ophthalmology update - cleveland clinic · from other masquerade syndromes such as age-related...

s p e c i a l e d i t i o n 2 013ophthalmology Update

advances in diagnostics

From cole eye institute

Welcome to our latest edition of Ophthalmology Update.

At the Cole Eye Institute, we are proud to be taking a leadership role in pioneering

the use of advanced diagnostics and technology to improve patient care. In this issue,

we take a look at many of our efforts in that area. Highlights include:

- Our surgeons and researchers are developing the next generation of intraoperative

optical coherence tomography (OCT) devices and instrumentation to improve surgical

decision-making and patient outcomes.

- Armed with a $2 million, five-year grant from the National Institutes of Health,

we are developing new ways to measure corneal mechanical properties and put that

information into clinical use.

- We are continuing to push the limits on OCT and have found that by refocusing

the device, we can actually image the choroid. This important diagnostic advance

allows us to differentiate central serous chorioretinopathy from age-related

macular degeneration.

- We also are using ultra-widefield imaging (UWFI) to visualize up to a 200-degree retinal

field in a single image — nearly 83 percent of the total retinal surface. This gives us a

better idea of the scope of retinal disease burden in patients with diabetes, central retinal

vein occlusions, branch retinal vein occlusions, and arterial disease and occlusions.

- As an established leader in the use of electronic health records (EHR), we offer an

update and resource guide for how to develop a strategy for implementing an image

management system and EHR system that is right for your practice.

In addition, we are excited to give you a look inside our new 600-square-foot ophthalmic

surgical education lab, made possible with a generous $1 million donation from Timken

Foundation. The Louise Timken Microsurgical Education Lab, featuring surgical simula-

tors, is now the centerpiece of our residency program.

Also in this issue, you will find a wealth of information about our CME opportunities, our

staff, their notable publications and the launch of our online forum, Consult QD-Ophthal-

mology, offering insights and perspectives from us and other thought leaders.

If you have additional thoughts or comments on Ophthalmology Update, please feel

free to contact me at [email protected].

Sincerely,

Daniel F. Martin, MDCHA IrMAN , CoLE EyE INsT I TUTE

dear colleagues

intraoperative oct

6

O p h t h a l m O l O g y U p d a t e / / S p e c i a l e d i t i O n 2 0 1 3 / / c l e v e l a n d c l i n i c . O r g / O U S p e c i a l

Optical coherence tomography

(OCT) serves as a noninvasive

imaging modality capable of pro-

viding high-resolution images of biological

structures in living tissues. Using oCT,

the retina’s distinctive layers can be seen,

enabling in vivo histology to comprehen-

sively map and measure layer thicknesses

and identify subsurface pathologies. “For

this reason, OCT has become the standard

of care in diagnosing and monitoring many

eye diseases, such as age-related macular

degeneration or macular holes, but it has

not yet been widely utilized in the surgical

environment due to the lack of an integrat-

ed intraoperative OCT platform,” explains

Cole Eye Institute vitreoretinal surgeon

and assistant professor of ophthalmology

Justis P. Ehlers, MD. “one can assess the

preoperative and postoperative anatomic

configurations, but our ability to assess

the immediate alterations of anatomy that

occur during surgery is currently lacking.”

Crafting New Instrumentation

for Integrated OCT

At Cole Eye Institute, surgeons and

researchers are developing the next

generation of intraoperative OCT de-

vices and instrumentation to improve

ophthalmic surgical outcomes in real

time. Led by the combined efforts

of Drs. Ehlers, sunil srivastava, MD,

and yuankai K. Tao, PhD, a prototype

intraoperative microscope-integrated

OCT system including dedicated surgi-

cal instruments and specially crafted

analysis software is in use at Cleveland

Clinic in the research setting.

“The major advantage of this instrumen-

tation is the ability to provide images

of micron-thick subsurface tissue layers

during a surgical procedure,” says

Forging next-Generation integrated intraoperative oct instrumentation

Dr. Tao, a Cleveland Clinic ophthalmic

researcher who is working on develop-

ing a fully microscope-integrated OCT

system for intraoperative use. “This

provides direct feedback to the surgeon

regarding the location and depth of the

surgical intervention during surgical ma-

neuvers, information previously unavail-

able with conventional surgical micro-

scopes.” The hope is that by utilizing

this information, the new technology will

lead to improved surgical decision-mak-

ing and patient outcomes.

Through the use of integrated OCT instru-

mentation, surgeons will have superior

ability to differentiate between anatom-

ical structures that appear transparent

when viewed through conventional

microscopes. During surgical procedures,

they will be able to visualize eye tissue

layers in real time to provide crucial

feedback when assessing an operation’s

success or level of completion. Addi-

tionally, the high-resolution anatomic

information obtained with OCT may open

the door to novel surgical procedures that

were previously not possible without this

technology.

A microscope-integrated intraoperative

OCT device would enable the surgeons

to directly observe a 3-D high-resolution

surgical field and directly assess the field

and level of intervention. While com-

mercial portable OCT devices have been

available for use in the surgical arena (ei-

ther immediately before or after a surgi-

cal maneuver), they can be cumbersome

and cannot provide direct guidance to

the surgeon at the point of intervention;

instead they require the surgeon to pause,

image and then continue the procedure.

In addition to the microscope-integrat-

ed system, researchers are developing

OCT-friendly surgical instruments. These

novel instruments will provide surgeons

with improved ability to visualize underly-

ing tissues as well as the instruments

7

C l e v e l a n d C l i n i C / / C o l e e y e i n s t i t u t e / / I n n o v a t I o n s

with OCT imaging. Software algorithms

are also being created to facilitate analy-

sis of the dynamic surgical environment

and the rapid changes that may occur

following surgical manipulation. When

combined with the microscope-integrat-

ed system, these advances will help to

provide an integrative solution to utilizing

OCT during ophthalmic surgery.

PIONEER Study Identifying

Potential Applications

To help identify the optimal applications

for intraoperative oCT, the PIoNEEr

study was initiated at the Cole Eye

Institute. It is a prospective study exam-

ining the use of intraoperative OCT in

ophthalmic incisional surgery. To date,

more than 500 patients have enrolled in

the study, a number significantly larger

than that for any any previously pub-

lished intraoperative OCT study. In the

PIoNEEr study, a microscope-mounted

portable oCT system is utilized for intra-

operative imaging.

“From the retinal standpoint, early

data suggest that the technique may be

especially helpful for macular conditions

such as macular holes and epiretinal

membranes,” says Dr. Ehlers, principal

investigator for the PIoNEEr study.

It may also facilitate gathering of prog-

nostic information for retinal detach-

ments as well as information on prolif-

erative diabetic retinopathy. significant

architectural alterations appear to occur

following surgical interventions. Visu-

alizing these changes may help guide

surgeons in surgical maneuvers and in

understanding when surgical objectives

have been achieved.

Cornea surgeons are utilizing the tech-

nology for lamellar keratoplasty, includ-

ing Descemet’s stripping automated

endothelial keratoplasty and deep ante-

rior lamellar keratoplasty. In these cases,

oCT allows the surgeon to visualize graft

placement, interface fluid and depth

of dissection. This information can be

utilized to minimize residual interface

fluid prior to completing the surgical

procedure. Additionally, PIoNEEr is

examining the use of intraoperative OCT

technology for cataract surgery in as-

sessing wound construction, intraocular

lens placement and capsular dynamics.

The Cole Eye Institute was recently

awarded a $3 million innovation platform

grant through the state of Ohio’s Third

Frontier program supporting the ophthal-

mic Imaging Center, including the intra-

operative OCT program, and a $1 million

NIH/NEI grant to support the intraopera-

tive OCT program. Additionally, Cleveland

Clinic is partnering with Duke University

in a dual-center grant funded by the NIH

to investigate the use of microscope-inte-

grated OCT during ophthalmic surgery.

For more information, contact

Dr. Ehlers, Dr. Srivastava or Dr. Tao

at [email protected].

oct choroid imaging

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emerging approaches to oct imaging Yield new insights into choroid

Optical coherence tomography

(oCT) has revolutionized many

aspects of ophthalmology, and

the Ophthalmic Imaging Center at Cleve-

land Clinic’s Cole Eye Institute continues

to push the envelope on its uses.

OCT has been used for several years to

image the retina and the vitreoretinal

interface, but not to evaluate the choroid,

as it was widely believed that OCT could

not obtain quality choroidal images, says

Peter K. Kaiser, MD, Director of the oph-

thalmic Imaging Center.

“However, it turns out that the reason we

weren’t imaging the choroid had to do

with how we focused the OCT device. If

we focused the device more into the cho-

roid than the retina, essentially pushing

the focus further into the eye, we can

actually image the choroid with current

oCT scanners,” says Dr. Kaiser.

This technique was first described by

richard F. spaide, MD, of New york, who

termed it enhanced depth imaging.

“There are various names for this

technique, but what it really allows

is evaluating the choroid, and in some

cases, you can image the sclera and

orbital fat,” Dr. Kaiser says.

This is important because some diseases

affect the choroid in different ways, and

having better information aids in diagno-

sis and care, he notes.

One of the earliest applications Dr.

Kaiser and his colleagues have found

is that the choroid is thickened in

patients with central serous chorioreti-

nopathy. In those patients, an enhanced

imaging OCT scan is a much easier way

to make a diagnosis than fluorescein or

indocyanine green angiography.

“When you are able to see the choroid

is thickened in both eyes, you know

your diagnosis is central serous. We

previously had no way to differentiate it

from other masquerade syndromes such

as age-related macular degeneration

(AMD),” he says.

This is particularly true in older patients

who have subretinal pigment epithelial

fluid, in whom it can be misdiagnosed as

exudative AMD.

“I have seen numerous patients who have

been receiving anti-VEGF injections at

an outside ophthalmologist’s office and

they come to me for a second opinion.

We do enhanced depth imaging and are

able to tell them they have central serous

chorioretinopathy and don’t need any

injections, and in fact they have a much

better visual prognosis,” he says.

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Automated Software

In the past, Dr. Kaiser notes, ophthalmol-

ogists had to do manual measurements

to determine choroidal thickness, which

is very tedious. The Ophthalmic Imaging

Center has developed automated analysis

software that allows physicians to look

at choroidal thickness, area and volume

across the OCT scan.

Dr. Kaiser and his colleagues have made

several other interesting observations about

the choroid in their work. For example,

patients who are very myopic have a very

thin choroid. Patients with age-related cho-

roidal atrophy have features that are not

typical of macular degeneration but are still

losing vision. “It is a different mechanism

than macular degeneration,” he says.

Enhanced depth OCT also is useful in

managing uveitis. “With treatment, you

can actually see the choroidal thickness

go back toward normal in many uveitic

disorders,” Dr. Kaiser says.

He and his colleagues are also using

enhanced depth imaging to examine

retinal degeneration and ocular tumors.

“This is a field in its infancy. In the past,

we couldn’t really image the choroid, so

we didn’t really pay attention to it. Now

that we can image it, we are looking at

it in more detail,” he says.

The Ophthalmic Imaging Center is also

using different-wavelength OCT systems

that have different penetration than the

currently available commercial spectral

domain OCT devices to obtain an even

better view of the choroid.

“As we do more and more scans, we

learn more and more about this area,”

he concludes.

For more information, contact Dr. Kaiser


“When you are able

to see the choroid is

thickened in both eyes,

you know your diag-

nosis is central serous.

We previously had no

way to differentiate it

from other masquer-

ade syndromes such

as age-related macular

degeneration (AMD).”

cornea Modeling

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niH award supports early diagnosis and Patient-Specific Therapy of the Cornea

F ueled by a recent $2 million,

five-year grant from the National

Institutes of Health’s National

Eye Institute, researchers at Cleveland

Clinic’s Cole Eye Institute are developing

new ways to measure corneal mechan-

ical properties and put that information

into clinical use.

Principal Investigator William J. Dupps Jr.,

MD, PhD, explains that the goal of this

study is to develop patient-specific model-

ing for simulation-based therapy that can

eventually lead to more customized treat-

ments for conditions such as keratoconus.

“Although mechanical properties can po-

tentially be assessed in any type of tissue,

we are focusing on the cornea because it

has the best clinical potential of any part

of the eye, perhaps of the entire body, for

harnessing mechanical measurements

that can be turned into actionable clinical

information,” says Dr. Dupps, who is a

cornea and refractive surgery specialist

with appointments in the Biomedical

Engineering Department and Transplant

Center at Cleveland Clinic.

“We are trying to capture three-dimen-

sional information about corneal material

strength and incorporate it into a com-

puterized structural representation of the

eye. A key part of what we are doing is

developing patient-specific models so we

can investigate the behavior of a specific

patient’s cornea instead of studying an

idealized model,” he says.

Corneal strength is not uniform across

the cornea’s width or thickness, partic-

ularly in eyes with keratoconus or prior

corneal surgery. Dr. Dupps hopes that

being able to combine corneal shape

and material properties in 3-D models

will help researchers better under-

stand the underlying mechanisms of

keratoconus and postoperative corneal

ectasia. More important for patients,

however, would be the extension of

these findings in ways that allow earlier

detection of keratoconus and more

effective screening of refractive surgery

patients, he says.

“Our hypothesis is that differences in

local corneal material properties play

a direct role in determining corneal

15


shape and, consequently, refractive

error. For example, some of the weak-

ening that arises early in the course of

keratoconus probably occurs focally and

is likely a driver of early shape changes,”

says Dr. Dupps.

A recent publication in the journal

Investigative Ophthalmology & Visual

Science from Dr. Dupps’ lab has tested

this hypothesis by simulating the impact

of focal material weakness in virtual

models of keratoconus.

The importance of early diagnosis is

greater than ever because collagen cross-

linking now provides a middle-ground

treatment option between rigid contact

lens use and corneal transplantation.

Collagen crosslinking, a procedure

that involves stiffening the cornea, is

currently in FDA studies. The Cole Eye

Institute recently received Institutional

Review Board approval to participate as

a clinical site in the ACos/Avedro KXL

crosslinking study.

The current approach to crosslinking is

to saturate the cornea with riboflavin

drops for about a half hour, followed

by the application of ultraviolet light for

another half hour. This new study ran-

domly assigns patients with keratoconus

or postoperative ectasia to one of three

treatment arms in which shorter dura-

tions of treatment with higher intensities

of light are used.

“The study is currently the only indus-

try-sponsored crosslinking trial in the

U.s., and its purpose is to provide

access to a very promising treatment

while studying the optimal combination

of treatment intensity and duration,”

Dr. Dupps says.

Beyond Diagnostic Uses

Computational modeling of the cornea to

achieve patient-specific, simulation-based

therapy is another important aspect of the

research program, he says.

“Once we have developed a number of

computational models from clinical mea-

surements, and have validated that the

models accurately represent the behavior

of their living counterparts, then we can

begin to ask questions of these virtual

eyes that would be impractical or unsafe

in actual patients,” he says.

He and his colleagues are working to

simulate treatment of normal myopic

model eyes to see how predicted out-

comes compare with actual outcomes in

LAsIK. In another arm of the study, the

results of clinical crosslinking treatments

in keratoconus eyes will be compared

16


with the predicted outcomes of

simulations based on the same patient

and treatment.

“Once we have validated the models,

we can begin to use them to modify

treatments to better customize treat-

ments to patients’ specific corneal

material properties and achieve better,

more predictable outcomes,” he says.

Safety

safety is another concern, as post-LAsIK

ectasia can be the result of early kerato-

conus, undetected corneal biomechan-

ical weakness, or a mismatch between

the amount of surgery and the cornea’s

capacity for maintaining a stable post-

operative shape over time.

“We plan to simulate LAsIK on a variety

of patient models, including patients

with varying degrees of keratoconus,

to investigate the structural response

to many patient-specific structural vari-

ables and surgical parameters. By doing

hundreds of simulations in these virtual

eyes with systematic changes in vari-

ables, we can do a sensitivity analysis

to determine which risk factors are the

most important for avoiding postopera-

tive ectasia,” he says.

He notes that the ultimate intended ap-

plication of these analyses is the creation

of patient-specific treatment designs.

For example, crosslinking currently uses

a standard treatment zone that encom-

passes most of the cornea – 8 to 9 mm.

However, in previously published work

from his group, Dr. Dupps has found that

much greater effect can potentially be

achieved with a customized treatment

zone that is centered over the point

of weakness.

“Instead of just stabilizing the cornea,

there is great potential to actually re-

verse shape changes by altering corneal

stiffness in a more rational way,” he

says. “We are currently applying the

same principle to develop treatments for

more common refractive errors such as

nearsightedness and astigmatism.”

For more information, contact Dr. Dupps


17


Case Study: advanced diagnostics lead to Resolution of Microsporidial Keratitis

The use of electron microscopy by corneal surgeons

at Cleveland Clinic’s Eye Institute can facilitate

diagnosis in difficult cases. In this example, electron

microscopy led to the resolution of a prolonged case of

microsporidial keratitis after cataract surgery in a 70-year-

old immunocompetent male who had been referred for

evaluation of chronic unilateral keratitis and iritis.

Punctate keratitis and iritis had been noted within two

weeks after uncomplicated cataract surgery at anoth-

er facility, and progressed to an epithelial defect and

presumed herpetic kerato-uveitis contiguous with the

temporal cataract wound.

The patient experienced multiple flare-ups over two years

that responded well to topical steroids. However, their

use led to ocular hypertension.

The patient underwent penetrating keratoplasty and

Baerveldt shunt placement at the Cole Eye Institute.

subsequent electron microscopy testing, performed by

James McMahon, PhD, in Anatomic Pathology, revealed

the presence of microsporidial stromal keratitis that had

been missed previously with traditional microscopy.

Cornea surgeon William J. Dupps Jr., MD, PhD, notes that

no evidence of recurrence was seen in the graft after post-

operative treatment with topical fumagillin and oral alben-

dazole. The patient’s vision corrected to 20/20 with a rigid

contact lens. He is a hobby pilot and was able to resume

flying after a long hiatus due to his vision problems.

Cataract surgery and local immunosuppression from the

topical steroids were the only identifiable risk factors in

this unusual case, notes Dr. Dupps. The clinical presenta-

tion can overlap with herpetic kerato-uveitis or infectious

crystalline keratopathy and delay diagnosis and appropri-

ate management.

“Getting this diagnosis enabled us to appropriately utilize a

more suitable antimicrobial to treat the patient’s chronic in-

fection and prevent recurrence in the graft,” he says. “Being

able to decrease his steroid use through better control of the

infection also was important for giving him relief and allow-

ing us to better manage his postoperative medications.

“While electron microscopy is not a new technology, its use in

this case demonstrates the value of a less commonly utilized

advanced diagnostic technique,” he concludes.

Ultra-Widefield Imaging

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expanding the Retinal imaging Field with Ultra-Widefield Technology

Conventional retinal imaging

includes the use of a fundus

camera that limits the visual field

to approximately 30 to 50 degrees of

the retina in a single capture. However,

ophthalmologists at Cleveland Clinic’s

Cole Eye Institute are using an enhanced

retinal imaging technology, ultra-widefield

imaging (UWFI), to visualize up to

a 200-degree retinal field in a single

image, which translates to nearly 83

percent of the total retinal surface.

The UWFI system used at the Cole Eye

Institute is the Optos® 200Tx™ sys-

tem. This technology not only generates

fundus images but is also used to provide

high-resolution ultra-widefield fluorescein

angiograms, particularly important for

imaging retinal vascular diseases and

inflammatory eye disorders. In addition,

ultra-widefield fundus autofluorescence

is being used to better characterize

diseases impacting the retinal pigment

epithelium not only in the macula but

also the periphery, such as degenerative

retinal diseases.

Assessing Disease Burden

“Ultra-widefield imaging gives us a much

better idea of the entire scope of retinal

disease burden in diabetes and retinal

vascular occlusive disease,” says Justis

P. Ehlers, MD, vitreoretinal surgeon and

Assistant Professor at Cole Eye Institute.

For example, it can detect neovascu-

larization that is present in a diabetic

patient that may not be visualized with

standard angiography. Because UWFI

provides an overview of the entire retinal

landscape in more detail rather than just

a focused 30-degree field with survey

photos, physicians may be able to better

characterize the severity of the diseases

that they are managing.

Cole Eye Institute ophthalmologists are

seeking to understand how UWFI can

clarify how to best manage patients based

on the degree of ischemic burden. While

the treatment repercussions of UWFI

are not known for all retinal disorders,

researchers are producing early data to

learn more about the best uses for UWFI

in clinical diagnosis and management.

Titrating Therapy in Ocular

Inflammatory Diseases

To improve the diagnosis and measure-

ment of ocular inflammatory activity, Cole

Eye Institute ophthalmologists use UWFI,

particularly fluorescein angiography. “In

our patients with inflammatory diseases,

21


we are able to detect areas of inflamma-

tion or areas of activity that were poorly

recognized on traditional angiography,”

says sunil srivastava, MD, retinal sur-

geon and uveitis specialist at Cole Eye

Institute, referring to a study conducted

at Cleveland Clinic. He says, “At the

clinic, we use ultra-widefield angiography

on the vast majority of, if not all, patients

with inflammatory eye disease because

we get a much better assessment of what

is going on with these patients.”

Most anti-inflammatory medications have

varying levels of toxicity. “For this reason

I monitor all of my patients with retinal

inflammatory diseases who are taking

these drugs with UWF angiography,” Dr.

Srivastava adds. “It allows me to better

titrate the dosing based on the presence

of inflammatory activity.”

Cole Eye Institute ophthalmologists have

determined that UWFI is especially infor-

mative in patients with retinal vasculitis.

One disease, Susac’s Syndrome, has

been particularly well-characterized with

UWFI at the Cole Eye Institute. At the

International Susac syndrome Consulta-

tion Clinic at Cleveland Clinic, one of the

largest clinics in the world for assessing

those with the disease, ophthalmologists

have learned that UWF angiography is

the best way to determine if the disease

is active in the eye. Says Dr. Srivastava,

“Ultra-widefield imaging makes a huge

difference for these patients because it

helps us decide when to intervene and

treat in order to prevent vision loss.”

Inherited Retinal Disease

UWFI with fundus autofluorescence

provides a better perspective on inherited

retinal diseases. “We do ultra-wide-

field fundus autofluorescence on all

our patients with retinal dystrophies,”

explains Elias Traboulsi, MD, Head of the

Department of Pediatric Ophthalmology

and Director of the Center for Genetic

Eye Diseases at Cole Eye Institute. While

the list of retinal dystrophies is long,

among the most common are Stargardt

disease, retinitis pigmentosa, Usher

syndrome and choroideremia. “Many of

these diseases have very characteristic

patterns of abnormality that we can now

recognize because we can see nearly

the entire retina in just one image,” he

adds. No longer is it necessary to spend

hours piecing together a collage of retinal

images that even when complete do not

capture the entire periphery.

Distinguishing between patterns of ab-

normalities helps ophthalmologists with

differential diagnosis, often between a

number of very rare inherited diseases.

Cole Eye Institute ophthalmologists are

hopeful UWFI will also assist in under-

standing the progression of these rare

disorders as in well as comparing the

effects of treatment. “I think it is also

going to be very helpful for us in follow-

ing patients who will eventually become

eligible for gene therapy,” Dr. Traboulsi

adds. “As that becomes available, we

have to have additional ways of monitor-

ing these patients.”

For more information, contact

Dr. Srivastava or Dr. Traboulsi at

[email protected].

eHR Guide

24


image integration into electronic Health Record systems

Ophthalmology practices have

grown increasingly reliant on

digital diagnostic image capture,

and many ophthalmologists recognize a

need to store, retrieve, manipulate and

display such depictions in an efficient

and productive manner. The images may

vary from a PDF of an advance beneficia-

ry notice from an insurance provider to a

spectral domain OCT report.

The acquisition of these data can have

huge financial implications during chart

audits by a recovery audit contractor or

when an insurance plan refuses payment

for a drug without supportive documen-

tation. It also can have a large impact

on practice efficiency. A recent study

presented at the Association for Research

in Vision and Ophthalmology Annual

Meeting showed that the implementa-

tion of a DICoM-compatible workflow

reduced the need to enter or edit patient

demographic information by 50 percent

and reduced the need to manage misfiled

images by 85 percent.

As a result, a growing number of

clinicians are turning to either their

electronic medical record (EMr) system

or an image management system (IMs)

that connects to their offices’ numerous

data-acquisition devices for ready access

to these types of documents. Picture

archiving and communication systems

(PACss) originated in the 1980s first

in radiology and then cardiology. Only

in the past decade have PACss — a

generic term for IMss (the two are often

used interchangeably) — expanded into

ophthalmology.

Even so, the market penetration of

stand-alone PACSs in ophthalmology

remains small because many practi-

tioners first tackle the job of implement-

ing electronic health records (EHR)

systems as mandated by the federal

Department of Health and Human

Services. The costs and implementation

challenges of installing both types of

systems at once are sufficiently daunting

that many ophthalmologists are putting

off the investment in an IMs until after

an EHR system is up and running. At

the same time, other practitioners and

many industry observers see advantages

in implementing both at once. In fact,

an American Academy of Ophthalmology

(AAO) survey highlighted that one of the

largest barriers to EHR implementation

was the lack of integration with existing

imaging devices. The AAO has provided

clinicians recommendations for adopting

EHR and image integration systems.

(Figure 1).

Figure 1. Example of a combined clinical display (two different modalities on the same report) allowing for better decision-making.

25


A Shopper’s Guide

With the advent of any new technology

such as IMss and EHrs, potential buyers

must develop a strategy to ensure that

the system they acquire is right for their

practice. Here’s a brief summary:

• List your diagnostic equipment inven-

tory. Such an inventory allows you to

approach EHR vendors with a clear in-

dication of your practice’s clinical needs

concerning image management and

thereby ensure compatibility. Be sure to

note the make, model, year, software

version, Ethernet capability and DICoM

conformance. These will help immense-

ly in determining whether existing in-

terfaces can be used to pull the images

and data or whether customized work

will be necessary, resulting in increased

costs. In the investigation process,

consider investing in newer models to

improve connectivity.

• Determine your threshold for image

integration. There is a lot of variability

in the amount of image integration,

from rudimentary to robust. Depend-

ing on the type of practice, you may

find that the IMss of the EHr are

insufficient. For example, a multispe-

cialty group practice might just want

the integration of PDF reports while

a retina-only practice may also need

the ability to integrate OCT reading

software. This exercise is critical in

determining whether you will need

a separate IMs — products such

as Forum® (Carl Zeiss Meditec Inc.)

or Axis™ (sonamed Escalon) — or

whether you can get by on what the

EHR vendors are providing.

• Test-drive at trade shows. Along with

the typical vendor showcases, the

AAO has set up special sections at the

annual meeting at the IHE Showcase. It

also provides user satisfaction surveys

at aao.org/aaoe/ehr-central. Plan on

setting up a specific meeting time with

the vendor rather than using a “drop in”

approach.

• Evaluate the user interface. The adage

“it’s all in the design” could not be more

applicable than it is to image manage-

ment in EHR systems. The user interface

is where practitioners spend most of

their time with the images to sort, group,

manipulate and display them. If the

interface doesn’t meet their standards or

facilitate their understanding, then it will

most certainly be underutilized.

• Talk with and visit colleagues. Before

we implemented our EHR and PACS,

we traveled to offices of colleagues to

get a firsthand account of how the sys-

tem was working in real practice. They

provided honest feedback as to what

was successful, what was not, where

they had trouble with implementation

and how to best negotiate the contract.

• Have a budget and live by it. EHR

implementations can run from $50,000

to $500,000. It’s important to budget

honestly for what your practice can af-

ford. Be certain to not only factor in the

benefits of meaningful use dollars, but

the reduced transcription fee and lower

image and record storage costs.

Modality WorklistFigure 2.

Hospital Information System or EMR

PACS/IMS

Capture Device

Jane Smith ID: 123456

Worklist Order Jane Smith ID: 123456

26


Cutting-edge Imaging Features

Last year, Cole Eye Institute installed

one of the most comprehensive imaging

PACSs systems, which improves patient

experience and physicians’ ability to

interpret data rapidly. The features that

relate to image management include:

1. Images everywhere — The ability to

access patient images, regardless of the

office location allows for continuity

of patient care. In addition, any other

physician at Cleveland Clinic can

review the images, including those in pri-

mary care, endocrinology and neurology.

Patients will also be able to review their

images from their MyChart® account.

2. Combined clinical displays — This

represents the greatest breakthrough in

image analysis, allowing for the combi-

nation of modalities on a single report.

This supports improved physician deci-

sion-making (Figure 1).

3. Link between the PACS and Epic

(Modality Worklist) – The link allows

for the proper demographic information

to be passed to the camera and reduces

manual entry and acquisition time for

the photographers (Figure 2).

4. Bidirectional capabilities — Physi-

cians have access to review software to

annotate, zoom in on a particular spot

or perform additional analyses. They can

do this from the primary workstation and

save their images to the central archive

for all to see (Figure 3).

5. Launching of the imaging system

from the EHR and image sorting — This

allows for the launch of the stand-alone

PACS from the EHR as well as sorting of

data by laterality, dates, ordering provider

and modality.

Conclusions

The image integration with your select-

ed EHR can make or break your user

experience. Planning and investigation

are the keys to making the migration to

the digital age. Cole Eye Institute has

implemented one of the most sophisticat-

ed systems to date, improving both the

physician and patient experience.

For more information, contact rishi singh,

MD, at [email protected].

Bidirectional connectivity• OCT system stores exam data

in the central archive

• Review stations access exam

data in the central archive

• Any changes made to the

exam data are updated in

the central archive.

Central Archive

Review Station Software

Figure 3.

27


An open, online forum from

Cleveland Clinic’s Cole Eye

Institute. Impact your practice

with a daily dose of insights and

perspectives from us and other

thought leaders.

Explore the latest insights.

ConsultQD.org/oph

consult Qd-ophthalmology

Learn from CEO Toby Cosgrove, MD, how blending innovation, efficiency and compassion can lead to success in a challenging healthcare environment.

• Get ideas on teamwork, efficiency and collaboration to share with colleagues.

• Learn how Cleveland Clinic has cut costs and improved quality.• Discover where healthcare is heading from one of the

industry’s leaders.

“A pioneer in American healthcare, Toby Cosgrove shows just how the diligence and innovative thinking behind the Cleveland Clinic has helped solve fundamental problems most other places barely touch. There are lessons here for everyone — patient, physician, and policymaker alike.”

– Atul Gawande, MD professor at Harvard Medical School and bestselling author of

The Checklist Manifesto

Visit clevelandclinic.org/ClevelandClinicWay for details or to order a copy.

investigations

30


clinical trials

rETINAL DIsEAsEs

A Prospective, Two-Cohort, Single-Masked Study to Evaluate the Effect of ESBA1008 Applied by Microvolume Injection or Infusion in Subjects with Exudative Age-Related Macular Degeneration

Objective: Demonstrate a treatment effect of EsBA1008 applied as micro-volume injection or infusion on retinal function and morphology in subjects with exudative AMD.

Contact: rishi singh, MD, 216.445.9497, or Gail Kolin, 216.445.4086

Ozurdex® for Diabetic Macular Edema Treated with Pars Plana Vitrectomy and Membrane Removal (OPERA Study)

Objective: Examine the use of ozurdex in patients who are undergoing pars plana vitrectomy for macular edema due to diabetic macular edema.

Contact: sunil srivastava, MD, 216.636.2286, or Kim Baynes, 216.444.2566

Safety and Efficacy of Intravitreal Ranibizumab for Diabetic Macular Edema Previously Treated with Intra-vitreal Bevacizumab: A Randomized Dual-Arm Comparative Dosing Trial (Phase:1/2): REACT Study

Objective: Assess the ocular and sys-temic adverse events of ranibizumab for DME following previous treatment with intravitreal bevacizumab.

Contact: Justis Ehlers, MD, 216.636.0183, or Gail Kolin, 216.445.4086

The following studies are either currently enrolling new patients or are pending approval by the Institutional Review Board and should be enrolling shortly:

A Phase III, Randomized, Double- Masked, Controlled Trial to Establish the Safety and Efficacy of Intravitre-ous Administration of Fovista™ (Anti PDGF-B Pegylated Aptamer) Admin-istered in Combination with Lucentis® Compared to Lucentis Monotherapy in Subjects with Subfoveal Neovascular Age-Related Macular Degeneration

Objective: Evaluate the safety and efficacy of Fovista intravitreous ad-ministration.

Contact: rishi singh, MD, 216.445.9497, or Kathi Dastoli, rN, 216.445.5248

Randomized, Double-Masked, Vehicle-Controlled Clinical Evaluation to Assess the Safety and Efficacy of Nepafenac Ophthalmic Suspension, 0.3% for Improvement in Clinical Outcomes Among Diabetic Subjects Following Cataract Surgery

Objective: Demonstrate superiority of Nepafenac ophthalmic suspension, 0.3% dosed once daily relative to Nepafenac Vehicle based upon clinical outcomes among diabetic subjects following cataract surgery.

Contact: richard Gans, MD, 216.444.0848, or Gail Kolin, 216.445.4086

Prevention of Macular Edema in Patients with Diabetic Retinopathy Undergoing Cataract Surgery

Objective: Determine the safety and efficacy of intravitreal aflibercept injec-tion in patients with diabetic retinopa-thy in the prevention of macular edema following cataract surgery.

Contact: rishi singh, MD, 216.445.9497, or Gail Kolin, 216.445.4086

Prospective Intraoperative and Perioperative Ophthalmic Imaging with Optical Coherence Tomography (PIONEER Study)

Objective: Assess the feasibility and utility of intraoperative OCT and periop-erative oCT in optimizing the manage-ment of surgical ophthalmic diseases.

Contact: Justis Ehlers, MD, 216.636.0183, or Jamie reese, rN, 216.636.0183

UVEITIs

A Randomized, Double-Masked, Placebo-Controlled Study of the Safety and Efficacy of Gevokizumab in the Treatment of Active Noninfectious Intermediate, Posterior, or Pan-Uveitis (Eyeguard-A Study)

Objective: Demonstrate the superiority of gevokizumab compared to placebo in the treatment of subjects with active noninfectious intermediate, posterior or pan-uveitis. The safety of gevokizumab will also be assessed.

Contact: Careen Lowder, MD, 216.444.3642, or Laura Holody, 216.445.3762

A Randomized, Double-Masked, Placebo-Controlled Study of the Safety and Efficacy of Gevokizumab in the Treatment of Subjects with Non-infectious Intermediate, Posterior or Pan-Uveitis Currently Controlled with Systemic Treatment (Eyeguard-C Study)

Objective: Demonstrate the superiority of gevokizumab compared to placebo in reducing the risk of recurrent uveitic disease in subjects with noninfectious intermediate, posterior or pan-uveitis currently controlled with systemic treat-ment. The safety of gevokizumab will also be assessed.


31

C l e v e l a n d C l i n i C / / C o l e e y e i n s t i t u t e / / i n v e s t i g a t i o n s

Open-Label, Safety and Tolerability Study of Suprachoroidal Triamcinolone Acetonide via Microneedle in Subjects with Noninfectious Uveitis

Objective: Evaluate the safety, tolerabil-ity and efficacy of an injection of triam-cinolone acetonide (TA) into the SCS of human subjects using a microneedle.


A Phase III, Multinational, Multicenter, Randomized, Masked, Controlled, Safety and Efficacy Study of a Fluo-cinolone Acetonide Intravitreal (FAI) Insert in Subjects with Chronic Nonin-fectious Uveitis Affecting the Posterior Segment of the Eye (PSV-FAI-001)

Objective: Evaluate the safety and efficacy of an FAI insert in the manage-ment of subjects with chronic nonin-fectious uveitis affecting the posterior segment of the eye.


THyroID EyE DIsEAsE

A Multicenter, Double-Masked, Placebo-Controlled, Efficacy and Safety Study of RV-001, an Insu-lin-Like Growth Factor-1 Receptor (IGF-1R) Antagonist Antibody (fully human), Administered Every 3 Weeks (Q3W) by Intravenous (IV) Infusion in Patients Suffering from Active Thyroid Eye Disease (TED)

Objective: Investigate the efficacy, safety and tolerability of rV-001 (a fully human anti-IGF-1r antibody) administered every three weeks for six months, in comparison to placebo, in the treatment of patients suffering from active TED.

Contact: Julian Perry, MD, 216.444.3635, or Amy Wunderle, rN, 216.636.5294

PEDIATrIC EyE DIsEAsE

Bilateral Lateral Rectus Recession vs. Unilateral Recess-Resect for Intermit-tent Exotropia (IXT1)

Objective: Evaluate the effectiveness of bilateral lateral rectus muscle recession versus unilateral lateral rectus recession with medial rectus resection procedures for the treatment of strabismus.

Contact: Elias Traboulsi, MD, 216.444.4363, or sue Crowe, rN, 216.445.3840

The Natural History of the Progression of Atrophy Secondary to Stargardt Disease: Prospective Observation

Objective: Assess the rate of progres-sion of Stargardt disease by measuring the growth of macular atrophic lesions using fundus autofluorescence.

Contact: Elias Traboulsi, MD, 216.444.4363, or Meghan Marino, 216.445.7671

GENETICs

Molecular Genetics of Eye Diseases

Objective: Study the molecular genetics of ophthalmic disorders through the compilation of a collection of DNA, plasma and eye tissue samples from patients and from families with a broad range of eye diseases and malforma-tions.

Contact: Elias Traboulsi, MD, 216.444.4363, or sonal Uppal, PhD, 216.444.7137

Genetics of Uveitis

Objective: Identify changes in genes that may lead to uveitis.


CorNEA/rEFrACTIVE sUrGEry

LASIK Flap Thickness and Visual Outcomes Using the WaveLight FS200 Femtosecond Laser

Objective: To evaluate the visual out-come, accuracy and predictability of LAsIK flap thickness using the new WaveLight® Fs200 femtosecond laser and compare these results to those obtained using the IntraLase™ Fs60 femtosecond laser.

Contact: William J. Dupps Jr., MD, PhD, 216.444.8158, or Laura Holody, 216.445.2264

Long-Term Safety Follow-up for Subjects Previously Implanted with the AcrySof® Cachet™ Phakic Lens in Clinical Studies C-02-23, C-02-40, C-03-21 and C-05-57

Objective: Estimate the annualized endothelial cell loss rate (for up to 10 years following date of implantation) of subjects previously implanted with the L-series Acrysof Cachet Phakic Lens from clinical studies.

Contact: William J. Dupps, Jr., MD, PhD, 216.444.8158, or Laura Holody, 216.445.2264

THE FoLLoWING sTUDy HAs CoMPLETED PATIENT ENroLLMENT IN THE PAsT yEAr AT CoLE EyE INsTITUTE AND Is IN FoLLoW-UP:

Investigator Initiated Observational Study of Intravitreal Aflibercept Injec-tion for Exudative Age-Related Macular Degeneration Previously Treated with Ranibizumab or Bevacizumab

32


Cole Eye Institute | Publications

JOURNAL PUBLICATIONS

Am.J.Emerg.Med.

Nguyen TM, Phelan MP, Werdich XQ, Rychwalski PJ, Huff CM. subconjunctival hemorrhage in a patient on dabigatran (Pradaxa). Am J Emerg Med. 2013 Feb;31(2):455.

Am.J.Ophthalmol.

Browning DJ, Kaiser PK, Rosenfeld PJ, stewart MW. Aflibercept for age-related macular degeneration: a game-changer or quiet addition? Am J Ophthalmol. 2012 Aug;154(2):222-226.

Mehta VJ, Perry JD. Blepharoptosis repair outcomes from trainee versus experienced staff as the primary surgeon. Am J Ophthalmol. 2013 Feb;155(2):397-403.

Morales-Canton V, Quiroz-Mercado H, Velez-Montoya r, Zavala-Ayala A, Moshfeghi AA, shusterman EM, Kaiser PK, Sanislo sr, Gertner M, Moshfeghi DM. 16 and 24 Gy low-voltage X-ray irradiation with ranibizumab therapy for neovascular age-related macular degeneration: 12-month outcomes. Am J Ophthalmol. 2013 Jun;155(6):1000-1008.

Nicholson BP, Singh RP, Sears JE, Lowder CY, Kaiser PK. Evaluation of fluocinolone acetonide sustained release implant (Retisert) dissociation during implant removal and exchange surgery. Am J Ophthalmol. 2012 Dec;154(6):969-973.

Perry JD. Dysfunctional epiphora: a critique of our current construct of “functional epiphora”. Am J Ophthalmol. 2012 Jul;154(1):3-5.

stacy rC, Jakobiec FA, Herwig MC, schoenfield L, Singh A, Grossniklaus HE. Diffuse large B-cell lymphoma of the orbit: clinicopathologic, immunohistochemical, and prognostic features of 20 cases. Am J Ophthalmol. 2012 Jul;154(1):87-98.

BMC Ophthalmol.

Wang y, Abu-Asab Ms, Li W, Aronow ME, Singh AD, Chan CC. Autoantibody against transient receptor potential M1 cation channels of retinal oN bipolar cells in paraneoplastic vitelliform retinopathy. BMC Ophthalmol. 2012 Nov;12:56.

Br.J.Ophthalmol.

Bahl RS, Marcotty A, Rychwalski PJ, Traboulsi EI. Comparison of inferior oblique myectomy to recession for the treatment of superior oblique palsy. Br J Ophthalmol. 2013 Feb;97(2):184-188.

Dhoot DS, Huo S, Yuan A, Xu D, Srivistava S, Ehlers JP, Traboulsi E, Kaiser PK. Evaluation of choroidal thickness in retinitis pigmentosa using enhanced depth imaging optical coherence tomography. Br J Ophthalmol. 2013 Jan;97(1):66-69.

Ehlers JP. The MANTA 1-year results: the anti-VEGF debate continues. Br J Ophthalmol. 2013 Mar;97(3):248-250.

Ehlers JP, Kaiser PK, McNutt sA, Srivastava SK. Contrast-enhanced intraoperative optical coherence tomography. Br J Ophthalmol. 2013 Apr;97(11):1384-1386.

Li LH, Li N, Zhao Jy, Fei P, Zhang GM, Mao JB, Rychwalski PJ. Findings of perinatal ocular examination performed on 3573, healthy full-term newborns. Br J Ophthalmol. 2013 May;97(5):588-591.

Moshfeghi AA, Morales-Canton V, Quiroz-Mercado H, Velez-Montoya r, Zavala-Ayala A, shusterman EM, Kaiser PK, Sanislo sr, Gertner M, Moshfeghi DM. 16 Gy low-voltage x-ray irradiation followed by as needed ranibizumab therapy for age-related macular degeneration: 12 month outcomes of a ‘radiation-first’ strategy. Br J Ophthalmol. 2012 oct;96(10):1320-1324.

Pelayes DE, Zarate JO, Biscotti CV, Singh AD. Calibrated needle for ophthalmic fine needle aspiration biopsy. Br J Ophthalmol. 2012 Aug;96(8):1147-1148.

Suhler EB, Lowder CY, Goldstein DA, Giles T, Lauer AK, Kurz PA, Pasadhika s, Lee sT, de saint sardos A, Butler NJ, Tessler HH, Smith JR, Rosenbaum JT. Adalimumab therapy for refractory uveitis: results of a multicentre, open-label, prospective trial. Br J Ophthalmol. 2013 Apr;97(4):481-486.

Traboulsi EI. Childhood retinal dystrophies: what’s in a name? Br J Ophthalmol. 2013 Mar;97(3):247.

Cleve.Clin.J.Med.

Alraiyes AH, Alraies MC, Almeida FA, Singh AD. Flashing lights, floaters, and reduced vision. Cleve Clin J Med. 2012 sep;79(9):616-618.

Teng K, Eng C, Hess CA, Holt MA, Moran rT, Sharp RR, Traboulsi EI. Building an innovative model for personalized healthcare. Cleve Clin J Med. 2012 Apr;79 suppl 1:s1-s9.

Clin.Ophthalmol.

Singh R, Alpern L, Jaffe GJ, Lehmann rP, Lim J, reiser HJ, sall K, Walters T, sager D. Evaluation of nepafenac in prevention of macular edema following cataract surgery in patients with diabetic retinopathy. Clin Ophthalmol. 2012;6:1259-1269.

Cornea

Smadja D, Colin J, Krueger RR, Mello Gr, Gallois A, Mortemousque B, Touboul D. Outcomes of deep anterior lamellar keratoplasty for keratoconus: learning curve and advantages of the big bubble technique. Cornea. 2012 Aug;31(8):859-863.

Curr.Opin.Ophthalmol.

Englander M, Kaiser PK. Combination therapy for the treatment of neovascular age-related macular degeneration. Curr Opin Ophthalmol. 2013 May;24(3):233-238.

Pasquali T, Krueger R. Topography-guided laser refractive surgery. Curr Opin Ophthalmol. 2012 Jul;23(4):264-268.

Traboulsi EI. Pigmented and depigmented lesions of the ocular fundus. Curr Opin Ophthalmol. 2012 sep;23(5):337-343.

Doc.Ophthalmol.

Peachey NS, sturgill-short GM. response properties of slow PIII in the Large (vls) mutant. Doc Ophthalmol. 2012 Dec;125(3):203-209.

Eur.Oncol.Haematol.

Lima Br, Singh AD. Bevacizumab therapy for choroidal melanoma. Eur Oncol Haematol. 2012 May;8(2):101-104.

Exp.Eye Res.

Bonilha VL, shadrach KG, rayborn ME, Li y, Pauer GJT, Hagstrom SA, Bhattacharya sK, Hollyfield JG. Retinal deimination and PAD2 levels in retinas from donors with age-related macular degeneration (AMD). Exp Eye Res. 2013 Jun;111:71-78.

Eye (Lond.)

Ehlers JP, rayess H, steinle N. Topical dorzolamide therapy for taxane-related macular oedema. Eye (Lond ). 2013 Jan;27(1):102-104.

Singh AD. Ocular phototherapy. Eye (Lond). 2013 Feb;27(2):190-198.

33


Graefes Arch.Clin.Exp.Ophthalmol.

Gomes BDAF, santhiago Mr, de Azevedo MNL, Moraes HV, Jr. Evaluation of dry eye signs and symptoms in patients with systemic sclerosis. Graefes Arch Clin Exp Ophthalmol. 2012 Jul;250(7):1051-1056.

Kaiser PK, Cruess AF, Bogaert P, Khunti K, Kelly sP. Balancing risk in ophthalmic prescribing: assessing the safety of anti-VEGF therapies and the risks associated with unlicensed medicines [Erratum in: Graefes Arch Clin Exp Ophthalmol. 2013 Feb;251(2):625-626]. Graefes Arch Clin Exp Ophthalmol. 2012 Nov;250(11):1563-1571.

Immunotherapy

Xu D, Kaiser PK. Intravitreal aflibercept for neovascular age-related macular degeneration. Immunotherapy. 2013 Feb;5(2):121-130.

Infect.Immun.

Van Grol J, Muniz-Feliciano L, Portillo JA, Bonilha VL, subauste Cs. CD40 induces anti-toxoplasma gondii activity in nonhematopoietic cells dependent on autophagy proteins. Infect Immun. 2013 Jun;81(6):2002-2011.

Int.J.Inflam.

Cruz-Guilloty F, saeed AM, Echegaray JJ, Duffort s, Ballmick A, Tan y, Betancourt M, Viteri E, ramkhellawan GC, Ewald E, Feuer W, Huang D, Wen r, Hong L, Wang H, Laird JM, sene A, Apte rs, salomon RG, Hollyfield JG, Perez VL. Infiltration of proinflammatory m1 macrophages into the outer retina precedes damage in a mouse model of age-related macular degeneration. Int J Inflam. 2013;2013:503725.

Int.J.Radiat.Oncol.Biol.Phys.

Khan N, Khan MK, Bena J, Macklis r, Singh AD. Plaque brachytherapy for uveal melanoma: a vision prognostication model. Int J Radiat Oncol Biol Phys. 2012 Nov 1;84(3):e285-e290.

Marwaha G, Wilkinson A, Bena J, Macklis R, Singh AD. Dosimetric benefit of a new ophthalmic radiation plaque. Int J Radiat Oncol Biol Phys. 2012 Dec 1;84(5):1226-1230.

Invest.Ophthalmol.Vis.Sci.

Folgar FA, Chow JH, Farsiu s, Wong WT, schuman sG, o’Connell rV, Winter KP, Chew Ey, Hwang Ts, Srivastava SK,

Harrington MW, Clemons TE, Toth CA. Spatial correlation between hyperpigmentary changes on color fundus photography and hyperreflective foci on sDoCT in intermediate AMD. Invest Ophthalmol Vis Sci. 2012;53(8):4626-4633.

Hewing NJ, Weskamp G, Vermaat J, Farage E, Glomski K, swendeman s, Chan rVP, Chiang MF, Khokha r, Anand-Apte B, Blobel CP. Intravitreal injection of TIMP3 or the EGFr inhibitor erlotinib offers protection from oxygen-induced retinopathy in mice. Invest Ophthalmol Vis Sci. 2013;54(1):864-870.

Li y, Lowder C, Zhang X, Huang D. Anterior chamber cell grading by optical coherence tomography. Invest Ophthalmol Vis Sci. 2013 Jan;54(1):258-265.

Loyet KM, DeForge LE, Katschke KJ, Jr., Diehl L, Graham rr, Pao L, sturgeon L, Lewin-Koh sC, Hollyfield JG, van Lookeren Campagne M. Activation of the alternative complement pathway in vitreous is controlled by genetics in age-related macular degeneration. Invest Ophthalmol Vis Sci. 2012 oct;53(10):6628-6637.

Xu D, Yuan A, Kaiser PK, Srivastava SK, Singh RP, Sears JE, Martin DF, Ehlers JP. A novel segmentation algorithm for volumetric analysis of macular hole boundaries identified with optical coherence tomography. Invest Ophthalmol Vis Sci. 2013 Jan;54(1):163-169.

Yu M, Zou W, Peachey NS, McIntyre TM, Liu J. A novel role of complement in retinal degeneration. Invest Ophthalmol Vis Sci. 2012 Dec;53(12):7684-7692.

J.Cataract Refract.Surg.

Mello Gr, rocha KM, santhiago Mr, Smadja D, Krueger RR. Applications of wavefront technology. J Cataract Refract Surg. 2012 sep;38(9):1671-1683.

smadja D, santhiago Mr, Mello Gr, roberts CJ, Dupps WJ, Jr., Krueger RR. Response of the posterior corneal surface to myopic laser in situ keratomileusis with different ablation depths. J Cataract Refract Surg. 2012 Jul;38(7):1222-1231.

J.Child Neurol.

Moosa ANV, Traboulsi EI, reid J, Prieto L, Moran r, Friedman Nr. Neonatal stroke and progressive leukoencephalopathy in a child with an ACTA2 mutation. J Child Neurol. 2013 Apr;28(4):531-534.

J.Clin.Invest.

omarova s, Charvet CD, reem rE, Mast N, Zheng W, Huang S, Peachey NS, Pikuleva IA. Abnormal vascularization in mouse retina with dysregulated retinal cholesterol homeostasis. J Clin Invest. 2012 Aug 1;122(8):3012-3023.

J.Comp.Neurol.

ramsey M, Perkins BD. Basal bodies exhibit polarized positioning in zebrafish cone photoreceptors. J Comp Neurol. 2013 Jun 1;521(8):1803-1816.

J.Neurophysiol.

Peachey NS, Pearring JN, Bojang P, Jr., Hirschtritt ME, sturgill-short G, ray TA, Furukawa T, Koike C, Goldberg AFX, shen y, McCall MA, Nawy s, Nishina PM, Gregg rG. Depolarizing bipolar cell dysfunction due to a Trpm1 point mutation. J Neurophysiol. 2012 Nov;108(9):2442-2451.

J.Neurosci.

Matsuoka rL, Jiang Z, samuels Is, Nguyen-Ba-Charvet KT, sun Lo, Peachey NS, Chedotal A, yau KW, Kolodkin AL. Guidance-cue control of horizontal cell morphology, lamination, and synapse formation in the mammalian outer retina. J Neurosci. 2012 May 16;32(20):6859-6868.

J.Ocul.Pharmacol.Ther.

Nguyen QD, Campochiaro PA, shah sM, Browning DJ, Hudson HL, sonkin PL, Hariprasad sM, Kaiser PK, Slakter J, Haller JA, Do DV, Mieler W, Chu K, Ingerman A, Vitti R, Berliner AJ, Cedarbaum J. Evaluation of very high and very low-dose intravitreal aflibercept in patients with neovascular age-related macular degeneration. J Ocul Pharmacol Ther. 2012 Dec;28(6):581-588.

J.Ophthalmol.

Singh RP, shusterman EM, Moshfeghi D, Danis r, Gertner M. Pilot study of the delivery of microcollimated pars plana external beam radiation in porcine eyes: 270-day analysis. J Ophthalmol. 2012;2012:615214.

J.Refract.Surg.

Armstrong BK, Lin MP, Ford Mr, santhiago Mr, Singh V, Grossman GH, Agrawal V, Roy AS, Butler RS, Dupps WJ, Wilson SE. Biological and biomechanical responses to traditional epithelium-off and transepithelial riboflavin-UVA CXL techniques in rabbits. J Refract Surg. 2013 May;29(5):332-341.

34


Au JD, Krueger RR. optimized femto-LAsIK maintains preexisting spherical aberration independent of refractive error. J Refract Surg. 2012 Nov;28(11 suppl):s821-s825.

Krueger RR, Chan P. Introduction to commercially approved customized ablation: tenth year in review. J Refract Surg. 2012 Nov;28(11 suppl):s813-s814.

santhiago Mr, smadja D, Zaleski K, Espana EM, Armstrong BK, Wilson SE. Flap relift for retreatment after femtosecond laser-assisted LAsIK. J Refract Surg. 2012 Jul;28(7):482-487.

smadja D, santhiago Mr, Mello Gr, Krueger RR, Colin J, Touboul D. Influence of the reference surface shape for discriminating between normal corneas, subclinical keratoconus, and keratoconus. J Refract Surg. 2013 Apr;29(4):274-281.

smadja D, santhiago Mr, Mello Gr, Touboul D, Mrochen M, Krueger RR. Corneal higher order aberrations after myopic wavefront-optimized ablation. J Refract Surg. 2013 Jan;29(1):42-49.

J.Transl.Med.

Triozzi PL, Achberger s, Aldrich W, Singh AD, Grane R, Borden EC. The association of blood angioregulatory microrNA levels with circulating endothelial cells and angiogenic proteins in patients receiving dacarbazine and interferon. J Transl Med. 2012 Dec 5;10(1):241.

JAMA Ophthalmol.

McAnany JJ, Genead MA, Walia s, Drack AV, stone EM, Koenekoop rK, Traboulsi EI, Smith A, Weleber RG, Jacobson SG, Fishman GA. Visual acuity changes in patients with Leber congenital amaurosis and mutations in CEP290. JAMA Ophthalmol. 2013 Feb 1;131(2):178-182.

Naik rK, rentz AM, Foster Cs, Lightman s, Belfort R, Lowder C, Whitcup sM, Kowalski JW, revicki DA. Normative comparison of patient-reported outcomes in patients with noninfectious uveitis. JAMA Ophthalmol. 2013 Feb 1;131(2):219-225.

Johns Hopkins Advanced Studies in Ophthalmology

Kaiser PK. Factor dosing regimens: Benefits and burdens... roundtable meeting held on July 6, 2012. Johns Hopkins Advanced Studies in Ophthalmology. 2013;10(2):33-38.

Melanoma Res.

Triozzi PL, Elson P, Aldrich W, Achberger s, Tubbs R, Biscotti CV, Singh AD. Elevated blood beta-2 microglobulin is associated with tumor monosomy-3 in patients with primary uveal melanoma. Melanoma Res. 2013 Feb;23(1):1-7.

Mol.Vis.

Bollinger KE, Crabb Js, yuan X, Putliwala T, Clark AF, Crabb JW. Proteomic similarities in steroid responsiveness in normal and glaucomatous trabecular meshwork cells. Mol Vis. 2012;18:2001-2011.

Monogr.Clin.Cytol.

Biscotti CV, Singh AD. Preface [FNA cytology of ophthalmic tumors]. Monogr Clin Cytol. 2012;21:viii.

Nat.Genet.

Seven new loci associated with age-related macular degeneration. Nat Genet. 2013 Apr;45(4):433-439.

Koenekoop rK, Wang H, Majewski J, Wang X, Lopez I, ren H, Chen y, Li y, Fishman GA, Genead M, schwartzentruber J, solanki N, Traboulsi EI, Cheng J, Logan CV, McKibbin M, Hayward BE, Parry DA, Johnson CA, Nageeb M, Poulter JA, Mohamed MD, Jafri H, rashid y, Taylor Gr, Keser V, Mardon G, Xu H, Inglehearn CF, Fu Q, Toomes C, Chen r. Mutations in NMNAT1 cause Leber congenital amaurosis and identify a new disease pathway for retinal degeneration. Nat Genet. 2012 Jul 29;44(9):1035-1039.

Ophthal.Plast.Reconstr.Surg.

Lee BJ, Nelson CC, Lewis CD, Perry JD. External dacryocystorhinostomy surgery in patients with Wegener granulomatosis. Ophthal Plast Reconstr Surg. 2012 Nov-Dec;28(6):389-392.

Ophthalmic Epidemiol.

yoder Js, Verani J, Heidman N, Hoppe-Bauer J, Alfonso EC, Miller D, Jones DB, Bruckner D, Langston R, Jeng BH, Joslin CE, Tu E, Colby K, Vetter E, ritterband D, Mathers W, Kowalski rP, Acharya Nr, Limaye AP, Leiter C, roy s, Lorick s, roberts J, roberts J, Beach MJ. Acanthamoeba keratitis: the persistence of cases following a multistate outbreak. Ophthalmic Epidemiol. 2012 Aug;19(4):221-225.

Ophthalmic Genet.

Ariss M, Natan K, Friedman N, Traboulsi EI. ophthalmologic abnormalities in Mowat-Wilson syndrome and a mutation in ZEB2. Ophthalmic Genet. 2012 sep;33(3):159-160.

Charkoudian LD, Baranano DE, Fortun J, yan J, Srivastava SK. Choroidal neovascularization in Bardet-Biedl syndrome. Ophthalmic Genet. 2013 Mar-Jun;34(1-2):52-54.

Coussa rG, Kim J, Traboulsi EI. Choroideremia: Effect of age on visual acuity in patients and female carriers. Ophthalmic Genet. 2012 Jun;33(2):66-73.

Coussa RG, Traboulsi EI. Choroideremia: A review of general findings and pathogenesis. Ophthalmic Genet. 2012 Jun;33(2):57-65.

Tarabishy AB, Hise AG, Traboulsi EI. Ocular manifestations of the autoinflammatory syndromes. Ophthalmic Genet. 2012 Dec;33(4):179-186.

Ophthalmic Res.

Singh AD, Pabon s, Aronow ME. Management of radiation maculopathy. Ophthalmic Res. 2012;48 suppl 1:26-31.

Ophthalmic Surg.Lasers Imaging

Gupta PK, Ehlers JP, Kim T. Evaluation of clear corneal wound dynamics with contrast-enhanced spectral-domain optical coherence tomography. Ophthalmic Surg Lasers Imaging. 2012 May-Jun;43(3):222-228.

Ophthalmic Surg.Lasers Imaging Retina

Gupta N, Punjabi os, steinle NC, Singh RP. Rate of hypotony following 25-gauge pars plana vitrectomy. Ophthalmic Surg Lasers Imaging Retina. 2013 Mar-Apr;44(2):155-159.

Paspulati A, Punjabi OS, Theodoropoulou S, Singh RP. Triamcinolone acetonide as an adjuvant to membrane peeling surgery: A pilot study. Ophthalmic Surg Lasers Imaging Retina. 2013 Jan-Feb;44(1):41-45.

roth BM, Yuan A, Ehlers JP. Retinal and choroidal findings in oxalate retinopathy using EDI-OCT. Ophthalmic Surg Lasers Imaging Retina. 2012 Nov-Dec;43(6 Suppl): S142-S144.

Ophthalmology

Aronow ME, Nakagawa JA, Gupta A, Traboulsi EI, Singh AD. Tuberous sclerosis complex: genotype/phenotype correlation of retinal findings. Ophthalmology. 2012 sep;119(9):1917-1923.

Grunwald JE, Daniel E, ying Gs, Pistilli M, Maguire MG, Alexander J, Whittock-Martin r, Parker Cr, sepielli K, Blodi BA, Martin DF. Photographic assessment of baseline fundus morphologic features in the comparison of age-related macular degeneration treatments trials. Ophthalmology. 2012 Aug;119(8):1634-1641.

Hagstrom SA, ying Gs, Pauer GJT, sturgill-short GM, Huang J, Callanan DG, Kim IK, Klein ML, Maguire MG, Martin DF. Pharmacogenetics for genes associated with age-related macular degeneration in the comparison of AMD treatments trials (CATT). Ophthalmology. 2013 Mar;120(3):593-599.

Heier Js, Brown DM, Chong V, Korobelnik JF, Kaiser PK, Nguyen QD, Kirchhof B, Ho A, ogura y, yancopoulos GD, stahl N, Vitti r, Berliner AJ, soo y, Anderesi M, Groetzbach G, sommerauer B, sandbrink r, simader C, schmidt-Erfurth U. Intravitreal aflibercept (VEGF trap-eye) in wet age-related macular degeneration. Ophthalmology. 2012 Dec;119(12):2537-2548.

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Kaiser PK. Emerging therapies for neovascular age-related macular degeneration: drugs in the pipeline. Ophthalmology. 2013 May;120(5 Suppl):S11-S15.

Martin DF, Maguire MG, Fine sL, ying Gs, Jaffe GJ, Grunwald JE, Toth C, redford M, Ferris FL, III. ranibizumab and bevacizumab for treatment of neovascular age-related macular degeneration: Two-year results. Ophthalmology. 2012 Jul;119(7):1388-1398.

Nguyen QD, Do DV, Haller JA, Heier Js, Kaiser PK. Putting theories and results into practice: managing cases. Ophthalmology. 2013 May;120(5 suppl):s16-s22.

Perry JD, Mehta MP, Lewis CD. Internal cantholysis for repair of moderate and large full-thickness eyelid defects. Ophthalmology. 2013 Feb;120(2):410-414.

schein oD, Banta JT, Chen TC, Pritzker S, Schachat AP. Lessons learned: Wrong intraocular lens. Ophthalmology. 2012 oct;119(10):2059-2064.

ying Gs, Huang J, Maguire MG, Jaffe GJ, Grunwald JE, Toth C, Daniel E, Klein M, Pieramici D, Wells J, Martin DF. Baseline predictors for one-year visual outcomes with ranibizumab or bevacizumab for neovascular age-related macular degeneration. Ophthalmology. 2013 Jan;120(1):122-129.

PLoS One

Qi JH, Ebrahem Q, Ali M, Cutler A, Bell B, Prayson N, Sears J, Knauper V, Murphy G, Anand-Apte B. Tissue inhibitor of metalloproteinases-3 peptides inhibit angiogenesis and choroidal neovascularization in mice. PLoS One. 2013;8(3):e55667.

Retin.Cases Brief Rep.

Ahmad BU, Barakat Mr, Feldman M, Singh RP. Bilateral subcutaneous emphysema from pressurized infusion during pars plana vitrectomy: A case report. Retin Cases Brief Rep. 2012 Winter;6(1):22-24.

Gupta N, Singh RP. Resolution of a choroidal abscess in the setting of endophthalmitis in an immunocompetent host with noninvasive treatment. Retin Cases Brief Rep. 2012 spring;6(2):184-186.

Hall EF, Ahmad B, Schachat AP. Spectral-domain optical coherence tomography findings in acute retinal pigment epitheliitis. Retin Cases Brief Rep. 2012 summer;6(3):309-312.

Retina

Ehlers JP, Tao YK, Farsiu s, Maldonado r, Izatt JA, Toth CA. Visualization of real-time intraoperative maneuvers with a microscope-mounted spectral domain optical coherence tomography system. Retina. 2013 Jan;33(1):232-236.

Ehlers JP, Yuan A, Kaiser PK, Dhoot D, Sears JE, Martin DF, Singh RP, Srivastava SK. Trans-tamponade optical coherence tomography: Postoperative imaging in gas-filled eyes. Retina. 2013 Jun;33(6):1172-1178.

Ehlers JP, Xu D, Kaiser PK, Singh RP, Srivastava SK. Intrasurgical dynamics of macular hole surgery: An assessment of surgery-induced ultrastructural alteration with intraoperative optical coherence tomography. Retina. 2013 Jul;E-Pub

Ehlers JP, ohr MP, Kaiser PK, Srivastava SK. Novel microarchitectural dynamics in rhegmatogenous retinal detachments identified with intraoperative optical coherence tomography. Retina. 2013 Jul-Aug;33(7):1428-34.

Ginat DT, Singh AD, Moonis G. Multimodality imaging of hydrogel scleral buckles. Retina. 2012 sep;32(8):1449-1452.

Ginat DT, Singh AD, Moonis G. reply [Multimodality imaging of hydrogel scleral buckles]. Retina. 2013 May;33(5):1090.

shen By, Punjabi os, Lowder CY, Sears JE, Singh RP. Early treatment response of fluocinolone (rETIsErT) implantation in patients with uveitic macular edema: An optical coherence tomography study. Retina. 2013 Apr;33(4):873-877.

Yuan A, Ehlers JP. Crystalline retinopathy from primary hyperoxaluria. Retina. 2012 oct;32(9):1994-1995.

Retina Today

Ho AC, Prenner JL, Kaiser rs, Kaiser PK. Maximizing patient outcomes in AMD: A review of evolving, evidence-based therapeutic options for clinical practice. Retina Today. 2012 sep;1-20.

Kaiser PK. Choroidal imaging offers a new window on disease management: The technology is already in use for diagnosis and management of some conditions. Retina Today. 2012 Apr;60-63.

Surv.Ophthalmol.

Aronow M, sun y, saunthararajah y, Biscotti C, Tubbs r, Triozzi P, Singh AD. Monosomy 3 by FIsH in uveal melanoma: Variability in techniques and results. Surv Ophthalmol. 2012 sep-oct;57(5):463-473.

Aronow ME, Adamus G, Abu-Asab M, Wang y, Chan CC, Zakov ZN, Singh AD. Paraneoplastic vitelliform retinopathy: clinicopathologic correlation and review of the literature. Surv Ophthalmol. 2012 Nov-Dec;57(6):558-564.

Ther.Adv.Chronic Dis.

ohr M, Kaiser PK. Aflibercept in wet age-related macular degeneration: a perspective review. Ther Adv Chronic Dis. 2012 Jul;3(4):153-161.

Trans.Am.Ophthalmol.Soc.

Krueger RR, Uy H, McDonald J, Edwards K. Ultrashort-pulse lasers treating the crystalline lens: Will they cause vision-threatening cataract? (an American ophthalmological society thesis). Trans Am Ophthalmol Soc. 2012;110:130-165.

Vis.Neurosci.

samuels Is, Lee CA, Petrash JM, Peachey NS, Kern Ts. Exclusion of aldose reductase as a mediator of ErG deficits in a mouse model of diabetic eye disease. Vis Neurosci. 2012 Nov;29(6):267-274.

WHOLE BOOKS

Case Reviews in Ophthalmology

Friedman NJ, Kaiser PK. Case Reviews in Ophthalmology. Edinburgh: Saunders Elsevier; 2012. 262 pgs.

Essentials of Glaucoma Surgery

Kahook My, Berdahl JP, Eisengart JA, Khaimi MA, radcliffe NM, stein JD, Zink JM. Essentials of Glaucoma Surgery. Thorofare, NJ: sLACK; 2012. 448 pgs.

FNA Cytology of Ophthalmic Tumors

Biscotti CV, Singh AD. FNA Cytology of Ophthalmic Tumors. Basel; New york, Ny: Karger; 2012. 99 pgs.

Genetic Diseases of the Eye

Traboulsi EI. Genetic Diseases of the Eye. 2nd ed. New york: oxford University Press; 2012. 923 pgs.

Ophthalmic Ultrasonography

Singh AD, Hayden BC. Ophthalmic Ultrasonography. Edinburgh: Saunders Elsevier; 2012. 215 pgs.

Review of Ophthalmology

Trattler WB, Kaiser PK, Friedman NJ. Review of Ophthalmology. 2nd ed. Edinburgh; New york, Ny: saunders Elsevier; 2012. 389 pgs.

Textbook of Refractive Laser Assisted Cataract Surgery (ReLACS)

Krueger RR, Talamo JH, Lindstrom rL. Textbook of Refractive Laser Assisted Cataract Surgery (ReLACS). New york, Ny: springer; 2013. 289 pgs.

BOOK CHAPTERS

Age-related Macular Degeneration

Barakat M, steinle N, Kaiser PK. Combination therapies for the treatment of AMD. In: Firestein Gs, ed. Age-Related Macular Degeneration. 2nd ed. Heidelberg; New york, Ny: springer; 2013. Chapter 16. p. 247-261.

36


Atlas of Postsurgical Neuroradiology: Imaging of the Brain, Spine, Head, and Neck

Ginat DT, Moonis G, Hayden BC, Singh AD. Imaging the postoperative orbit. In: Ginat DT, Westesson PLA, eds. Atlas of Postsurgical Neuroradiology: Imaging of the Brain, Spine, Head, and Neck. Heidelberg: springer; 2012. Chapter 2. p. 33-73.

Clinical Scenarios in Surgery: Decision Making and Operative Technique

Nayeb-Hashemi N, Tu Ey, Azar DT. Correction of presbyopia with monovision. In: Dimick JB, Upchurch Gr, Jr., sonnenday CJ, eds. Clinical Scenarios in Surgery: Decision Making and Operative Technique. Philadelphia, PA: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2012. Chapter 16. p. 143-149.

reggiani Mello GH, smadja D, Krueger RR. Femtosecond laser photodisruption of the crystalline lens for restoring accommodation. In: Dimick JB, Upchurch Gr, Jr., sonnenday CJ, eds. Clinical Scenarios in Surgery : Decision Making and Operative Technique. Philadelphia, PA: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2012. Chapter 27. p. 225-232.

Essentials of Glaucoma Surgery

Eisengart JA. Surgical management of neovascular glaucoma. In: Kahook My, ed. Essentials of Glaucoma Surgery. Thorofare, NJ: sLACK; 2012. Chapter 31. p. 275-278.

Eisengart JA. Surgical management of uveitic glaucoma. In: Kahook My, ed. Essentials of Glaucoma Surgery. Thorofare, NJ: sLACK; 2012. Chapter 32. p. 279-283.

Eisengart JA. Trabeculectomy: Management of postoperative complications. In: Kahook My, ed. Essentials of Glaucoma Surgery. Thorofare, NJ: sLACK; 2012. Chapter 5. p. 49-58.

Eisengart JA. Glaucoma drainage devices: Management of intraoperative and postoperative complications. In: Kahook My, ed. Essentials of Glaucoma Surgery. Thorofare, NJ: sLACK; 2012. Chapter 13. p. 121-131.

Eisengart JA. Glaucoma drainage device implantation combined with pars plana vitrectomy. In: Kahook My, ed. Essentials of Glaucoma Surgery. Thorofare, NJ: sLACK; 2012. Chapter 38. p. 319-322.

szymarek TN, Moroi sE, Eisengart JA. Glaucoma surgery in the nanophthalmic eye. In: Kahook My, ed. Essentials of Glaucoma Surgery. Thorofare, NJ: sLACK; 2012. Chapter 33. p. 285-291.

Genetic Diseases of the Eye

Ariss MM, ragge NK, Moodley M, Traboulsi EI. The phakomatoses. In: Traboulsi EI, ed. Genetic Diseases of the Eye. 2nd ed. New york, Ny: oxford University Press; 2012. Chapter 46. p. 764-804.

Ariss MM, Traboulsi EI, Singh AD. Systemic associations of eyelid tumors. In: Traboulsi EI, ed. Genetic Diseases of the Eye. 2nd ed. New york, Ny: oxford University Press; 2012. Chapter 47. p. 807-815.

Broaddus E, Patno D, Reid J, Chapa J, Traboulsi EI, Singh AD. Prenatal imaging of the eye and ocular adnexae. In: Traboulsi EI, ed. Genetic Diseases of the Eye. 2nd ed. New york, Ny: oxford University Press; 2012. Chapter 11. p. 163-173.

Brooks BP, Traboulsi EI. Anophthalmia, colobomatous, microphthalmia, and optic fissure closure defects. In: Traboulsi EI, ed. Genetic Diseases of the Eye. 2nd ed. New york, Ny: oxford University Press; 2012. Chapter 5. p. 64-84.

Brooks BP, Traboulsi EI. Congenital anomalies of the optic nerve. In: Traboulsi EI, ed. Genetic Diseases of the Eye. 2nd ed. New york, Ny: oxford University Press; 2012. Chapter 9. p. 124-149.

Chappelow AV, Traboulsi EI. Stargardt disease. In: Traboulsi EI, ed. Genetic Diseases of the Eye. 2nd ed. New york, Ny: oxford University Press; 2012. Chapter 31. p. 467-475.

Crabb JW. Proteomic biomarkers for age-related macular degeneration. In: Traboulsi EI, ed. Genetic Diseases of the Eye. 2nd ed. New york, Ny: oxford University Press; 2012. Chapter 22. p. 373-380.

Edelman E, Belfort rN, Fu EX, Singh AD. Genetics of retinoblastoma. In: Traboulsi EI, ed. Genetic Diseases of the Eye. 2nd ed. New york, Ny: oxford University Press; 2012. Chapter 49. p. 828-841.

Gabriel LAr, Peachey NS, Sunness JS. Retinal function testing and genetic disease. In: Traboulsi EI, ed. Genetic Diseases of the Eye. 2nd ed. New york, Ny: oxford University Press; 2012. Chapter 20. p. 343-355.

Heidary G, Traboulsi EI, Engle EC. The genetics of strabismus and associated disorders. In: Traboulsi EI, ed. Genetic Diseases of the Eye. 2nd ed. New york, Ny: oxford University Press; 2012. Chapter 42. p. 657-686.

Kim BJ, Waheed NK. Gene therapy for ocular diseases. In: Traboulsi EI, ed. Genetic Diseases of the Eye. 2nd ed. New york, Ny: oxford University Press; 2012. Chapter 52. p. 895-905.

Lewis C, Heher KL, Katowitz JA, Traboulsi EI. Malformations of the ocular adnexae. In: Traboulsi EI, ed. Genetic Diseases of the Eye. 2nd ed. New york, Ny: oxford University Press; 2012. Chapter 3. p. 40-56.

Qian y, Lewis rA, Traboulsi EI. Pigmentary retinopathy in systemic inherited disease. In: Traboulsi EI, ed. Genetic Diseases of the Eye. 2nd ed. New york, Ny: oxford University Press; 2012. Chapter 40. p. 603-636.

robitaille JM, Guernsey DL, Traboulsi EI. Familial exudative vitreoretinopathy, Norrie disease, and other developmental retinal vascular disorders. In: Traboulsi EI, ed. Genetic Diseases of the Eye. 2nd ed. New york, Ny: oxford University Press; 2012. Chapter 35. p. 504-518.

rosberger DF, Patel rD, Traboulsi EI. Hereditary vitreoretinopathies. In: Traboulsi EI, ed. Genetic Diseases of the Eye. 2nd ed. New york, Ny: oxford University Press; 2012. Chapter 36. p. 519-542.

sachdeva r, Abrams Ls, Traboulsi EI. Albinism. In: Traboulsi EI, ed. Genetic Diseases of the Eye. 2nd ed. New york, Ny: oxford University Press; 2012. Chapter 45. p. 742-763.

Sachdeva R, Traboulsi EI. Aniridia. In: Traboulsi EI, ed. Genetic Diseases of the Eye. 2nd ed. New york, Ny: oxford University Press; 2012. Chapter 8. p. 109-123.

Santos A, Traboulsi EI. Congenital abnormalities of the retinal pigment epithelium. In: Traboulsi EI, ed. Genetic Diseases of the Eye. 2nd ed. New york, Ny: oxford University Press; 2012. Chapter 10. p. 150-162.

Smith JEH, Traboulsi EI. Malformations of the anterior segment of the eye. In: Traboulsi EI, ed. Genetic Diseases of the Eye. 2nd ed. New york, Ny: oxford University Press; 2012. Chapter 7. p. 92-108.

Traboulsi EI, Leroy BP, Zeitz C. Congenital stationary night blindness. In: Traboulsi EI, ed. Genetic Diseases of the Eye. 2nd ed. New york, Ny: oxford University Press; 2012. Chapter 32. p. 476-483.

Traboulsi EI, Apte SS. Ectopia lentis and associated systemic disease. In: Traboulsi EI, ed. Genetic Diseases of the Eye. 2nd ed. New york, Ny: oxford University Press; 2012. Chapter 43. p. 689-711.

Traboulsi EI. Cone dysfunction syndromes, cone dystrophies, and cone-rod degenerations. In: Traboulsi EI, ed. Genetic Diseases of the Eye. 2nd ed. New york, Ny: oxford University Press; 2012. Chapter 26. p. 410-420.

37


Wackernagel W, Singh AD. Genetic aspects of uveal melanoma. In: Traboulsi EI, ed. Genetic Diseases of the Eye. 2nd ed. New york, Ny: oxford University Press; 2012. Chapter 48. p. 816-827.

Zein WM, Lewanda AF, Traboulsi EI, Jabs EW. Ocular manifestations of syndromes with craniofacial abnormalities. In: Traboulsi EI, ed. Genetic Diseases of the Eye. 2nd ed. New york, Ny: oxford University Press; 2012. Chapter 12. p. 174-189.

Ophthalmic Ultrasonography

Armstrong BK, Mello Gr, Krueger RR. Ocular biometry. In: Singh AD, Hayden BC, eds. Ophthalmic Ultrasonography. Edinburgh: saunders Elsevier; 2012. Chapter 7. p. 63-75.

Hayden BC, Singh AD. Practical considerations. In: Singh AD, Hayden BC, eds. Ophthalmic Ultrasonography. Edinburgh: saunders Elsevier; 2012. Chapter 2. p. 5-7.

Hayden BC, Kelley L, Singh AD. Theoretical considerations. In: Singh AD, Hayden BC, eds. Ophthalmic Ultrasonography. Edinburgh: saunders Elsevier; 2012. Chapter 1. p. 1-4.

Hayden BC, Singh AD. Clinical methods: Ultrasound biomicroscopy. In: Singh AD, Hayden BC, eds. Ophthalmic Ultrasonography. Edinburgh: Saunders Elsevier; 2012. Chapter 4. p. 25-29.

Hayden BC, Singh AD. Clinical methods: A- and B- scans. In: Singh AD, Hayden BC, eds. Ophthalmic Ultrasonography. Edinburgh: saunders Elsevier; 2012. Chapter 3. p. 9-23.

Lowder CY, Lima Br. ocular inflammatory diseases. In: Singh AD, Hayden BC, eds. Ophthalmic Ultrasonography. Edinburgh: saunders Elsevier; 2012. Chapter 12. p. 133-147.

Lystad LD, Hayden BC, Singh AD. Optic nerve diseases. In: Singh AD, Hayden BC, eds. Ophthalmic Ultrasonography. Edinburgh: saunders Elsevier; 2012. Chapter 13. p. 149-160.

Rockwood EJ, Hayden BC, Singh AD. Glaucoma. In: Singh AD, Hayden BC, eds. Ophthalmic Ultrasonography. Edinburgh: saunders Elsevier; 2012. Chapter 9. p. 87-96.

Sachdeva R, Broaddus E, Singh AD. Ocular prenatal imaging. In: Singh AD, Hayden BC, eds. Ophthalmic Ultrasonography. Edinburgh: saunders Elsevier; 2012. Chapter 14. p. 161-170.

santhiago Mr, Dupps WJ, Jr., Singh AD. Corneal diseases. In: Singh AD, Hayden BC, eds. Ophthalmic Ultrasonography. Edinburgh: saunders Elsevier; 2012. Chapter 8. p. 77-85.

Sharma S, Singh RP. Vitreoretinal diseases. In: Singh AD, Hayden BC, eds. Ophthalmic Ultrasonography. Edinburgh: Saunders Elsevier; 2012. Chapter 10. p. 97-110.

steinle NC, Dadgostar H, Sears JE. Ocular trauma. In: Singh AD, Hayden BC, eds. Ophthalmic Ultrasonography. Edinburgh: saunders Elsevier; 2012. Chapter 16. p. 179-186.

Traboulsi EI, Singh AD. Pediatric eye diseases. In: Singh AD, Hayden BC, eds. Ophthalmic Ultrasonography. Edinburgh: saunders Elsevier; 2012. Chapter 15. p. 171-177.

Turell ME, Hayden BC, schoenfield L, Singh AD. Intraocular tumors. In: Singh AD, Hayden BC, eds. Ophthalmic Ultrasonography. Edinburgh: Saunders Elsevier; 2012. Chapter 11. p. 111-131.

Ophthalmic Radiation Therapy — Techniques and Applications

Medina C, Ehlers JP. Radiation and age-related macular degeneration. In: Singh A et al. Ophthalmic Radiation Therapy – Techniques and Applications. In press.

Pediatric Ophthalmology and Strabismus

Nicholson BP, Traboulsi EI. Connective tissue, skin, and bone disorders. In: Wright KW, strube yNJ, eds. Pediatric Ophthalmology and Strabismus. 3rd ed. New york, Ny: oxford University Press; 2012. Chapter 56. p. 1139-1166.

Turell ME, Singh AD. Nonvascular hamartomas. In: Wright KW, strube yNJ, eds. Pediatric Ophthalmology and Strabismus. 3rd ed. New york, Ny: oxford University Press; 2012. Chapter 48. p. 928-937.

Retina

Ehlers JP, Toth CA. Macular translocation. In: Ryan S et al. Retina 5th ed. Elseiver; Chapter 120. 2012.

Ehlers JP, Hawkins BS, Schachat AP. Ocular histoplasmosis. In: Ryan S et al. Retina. 5th ed. Elseiver; Chapter 70. 2012.

Retinal and Choroidal Manifestations of Selected Systemic Diseases

Ahn ES, Tarabishy AB, Schachat AP. Posterior pole manifestations of hematologic diseases. In: Arevalo JF, ed. Retinal and Choroidal Manifestations of Selected Systemic Diseases. New york, Ny: springer; 2013. Chapter 23. p. 425-450.

Arevalo JF, Yen Lowder C, Garcia RA. Retinal and choroidal manifestations of systemic lupus erythematosus (sLE). In: Arevalo JF, ed. Retinal and Choroidal Manifestations of Selected Systemic Diseases. New york, Ny: springer; 2013. Chapter 18. p. 333-352.

sears NC, Yen Lowder C. Retinal and choroidal manifestations of viral diseases. In: Arevalo JF, ed. Retinal and Choroidal Manifestations of Selected Systemic Diseases. New york, Ny: springer; 2013. Chapter 8. p. 139-1608.

Yen Lowder C, da rocha Lima B. retinal and choroidal manifestations of sarcoidosis. In: Arevalo JF, ed. Retinal and Choroidal Manifestations of Selected Systemic Diseases. New york, Ny: springer; 2013. Chapter 11. p. 211-223.

Textbook of Refractive Laser Assisted Cataract Surgery (ReLACS)

Klyce sD, Palanker DV, Edwards KH, Krueger RR. Imaging systems and image-guided surgery. In: Krueger RR, Talamo JH, Lindstrom rL, eds. Textbook of Refractive Laser Assisted Cataract Surgery (ReLACS). New york, Ny: springer; 2013. Chapter 5. p. 49-58.

Krueger RR, Parel JMA, Huxlin Kr, Knox WH, Hohla K. The future of reLACs and femtosecond laser ocular surgery. In: Krueger RR, Talamo JH, Lindstrom rL, eds. Textbook of Refractive Laser Assisted Cataract Surgery (ReLACS). New york, Ny: springer; 2013. Chapter 19. p. 249-277.

Lubatschowski H, Krueger RR, Smadja D. Femtosecond laser fundamentals. In: Krueger RR, Talamo JH, Lindstrom rL, eds. Textbook of Refractive Laser Assisted Cataract Surgery (ReLACS). New york, Ny: springer; 2013. Chapter 3. p. 17-37.

Uy Hs, Krueger RR. Nucleus fragmentation and disassembly in reLACs. In: Krueger RR, Talamo JH, Lindstrom rL, eds. Textbook of Refractive Laser Assisted Cataract Surgery (ReLACS). New york, Ny: springer; 2013. Chapter 8. p. 101-113.

Uy Hs, Krueger RR, Edwards KH, Frey R, Schneider S. Commercially available systems: LensAr laser system. In: Krueger RR, Talamo JH, Lindstrom rL, eds. Textbook of Refractive Laser Assisted Cataract Surgery (ReLACS). New york, Ny: springer; 2013. Chapter 16. p. 207-219.

Textbook of Uncommon Cancer

Choueiri M, Singh AD. Ophthalmic cancers. In: Raghavan D, ed. Textbook of Uncommon Cancer. 4th ed. Hoboken, NJ: Wiley-Blackwell; 2012. Chapter 62. p. 835-846.

education

40


cole eye institute | training

teaching Young ophthalmologistsResidency and fellowship training is

considered a high priority at Cleveland

Clinic’s Cole Eye Institute and is led by

outstanding faculty in a leading-edge

facility. Our programs are highly com-

petitive and produce superbly trained

clinical and academic ophthalmologists.

rEsIDENCy ProGrAM

Our residency training program’s mission

is to prepare future leaders in patient

care, teaching and vision research. The

program meets all the requirements of

the American Board of Ophthalmology

and the Accreditation Council for Gradu-

ate Medical Education.

Four residents are matched annually

in the three-year program. Residents

rotate among the institute’s nine de-

partments and at MetroHealth Medical

Center, Cleveland Clinic Lakeland and

Cleveland Clinic Stephanie Tubbs Jones

Health Center. Residents work under

the direct supervision of the staff during

each rotation through:

• Cornea, external disease,

anterior segment

• Glaucoma

• Neuro-ophthalmology/oncology

• Ophthalmic pathology

• Ophthalmic plastic, reconstructive

and orbital surgery

• Pediatric ophthalmology and

adult strabismus

• Refractive surgery

• Retina, vitreous, low vision

• Uveitis, ocular inflammatory disease

and immunology

Our institute is specially designed to enable clinicians to develop

tomorrow’s advances. For example, we recently received a $1 million

donation from the Timken Foundation of Canton, ohio to create

a 600-square-foot ophthalmic surgical education lab. The Louise Timken

Microsurgical Education Lab employs the latest advancements in synthetic

models and computer simulation technology and is now the centerpiece of

our residency program. It is named for the late Louise Timken, who was

the first woman in the country to fly and own a jet aircraft.

introducing the louise timken Microsurgical Education Lab

41

C l e v e l a n d C l i n i C / / C o l e e y e i n s t i t u t e / / e d u c a t i o n

This curriculum provides a balanced

exposure to all subspecialty areas of

ophthalmology, ensuring graduates

the ability to perform general oph-

thalmology with skill, knowledge and

confidence. Each resident works in a

one-on-one relationship with a staff

physician to provide the best opportuni-

ty to study disease processes and their

medical and surgical management.

This arrangement also provides excel-

lent supervision and optimal continuity

of patient care in the outpatient and

hospital settings.

Residents are expected to participate

in clinical and basic research activities

utilizing the staff’s expertise. They

complete independent clinical research

projects that involve reviewing the

literature, developing a hypothesis,

and designing and executing the study.

Activities are carefully supervised by

an experienced clinical investigator.

Residents are expected to submit

and present their research at national

meetings and to write several papers

for publication based on their research

activities. Each June, ophthalmology

residents, fellows and staff participate

in the Annual Research, Residents and

Alumni Meeting, a scientific forum for

the presentation of research projects.

rEsIDENCy GrADUATEs

(June 2013)

Elisabeth Aponte, MD

John Au, MD

Igor Estrovich, MD

sumit sharma, MD

rEsIDENTs, 1sT yEAr

(July 2013)

Maria Choudhary, MD

Joseph Griffith, MD

Nathaniel sears, MD

Adam Weber, MD

rEsIDENTs, 2ND yEAr

(July 2013)

Katie Hallahan, MD

Priyanka Kumar, MD

Tal rubinstein, MD

Jack shao, MD

rEsIDENTs, 3rD yEAr

(July 2013)

Jedediah McClintic, MD

stephen McNutt, MD

Karolinne rocha, MD, PhD

Georgios Trichonas, MD

FELLoWsHIP ProGrAM

We offer high-quality fellowship training

opportunities in a variety of subspe-

cialties to create the next generation of

academic leaders in their fields. Training

combines an excellent academic envi-

ronment with close mentorship support.

Fellowships include:

• Two-year vitreoretinal fellowship (two

positions annually/four positions total)

• One-year cornea, external disease

and refractive surgery fellowship

(two positions)

• One-year glaucoma fellowship

(one position)

• One-year pediatric ophthalmology

fellowship (one position)

• Two-year oculoplastics fellowship

(sponsored by ASOPRS) (one position)

• One-year ophthalmic oncology

fellowship (one position)

FELLoWsHIP GrADUATEs

(June 2013)

Cornea, External Disease

and Refractive Surgery

Patrick Chan, MD

Neema Nayeb-Hashemi, MD

Glaucoma

Elisa Bala, MD

Pediatric Ophthalmology

Palak Wall, MD

Vitreoretinal Surgery

Matthew ohr, MD

omar Punjabi, MD

CUrrENT FELLoWs

(July 1, 2013-June 30, 2014)

Cornea, External Disease

and Refractive Surgery

John Au, MD

Viral Juthani, MD

Glaucoma

Mona Kaleem, MD

Oculoplastics

Bryan Costin, MD

Ophthalmic Oncology

Carlos Medina, MD

Pediatric Ophthalmology

Melanie schmitt, MD

Vitreoretinal Surgery

robert Courtney, MD

Miriam Englander, MD

Ashleigh Levison, MD

Adiel smith, MD

For more information about Cole

Eye Institute fellowship programs,

visit clevelandclinic.org/eyefellowships

or contact Jane Sardelle at

[email protected].

42


distinguished lecture series

Feb. 20, 2014 Myeloid Wnt Ligands and a Fetal Light Response

Pathway Regulate Vascular Development in the Eye

Richard A. Lang, PhD

Director of the Visual Systems Group

Professor, Department of Pediatrics

Cincinnati Children’s Hospital

Medical Center

Cincinnati, Ohio

March 20, 2014 Innate Immunity in the Pathogenesis

of Microbial Keratitis

Eric Pearlman, PhD

Professor and Director of Research

Department of ophthalmology & Visual sciences

Case Western reserve University

Cleveland, Ohio

April 17, 2014 Investigating Mechanisms of

Retinal Degeneration

Janis Lem, PhD

Director and Associate Professor

Transgenic Core Facility

Tufts Medical Center

Boston, Mass.

May 29, 2014 A New Look at Corticosteroid Actions in the Eye

Francine Behar-Cohen, MD, PhD

Professor of Ophthalmology

Ophthalmology, Hotel-Dieu de Paris

Universite Paris Descartes

Centre de Recherche des Cordeliers

Paris, France

Sept. 18, 2014 Advances in Glaucoma Surgery

Malik Y. Kahook, MD

The slater Family Endowed Chair in ophthalmology


Chief, Glaucoma Service Department of Ophthalmology

University of Colorado school of Medicine

Aurora, Colo.

Oct. 16, 2014 Targeting Conventional Outflow:

The Next Generation of Glaucoma Drugs

W. Daniel Stamer, PhD


Professor of Biomedical Engineering

Duke University

Durham, N.C.

Nov. 20, 2014 Cataract Surgery: The New Glaucoma Procedure?

Steven L. Mansberger, MD, MPH

Vice Chair, Director of Glaucoma Services

Devers Eye Institute

Portland, Ore.

43

C l e v e l a n d C l i n i C / / C o l e e y e i n s t i t u t e / / e d u c a t i o n

cole eye institute Grand RoundsOphthalmologists are welcome to attend Cole Eye Institute

Grand rounds, held Mondays from 7-8 a.m. from september

(beginning the Monday after Labor Day) through mid-June,

except during holidays and during major meetings.

Meetings are located in the James P. storer Conference room,

1st Floor at Cole Eye Institute.

Residents and fellows present two or three cases at each

meeting that represent outstanding teaching examples, followed

by discussion. Cases may feature rare or difficult-to-manage

conditions, unusual presentations of common disorders and/or

leading-edge diagnosis and management. Three to four M&M

cases are presented annually.

AMA PrA Category 1 Credits™ are offered through an online

evaluation site and a date-specific sign-on code available at

each meeting.

No registration is required. For details, please contact

Jane Sardelle at [email protected].

cole eye institute cMeMark your calendars for continuing

medical education symposia hosted

by the Cole Eye Institute. you’ll gain

insights into leading-edge diagnostic,

medical and surgical techniques, as

well as the promise that research holds

for patients with ophthalmic conditions.

Neuro-Ophthalmology Update

Saturday, Feb. 22, 2014

Activity Director:

Gregory s. Kosmorsky, Do

Uveitis Update

Saturday, March 8, 2014

Activity Directors:

Careen y. Lowder, MD, PhD, and

sunil srivastava, MD

North Coast Retina Symposium

Friday-Saturday, May 30-31, 2014

Activity Directors:

Daniel F. Martin, MD, and

sunil srivastava, MD

CME courses will be held at the Cole

Eye Institute’s James P. Storer Confer-

ence Center. For details, or to con-

firm dates for any of our 2014 CME

courses, please contact Jane Sardelle


our institute

46


cole eye institute overview

At Cleveland Clinic Cole Eye

Institute, our team of the

world’s foremost clinicians and

researchers is committed to delivering

the finest healthcare available today

and to improving tomorrow’s care

through innovative basic, clinical and

translational research.

We believe that research and patient

care are interdependent. Therefore, we

forge synergistic relationships through

analytical and integrative processes,

such as surgical outcomes analysis. We

are pioneering treatment protocols for

complex vision-threatening disorders

through our clinical trials and aggres-

sive research programs to shorten the

gap between the laboratory discoveries

and patient care.

Cleveland Clinic’s ophthalmology pro-

gram is rated No. 7 in the U.S. News &

World Report “Best Hospitals” survey

and top-ranked in Ohio.

Clinical Expertise

As one of the country’s leading com-

prehensive eye institutes, Cole Eye

Institute is able to enhance the lives of

our patients and to serve our referring

physicians by providing early, accurate

diagnosis and excellent, efficient, lead-

ing-edge care.

In 2012, we had our most productive

year ever. Across all Cleveland Clinic

ophthalmology locations in Northeast

Ohio, we conducted 241,264 phy-

sician visits and performed 12,742

surgeries. As more of our retina and

other subspecialists see patients in

our community locations, we have

achieved a geographic expansion that

dramatically increases patient access to

our services. We are proud that this is

part of Cleveland Clinic’s dedication to

putting patients first.

We offer primary, secondary and tertia-

ry ophthalmologic services for all ages.

our internationally recognized staff of

45 ophthalmologists and researchers is

composed almost entirely of subspecial-

ists, and eight optometrists round out

our comprehensive services.

Patient-Centered Facilities

Cleveland Clinic Cole Eye Institute offers

leading-edge care at our main campus

and in the community. The goal is to

deliver maximum patient comfort and

optimum service and quality. our main

campus building allows us to provide

the full spectrum of clinical services at

one location. Exam lanes, a diagnostic

services suite and operating rooms are

all housed in one building, with features

such as:

• Windows with special filters to

minimize light on dilated or newly

treated eyes

• A comfortable waiting room with

a special play area for children

• Valet parking and an easy

postoperative pickup area

• Conveniently located food services

Fostering Innovation

In addition, our Education Pavilion with

the James P. Storer Conference Center

(designed with televideo technology)

features video rooms, resident carrels

and ample conference space. Our entire

staff is committed to working with

residents and fellows to maximize their

growth and education as they prepare

to be the leaders of tomorrow.

47

C l e v e l a n d C l i n i C / / C o l e e y e i n s t i t u t e / / o u r i n s t i t u t e

Unique Capabilities of the Cole Eye instituteElectronic Medical Records

Cole Eye Institute was among the first

academic centers to customize an elec-

tronic medical record for ophthalmic

use. A two-year project allowed Cole

Eye Institute staff across the system to

share this type of record by the end of

2012. The electronic medical record

integrates ophthalmic imaging and pro-

vides full access to patient histories as

well as streamlines data collection.

The Center for Genetic Eye Diseases

The Center for Genetic Eye Diseases

provides multidisciplinary clinical

diagnostic and therapeutic services for

patients with inherited eye conditions

such as corneal and retinal dystrophies

and microphthalmia. Patients with

inherited disorders that involve the eye,

such as neurofibromatosis, albinism,

neurodegenerative disorders and Marfan

syndrome, are referred to the center by

physicians from around the country.

A regularly held specialty clinic is

dedicated to patients with retinal

dystrophies and their families.

National Eye Donor Program

The Foundation Fighting Blindness

Center, a central collection agency for

eyes donated by individuals across the

United states for blindness research,

shares tissue samples with research-

ers worldwide. Formally known as the

Retinal Degeneration Pathophysiology

Facility, the collection center accepts

eye donations from people of all ages

with normal vision or any degree of

vision loss resulting from a retinal

degenerative disease.

Cole Eye Institute staff members pre-

pare a detailed medical report about

each donated eye to help researchers

track the effects of eye disease in differ-

ent types of people and environments.

48


2012 cole eye institute outcomes snapshots

182,663 Total Visits

8,054 Total Surgeries

10,020 Total Surgical Procedures (surgeries in operating rooms and all outpatient procedures)

1,807 Total Laser Procedures

49


Cole Eye Institute New Staff Spotlight

Annapurna Singh, MD

ophthalmologist Annapurna singh, MD, joined Cleveland Clinic in

2013. she previously served on the staffs of University Hospitals of

Cleveland; optimax Laser Centre, Leeds, United Kingdom; and scheie

Eye Institute, Philadelphia, Pa.

Her specialty interests include medical, laser and surgical treatment of

glaucoma and cataract surgery.

Dr. singh completed residencies at the University of Florida, Gainesville,

Fla; and Erie County Medical Center, Buffalo, N.y. she completed her

glaucoma fellowship at Scheie Eye Institute, Philadelphia.

Dr. singh graduated from All India Institute of Medical sciences,

New Delhi, India.

Dr. Singh practices at Cleveland Clinic main campus and Hillcrest

Hospital. She can be reached at 216.445.5277 or [email protected].

Palak Wall, MD

ophthalmologist Palak Wall, MD, joined Cleveland Clinic as staff in

2013 after completing her residency at The ohio state University

Medical Center in Columbus, ohio. she also completed a fellowship in

pediatric ophthalmology at Cleveland Clinic.

Her specialty interests include pediatric ophthalmology and strabismus,

retinopathy of prematurity, and pediatric oculoplastic disorders.

Dr. Wall graduated from The ohio state University College of Medicine

and Public Health.

Dr. Wall practices at Cleveland Clinic main campus and can be reached

at 216.444.4821 or [email protected].

50


Cole Eye Institute Leadership

CHAIrMAN, CoLE EyE INsTITUTE

Daniel F. Martin, MD .....................................216.444.0430

INsTITUTE VICE CHAIrMAN

INsTITUTE QUALITy rEVIEW oFFICEr

Andrew P. schachat, MD ...............................216.444.7963

INsTITUTE VICE CHAIrMAN

For EDUCATIoN

Elias I. Traboulsi, MD ....................................216.444.2030

CENTEr DIrECTor, CLEVELAND CLINIC

FLorIDA oPHTHALMoLoGy

Albert Caruana Jr., MD ..................................954.659.5000

Comprehensive Ophthalmology

Aimee Chappelow, MD ..................................440.988.4040

John Costin, MD ...........................................440.988.4040

richard E. Gans, MD, FACs ...........................216.444.0848

Philip N. Goldberg, MD ................................216.831.0120

Michael Gressel, MD .....................................440.988.4040

Mohinder Gupta, MD .....................................419.289.6466

shari Martyn, MD ........................................216.831.0120

Peter McGannon, MD ....................................216.529.5320

Michael E. Millstein, MD ................................216.831.0120

Wynne Morley, MD ........................................440.366.9444

sheldon M. oberfeld, MD ..............................440.461.4733

stella Paparizos, MD .....................................216.444.2020

Allen s. roth, MD ........................................216.831.0120

David B. sholiton, MD ...................................216.831.0120

scott A. Wagenberg, MD ................................440.461.4733

Cornea and External Disease

William J. Dupps Jr., MD, PhD .......................216.444.2020

Jeffrey M. Goshe, MD ....................................216.444.0845

roger H.s. Langston, MD ..............................216.444.5898

Peter McGannon, MD ....................................440.529.5320

David M. Meisler, MD ....................................216.444.8102

Wynne Morley, MD ........................................440.366.9444

sheldon M. oberfeld, MD ..............................440.461.4733

Allen s. roth, MD .........................................216.831.0120

scott A. Wagenberg, MD ................................440.461.4733

steven E. Wilson, MD ....................................216.444.5887

Cole Eye Institute | Staff List

51


Glaucoma

Jonathan A. Eisengart, MD .............................216.445.9429

Edward J. rockwood, MD ..............................216.444.1995

Annapurna singh, MD ...................................216.444.2020

shalini sood-Mendiratta, MD..........................216.445.5277

Keratorefractive Surgery


ronald r. Krueger, MD, MsE ..........................216.444.8158

Michael E. Millstein, MD ................................216.831.0120

Allen s. roth, MD .........................................216.831.0120

steven E. Wilson, MD ....................................216.444.5887

Neuro-Ophthalmology

Gregory s. Kosmorsky, Do .............................216.444.2855

Lisa D. Lystad, MD .......................................216.445.2530

Oculoplastics and Orbital Surgery

Mark Levine, MD ..........................................440.988.4040

Julian D. Perry, MD .......................................216.444.3635

Ophthalmic Anesthesia

Marc A. Feldman, MD ...................................216.444.9088

M. Inton-santos, MD .....................................216.445.1016

J. Victor ryckman, MD ..................................216.444.6330

sara spagnuolo, MD .....................................216.444.6324

Ophthalmic Oncology

Arun D. singh, MD ........................................216.445.9479

Ophthalmic Research

Bela Anand-Apte, MBBs, PhD ........................216.445.9739

Vera Bonilha, PhD .........................................216.445.7960

John W. Crabb, PhD ......................................216.445.0425


Stephanie Hagstrom, PhD ..............................216.445.4133

Joe G. Hollyfield, PhD ...................................216.445.3252

Neal s. Peachey, PhD ....................................216.445.1942

yuankai Tao, PhD .........................................216.445.3867

Pediatric Ophthalmology and Adult Strabismus

Fatema Ghasia, MD.......................................216.444.2020

Andreas Marcotty, MD ...................................216.831.0120

Elias I. Traboulsi, MD ....................................216.444.2030

Palak Wall, MD .............................................216.444.2020

Retina

Amy Babiuch, MD .........................................440.366.9444

ryan Deasy, MD ...........................................440.695.4010

Justis P. Ehlers, MD ......................................216.636.0183

Peter K. Kaiser, MD ......................................216.444.6702

Daniel F. Martin, MD ....................................216.444.0430

Andrew P. schachat, MD ...............................216.444.7963

Jonathan E. sears, MD ..................................216.444.8157

rishi P. singh, MD ........................................216.445.9497

sunil K. srivastava, MD .................................216.636.2286

richard Wyszynski, MD .................................440.988.4040

Alex yuan, MD, PhD .....................................216.444.2020

Uveitis

Careen y. Lowder, MD, PhD ...........................216.444.3642

sunil K. srivastava, MD .................................216.636.2286

Cleveland Clinic Florida

Albert Caruana Jr., MD ..................................954.659.5000

Dean Mitchell, MD ........................................877.463.2010

Geetha Vedula, MD .......................................877.463.2010

Patient Referral Information

To refer a patient to the Cole Eye Institute, please call our

referring physician hotline at 855.rEFEr.123 (855.733.3712).

52


24/7 ReferralsReferring Physician Hotline 855.REFER.123 (855.733.3712) clevelandclinic.org/refer123Live help connecting with our specialists, scheduling and

confirming appointments, and resolving service-related issues.

Hospital Transfers800.553.5056

Physician Directory

View our staff online at clevelandclinic.org/staff.

Same-Day Appointments

Cleveland Clinic offers same-day appointments to help your patients get the care they need, right away. Have your patients call our same-day appointment line, 216.444.CArE (2273) or 800.223.CArE (2273).

Track Your Patients’ Care Online

Establish a secure online DrConnect account for real-time information about your patients’ treatment at Cleveland Clinic at clevelandclinic.org/drconnect.

Critical Care Transport Worldwide

To arrange for a critical care transfer, call 216.448.7000 or 866.547.1467. Learn more at clevelandclinic.org/criticalcaretransport.

CME Opportunities: Live and Online

Visit ccfcme.org to learn about the Cleveland Clinic Center for Continuing Education’s convenient, complimentary learning opportunities.

Outcomes Data

View outcomes books at clevelandclinic.org/outcomes.

Clinical Trials

We offer thousands of clinical trials for qualifying patients. Visit clevelandclinic.org/clinicaltrials.

Executive Education

Learn about the Executive Visitors’ Program and the two-week samson Global Leadership Academy immersion program at clevelandclinic.org/executiveeducation.

About Cleveland ClinicCleveland Clinic is an integrated healthcare delivery sys-tem with local, national and international reach. At Cleve-land Clinic, more than 3,000 physicians and researchers represent 120 medical specialties and subspecialties. We are a nonprofit academic medical center with a main cam-pus, eight community hospitals, more than 75 northern Ohio outpatient locations (including 16 full-service family health centers), Cleveland Clinic Florida, Cleveland Clinic Lou ruvo Center for Brain Health in Las Vegas, Cleveland Clinic Canada, sheikh Khalifa Medical City and Cleveland Clinic Abu Dhabi.

In 2013, Cleveland Clinic was ranked one of America’s top four hospitals in U.S. News & World Report’s annual “Best Hospitals” survey. The survey ranks Cleveland Clinic among the nation’s top 10 hospitals in 14 specialty areas, and the top in heart care for the 19th consecutive year.

download today! Physician Referral AppContacting us is easier than ever before.

With our new free Physician Referral

App, you will

be able to view all our specialists,

transfer a patient and get in touch

immediately with one click of your

iPhone®, iPad®, or Android™ phone

or tablet. Download today at the App

Store or Google Play.

cole eye institute Resources

53


Main Campus 9500 Euclid Ave./i20 Cleveland, OH 44195 216.444.2020

Ashland Lakeland Eye Surgeons 21 Sugarbush Court Ashland, OH 44805 419.289.6466

Avon Lakeland Eye Surgeons 33100 Cleveland Clinic Blvd. Avon, OH 44011 440.695.4010

Beachwood Cole Eye Institute, Beachwood 2000 Auburn Drive, Suite 100 Beachwood, OH 44122 216.831.0120

Elyria Lakeland Eye Surgeons 303 Chestnut Commons Drive Elyria, OH 44035 440.366.9444

Independence Cleveland Clinic Independence 5001 Rockside Road Crown Centre II Independence, OH 44131 216.986.4000

Lakewood Lakeland Eye Surgeons Lakewood Hospital Professional Bldg. 14601 Detroit Ave. – Suite 550 Lakewood, OH 44107 216.529.5320

Lorain Lakeland Eye Surgeons 5700 Cooper Foster Park Road Lorain, OH 44053 440.988.4040

Mansfield Lakeland Eye Surgeons 1456 Park Avenue West – Suite P Ontario, OH 44906 419.529.5156

Mayfield Heights Cole Eye Institute, Hillcrest Atrium Medical Building 6770 Mayfield Road – Suite 326 Mayfield Heights, OH 44124 440.461.4733

Strongsville Cleveland Clinic Strongsville 16761 SouthPark Center Strongsville, OH 44136 440.878.2500

Twinsburg Cleveland Clinic Twinsburg 8701 Darrow Road Twinsburg, OH 44087 330.888.4000

Cleveland Clinic Florida 2950 Cleveland Clinic Blvd. Weston, FL 33331 954.659.5000

Please direct any correspondence to:

Medical Editor Justis P. Ehlers, MD

Cole Eye Institute Cleveland Clinic 9500 Euclid Ave. Cleveland, OH 44195

Chairman, Cole Eye Institute Daniel F. Martin, MD

Vice Chairman and Quality Review Officer Andrew P. Schachat, MD

Director, Residency Training Program Vice Chairman for Education Elias I. Traboulsi, MD

Managing Editor Ann Bakuniene-Milanowski

Art Director/Designer Michael Viars

Marketing Manager Bill Sattin, PhD

Marketing Associate Mary Anne Connor

Principal Photography Russell Lee

Contributing Photography Cleveland Clinic Center for Medical Art and Photography

Cole Eye InstituteThe Cleveland Clinic Foundation9500 Euclid Avenue/AC311Cleveland, oH 44195

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