Fellows, residents from around the world show promise for future of retinal research.
The 4th annual Ophthalmology Times® Research Scholar Honoree Program recognized future retina researchers, albeit in a virtual platform in 2020.
Program chairman Rishi P. Singh, MD, a staff surgeon at the Cleveland Clinic Cole Eye Institute and an associate professor of ophthalmology at the Lerner College of Medicine at Case Western Reserve University, said that although the program “grows and grows” each year, he has been particularly impressed with the science and quality of abstracts submitted this year, especially given the complications that the coronavirus disease 2019 (COVID-19) pandemic presented.
“To get to this stage, it was a very, very selective process,” said Singh, adding that the competitive nature of the program made it difficult for the judges to narrow the field. “Thank you for participating in the program, and I am so proud of what we have been able to accomplish.”
Singh and fellow judges Thomas A. Albini, MD, professor of clinical ophthalmology at Bascom Palmer Eye Institute in Miami, Florida; Mark S. Blumenkranz, MD, MMS, HJ Smead Professor Emeritus in the Department of Ophthalmology at Stanford University; Seenu M. Hariprasad, MD, Shui-Chin Lee Professor of Ophthalmology and Visual Science and acting chair of Ophthalmology and Visual Science at the University of Chicago; and Jonathan L. Prenner, MD, chairman of the Department of Ophthalmology at Rutgers Robert Wood Johnson Medical School, New Jersey, had preselected 15 presenters from more than 100 entrants. Each presenter discussed their research for 7 minutes via an online meeting portal, including what role they played in the research.
The remaining 3 minutes of each presentation were left for a question-and-answer session by the judges.
“Every one of you is a winner in this program,” Singh said. “The presentations to our faculty are truly coveted spots.”
The judges agreed, noting that the prestige associated with this program is now making its way into fellow and resident applications at their various affiliations.
This year’s winner, Charles G. Miller, MD, PhD, a fellow at the Scheie Eye Institute at the University of Pennsylvania, presented “The Proteome of Proliferative Vitreoretinopathy (PVR): New Insight into the Central Role of Extracellular Matrix.”
“Although we know PVR to be a scarring-type reaction that occurs on the surface of the retina following retinal detachment, it is important to realize that we do not understand all of the molecular underpinnings of the pathogenesis of PVR,” Miller pointed out. “It is that lack of understanding that led to this project.”
According to Miller, the only treatment for PVR is surgical, and PVR remains “the leading cause for retinal detachment repair failure, and usually necessitates an additional surgery.” Hence, surgeons do what they can to avoid PVR in the first place.
By understanding the molecular pathogenesis in greater detail, Miller said he hopes researchers “can develop novel medical therapies to help prevent PVR in patients who we know are at high risk, and help avoid having to resort to these heroic surgeries as we do today.”
While an ongoing phase 3 study is evaluating methotrexate in an intravitreal formulation, the “half dozen or so” agents that have been investigated have failed, Miller added.
“We looked at preretinal membranes that have formed in the context of PVR and cataloged the entire protein content as a modality to try to get at that molecular pathogenesis,” he said. “We would really like to use these data to identify a novel therapeutic target. Or a protein that is important in the pathogenesis of PVR, that nobody has tried to target with therapy before.”
Additionally, Miller said he believes researchers may be able to use the proteomics data to identify biomarkers for PVR. He envisions a molecular assay that can be used to send a vitreous sample taken at the time of surgery, “to determine whether or not we would want to treat postoperatively because we know that based on elevated levels of, for example, TGFB in their vitreous, that they’re at high risk for developing PVR postoperatively.”
In his study, fibronectin (an extracellular matrix protein) was found to be expressed at 130-fold higher levels in PVR compared with idiopathic epiretinal membrane (ERM). Miller hopes to “beef up the data set to have half a dozen samples of ERM, in order to corroborate” the current findings.
The remaining top 5 finalists (in order) are: Fifth-place winner Anna Stulova, MD, a fellow in the ophthalmology department at Lomonosov Moscow State University in Russia for her presentation “Early Visual Functions Deficiency and OCT-A Changes at the Preclinical Stage of Diabetic Retinopathy: A Prospective Study”; fourth-place winner Tina Felfeli, MD, resident at the University of Toronto for her presentation “Significance of Early Outer Retinal Findings on En Face and Cross-Sectional Optical Coherence Tomography Imaging of Eyes with Macula-Off Rhegmatogenous Retinal Detachment”; Third-place winner Samir N. Patel, MD, a fellow at Wills Eye Hospital for his presentation “The Impact of Systemic Immunosuppression on Endophthalmitis After Intravitreal Anti-VEGF Injections”; and runner-up went to Jamie Odden, MD, MPH, a resident at University of Pittsburgh Medical Center, for her presentation “Intravitreal Injections and Endophthalmitis: Does Lidocaine Gel Change the Risk of the Infection?”Clinical
Blumenkranz delivered a keynote address titled “10 Principle-based Rules of Engagement that May Be of Value to You as You Embark on the Next Phase of Your Careers.” His advice recommended remembering to prioritize friends and family as the constants that sustain you in good times and bad and to “be the author of your own narrative,” as it is an affirmative and creative act, rather than letting others define you.
“An important part of that is choosing your own metrics to determine your success and understanding the difference between the knowledge of facts and wisdom, the latter the ability to use one’s intelligence, common sense, and life experiences to interpret facts to solve new and difficult problems,” Blumenkranz said.
Know the difference
Another caveat is to understand the difference between efficiency and effectiveness.
“Be a trustworthy person because trust is the most precious of all treasures. It is given freely by strangers but once lost, can rarely be regained at any cost,” he said. “Trust is based not only on good ethics but technical competence to accomplish the tasks at hand, and both are equally important. Be honest and be reliable—although not necessarily predictable.”
Blumenkranz added that it is essential to know the difference between urgent and important. Although the former may provide a sense of false accomplishment, the latter is where time should be spent, he said.
Finally, he said to be a good communicator, both afferent and efferent loops and to “remember that the practice of medicine is not only a sacred responsibility, but an honor and the patients are the gifts you are rewarded with for that honor.”
See more Research Scholar Honoree Program coverage here