khan, Ph.D.

S. Khanna, M.D.

N. Liles, M.D., M.P.H.

C. Lin, Ph.D.

X. Liu, M.D., Ph.D.

A. Maa, M.D.

M. McKee, M.D.

A. Kaplan, M.D.

J. Weizer, M.D.

M. Woodward, M.D., M.S.

G. Oren, M.I.L.S.

D. Ozzello, M.D.

Y. Paulus, M.D.

J. Pearring, Ph.D.

H. Petty, Ph.D.

C. Podd, O.D.

L. Prasov, M.D., Ph.D.

D. Puro, M.D., Ph.D.

T. Smith, M.D.

K. Soong, M.D.

W. Sray, M.D.

A. Sugar, M.D.

J. Sundstrom, M.D., Ph.D.

B. Tannen, M.D., J.D.

S. Temple, Ph.D.

D. Thompson, Ph.D.

2021 S. Wood, O.D., M.S.

R. Wu, M.D.

T. Wubben, M.D., Ph.D.

G. Xu, Ph.D.

D. Zacks, M.D., Ph.D.

A. Zhang, M.D.

J. Zhang, M.D.

New Faculty Members Tatiana Deveney, M.D., attended medical school at the University of Rochester School of Medicine and Dentistry. She completed post-graduate education in ophthalmology and neuro-ophthalmology at the University of Michigan and was selected to be the graduate chief resident. She currently sees neuro-ophthalmic patients and helps direct the ophthalmology inpatient consult service. She is actively involved with medical student and resident education, clinical research on the diagnosis of neuro-ophthalmic disease, and quality improvement projects.

Michael Huvard, M.D., earned his medical degree from the University of Illinois Chicago College of Medicine. Following medical school, he completed his ophthalmology residency at the University of Michigan Kellogg Eye Center, followed by a 2-year fellowship in Vitreoretinal Diseases and Surgery at the University of Colorado Sue Anschutz-Rodgers Eye Center.

The focus of his research is better defining the clinical outcomes of diseases and surgery of the retina and vitreous, such as retinal detachments and posterior segment infectious and inflammatory disorders, and improving medical and surgical education for medical trainees.

Sangeeta Khanna, M.D., is a fellowship trained neuro-ophthalmologist and American Board of Ophthalmology certified ophthalmologist. She was an Associate Professor of Ophthalmology and Neurology at Saint Louis University, St Louis, Missouri before joining Kellogg Eye Center. She completed her medical school and ophthalmology residency at All India Institute of Medical Sciences, New Delhi, India; a second ophthalmology residency at Washington University in St. Louis and fellowship in neuro-ophthalmology at Case Western Reserve University in Cleveland, Ohio.

Jason Miller, M.D., Ph.D., completed his M.D. and Ph.D. at the University of California, San Francisco (UCSF). He became the inaugural awardee for the University of Michigan Kellogg Eye Center's Pre-Residency Research Fellowship, where he established an independent laboratory program on dry age-related macular degeneration (AMD) prior to joining residency. After completing both residency and a medical retina fellowship at Kellogg, Dr. Miller joined the faculty in the retina division in 2021, with a clinical and research focus on AMD. Kevin Mundy, M.D., completed his residency at Vanderbilt Eye Institute and spent the last six years at Casey Eye Institute in Oregon.

Dr. Mundy grew up in Livonia and attended UM for medical school. He will be joining the comprehensive ophthalmology service. His time will be spent providing comprehensive ophthalmology clinical care at Kellogg’s Canton location and participating in resident clinical education at the main Kellogg Eye Center location on Wall Street.

Daniel J. Ozzello, M.D., is a graduate of the University of Colorado School of Medicine, and completed residency training at the Wills Eye Hospital in Philadelphia, Pennsylvania before obtaining additional fellowship subspecialty training at the University of California, San Diego. He is interested in autoimmune orbital conditions such as thyroid eye disease as well as tissue healing after surgery and trauma.

Angela Verkade, M.D., completed her M.D. at the University of Michigan Medical School. After medical school, she completed residency training at Baylor College of Medicine where she served as Chief Resident in her final year. She then completed cornea fellowship at Bascom Palmer Eye Institute, where she developed an interest in corneal transplantation and management of complex ocular surface disease. She was on the faculty at Duke University prior to returning to the University of Michigan Kellogg Eye Center.

CME Programs Each year, Kellogg offers an informative series of continuing medical education (CME) programs designed to share new approaches to the diagnosis and management of eye disease across subspecialties.

For more information or to register for these programs, visit: www.umkelloggeye.org For questions, contact Jennifer Burkheiser, CME Coordinator, at (734) 763-2357 or kelloggCME@umich.edu.

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FACULTY HONORS AND RECOGNITION

Steven F. Abcouwer, Ph.D. Chief Editor, Journal of Ophthalmology Editorial Board Member, American Journal of Physiology: Endocrinology and Metabolism Editorial Board Member, Investigative Ophthalmology and Vision Science Editorial Board Member, Journal of Diabetes Research Member, Study Section, Pathophysiology of Eye Diseases-1 (PED1) Review Editor, Editorial Board, Retina Section, Frontiers in Ophthalmology Scientific Review Editor, Molecular Vision Journal Fernanda Abalem, M.D. Board member, Leadership Course, Pan-American Academy of Ophthalmology-American Academy of Ophthalmology Chair, Big Data Conference, Association for Research in Vision and Ophthalmology Chair, Career Development Course, Association for Research in Vision and Ophthalmology Member, Professional Development and Education Committee, Association for Research in Vision and Ophthalmology Kari E. Branham, M.S., C.G.C. Chair, Genetics Review Committee, Foundation Fighting Blindness Clinical Consortium Co-Chair, National Society of Genetic Counselors Ophthalmology and Hearing Loss Special Interest Group Expert Review Panel Member, ClinGen, Early Onset Retinal Degeneration Theresa M Cooney, M.D. Best Doctors in America Castle Connelly Top Doctor Oral Examiner, American Board of Ophthalmology Senior Advisor and Mentorship Chair, Board of Directors, Michigan Society of Eye Physicians and Surgeons Sherry H. Day, O.D. Board Member, Vision Rehabilitation Committee, American Optometric Association Chair, Academic Medical Center Optometrists SIG, American Academy of Optometry Lindsey B. De Lott, M.D. Pilot Grant Award, Optic Neuritis Early Phenotyping, North American Neuro-Ophthalmology Society Monte A. Del Monte, M.D. Americas Top Doctors Best Doctors in America Castle Connolly Top Doctors Consultant, International Affairs Committee, American Association Pediatric Ophthalmology Invited Lecture, 22nd Marshall M. Parks Memorial Lecture, American Academy of Ophthalmology

JULY 1, 2020 — SEPTEMBER 30, 2021

Monte A. Del Monte, M.D. (cont.)

Member, AVROBIO Inc., Cystinosis Scientific Advisory Board Member, Executive Committee and Finance Committee, Costenbader Pediatric Ophthalmology Society Member, Leadiant/Cystaran Medical Advisory Board Nominating Committee Chair, Costenbader Pediatric Ophthalmology Society Past-President, Costenbader Pediatric Ophthalmology Society Secretariat Award, American Academy of Ophthalmology Section Head, Pediatric Ophthalmology Editorial Board, Eyewiki, The Eye Encyclopedia, American Academy of Ophthalmology, Strabismus Consult Leader, World Society for Pediatric Ophthalmology and Strabismus Karen S. DeLoss, O.D. Board Member, Contact Lens and Cornea Section, American Optometrist Association Chair, Maintenance of Fellowship Committee, American Academy of Optometry Hakan Demirci, M.D. In-Service Exam Subcommittee, Education Committee, American Society of Ophthalmic Plastic and Reconstructive Surgery Joshua R. Ehrlich, M.D., M.P.H. Advisory Committee, Center for Vision and Population Health, Prevent Blindness Annual Meeting Program Committee, Association for Research in Vision and Opthalmology Chair, AGS Cares Task Force, American Glaucoma Society Chair, Center for Vision and Population Health, Prevent Blindness Editorial Board, Ophthalmic Epidemiology Member, Association for Research in Vision, Annual Meeting Program Committee Member, Committee on Aging, American Academy of Ophthalmology Member, Lancet Global Health Commission on Global Eye Health Member, Task Force on Academic Global Ophthalmology, American Academy of Ophthalmology Member, Vision Loss Experts Group Research Assistant Professor, Institute for Social Research Reviewer, Special Emphasis Panel, National Eye Institute, National Institutes of Health Reviewer, Special Emphasis Review Panel, Glaucoma and Retinopathy: Biomarkers, Diagnostics and Translation Studies in Development, National Institutes of Health Secretary, International Society of Geographic and Epidemiologic Ophthalmology Taskforce, Academic Global Ophthalmology, American Academy of Ophthalmology Visiting Scientist, Centers for Disease Control and Prevention

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FACULTY HONORS AND RECOGNITION

Angela Elam, M.D. Advisory Committee, Center for Vision Population Health, Prevent Blindness Advisory Committee, Vision Equity Taskforce, Prevent Blindness Chair, White Paper Sub-taskforce, American Academy of Ophthalmology Disparities Taskforce Research Scientist Award, Michigan Center for Urban African American Aging Research Victor M. Elner, M.D. Castle Connolly Top Doctors in Ocular Plastics and Ocular Oncology Top Doctors in Ocular Plastics and Ocular Oncology Patrice E. Fort, Ph.D. Invited Keynote Lecture, 31st Annual Meeting of the European Association for the Study of Diabetes Eye Complications Study Group Bruce A. Furr, C.O., Ph.D. Editorial Board, The Journal of Binocular Vision and Ocular Motility Thomas W. Gardner, M.D., M.S. Advisory Committee, Eye Health, American Diabetes Association American Association of Clinical Endocrinologists Task Force to Update Diabetes Mellitus Clinical Practice Guidelines Associate Editor, Acta Ophthalmologica Associate Editor, Diabetes Care Castle Connolly Top Doctors National Advisory Eye Council of the National Eye Institute Reviewer, Diabetes in America Reviewer, Mustafa Prize Reviewer, National Medical Research Council Scientific Advisory Committee, Lions Eye Institute for Transplant and Research Steno North American Fellowship, Novo Nordisk Foundation Kanishka T. Jayasundera, M.D., M.S. Board of Directors, Pan-American Ophthalmological Foundation Member, Scientific Advisory Board, Foundation Fighting Blindness Mark W. Johnson, M.D. Associate Editor, American Journal of Ophthalmology Best Doctors in America Castle Connolly Top Doctors Chair, American Academy of Ophthalmology Retina Subspecialty Day Editorial Board, Retina Gass Club, American Academy of Ophthalmology President, The Macula Society Ariane Kaplan, M.D. Council Member, Medical Student Education, Association of University Professors of Ophthalmology Book 1 Committee, Basic and Clinical Science Course, American Academy of Ophthalmology

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JULY 1, 2020 — SEPTEMBER 30, 2021

Scott Lawrence, M.D. (adjunct) Humanitarian Award, American Glaucoma Society Paul P. Lee M.D., J.D. Castle Connolly Top Doctor Chair, American Academy of Ophthalmology Board Task Force on Disparities in Visual Health President, Association of University Professors in Ophthalmology President, NAEVR and AEVR Research to Prevent Blindness – Unrestricted Grant Paul R. Lichter, M.D. Guest of Honor, American Glaucoma Society Best Doctors in America Castle Connolly Top Doctors US News and World Reports Top Doctors Shahzad I. Mian, M.D. Best Doctors in America Board of Directors, Cornea Society Board of Directors, Eversight Eye Bank Board of Directors, Eye Bank Association of America Castle Connelly Top Doctors Cornea, Basic and Clinical Science Course, American Academy of Ophthalmology Editor in Chief, Surgical Curriculum for Ophthalmology Residents, Association of University Professors in Ophthalmology Editorial Board, Cornea Examination Writing Committee, Examiner, American Board of Ophthalmology Senior Medical Director, Eversight Eye Bank Subspecialty Day Advisory Committee, American Academy of Ophthalmology Vice Chair, Medical Advisory Board, Eye Bank Association of America Jason Miller, M.D., Ph.D. Gragoudas Award, Macula Society Megherio Award, Retina Society Provisional Patent, “Treatment and Prevention of Dry Macular Degeneration” David C. Musch, Ph.D., M.P.H. Advisory Group, US Project, Cochrane Collaboration Eyes and Vision Group, American Academy of Ophthalmology Chair, FLAME Trial Treatment to Prevent Recurrence After Surgery for Trichiasis, National Eye Institute, National Institutes of Health Chair, Lowy Research Institute, Neurotech and MacTel Group (CNTF treatment for macular telangiectasia) Chair, SCORE-2 Trial, National Eye Institute, National Institutes of Health Consultant, Preferred Practice Pattern – Cataract/Anterior Segment Panel, American Academy of Ophthalmology

FACULTY HONORS AND RECOGNITION

David C. Musch, Ph.D., M.P.H. (cont.)

Editorial Board, Eye and Vision Editorial Board, JAMA Ophthalmology Editorial Board, Retina External Reviewer, Grant Applications, Hong Kong’s Research Grants Council Grant Reviewer, National Medical Research Council, Ministry of Health, Singapore Member, ADVISE Uveitis Treatment Trial, National Eye Institute, National Institutes of Health Member, META-MUST Uveitis Treatment Trials, National Eye Institute, National Institutes of Health Member, Special Emphasis Panel, ZEY1 VSN(07) (K08/K23/K99), National Eye Institute, National Institutes of Health Methodologist, Preferred Practice Patterns Committee and Opthalmic Technology Assessment, American Academy of Ophthalmology Reviewer: NEI contracts Christine C. Nelson, M.D. Board of Directors, World Association of Eye Hospitals Castle Connolly Top Doctors for Ocular Plastics Board of Trustees, American Society of Ophthalmic and Reconstruction Surgery Paula Anne Newman-Casey, M.D., M.S. AGS Cares Task Force, American Glaucoma Society Glaucoma Subcommittee Member, Annual Meeting Program Committee, American Academy of Ophthalmology Jacob Moses Lectureship, Ohio State University Kapetansky-Allergan Lecture, Midwest Glaucoma Society Patient Care Committee, Quality, Efficiency and Performance Measures Subcommittee, American Glaucoma Society Yannis Paulus, M.D. Alcon Young Investigator Grant Continuing Medical Education Committee, Association for Research in Vision and Ophthalmology Editorial Board, International Journal of Ophthalmic and Eye Science Editorial Board, International Journal of Ophthalmic Research Editorial Board, Ophthalmic Surgery, Lasers and Imaging Retina Editorial Board, Photonics Executive Committee, Optica, Technical group on Therapeutic Laser Applications Finance Committee, American Society of Retina Specialists Fundraising Committee, International Society for Eye Research Grant Reviewer, Raine Medical Research Foundation, University of Western Australia Grant Reviewer, Vision Research Program, Department of Defense Congressionally Directed Medical Research Programs Review Editor, Retina, Frontiers in Ophthalmology

JULY 1, 2020 — SEPTEMBER 30, 2021

Yannis Paulus, M.D. (cont.)

Study Section, Brain Imaging, Vision, Bioengineering and Low Vision Technology Development , National Eye Institute, National Institutes of Health Young Investigator Committee, International Society for Eye Research US and International patent 2115-008093-WO-POA “Multi-Modal Imaging For Cell Tracking” US Patent 17320755 “Low Energy Photoacoustic Microscopy (PAM) and combined PAM, dye-based microscopy, and optical coherence tomography” US Patent 42904767 and International Patent “Apparatus for testing age-related macular degeneration and method of using the same” US Provisional Patent 63/121,688 “Room-temperature Phosphorescence Nanoparticles and Methods of Making the Same” US Provisional Patent 63/253,686 “Ocular Drug Delivery Devices and Methods of Fabrication and Use Therefore” Jillian N. Pearring, Ph.D. National Institutes of Health Early Career Reviewer, Biology and Development of Eye Study Section, National Eye Institute, National Institutes of Health RD2021 Platform Session Moderator, Photoreceptors RD2021 Young Investigator Travel Awardee Lev Prasov, M.D., Ph.D. Co-Chair, ClinGen Variant Curation Expert Panel, Anterior Segment Dysgenesis Guest Editor, PLoS Genetics Lead Guest Editor, Journal of Ophthalmology Member, ClinGen Gene Curation Expert Panel, Glaucoma and Neurophthalmology Donald G. Puro, M.D., Ph.D. Best Doctors in America Castle Connolly Top Doctors US News and World Reports Top Doctors Rajesh Rao, M.D. Reviewer, Audacious Goals Initiative U24 RFA, National Eye Institute, National Institutes of Health Study Section Reviewer, Neurobiology-F, Network of Underrepresented Residents and Fellows, VA Merit Grant Review Program Distinguished Alumni Award, Yale University School of Medicine Reviewer and Member, Neurobiology-F, Network of Underrepresented Residents and Fellows Study Section/Scientific Review Group, Merit Review Award Program, Office of Research & Development, Department of Veterans Affairs

43

FACULTY HONORS AND RECOGNITION

Manjool Shah, M.D. Dr. Degazon Lecture, Ophthalmological Society of Jamaica Member, Glaucoma Clinical Committee, American Society of Cataract and Refractive Surgery Alan Sugar, M.D., M.S. Grants Working Group, California Institute for Regenerative Medicine Research Committee Medical Advisory Board, Eye Bank Association of America Troutman Award Committee, Cornea Society Value Based Health Care Working Group on Keratoconus, World Association of Eye Hospitals Debra A. Thompson, Ph.D. Reviewer, Intramural Research Program, Board of Scientific Counselors, National Eye Institute, National Institutes of Health Scientific Advisory Board, Foundation Fighting Blindness

JULY 1, 2020 — SEPTEMBER 30, 2021

Sara L. Weidmayer, O.D. Editorial Review Board, Review of Optometry Jennifer S. Weizer, M.D. Best Doctors in America Kwoon Y. Wong, Ph.D. Associate Editor, Frontiers in Cellular Neuroscience Maria A. Woodward, M.D., M.S. Advisory Committee, JAMA Ophthalmology Awards Committee, American Academy of Ophthalmology Secretariat Award, American Academy of Ophthalmology Senior Editor, Cornea Rebecca A. Wu, M.D. Castle Connolly Top Doctors

James Weiland, Ph.D. Bioengineering of Neuroscience and Vision Technologies study section, National Institutes of Health Vice President Conferences, IEEE Engineering in Medicine and Biology Society

David N. Zacks, M.D., Ph.D. Secretary, The Retina Society

Executive Officers of Michigan Medicine Marschall S. Runge, M.D., Ph.D. Executive Vice President for Medical Affairs, Dean, University of Michigan Medical School, C.E.O., Michigan Medicine

Annual Report Team Editor: Julie Rosenthal, M.D., M.S.

David C Miller, M.D., M.P.H President, University of Michigan Health System, Executive Vice Dean for Clinical Affairs

Editorial Assistants: Sara Reynolds, Jo Kristine Scott

Debra F. Weinstein, M.D. Executive Vice Dean for Academic Affairs, Medical School Chief Academic Officer for Michigan Medicine Steven L. Kunkel, Ph.D. Executive Vice Dean for Research, Medical School Chief Scientific Officer, Michigan Medicine Patricia D. Hurn, Ph.D. Dean, University of Michigan School of Nursing The Regents of the University of Michigan Jordan B. Acker, Michael J. Behm, Mark J. Bernstein, Paul W. Brown, Sarah Hubbard, Denise Ilitch, Ron Weiser, Katherine E. White, Mary Sue Coleman (ex officio) © 2022 Regents of the University of Michigan A Non-discriminatory, Affirmative Action Employer 44

Jason Zhang, M.D. Member, Multimedia Subcommittee, Education and Communication Committee, American Glaucoma Society

Design and Art Direction: David Murrel Writers: Shelley Zalewski, MargaretAnn Cross

Photographers: Michigan Creative: Eric Bronson, Daryl Marshke, Scott Soderberg, Austin Thomason Nicole Haley Photography: Nicole Haley

FOR PATIENT APPOINTMENTS, PLEASE CALL 734.763.8122 For additional copies, please contact: University of Michigan Department of Ophthalmology and Visual Sciences W.K. Kellogg Eye Center 1000 Wall Street Ann Arbor, Michigan 48105 www.umkelloggeye.org

INNOVATION TEAMWORK INCLUSIVITY CARING INTEGRITY

Department of Ophthalmology and Visual Sciences 1000 Wall Street Ann Arbor, MI 48105

Kellogg Among Nation’s Best in Eye Care The University of Michigan Kellogg Eye Center is proud to be ranked in the top 10 in the country by U.S. News & World Report—recognizing our outstanding care for patients with complex eye conditions.

Kellogg has seen extraordinary growth in all aspects of patient care, research and education since the department was established in 1872. Every day, our clinicians, scientists, trainees and staff work together to shape the future of eye care and vision science. We are proud to be part of Michigan Medicine.

~ Our Purpose ~ To improve lives through curing, preventing and treating eye disease