Harvard Medical School Department of Department of Ophthalmology Frontiers in Ophthalmology 2011

Produced by the HMS Department of Ophthalmology 243 Charles Street, Suite 800 CONTENTS Boston, Massachusetts 02114 (617) 573-3526 www.MassEyeAndEar.org [email protected] 2 welcome Editors-in-Chief Senior Writer/Editor: Suzanne Ward Joan W. Miller , MD Publications Manager 6 People & Partners Chief and Chair HMS Ophthalmology Vice Chairs Department of Ophthalmology Scientific Communications Affiliate and Partner Profiles Massachusetts Eye and Ear Infirmary Consultant: Discoveries Making a Difference Massachusetts General Hospital Wendy Chao, PhD Collaborating to Cure Harvard Medical School Review Committee: John I. Loewenstein, MD Wendy Chao, PhD Associate Professor of Janet Cohan 46 Life-transforming care Ophthalmology Kathryn Colby MD, PhD Age-Related Macular Degeneration Harvard Medical School Mary Leach Ocular Oncology Associate Chief for Graduate Melissa Paul Clinical Innovations Medical Education Reza Dana, MD, MPH, MSc Keratoprosthesis Massachusetts Eye and Ear Infirmary Jennifer Street Vision Rehabilitation Janey Wiggs, MD, PhD

Special thanks to the HMS Writing Credits: Department of Ophthalmology Vannessa Carrington 72 Research & Discovery Vice Chairs: Judith Gibian Cornea Mary Leach Uvea Lloyd P. Aiello, MD, PhD Melissa Paul Retina HMS Vice Chair, Centers of Charles Ruberto, PhD Optic Nerve/Glaucoma Excellence Melanie Saunders Beetham Eye Institute at Joslin Jennifer Street Diabetes Center David Sullivan, PhD 110 MiLestones in medical education Patricia A. D’Amore, MD, MBA Administrative Manager: HMS Vice Chair, Basic Research Janet Cohan Setting Standards for Medical Student Education Schepens Eye Research Institute HMS Program Photography: Clinical Fellowship Programs Reza Dana, MD, MPH, MSc John Earle Photography High-Value Education Programs HMS Vice Chair, Academic Programs www.johnearlephoto.com Focus on Faculty Massachusetts Eye and Ear Infirmary/ Schepens Eye Research Institute Design: Visual Dialogue 134 funding & philanthropy David G. Hunter, MD, PhD Designers: Fritz Klaetke, HMS Vice Chair, Promotions and Rita Ferreira, Kimber Couzo, Donor Profiles Reappointments Benjamin Shaykin Foundation Profiles Children’s Hospital Boston www.visualdialogue.com Alumni Giving Society

John I. Loewenstein, MD Production Management: HMS Vice Chair, Medical Education Process Reaching out Massachusetts Eye and Ear Infirmary www.processcorp.net 148 Around the Corner Printing: Around the World Capitol Offset An Interview with Claes Dohlman, MD, PhD www.capitoloffset.com 162 appendices 3 W E L CO

Message from the Chair M E

“The pace and progress of Welcome colleagues, friends and supporters to the Harvard Medical School (HMS) vision science is hurtling Department of Ophthalmology’s inaugural edition of Frontiers in Ophthalmology. forward at momentous I am proud and excited to share with you this first report, which highlights signifi- speed, spurred on by cant clinical, scientific, and educational milestones of the department’s world-class affiliated hospitals and research institutions. Our report reflects on two decades of a host of exciting new discovery and progress in the field of vision science, and the tools and technologies research discoveries, an that are transforming the lives of people and patients across the globe. unprecedented culture From Boston to Bangladesh, improving ophthalmic care and its delivery to mil- of collaboration, and the lions of people worldwide is a shared vision and singular goal of the HMS ophthal- unflagging efforts of our mic community. Advancing technology, expanded global connections, and thriving clinicians, scientists, and new alliances among HMS affiliates and across the broader scientific community educators.” are fueling gains in vision science, education, and medicine. As you’ll read in the fol- — Joan W. Miller, MD lowing pages, HMS scientists, physicians, and academics from all ophthalmic dis- ciplines and across every subspecialty are brainstorming in the lab, the classroom, and the clinic. Their shared knowledge is driving ideas forward and, ultimately, improving care to patients.

Educating the next generation groundbreaking advances in human genetics, regen- of leaders erative medicine, and inflammation and ; The HMS Department of Ophthalmology has a proud these, in turn, have led to a host of new treatments, history of teaching, training, and mentoring generations technologies, and therapies aimed at alleviating the of students who become leaders in their field. In the last suffering associated with eye diseases and blindness. several years, we’ve reinvigorated, refined and retooled HMS researchers have focused intensely on these areas, our educational program to challenge and inspire stu- and are beginning to unravel some of the mysteries sur- dents at every level of their medical education. rounding disease processes, and the biological mecha- Our training program features a newly restructured nisms or environmental influences that may cause them surgical curriculum for residents, which now integrates to go awry. lectures and customized wet lab sessions supervised by For example, you’ll read about advances in age-relat- attending physicians. Groundbreaking faculty efforts ed macular degeneration (AMD) pioneered by the HMS are reshaping resident education with the development Angiogenesis Research Group. The foundations of the of revolutionary, computer-simulated technologies group’s work not only illuminated how new blood vessel that fine-tune surgical knowledge and skills outside formation in the eye (neovascularization) contributes the operating room. Innovative courses and confer- to severe forms of AMD, but also spurred revolution- ences—including our nationally recognized cataract ary clinical treatments that halt and sometimes reverse course and new vitreoretinal course—offer students pathological blood vessel growth. Today, anti-VEGF in- added venues of scientific inquiry and learning, and at- hibitors and therapies developed in our labs have saved tract prominent, international speakers. We continue to or improved the sight of nearly a million people around forge strong alumni ties through our expanded lecture the world. Recent and exciting results from a large- series, a robust visiting professors program, a new AMD scale, phase 3 clinical trial for treating macular edema in symposium, and a newly revamped and expanded three- diabetic patients showed dramatic visual improvement day Annual Meeting & Alumni Reunion. Across the HMS using the anti-VEGF drug Lucentis®. These ground- community and abroad, our expanded alliances with breaking efforts represent a quantum leap in treatment affiliates and partners have sparked unprecedented op- for patients with diabetes—the first in 25 years—and are portunities for surgical, clinical, and research training. rapidly establishing new standards of care. All of these endeavors offer an unparalleled educational In cornea, HMS faculty members are pursuing novel experience for our brilliant young trainees. translational research that has shed new light on the roles of angiogenesis and inflammation in ocular dis- Advancing science ease. Clinical trials in these areas are providing a robust Thanks to a paradigm shift in collaboration among basic baseline of data—facilitating the development of thera- researchers and clinician scientists, insights gained pies to combat these diseases. HMS cornea scientists in the lab are accelerating bench-to-bedside discover- are also leading industry efforts to harness powerful, welcomE ies faster than ever before. The last decade has seen new imaging technologies that more precisely target, 4 W

E track, and treat corneal disease, and ultimately improve and expanding educational and research partnerships. L CO patient outcomes. You’ll also read about advances to Children’s Hospital Boston and Mass. Eye and Ear have M

E our Boston Keratoprosthesis (Kpro)—the most widely integrated their pediatric services, and now offer general used corneal prosthesis in the world—coupled with ag- pediatric ophthalmology and highly specialized pedi- gressive outreach efforts to make it available to patients atric strabismus care at both institutions. The recent worldwide. To date, some 5,000 people in 50 countries, merger between Schepens Eye Research Institute and including the United States, are beneficiaries of our Mass. Eye and Ear has created the world’s largest oph- KPro programs. thalmology research enterprise. We’ve also welcomed a In 2005, significant advances in whole-genome cadre of bright, talented physicians and clinician scien- screening technologies, coupled with increasingly tists to support these important endeavors and to meet a powerful computing capabilities, are enabling us to steady rise in patient volume. initiatives, and the establishment of new healthcare explore DNA inheritance with unimaginable precision Joan W. Miller, MD alliances have all contributed to the department’s and speed. For the first time, opportunities to examine The future is now strong growth and increasing national and international gene-gene and gene-environment interactions will help The pace and progress of vision science is hurtling presence. In 2008, Dr. Miller created five HMS Vice Chair Henry Willard Williams Professor of Ophthalmology us determine who may be at increased risk for specific forward at momentous speed, spurred on by a host of positions to lead the areas of basic research, academic diseases. Efforts within the department are already exciting new research discoveries, an unprecedented Chief and Chair, Department of Ophthalmology programs, centers of excellence, medical education, underway to exploit this potential: we are currently culture of collaboration, and the unflagging efforts of Massachusetts Eye and Ear Infirmary promotions, and reappointments. This new leadership structure has helped integrate the efforts of HMS affili- integrating information and expertise across the our premier group of clinicians, researchers, and educa- Massachusetts General Hospital department through new centers of excellence, build- tors. As you’ll read in these pages, our affiliate institu- ates and partners—promoting communication and ing a massive biorepository of donor tissue and DNA tions that comprise the HMS Department of Ophthal- Harvard Medical School multidisciplinary collaborations in all three mission- samples, integrating vast amounts of genetic and clinical mology have made remarkable gains in medical science Dr. Joan Whitten Miller was born in Toronto, Ontario, critical areas. information, and launching our new Ocular Genom- and ophthalmic practice that are both broad in scope Canada and is a graduate of Massachusetts Institute of Dr. Miller is emphatically committed to supporting ics Institute. All of these efforts welcome a new era of and high in impact. Technology and Harvard Medical School. She completed the incredible talent and dedication of HMS faculty. She personalized medicine—which ultimately means better Despite these gains, there is much to accomplish and her ophthalmology residency and vitreoretinal fellow- has championed numerous administrative supports that care for everyone. a growing imperative to do so; as our population grows ship at Massachusetts Eye and Ear Infirmary. Dr. Miller have created a progressive and rewarding 21st century older, we can expect a significant rise in the number joined the HMS faculty in 1991. She became the first work environment. Dr. Miller has vigorously promoted Pursuing excellence in patient care of people who become blind or visually impaired due women physician to attain the rank of HMS Professor of superb faculty funding and mentoring programs, a The cornerstone of our mission is the quality of care we to age-related diseases such as macular degeneration, Ophthalmology and, in 2003, became the first woman to renewed emphasis on promotions and appointments, provide to patients. Significant efforts by HMS faculty glaucoma, and cataracts. An epidemic rise in the United serve as chair of the department. Additionally, Dr. Miller and new venues for professional advancement and are impacting our full spectrum of patient care—from States of type 2 diabetes is also triggering a surge in dia- is director of Mass. Eye and Ear’s Angiogenesis Labora- recognition; she also received national recognition for prevention to treatment to rehabilitation. For example, betic retinopathy—another leading cause of blindness in tory and a vitreoretinal surgeon in the Retina Service. her strong advocacy efforts as the 2010 recipient of the cutting-edge technologies are giving us better prog- American adults. According to a study sponsored by the Dr. Miller is a preeminent leader in the field of retinal Women in Ophthalmology (WIO) Suzanne Veronneau- nostic information that enables us to diagnose and National Eye Institute, blindness or low vision affected research, and her seminal contributions have helped Troutman Award. WIO president, Jennifer Lim, MD, treat ocular diseases faster and more efficiently. More 3.3 million Americans age 40 or older in 2004; by 2020, save the sight of countless individuals suffering from lauded Dr. Miller as a “pioneer in enhancing the position targeted and less invasive drug treatments and therapies that number is projected to rise to 5.5 million Americans. age-related macular degeneration (AMD) and diabetic and involvement of women in ophthalmology locally and are preventing, saving, and sometimes restoring sight These are sobering statistics that underscore the rel- retinopathy. Her main research interests focus on ocular nationally. Women have achieved parity guided by your in patients, young or old. Recent and exciting develop- evance of our mission and the call to action for continu- neovascularization and retinal disease; besides eluci- gender-neutral policies, efforts to encourage women…to ments in lens technology—already helping to improve ing investments in vision science. dating the molecular mechanisms of angiogenesis and leadership positions in patient-care, teaching, research Kpro outcomes—may soon offer great therapeutic ben- Thanks to you, our generous friends and supporters, neuroprotection, she leads studies that contribute the and administration and your support of their academic efits across a broad range of eye disorders and diseases. our quest for innovation continues unabated across the development of effective therapies and drug delivery achievement…You stand out as a strong female voice in Pioneering advancements in rehabilitative medicine are HMS ophthalmic community. As you read on, I hope systems. She and her colleagues at Mass. Eye and Ear the ophthalmology community.” enabling site-challenged patients to maximize their you’ll share our excitement about the significant prog- pioneered the development of photodynamic therapy A committed teacher and mentor, Dr. Miller has super- vision—sometimes even restoring sight—with new ress made to date and of the discoveries yet to come. It’s (PDT) using verteporfin (Visudyne®), the first phar- vised more than fifty clinical and research fellows, most tools, technologies, and therapies that improve their a marvelous, inspiring, and empowering time to be at the macologic therapy for AMD able to reduce and slow of whom now hold positions in academic ophthalmol- quality of life. forefront of vision science. vision loss. The group also identified the importance of ogy around the world. Her outstanding contributions to Physicians and faculty across the HMS ophthalmic Welcome to our world of vision. vascular endothelial growth factor (VEGF) in neovascu- retinal science make her a sought-after lecturer in the community have a long tradition of collaborating on lar AMD, and helped develop the prominent anti-VEGF United States and abroad. She has published more than patient care, research, and academic activities. We’ve therapies, pegaptanib and ranibizumab—the latter 140 peer-reviewed papers and 55 book chapters and recently forged critical new alliances that have enabled able to improve vision in about one-third of patients review articles. She is co-editor of Albert and Jakobiec’s unprecedented expansions in service to our patients with neovascular AMD. While these approaches have Principles and Practice of Ophthalmology, 3rd ed. and and enhanced our quality of care. For example, we’ve improved the outlook for patients with AMD, Dr. Miller a named inventor on nine U.S. patents. She has been boosted our presence in the Longwood Medical Area by and her colleagues continue investigations to elucidate honored with numerous awards, including the Rosenthal launching a new outpatient practice at Joslin Diabetes the pathophysiology and to develop next-generation Award and Donald J. Gass Medal of the Macula Society, Center’s Beetham Eye Institute, and by adding emer- Joan W. Miller, MD therapies for AMD. the Retina Research Award from the Club Jules Gonin, gency eye trauma coverage and inpatient consultation Henry Willard Williams Professor of Ophthalmology Throughout her tenure as Chair, Dr. Miller has sought the Alcon Research Institute Award, the ARVO/Pfizer at Brigham & Women’s Hospital. The Massachusetts Chief and Chair, Department of Ophthalmology vigorously to grow and diversify the core missions of the Ophthalmic Translational Research Award, the Found- Eye and Ear Infirmary and Massachusetts General Massachusetts Eye and Ear Infirmary HMS Department of Ophthalmology, and to establish er’s Award from the American Society of Retinal Special- Hospital officially joined forces when Mass. Eye and Ear Massachusetts General Hospital the department as the undisputed global leader in ists, the HMS 2010 Joseph B. Martin Dean’s Leadership established a formal department of ophthalmology at Harvard Medical School ophthalmic medicine, education, and research. She has Award for the Advancement of Women Faculty, the Mass General, enabling highly coordinated patient care fostered numerous initiatives that have unified and built Suzanne Veronneau-Troutman Award from Women in upon the intellectual and innovative force of the faculty. Ophthalmology, and the Paul Henkind Memorial Award Substantial investments in leadership and resources, from the Macula Society. expanded educational and training venues, new research