SPECIAL EDITION 2013 Ophthalmology Update Advances in Diagnostics From Cole Eye Institute
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
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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
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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
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
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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
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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
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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,
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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
eHR Guide
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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.
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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
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
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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
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
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
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
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
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.
Contact: Careen Lowder, MD, 216.444.3642, or Laura Holody, 216.445.3762
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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.
Contact: sunil srivastava, MD, 216.636.2286, or Kim Baynes, 216.444.2566
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.
Contact: Careen Lowder, MD, 216.444.3642, or Laura Holody, 216.445.3762
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.
Contact: sunil srivastava, MD, 216.636.2286, or Kim Baynes, 216.444.2566
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
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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
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.
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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
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.
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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
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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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
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.
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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.
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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
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
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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
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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
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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
Professor of 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 Ophthalmology
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.
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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
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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
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.
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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.
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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
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
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
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].
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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
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
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
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
William J. Dupps Jr., MD, PhD .......................216.444.2020
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
William J. Dupps Jr., MD, PhD .......................216.444.2020
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
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
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
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or tablet. Download today at the App
Store or Google Play.
cole eye institute Resources
53
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
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