2023 University of Michigan Kellogg Eye Center Annual Report

UNIVERSITY OF MICHIGAN W.K. KELLOGG EYE CENTER

ANNUAL REPORT

2023

University of Michigan Kellogg Eye Center Annual Report 2023

6 Contents 1

The Chair’s Perspective

8

Michigan’s 15th President Joins the Department

Victors in Clinical Care 2

A Rare Syndrome, A Team Approach

4

Interventions Address Impaired Vision and Related Distress

6

Oculoplastics: Building on an Extraordinary Legacy

9 Prioritizing Patient Wellness—and

Our Own

29 Applauding a Good Catch: Safety First Improving Clinical Care Through Research 5 Assessing Age-Related Vision Impairment 7

Unlocking the Therapeutic Potential of Tears

12

Image-Guided Medical Robotics Comes to Kellogg

14

Using Artificial Intelligence to Improve IOL Formulas

15 Editing Genes to Treat Corneal Dystrophies 16

Clinical Trials Unit Assists in Michigan Medicine Research with Consequences for Eyes

17

12 17

Expanding Personalized Treatment and Clinical Research in Uveitis

26 Molecular Imaging of Macular Degeneration 30

Beyond the Electronic Health Record

32 Protecting Retinal Neurons From Diabetes New Discoveries

22 Leaders and Best in Education

18 An Out-of-This-World Perspective on

Residency from one of Forbes’ Thirty-Under-Thirty 19

Kellogg Post-Doc Receives Prestigious NIH grant

20

Kellogg PGY4 Sole Resident on ACGME Residency Program Review Committee

21 Pre-Med Awarded NIH Research Supplement

7

Patent Issued for Photo-Mediated Ultrasound Therapy

10

The Molecular Physiology of the Blood-Retinal Barrier

11

How Inflammation Triggers Photoreceptor Regeneration

33 The Alan Sugar, M.D., Research Professorship

13

The Genes That Drive Eye Size

24

Institutional Grants Anchor Research Infrastructure, Training

34

28

Microneedles for Sustained Retinal Drug Delivery

31 Mining Big Data for Novel Glaucoma Genes Honors and Awards 13

Selfless Service Beyond Kellogg’s Walls

27

Lecture in Professionalism and Ethics

32

Mark W. Johnson, M.D., Honored with Heed-Gutman Award

Front cover from left to right: Christine Nelson, M.D., Adam Jacobson, M.D., Shilpa Kodati, M.B.B.S., Mikiko Nagashima, Ph.D., Joshua Ong, M.D.

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2023-2024 Heed Fellows

Philanthropic Support

Honoring the Visionary Leadership of Paul P. Lee, M.D., J.D.

35 The Edna H. Perkiss Research Professorship Improving Vision Worldwide 36

Partnership Between U-M Med School, Business School, and the Kellogg Eye Center Drives Latest Kenya Initiative

Kellogg Updates 27

Alumni Highlights

38

First-Year and Graduating Residents

39

Departing Clinical Fellows

40

New Faculty

41

Faculty Honors and Recognition

Kellogg leadership team

From the Interim Chair After marking 150 years of ophthalmology at the University of Michigan last year, the Kellogg Eye Center has kicked off our second sesquicentennial with another year of amazing achievements.

If there’s a common theme to our 2023 report, it’s the power of teamwork.

Within our center, across the University and around the globe, our faculty have cemented longstanding partnerships and forged new, sometimes surprising ones to tackle the most vexing clinical and research questions, and to prepare the next generation of leaders in ophthalmology and vision science.

From the rarest inherited retinal dystrophies to the most severe ocular surface injuries, when presented with complex clinical challenges, team care is the standard of care at Kellogg. One example shared here is a baby who, at less than 12 hours old, was rushed to U-M with acute ophthalmic and systemic issues. Kellogg specialists in pediatric ophthalmology, genetics, retina, glaucoma and cornea came together to diagnose her rare genetic syndrome and perform the surgeries that will give her the best possible chance at vision.

This year’s research highlights include the renewal of four major institutional grants, the recruitment of new faculty, and the opening of our new image-guided medical robotics lab —all evidence that Kellogg is essentially built for team science. With the resources and support only available at a top academic eye center, our investigators initiated numerous novel projects in 2023, in partnership with experts in data analytics, artificial

intelligence, gene sequencing bioengineering, psychiatry and more.

In Kellogg’s model of ophthalmic education, teamwork is taught by example. Students, residents and fellows are encouraged to collaborate in pursuit of their own unique areas of interest. That approach resulted in a remarkably diverse group of learners in 2023, including a medical student helping with a vision clinic expansion in Kenya, and a resident who contributed to a textbook devoted to spaceflight-associated neuroocular syndrome, a condition which, as the name implies, is exclusive to astronauts.

I joined the Kellogg faculty in 2002, and not a day has passed since that I haven’t marveled at the compassion, talent and collegiality that fuel this amazing place.

As a national search for our next leader continues, it is my honor to serve as Interim Chair.

Shahzad I. Mian, M.D. Interim Chair and Professor, University of Michigan Department of Ophthalmology and Visual Sciences

Dr. Lee Assumes Expanded Role at Michigan Medicine The spirit of teamwork that drives Kellogg was driven by Emeritus Chair Paul Lee, M.D., J.D. Dr. Lee captained the Kellogg team from 2012 to 2022. In his new role as Senior Associate Dean of Clinical Affairs in the U-M Medical School and Executive Director of the U-M Medical Group, his talent and vision are now shaping the delivery of clinical care across all of University of Michigan Health.

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SHE SEEMS TO TRACK THINGS BETTER, ESPECIALLY BLACK

AND WHITE OR HIGH CONTRAST OBJECTS. MORE IMPORTANTLY,

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SHE CONTINUES TO THRIVE. SHE’S A LOVING, LOVABLE,

HAPPY-GO-LUCKY BABY, WHO INSPIRES US EVERY DAY. — Allison Schuelke

Aspen with her mother Allison Schuelke

Helping Baby Aspen: Aspen Schuelke was born March 1, 2022, in Jackson, Michigan, 40 miles west of Ann Arbor. Right away, doctors had several concerns, especially about her eyes.

Aspen’s eyes appeared small and cloudy. Her intraocular pressure (IOP) was very high, which had caused protruding scar tissue to develop on her right eye.

Less than 12 hours after her birth, Aspen was transferred to U-M C.S. Mott Children’s Hospital. There, she would be cared for by a multidisciplinary team, including a number of experts from Kellogg.

Her Kellogg team would eventually include childhood glaucoma specialist Adam Jacobson, M.D., pediatric retina specialist Cagri Besirli, M.D., Ph.D., cornea specialist Shahzad Mian, M.D., and ophthalmic genetics specialist Lev Prasov, M.D., Ph.D. “Along with severe corneal issues and glaucoma, Aspen was diagnosed with aniridia, a disorder that results in eyes without irises,” explains Dr. Jacobson.

“Her other doctors identified additional issues, including trouble taking nourishment, poor muscle tone, and a heart defect.”

Dr. Jacobson wondered if one syndrome might be behind Aspen’s many medical challenges. “One clue pointing to a genetic explanation is that her mother has anterior segment dysgenesis, or ASD,” he says. In ASD, the tissue in the front of the eye does not develop normally, increasing the risk of glaucoma and cataracts.

“Allison has a relatively mild form of glaucoma, which 2

has been monitored here at Kellogg for years.”

He consulted with Dr. Prasov, who evaluated daughter and mother in the Kellogg Multidisciplinary Ophthalmic Genetics Clinic (MOGC) together with the pediatric genetics team of Dr. Amanda Pritchard, M.D., and genetic counselor Adelyn Beil, M.S., CGC, M.P.H. Genetic testing identified that both carry a mutation in the gene FOXC1. “Aspen has a form of ASD associated with FOXC1 called Axenfeld-Rieger Syndrome,” explains Dr. Prasov. “Allison, who had never had genetic testing before, was found to carry the same FOXC1 variant, but in her case it has far less impact.”

While the genetic evaluation proceeded, the immediate challenge was stabilizing Aspen’s IOP. “Patients with this type of glaucoma do not tend to respond well to medications, and often require surgical intervention,” says Dr. Jacobson. “We first attempted to insert tubes to lower the pressure, but in such small, underdeveloped eyes, there was no room to safely place them. We instead performed a laser procedure, which has successfully kept the intraocular pressure controlled.”

In her first months of life, Aspen underwent multiple exams under anesthesia so that the team could monitor her IOP, the condition of her retinas, and the progressive scarring on her corneas. By the spring of 2023, the group was debating whether Aspen should receive a cornea transplant.

Cagri Besirli, M.D., Ph.D., Adam Jacobson, M.D., Shahzad Mian, M.D., Lev Prasov, M.D., Ph.D.

A Rare Syndrome, A Team Approach “There’s a difficult risk/reward calculation when dad have been essential members of the team from considering cornea transplantation for a child,” explains day one.”

Dr. Mian. “On top of the general risks of surgery under There is a long road ahead for Aspen and her anesthesia, corneal grafts are more likely to fail or be family. In addition to monitoring her IOP, which may rejected in young patients. one day require additional surgery, a procedure is being “Those risks need to be balanced with the potential planned on the right eye to further reduce the scarring benefit to the child’s vision,” he continues. “When a under the cornea of the right eye. If possible, the left clouded cornea blocks light from entering the retina, eye may eventually receive a cornea transplant. the visual pathways between the retina and the brain As Team Aspen at Kellogg addresses the ocular don’t develop properly. Delay the transplant too long, aspects of Aspen’s Axenfeld-Rieger Syndrome, Team and you may miss the window for Aspen at Mott continues to tackimproving vision.” le the systemic challenges of PROVIDING THE COMPLEX CARE In June 2023, after extensive ASPEN NEEDS IS TRULY A TEAM EFFORT, the syndrome. Not yet two years consultation with the care team old, Aspen has already endured AND ASPEN’S MOM AND DAD HAVE BEEN and Aspen’s parents, Dr. Mian countless specialty clinic evaluaESSENTIAL MEMBERS OF THE TEAM operated on Aspen’s right eye, tions, therapies and procedures FROM DAY ONE. removing the enlarged, opaque to improve her cardiovascular, cornea with the lens embedded in digestive and musculoskeletal — Shahzad Mian, M.D. it, and transplanting a new cornea. health.

“While we understood the risks, we really advoNonetheless, at the Schuelke home, there is plenty cated for the procedure,” says Allison Schuelke. “To of room for optimism. “We’ve noticed small improvegive Aspen the best possible chance at vision, we need ments in Aspen’s vision,” Allison says. “She seems to her developing brain to receive as much visual input track things better, especially black and white or high as possible.” contrast objects. More importantly, she continues to “Providing the complex care Aspen needs is truly thrive. She’s a loving, lovable, happy-go-lucky baby, who a team effort,” says Dr. Mian, “and Aspen’s mom and inspires us every day.”

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THERE’S A VICIOUS CYCLE OF VISION LOSS AND MENTAL DISTRESS. DISTRESS TENDS TO INCREASE AS VISION DECREASES, AND THE MORE

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PATIENTS STRUGGLE WITH

EMOTIONAL ISSUES, THE LESS LIKELY THEY ARE TO FULLY BENEFIT FROM LVR.

— K. Thiran Jayasundera, M.D., M.S.

K. Thiran Jayasundera, M.D., M.S.

For IRD Patients, Tailored Interventions Address Impaired Vision and Related Distress

R01 Grant 4

Inherited retinal diseases (IRDs) are a group of rare retinal diseases that damage the light-sensitive cells in the retina, causing progressive vision loss.

Different IRDs result in different low vision (LV) challenges. LV refers to vision problems that cannot be fully resolved with corrective lenses, medical or surgical therapies. Depending on their diagnosis, IRD patients may experience worsening central vision or peripheral vision, color blindness, night blindness, light sensitivity, blurred vision, or difficulty seeing details.

Retina specialist K. Thiran Jayasundera, M.D., M.S., is dedicated to improving vision outcomes for IRD patients. In clinical practice, he often refers patients to Kellogg’s Low Vision and Visual Rehabilitation Service.

The service provides comprehensive low vision rehabilitation (LVR) tailored to individual patients’ needs, combining technologies, devices, environmental modifications and skills training to help maximize their remaining vision and maintain independence in daily living.

Dr. Jayasundera’s latest research project focuses on the mental health of IRD patients. The two-part project is funded by an NIH R01 grant.

“Understandably, many patients coping with worsening vision also struggle with anxiety and depression,” he explains. “There’s a vicious cycle of vision loss and mental distress. Distress tends to increase as vision decreases, and the more patients struggle with emotional issues, the less likely they are to fully benefit from LVR.” The first objective of the project is to study the interplay between functional vision impairments and

emotional distress in patients with IRDs. Participants will undergo functional vision testing and general depression screening. They, will also complete two surveys designed specifically for IRD patients to self-report their vision disabilities, anxiety and depression. Both surveys were developed and validated by Dr. Jayasundera.

The project’s second component is a clinical trial of a therapeutic intervention. Participants will receive a targeted combination of LVR and psychotherapy using a template technique called emotion regulation therapy (ERT). ERT integrates components of cognitive-behavioral, acceptance, dialectical, mindfulness and experiential therapies. Developed by David Fresco, Ph.D., Co-Investigator on the R01, ERT has been proven effective in reducing anxiety and depression by addressing the underlying factors that worsen distress.

“Based on the IRD diagnosis, we know how to individualize a patient’s LVR,” he explains. “This study adds a component of psychotherapy, also individualized to patients’ reported symptoms. We hypothesize that when combining tailored psychotherapy with tailored vision rehabilitation, each will bolster the other. With relief from their anxiety and depression symptoms, patients will be better able to comply withparticipate in rehabilitation, and achieve the best possible vision results.”

If shown effective in this clinical trial, this approach could be adapted for other vision-related conditions that evoke distress.

Joshua Ehrlich, M.D., M.P.H.

Assessing Age-Related Vision Impairment

a battery of objective measures of visual function to gauge respondents’ distance and near vision and contrast sensitivity.

Dr. Ehrlich played a pivotal role in developing, testing and validating those measures. He can now begin analyzing the two years of available data, More than half of the 14 million people in the U.S. living adding an additional year’s data annually throughout with vision impairment (VI) or blindness are age 65 and the grant’s five-year duration. He will be assisted by older. Racial and ethnic minorities are disproportionateKellogg investigators Lindsey De Lott, M.D., M.S., and ly affected, and the number of people suffering from VI Angela Elam, M.D., M.P.H., and by colleagues at the is anticipated to double by 2050 as our population ages.

U-M Institute for Social Research, where he also has Social determinants of health (SDoH) like healthcare a faculty appointment. access and economic stability play a large role in shapThe project has three aims. First, to describe the ing who is impacted. state of vision impairment in older adults. Second, to Older adults with VI are analyze the impact various SDoH thought to be at elevated risk have on VI late in life. And finally, UNTIL NOW, WE HAVEN’T HAD for many adverse outcomes, to study the impact over time of NATIONALLY REPRESENTATIVE including dementia, admission VI and blindness on the developto a long-term care facility, and ment of dementia, placement LONGITUDINAL DATA IN THE U.S. ON even death. in a long-term care facility, and THE CONNECTION BETWEEN VI, SDOH Kellogg clinician-scientist mortality—all factors captured AND CRITICAL LATE-LIFE OUTCOMES. Joshua Ehrlich, M.D., M.P.H., in NHATS. is painting a more precise picWith this project, Dr. — Joshua Ehrlich, M.D., M.P.H. ture of the impact of age-assoEhrlich’s team is responding to ciated vision loss. A leader in vision-related population key strategic research goals included in the National and health services research in the U.S. and around Eye Institute’s five-year strategic plan, as well as interthe world, Dr. Ehrlich has been awarded a National national research priorities articulated by the Lancet Institutes of Health (NIH) R01 grant to analyze newlyGlobal Health Commission on Global Eye Health, a collected data on the vision health of U.S. seniors— worldwide consortium of experts of which Dr. Ehrlich a data set he helped develop. is part.

Since 2011, the NIH has funded the National “Until now, we haven’t had nationally representaHealth and Aging Trends Study (NHATS), which, through tive longitudinal data in the U.S. on the connection annual in-person surveys conducted in respondents’ between VI, SDoH and critical late-life outcomes,” he homes, gathers health data annually on more than explains. “These studies are the first step in closing 7,000 adults 65 years and older. In 2021, NHATS added that knowledge gap.”

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R01 Grant 5

Elaine Downie, M.D., and Brittany Simmons, M.D.

Oculoplastics: Building on an Extraordinary Legacy

teaching alongside clinical practice. Dr. Downie plans to receive faculty training to develop as an educator, and Dr. Simmons is involved in building a resident education curriculum in oculoplastics.

“Kellogg is now home to one of the largest and The Eye Plastic, Orbital and Facial Cosmetic Surgery most comprehensive oculoplastics programs in the Service at Kellogg provides comprehensive evaluation country,” says Dr. Aakalu. “We are the region’s high and treatment of conditions of the eyelids, orbit, and volume referral hub.” lacrimal (tear drainage) system arising from diseases, The expansive program includes specialty care for malignancies, congenital abnormalities, trauma, or patients with rare and debilitating conditions such as aging. In addition to providing comprehensive, multicongenital anophthalmos—a syndrome in which a baby disciplinary oculoplastics care, the program is known is born without one or both eyes. Dr. Nelson has led internationally for excellence in research and education. groundbreaking research into the condition, and develThe physician team includes Section Lead Vinay oped a regional referral program, in collaboration with Aakalu, M.D., M.P.H., Victor Elner, M.D., Ph.D., Denise Kellogg’s recently expanded Ocular Prosthetics Service.

Kim, M.D., Christine Nelson, M.D., and ocular oncology Another example of the program’s depth is multispecialist Hakan Demirci, M.D. To disciplinary ocular surface reconstruccontinue to meet a large and growKELLOGG IS NOW HOME tion, available to patients with severe ing clinical volume, two additional chemical or thermal eye injuries, or TO ONE OF THE LARGEST AND oculoplastics surgeons, Brittany advanced cicatrizing keratoconjunctival MOST COMPREHENSIVE Simmons, M.D., and Elaine Downie, disorders such as Stevens Johnson OCULOPLASTICS PROGRAMS M.D., joined the team in 2023.

Syndrome and Graft vs. Host DisIN THE COUNTRY. The Oculoplastics program ease. Dr. Kim works closely with other continues to benefit from consultaexperts at Kellogg, including cornea — Vinay Aakalu, M.D., M.P.H. tion with Terry J. Smith, M.D., Prospecialist Nambi Nallasamy, M.D., fessor Emeritus of Ophthalmology and Visual Sciences Steven Archer, M.D., from the Pediatric Ophthalmoland Internal Medicine. Dr. Smith’s game-changing ogy and Adult Strabismus Service, Karen DeLoss, O.D., translational research led to the development of teprofrom the Optometry, Corneal, and Contact Management tumumab —the first FDA-approved drug to treat thyroid Service, and rheumatologist April Marquardt, M.D., to eye disease. restore the damaged ocular surface using complex Faculty members guide trainees of all levels, techniques available in very few centers around the including medical students, ophthalmology and plastic country. surgery residents, oculoplastics and ocular oncology “With volume comes experience,” he adds. fellows, research post-docs, and international research “Patients and referring physicians can be confident fellows and observers. In 2023, that, no matter how complex or rare the symptom The team’s newest members are also emphasizing profile, someone on our team has dealt with it before.”

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OUR GROUP IS AT THE

FOREFRONT OF THE EMERGING STUDY OF TEAR BIOLOGY,

WE HOPE THAT MINING THE

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MOLECULAR COMPONENTS

OF TEARS MAY YIELD NOVEL BIOMARKERS FOR NEW THERAPIES.

— Vinay Aakalu, M.D., M.P.H.

R01 Grant Vinay Aakalu, M.D., M.P.H.

Unlocking the Therapeutic Potential of Tears Kellogg is also home to one of the nation’s most robust and diverse oculoplastics research portfolios, including numerous basic, clinical and translational research grants, clinical trials, and patent applications.

Dr. Aakalu in Principal Investigator on two NIH R01 grants. The latest aims to develop a novel treatment approach for the fatal disease Niemann-Pick Type C (N-P).

The project leverages his groundbreaking work deriving therapeutic agents from the peptides found in tears.

N-P is a rare, genetic neurodegenerative disorder characterized by the body’s inability to transport cholesterol and other fatty substances (lipids). As a result, lipids build up within brain and other cell types.

In earlier research into lipid and small molecule therapies to treat dry eye and corneal injuries,

Dr. Aakalu and his colleagues discovered that the peptide they were studying had something in common with N-P; namely, the protein receptor TMEM97.

“The TMEM97 receptor has been shown to impact the protein that is damaged in N-P,” explains Dr. Aakalu.

“We found that TMEM97 can, in turn, be impacted by the peptide-based formula we developed for dry eye.

With that knowledge, we applied those peptides to models of N-P and found that they yielded improvements in some features of the disease.”

The grant will fund future studies to advance a potential peptide-based treatment for N-P. While N-P is an unusual target in ophthalmology research, the development of peptide-based therapeutics represents an exciting new frontier for treating a range of ocular disorders.

“Our group is at the forefront of the emerging study of tear biology,” Dr. Aakalu says. “We hope that mining the molecular components of tears may yield novel biomarkers for new therapies.”

Patent Issued for Photo-Mediated Ultrasound Therapy A U.S. patent has been issued to Yannis M. Paulus, M.D., Xueding Wang, Ph.D., and Xinmai Yang, Ph.D., for Photomediated Ultrasound Therapy, or PUT, a noninvasive method of removing the microvessels whose growth is associated with numerous eye diseases, including wet age-related macular degeneration (AMD) and diabetic retinopathy.

PUT combines synchronized nanosecond laser

pulses with bursts of ultrasound. It delivers laser pulses at more than 10 times lower intensity than conventional laser combined with synchronized ultrasound bursts, making it possible to target microvessels with much greater precision, while posing far less risk to surrounding tissue.

“The ability to deliver more targeted therapy is especially valuable in the treatment of diseases such as AMD, where the growth of new blood vessels tends to cluster around the fovea—the center of the macula,” explains Dr. Paulus. “Unlike conventional laser treatment, which can result in a blind spot in the patient’s center of vision, PUT can remove microvessels while preserving central vision.”

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Michigan's 15th President Joins the Department

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KELLOGG’S CLINICAL EXPERTISE AND

CRITICAL MASS OF RESEARCH TALENT,

COMBINED WITH THE ALMOST UNLIMITED

POTENTIAL FOR COLLABORATIONS ACROSS THE UNIVERSITY, MAKES IT ONE OF THE

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In July 2022, Santa Ono, Ph.D., was named the 15th President of the University of Michigan. At the same time, the Kellogg Eye Center gained a renowned vision researcher.

Dr. Ono brings vast leadership experience to the president’s office, having previously held the position at both the University of Cincinnati and the University of British Columbia. At Michigan, he oversees the activities of more than 65,000 undergraduate and graduate students in nearly 300 degree programs across 19 schools and colleges on three campuses, as well as a research volume in excess of $1.86 billion.

But the chance to lead one of the world’s most influential academic institutions wasn’t the only thing that drew Dr. Ono to Michigan. He is, after all, a researcher at heart.

Dr. Ono began his academic career in immunogenetics research, studying the molecular biology of the immune system and its impact on the development of type 1 diabetes. He was urged to apply his expertise in immunology to eye diseases when recruited from Johns Hopkins University to the Harvard Medical School Schepens Eye Research Institute.

At Schepens and in subsequent positions, including at the University College London’s Moorfields Eye Institute, Dr. Ono led pioneering research into the role of the immune system in ocular surface diseases and agerelated macular degeneration (AMD). Among his many published findings was the identification of antibodies that may contribute to the progression of AMD and the transition from the dry to the wet form of the disease.

After a year fully devoted to his role as president, Dr. Ono is able to engage once again in research. A U-M professor of ophthalmology and visual sciences (as well as microbiology, immunology, and molecular, cellular and developmental biology) he is in the process of setting up his lab at Kellogg.

Dr. Ono credits Paul P. Lee, M.D., J.D., U-M Medical Group Executive Director, Senior Associate Dean of Clinical Affairs and former Kellogg Chair, with recruiting him to U-M. “Michigan has built an international reputation for research excellence, and that was a major draw for me,” he says. “Kellogg is globally respected for making fundamental contributions to our understanding of eye diseases and their treatments.”

“I have been involved in eye research at top institutions in the U.S., the U.K. and Canada, and have followed the work of basic and clinical scientists at Kellogg for decades,” he continues. “Kellogg’s clinical expertise

MOST ATTRACTIVE PLACES TO DO EYE RESEARCH ANYWHERE. IT’S A THRILL TO BE HERE, AND I CAN’T WAIT TO GET BACK INTO THE LAB. — Santa Ono, Ph.D.

and critical mass of research talent, combined with the almost unlimited potential for collaborations across the University, makes it one of the most attractive places to do eye research anywhere. It’s a thrill to be here, and I can’t wait to get back into the lab.”

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AS PHYSICIANS, WE

NEED TO TAKE THE ADVICE WE GIVE OUR PATIENTS

ABOUT STRESS REDUCTION,

EXERCISE AND CONDITIONING.

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IT’S NEVER TOO EARLY OR TOO LATE TO PRIORITIZE HABITS THAT PROMOTE WELLNESS.

— Amy Zhang, M.D.

Amy Zhang, M.D.

Prioritizing Patient Wellness — and Our Own The doctors, researchers and staff at Kellogg put patients’ health and safety first. But as Amy Zhang, M.D., is quick to remind us, it’s just as important to look out for our own well-being.

“To give patients our very best, we have to be at our best,” says Dr. Zhang. A glaucoma and cataract surgeon, she is one of seven Faculty Associates appointed to the Michigan Medicine Wellness Office. The office is dedicated to improving well-being and reducing professional burnout among faculty, staff and learners. Faculty Associates like Dr. Zhang undertake scholarly projects that inform wellness policies across the health system.

Since joining the office in 2022, Dr. Zhang’s projects have included collecting and analyzing data on how physicians manage their in-baskets—the mailbox function within the electronic health records database.

“Keeping current on correspondence and scheduling is one way to lessen daily stress,” she explains. She also analyzed health system-wide data on vacation utilization and presented her findings at the 2023 meeting of the AMA’s American Conference on Physician Health.

Now Dr. Zhang is addressing a specific workplace risk for ophthalmic clinicians: musculoskeletal pain and injury related to poor ergonomic design in equipment and instruments.

“It’s a bigger problem than we tend to acknowledge,” Dr. Zhang says. “It’s well documented that, as a result of our examination and operating room equipment, ophthalmologists are twice as likely as primary care doctors to suffer work-related neck or upper back pain.”

For example, the ophthalmologist’s go-to examination tool, the slit lamp, has remained essentially the

same since its invention in 1911. Its design limits one’s ability to sit as close as needed, requiring overextension of the neck to compensate.

Ophthalmic surgeons, too, risk developing musculoskeletal pain from maintaining static positions and improper ergonomic positioning throughout procedures.

And eye clinicians are also prone to repetitive motion injuries to hands and arms, such as carpal tunnel syndrome and cubital tunnel syndrome.

Over time, what starts out as discomfort can lead to serious upper extremity, cervical and spinal issues.

With grant support from Michigan Medicine, input from experts in ergonomics, biomedical engineering and physical therapy, and guidance on logistics and promotion from Kellogg’s cultural committee, Dr. Zhang is designing a pilot intervention for her fellow clinicians targeted for early 2024.

“The plan is to evaluate the effectiveness of offering ‘drop in’ instruction and support on-site to help clinicians learn simple exercises—micro-stretches— to counteract the postures we’re forced to maintain,” Dr. Zhang explains. “The intervention needs to be quick, easy and accessible, not just another item for an already jammed to-do list.”

In addition to the pilot intervention, Dr. Zhang is working with the AUPO to field a national survey of residents to gauge how early musculoskeletal issues arise.

“I didn’t realize how fit you need to be for a career in ophthalmology,” she acknowledges. “As physicians, we need to take the advice we give our patients about stress reduction, exercise and conditioning. It’s never too early or too late to prioritize habits that promote wellness.”

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David Antonetti, Ph.D., and Laura González-González, Ph.D.

The Molecular Physiology of the Blood-Retinal Barrier For the retina to do its job to help the brain convert light into vision, it requires a well-regulated metabolic environment. The blood-retinal barrier (BRB) is a structure of tightly joined cells that protect that environment, allowing nutrients in while keeping potentially damaging substances out.

A buildup of vascular endothelial growth factor (VEGF) in the retina damages the BRB, making it more permeable. This leads to fluid buildup, much like a bruise after a hard bump. VEGF-induced retinal injury is linked to blinding eye diseases like diabetic retinopathy (DR).

Understanding the molecular physiology of the BRB is a central focus in the lab of Kellogg investigator David Antonetti, Ph.D. He has received NIH R01 grant support for the following new studies: The role of Norrin in BRB Regeneration The Antonetti lab has worked for many years to understand how VEGF contributes to loss of the BRB. Current therapies blocking VEGF action have proven invaluable in the clinic. Now, Dr. Antonetti will serve as Principal Investigator on a project aimed at exploring the possibility of regenerating the BRB in diabetic retinopathy.

Specifically, he is exploring whether the cytokine norrin may play a role in BRB regeneration.

Norrin has already been shown to play a role in the development of the BRB. Building on that, the Antonetti lab has demonstrated in animal models that norrin can help restore the barrier properties of retinal blood vessels after they are weakened by diabetes.

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“Loss of norrin signaling may be as important as increased VEGF action in diabetic retinopathy,” he says. “We have already demonstrated that norrin acts to restore the BRB, helping the diabetes-injured retina recover function. And we have found new pathways that cells use to build the BRB. In all, this research supports prioritizing norrin as a therapeutic target.”

The Role of Heme in Retinal Vascular Development Dr. Antonetti will collaborate on a separate initiative arising from studying the genes expressed in retinal blood vessels—in particular, the gene FLCVR2.

This project will explore a completely novel hypothesis, that FLCVR2 plays a role in brain and retinal blood vessel growth by transporting a critical molecule — heme —into developing cells. Heme is best known as a component of hemoglobin, where it binds with the iron to carry oxygen in the bloodstream. But that’s not heme’s only function.

“In cell biology, heme is a real multitasker,” says Dr. Antonetti. “It’s a co-factor in several key reactions in cells. And remarkably, it appears to act as a signaling molecule in the regulation of blood vessel growth in the BRB.” As Dr. Antonetti was connecting the dots between heme and blood vessel growth in the BRB at Michigan, Thomas Arnold, M.D., was studying the role of the same transporter in his neonatal brain research at the University of California, San Francisco.

The two laboratories have merged their efforts, with Dr. Arnold and Dr. Antonetti as Co-Principal Investigators on the resulting R01 project grant.

“It’s really a brand new way to think about blood vessel development,” Dr. Antonetti says. “We hope it will lead to new ways to counter the out-of-control blood vessel growth that fuels blinding eye diseases.”

Dr. Nagashima injects CRISPR-Cas9 components into single cell stage zebrafish embryos

Peter Hitchcock, Ph.D., Mikiko Nagashima, Ph.D.

How Inflammation Triggers Photoreceptor Regeneration The degeneration and death of photoreceptor cells is tory response, and that this inflammation is required to a primary cause of blinding diseases like age-related make new photoreceptors. The inflammatory molecules macular degeneration and retinitis pigmentosa. signal specific cell types to begin to form new, regenerA fundamental focus in the study of these degenated photoreceptors. erative retinal diseases, as well as neurodegenerative “In zebrafish retinas, inflammation is a required diseases like Alzheimers, is the role inflammation plays step for photoreceptor regeneration,” explains Dr. in fueling retinal cell and neuron degeneration, and Hitchcock. “This is in distinct contrast to inflammation what can be done about it. in the human retina, where it is a part of healing, but Basic science researchers can lead to degeneration and THESE TINY FISH NATURALLY investigating inflammation and cell disease.” death in the brain and retina often Their game-changing ACCOMPLISH EXACTLY WHAT WE study zebrafish models. Unlike hufinding will be pursued with WOULD HOPE TO ACHIEVE IN mans, when these creatures’ brain a new NIH R21 grant, with PATIENTS WITH DEGENERATIVE and retinal cells die, they have the Dr. Hitchcock as Principal InvesEYE AND BRAIN DISEASES. ability to make new ones. tigator and Dr. Nagashima as “These tiny fish naturally Co-Investigator. The R21 — Peter Hitchcock, Ph.D. accomplish exactly what we would provides short-term funding hope to achieve in patients with degenerative eye and to pursue ideas that break new ground. brain diseases,” explains Peter Hitchcock, Ph.D., Profes“The subretinal space is where photoreceptors sor of Ophthalmology and Cell and Developmental live and die in humans, and where they live, die and Biology. “We can learn a lot from them.” regenerate in zebrafish,” explains Dr. Hitchcock. “Our New insights from their studies of zebrafish retiproject explores the unique inflammatory environment nas have led Dr. Hitchcock and his colleague, Assistant of that space in zebrafish, and the specific cells within Research Scientist Mikiko Nagashima, Ph.D., to view it that aid photoreceptor regeneration. inflammation in a whole new way.

“The insights we gain may someday be used From their research, Drs. Hitchcock and Nagashima to combat degenerative eye diseases by inducing have established that when photoreceptors in the regrowth of photoreceptor or other cells in the human retinas of zebrafish are dying, they trigger an inflammaretina.”

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R01 Grant 11

Mark Draelos, M.D., Ph.D.

Image-Guided Medical Robotics Comes to Kellogg Mark Draelos, M.D., Ph.D., stands at the intersection of ophthalmology and robotics. From that unique vantage point, the view is amazing.

Dr. Draelos began a joint faculty appointment at both Kellogg and Michigan Robotics in January 2023, launching the University’s Image-Guided Medical Robotics (IGMR) Lab with dedicated space at both Kellogg and the Ford Robotics building at U-M. Applying a deep understanding of clinical medicine, biomedical imaging and robotics, IGMR investigators are in the early stages of developing robotic systems with real-time image feedback to solve a range of healthcare problems.

In ophthalmology, those systems are built around Optical Coherence Tomography (OCT)—a non-invasive technology that uses light waves to image the structural layers and blood vessels of the eye.

“Marrying OCT with medical robotics promises to be a game-changer in ophthalmology,” says Dr. Draelos, “addressing some of our most crucial surgical and diagnostic challenges.”

A Better-Than-Bird’s-Eye View OCT is particularly well suited to ocular surgery because it provides images of the tiny structures of the eye in real time, without interrupting the procedure.

Dr. Draelos is developing a robot-assisted system that helps the surgeon better leverage that capability.

Eye surgeons perform incredibly delicate maneuvers while seated at the patient’s head, looking through a microscope that offers a top-down view. OCT can provide images from any angle, but once it is rotated (for example, to better view the angle and depth at which an instrument is penetrating), surgeons must 12

also ‘mentally rotate’ to transform their hand motions accordingly.

“Much like driving a vehicle in reverse guided by looking in the mirror, you have to think about which direction to turn the wheel,” he explains.

Dr. Draelos is developing a robotic system that does that mental transformation, better connecting hand and tool movements. At the same time, it employs virtual reality to visually and tactilely ‘separate’ the surgeon from the surgical field, replacing it with a greatly increased scale representation on which to operate.

Taking OCT Where It’s Never Been Before Robotic enhancements to OCT may soon make the technology more accessible and portable too, bringing earlier diagnosis and treatment to more people.

Today’s OCT, which requires an on-site skilled operator, is a stationary device largely relegated to the ophthalmology clinic. But the eyes are impacted by many diseases that might be initially diagnosed and managed elsewhere.

“Consider the potential to save eyesight if diabetic retinopathy could be found before patients are symptomatic, by using OCT technology in the primary care setting,” suggests Dr. Draelos. His team is working on an OCT-imaging robot that automates scanning. “Eventually, patients’ eyes could be scanned while their blood pressure is being checked.”

An automated, mobile system could bring better ophthalmic health to underserved, at-risk communities with limited familiarity with or access to specialty care.

It could also help those unable to be scanned with a traditional system, due to mobility or motion disorders.

“The goal of emerging technologies like these is not to move away from traditional ophthalmology clinics,” Dr. Draelos notes. “Rather, it’s about improving surgical practice, and expanding access to early diagnosis and referral for specialized care.”

The Genes That Drive Eye Size The length of a normal eye is about 16 mm at birth, growing over the first two years to about 23 mm. In some babies, eye growth stops too soon, and in others, eyes grow too large.

Nanophthalmos is an inherited disorder in which the eye is structurally normal, but stops growing at 16-20 mm. Exceedingly rare, it results in extreme farsightedness (hyperopia), angle-closure glaucoma, and other vision problems. Conversely, myopia is a more common condition, characterized by lengthening of the eye (as large as 30-32mm in some extreme cases).

Myopia results in nearsightedness, and in some instances, structural problems.

To support his work understanding the genetic factors that contribute to eye size disorders, Lev Prasov, M.D., Ph.D., has received a grant from the E. Matilda Ziegler Foundation for the Blind. The foundation supports innovative vision research by outstanding early-career investigators.

Dr. Prasov’s current project builds on his previous studies of families with instances of nanophthalmos caused by a variant of the gene MYRF. It aims to describe how the MYRF transcription factor impacts the development of retinal pigment epithelium (RPE) and its interactions with other eye cells. This work is

in collaboration with Kellogg medical retina specialist Jason Miller, M.D., Ph.D. “We know that as the eye grows, RPE cells are critical in eye size determination,” explains Dr. Prasov.

“But it’s unclear why defects in the RPE cause eye size disorders.”

A better understanding of the cell-to-cell interactions and genetic pathways that govern eye size could eventually lead to new methods of treating eye size disorders.

“Ultimately, we may be able to design interventions that manipulate those pathways,” he says, “stimulating eye growth in patients with nanophthalmos, and slowing eye growth in patients developing myopia.”

Selfless Service Beyond Kellogg’s Walls In recognition of a career of dedicated service, Christine Nelson, M.D., was presented with the Women in Ophthalmology (WIO) Humanitarian Award. The annual award recognizes a WIO member’s efforts to improve lives, alleviate suffering and contribute to the basic human dignity of those in need in the U.S. or abroad.

A clinician, researcher and educator, Dr. Nelson plays a pivotal role on the oculoplastics team. At the same time, as a Co-Director of the Jerome Jacobson International Program at Kellogg, she has traveled to locations from Ethiopia to Jamaica, lending her boundless energy and compassion to countless efforts to improve eye health among the underserved.

“No matter where she finds herself, she goes about the work at hand with humility and grace,” says Kellogg Interim Chair Shahzad Mian, M.D. “In her uniquely selfless way, she has represented Kellogg around the world while blazing the trail for many others, from the greenest medical students to the most seasoned faculty and alumni, to step out of their comfort zones and serve.

She’s an inspiration to us all.”

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Nambi Nallasamy, M.D.

Using Artificial Intelligence to Improve IOL Formulas

The resulting Nallasamy Formula was then tested against seven of the most commonly used formulas, using retrospective patient data. It outperformed them all.

Dr. Nallasamy and fellow cataract surgeons at Kellogg now employ it side-by-side with other formulas.

Having demonstrated that ML can improve IOL calculations for his patients, Dr. Nallasamy is now applying With more than 23 million procedures performed each it to challenges specific to other populations. year, cataract surgery is the world’s most common First, he hopes ML can help make cataract surgery surgical procedure. To achieve the best possible visual outcomes around the world more equitable by overoutcome for the patient, it’s crucial to implant an intracoming data biases inherent in IOL formulas. “Eye size ocular lens (IOL) with the optimal power. To select the and shape vary throughout the world,” he explains. “But IOL’s power, the surgeon relies on a formula to calculate our data sets reflect our local population. We need an which power will achieve a postoperative refraction that ML tool that can easily adjust to best matches the patient’s goals. different populations and IOL types A number of such formulas are IN ML, COMPUTERS ‘LEARN’ with minimal additional informaavailable, using different methodoloFROM PROCESSING DATA tion—a challenge called domain gies to weigh variables like the eye’s SETS FAR LARGER AND MORE adaptation.” length, corneal shape and lens thickMULTIFACETED THAN A HUMAN Dr. Nallasamy is also putting ness. While the accuracy of IOL power his ML approach to work to help calculation has risen over the years, MIND CAN ABSORB. surgeons navigate more complex so have patient expectations for their — Nambi Nallasamy, M.D. conditions, including patients rerefractive outcomes, creating demand quiring cataract surgery along with for still more powerful formulas. corneal transplantation, and those with corneal thinning Cornea and cataract surgeon Nambi Nallasamy, disorders like keratoconus.

M.D., saw this as an ideal application for an artificial inSelecting the right lens to meet these patients’ telligence (AI) technology called machine learning (ML). needs is especially challenging, because the cornea “In ML, computers ‘learn’ from processing data sets continues to change as they recover from surgery. far larger and more multifaceted than a human mind “Again, ML can generate a more customized lens calcucan absorb,” he explains. “In this case, we taught the lation formula when we fine tune the dataset we use,” computer to make IOL power decisions by processing he explains, “emphasizing measurements from optical data from nearly 10,000 patients who underwent biometry and tomography to better model the postopcataract surgery at Kellogg.” That data set included erative evolution of the cornea.” key patient demographics plus eight different eye measurements.

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Yan Zhang, Ph.D., Shahzad Mian, M.D., Lev Prasov, M.D., Ph.D.

Editing Genes to Treat Corneal Dystrophies

initiative at the U-M Medical School Office of Research, was the perfect opportunity to develop this project.

The program empowers a team of U-M researchers (‘scouts’) to identify bold early-stage ideas and spark the needed connections across the medical campus to Gene editing therapy—making changes to the DNA of make them happen. cells to correct mutations—is a promising avenue to The idea caught the attention of ‘scout’ Ivo Dinov, treat inherited ocular defects and blinding disorders.

Ph.D., who introduced Drs. Prasov and Mian to Yan Much research is devoted to applying gene editing Zhang, Ph.D., a researcher in the Department of Biologito conditions of the retina. Yet, as ophthalmic genetical Chemistry. Dr. Zhang is an expert in developing and cist Lev Prasov, M.D., Ph.D., and cornea specialist applying CRISPR-based technologies to tackle diverse Shahzad Mian, M.D., note, far less attention has been biological challenges. paid to how gene editing might be With funding from a Research used to treat corneal dystrophies, Scouts grant, their collaboration IT’S A TESTAMENT TO WHAT’S which impact about one in 2,000 will focus on two types of genetiPOSSIBLE IN AN INSTITUTION Americans. cally linked corneal dystrophies THAT FOSTERS COLLABORATION “Corneal dystrophies are good both linked to disruption of the AND PRIORITIZES BOLD SCIENCE. therapeutic candidates for gene same protein (TGFBI): lattice and editing,” says Dr. Prasov. “Specific granular.

— Shahzad Mian, M.D. genetic mutations common to Mining data from electronic several dystrophies have already been identified. Moremedical records, Drs. Prasov and Mian will identify over, those genes have been shown to be amenable to Kellogg patients with those corneal dystrophies for manipulation with editing tools like CRISPR-Cas9 base genetic testing. Separately, they will use donor corneal editing.” tissue to test different methods of delivering a treatDr. Mian sees two promising paths for using gene ment into the cornea to modify the gene. Dr. Zhang will editing to treat inherited corneal dystrophies. The apply the latest CRISPR technology to design various first is early intervention. “This could prove a sightgene editing reagents, evaluating them first in corneal saving approach for a patient identified as carrying cell lines, then in corneal tissue samples to identify the a mutation whose disease has not yet progressed to reagent that produces the optimal editing change. a completely opaque cornea.”

They hope the project will generate enough data The second is treating dystrophies that recur in to apply for larger NIH and/or foundation funding. “We corneal grafts. “Recurrence is all too common in corneal could not have pursued this idea without Dr. Zhang, and transplants,” Dr. Mian says. “If we could ‘edit out’ the we would likely never have connected with her had it genetic culprit, it would save many patients from neednot been for the Scout program,” says Dr. Mian. “It’s ing multiple transplants.” a testament to what’s possible in an institution that The Research Scouts Program, a new funding fosters collaboration and prioritizes bold science.”

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WE BELIEVE IN THE

TRANSFORMATIVE POWER

OF RESEARCH, THAT’S WHY

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WE DO ALL WE CAN TO SUPPORT EVERY AMAZING PATIENT WHO STEPS UP TO PARTICIPATE IN A CLINICAL STUDY.

— Julie Rosenthal, M.D., M.S.

Julie Rosenthal, M.D., M.S., James Green, CCRP, Lianne Shami, B.S., Kevin Haynes

KCRC Assists in Michigan Medicine Research with Consequences for Eyes At Kellogg, research involving patients is coordinated through the Kellogg Clinical Research Center (KCRC).

The KCRC provides the staff, infrastructure and resources to see a clinical study from initial Institutional Review Board approval through final data reporting.

Since opening its doors in 2015, clinical research volume at the KCRC has grown to more than 360 active studies, including more than 300 investigator-initiated studies and 50+ sponsored studies.

Along with coordinating the hundreds of patient interactions and protocol details required for those projects, a special team within the KCRC assists researchers from other Michigan Medicine departments whose studies have potential consequences for eye health.

“Many treatments for cancers and other diseases have potential ocular side effects,” explains Julie Rosenthal, M.D., M.S. The Associate Medical Director of the KCRC, Dr. Rosenthal oversees the Collaborative Ophthalmic Research Support (CORS) unit. “The clinical trials that evaluate those medications have specific protocols for monitoring participants’ eyes. Our team coordinates all of those eye-related components.”

Along with Dr. Rosenthal, the CORS team includes KCRC Administrative Director James Green and Clinical Research Coordinators Kevin Haynes and Lianne Shami.

A CORS study protocol—which can exceed 100 pages— is first thoroughly reviewed and its eye-related components consolidated. A plan is developed, detailing the required testing, imaging and measurements, and identifying which Kellogg specialists are needed.

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With a plan in place, every patient interaction is managed through the ODS team to streamline the process for everyone involved.

“Without this centralized service, patients might be seen by Kellogg physicians without knowledge of the protocol, which could lead to incorrect or incomplete examinations and testing,” notes Dr. Rosenthal.

“This could jeopardize the viability of the studies of our Michigan Medicine research partners.”

“Most appointments begin with a workup at the KCRC, after which Kellogg doctors complete the examinations,” explains James Green.

“It’s quite a scheduling challenge,” adds Kevin Haynes. “We try to work with the patient’s existing study appointments, to minimize trips to the medical campus, and coordinate with the availability of the right Kellogg specialists for exams and imaging.”

Currently, the KCRC is providing support for more than 60 active CORS studies, coordinating with researchers in endocrinology, oncology, neurology, immunology, pediatrics and more.

“In a cancer drug trial, we may be monitoring for side effects like changes in vision or intraocular pressure,” Lianne Shami explains. “In studies of genetic syndromes, we may be watching for visible changes in the cornea, in the case of Wilson’s disease, or the development of tumors in Von Hippel-Lindau disease.”

A comprehensive resource like the KCRC is rare, even in the largest academic eye centers. Extending that same high level of support to researchers in other specialties is a testament to Kellogg’s commitment to cooperation in advancing in research while delivering outstanding patient care.

“We believe in the transformative power of research,” says Dr. Rosenthal, “That’s why we do all we can to support every amazing patient who steps up to participate in a clinical study.”

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WE ALSO NEED PATIENT

DATA TO BETTER UNDERSTAND THE MANY FACTORS THAT

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COULD EXPLAIN VARIATIONS IN TREATMENT RESPONSE, TO HELP US DESIGN NEW THERAPIES.

— Shilpa Kodati, M.B.B.S.

Shilpa Kodati, M.B.B.S.

Expanding Personalized Treatment and Clinical Research in Uveitis Uveitis refers to a group of diseases that can inflame and destroy tissue within the eye. Occurring in one or both eyes, suddenly or gradually, it can cause severe pain, redness and light sensitivity, blurred vision, and can lead to complications including glaucoma, cataracts, macular edema and impaired vision.

Uveitis is responsible for up to 30,000 new cases of legal blindness and roughly 10-15 percent of all cases of blindness in the U.S. each year.

Uveitis can occur at any age, but is more common in working age adults. It can result from infections, autoimmune diseases or injuries. Because uveitis can present in conjunction with systemic autoimmune diseases and other conditions that can drive treatment decisions, it requires a nuanced, patient-specific approach to care.

Kellogg has built a multidisciplinary team to deliver that care. The Uveitis Service is a referral hub for not only ophthalmologists, but primary care doctors, rheumatologists and dermatologists around the region to connect their patients with individualized care and the latest treatment options, including clinical trials.

The goal is to make Kellogg’s Uveitis Service a center of excellence in both clinical care and translational research.

The Uveitis Team The Uveitis team is anchored by specialists Therese Sassalos, M.D., Susan Elner, M.D. and Shilpa Kodati, M.B.B.S., who joined the service in 2023. Additional expertise is provided by April Marquardt, M.D., a rheumatologist with an interest in autoimmune eye diseases, cataract and uveitis specialist Zvi Kresch, M.D., who has expertise in complex uveitic cataract

surgery, and inherited eye disease expert Thiran Jayasundera, M.D. Colleagues in pediatric ophthalmology and cornea are also consulted as needed.

The team is supported by a dedicated nurse, Lori Sager, R.N., responsible for monitoring immunomodulatory therapies and providing patient counseling. The multidisciplinary approach at Kellogg allows the uveitis clinic to provide the highest levels of individualized patient care.

Uveitis Research Spearheading uveitis research is Dr. Kodati, who has been recognized as one of two investigators supported annually by Kellogg’s NIH Mentored Clinician Scientist Training Grant (K12).

To understand the mechanisms of uveitis, Dr. Kodati is studying the molecular and cellular pathways that drive the disease. She is also investigating immunogenetic risk factors, as well as the role of the gut microbiome.

“Using bio-specimens from uveitis patients is a necessary tool, since animal models of the disease, while useful, don’t represent the heterogeneity of uveitis in humans,” she explains. “We also need patient data to better understand the many factors that could explain variations in treatment response, to help us design new therapies.”

With support from the K12, Dr. Kodati is overseeing the development of a uveitis biorepository at Kellogg.

Recently granted IRB approval, work is underway to collect clinical data and bio-samples including peripheral blood and intraocular samples. Fecal samples will also be collected for microbiome analysis.

K12 Grant 17

An Out-of-This-World Perspective on Residency from one of Forbes’ Thirty-Under-Thirty

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Chances are no clinician reading this report has ever treated a patient with spaceflight associated neuroocular syndrome. Ophthalmology resident Joshua Ong, M.D., helped edit the textbook on it.

Raised in Columbus, Ohio, Dr. Ong’s introduction to space medicine was co-authoring a NASA grant to study the impact of space travel on human health as an undergraduate at The Ohio State University. It was there he conducted tissue engineering research into skeletal muscle loss in astronauts; research that was launched into space in 2019.

He has remained connected to space medicine ever since, through medical school at the University of Pittsburgh, to his PGY1 year in Internal Medicine at Michigan Medicine, and now his residency at Kellogg.

Ophthalmology and space medicine converge in the phenomenon known as spaceflight associated neuroocular syndrome (SANS), a condition observed only in astronauts who have undergone long-duration spaceflight. The clinical characteristics seen in SANS include optic disc edema, hyperopic refractive shift, posterior globe flattening, and choroidal folds. A serious occurrence in space travel, NASA considers SANS a significant barrier to future planetary space missions, such as traveling to Mars. Yet the pathophysiology and mechanisms surrounding SANS are not clearly understood.

In 2022, Dr. Ong served as associate editor of the first textbook on SANS, published by a global team of multidisciplinary experts. Dr. Ong also co-authored two chapters, including “An introduction to space medicine and the physiological effects of spaceflight on the human body.” The book is intended to serve as a reference for space medicine clinicians and researchers studying SANS to protect vision in astronauts.

“A condition unique to space travelers may seem like an niche topic of study,” notes Dr. Ong. “But as the range of science discussed in the book illustrates, SANS research may drive innovations to improve human health on Earth.”

Dr. Ong is collaborating on several of those innovations, including: Visual assessment technology and machine learning—New low mass, low footprint technologies may help optimize the assessment of astronauts’ vision in real time in the austere environment of space. Those same advances might also help overcome barriers to screening and early intervention in underserved communities.

I CAN’T IMAGINE A MORE SUPPORTIVE ENVIRONMENT FOR PURSUING

ONE’S OWN UNIQUE PATH IN VISION SCIENCE THEN KELLOGG. — Joshua Ong, M.D.

Wearable technology to address central vision distortion —Prolonged periods of microgravity may lead to macular disruption, diminishing central vision.

Particularly on extended planetary missions, this could threaten astronaut safety and mission performance.

Emerging head-mounted display technology can digitally suppress central visual distortion. This may prove a useful tool for improving vision in individuals on Earth with irreversible central vision loss from age-related macular degeneration.

For his work on the latter, Dr. Ong placed second at the 2022 NASA Human Research Program Investigators’ Workshop. He was also named one of Forbes’ “30 Under 30” in healthcare for his pioneering work.

Here at Kellogg, the focus of Dr. Ong’s residency is gaining experience in different ophthalmic subspecialties. But he is staying engaged in space medicine research. “I can’t imagine a more supportive environment for pursuing one’s own unique path in vision science then Kellogg.”

Molly Thorson, Ph.D.

Kellogg Post-Doc Receives Prestigious NIH Grant Molly Thorson, Ph.D., a postdoctoral fellow at Kellogg, have much to learn about how it’s built and maintained has received a Ruth L. Kirschstein National Research through the life of the cell.”

Service Award (NRSA), or F32, from the National InstiThe outer segment is constructed of stacks of tutes of Health (NIH)/National Eye Institute (NEI). Dr. flattened membranous disks. Using a mouse model, Thorson has been part of the lab of investigator Jillian Dr. Thorson has identified several proteins involved in Pearring, Ph.D., since 2020, focusing on retinal cell that specialized architecture. Her work will provide a biology. more detailed blueprint of how This fellowship provides those proteins form the disk THIS AWARD IS REALLY A TESTAMENT postdoctoral scientists with architecture in a healthy cell, TO KELLOGG’S COMMITMENT TO AND three years of funding for laying the foundation for studLEADERSHIP IN BASIC SCIENCE EYE research and professional ies of how changes in specific development to maximize their proteins might alter the architecRESEARCH. IT’S A WIN FOR US ALL. potential for success as investure, possibly contributing — Molly Thorson, Ph.D. tigators in their chosen health to retinal degeneration. specialty.

The F32 award recognizes The F32 is among the most highly sought after not only the potential impact of Dr. Thorson’s work, but government awards in academic medicine. By some the depth and breadth of resources and support availestimates, as few as 500 to 700 individuals across all able at Kellogg. “In addition to a rigorous evaluation of NIH medical specialties receive support from an F32 my proposed research, the reviewers considered the fellowship each year. The NEI awards only 14 to 16 F32 many ways Kellogg makes projects like mine possible,” grants each year.

Dr. Thorson says. That includes the impressive track The projects funded by Dr. Thorson’s F32 involve record of Dr. Pearring and her lab, and the training, the study of the outer segment of rod photoreceptors research cores and data analysis capabilities available within retinal cells. here.

“The outer segment is highly organized to maxi“This award is really a testament to Kellogg’s mize light capture,” she explains. “It’s within that tiny commitment to and leadership in basic science eye architectural marvel that vision originates, yet we still research,” she adds. “It’s a win for us all.”

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Alejandra Maiz, M.D.

Kellogg PGY4 Sole Resident on ACGME Residency Program Review Committee In addition to the unending ‘to do list’ of a resident, Association and the American Osteopathic Association, PGY4 Alejandra Maiz, M.D., is finding time to ensure as well as one public member and one resident memthe high quality of ophthalmic training across the U.S. ber. Dr. Maiz was nominated during her post-graduate Dr. Maiz was selected to serve a two-year term year two (PGY2) of training by Kellogg Residency Proon the Ophthalmology Residency Program Review Comgram Director Bradford Tannen, M.D., J.D. mittee of the Accreditation Council for Graduate Medical “I was honored to be selected,” says Dr. Maiz, “and Education (ACGME). The ACGME sets and monitors it’s so gratifying that, as the sole voice for all residents, compliance with standards the committee listens and values for graduate medical training, my opinion.”

THE OPPORTUNITY TO INTERACT WITH ensuring that learners are “It has proved to be one of FACULTY FROM ACROSS THE COUNTRY prepared to deliver highthe most rewarding aspects of HAS GIVEN ME AN INVALUABLE quality, patient-focused care. my residency,” she continues.

Program Review Com“The opportunity to interact with PERSPECTIVE ON THE FIELD. mittees for each major medifaculty from across the coun— Alejandra Maiz, M.D. cal specialty are tasked with try has given me an invaluable setting residency education perspective on the field. It’s also and training standards that reflect the best practices in reinforced to me what exceptional residency training we their field. They also monitor programs for compliance, receive at Kellogg.” fielding surveys, conducting site visits, collecting and The experience has also shown Dr. Maiz how much analyzing data, and providing actionable feedback. work goes into managing a residency program. In The committee is comprised of representatives spite of that, she wants to remain involved in residency from the American Board of Ophthalmology, the Amerieducation going forward. “Among my career goals,” she can Academy of Ophthalmology, the American Medical says, “I hope to be a residency program coordinator.”

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Tyler Carman, B.S.

Pre-Med Awarded NIH Research Supplement In May 2023, Tyler Carman earned a B.S. in neurosciResearch Supplements to Promote Diversity in Healthence from the University of Michigan. The first college Related Research program, Tyler will complete two graduate in his family, Tyler plans to pursue an M.D. or years of post-baccalaureate training with the team.

M.D./Ph.D. But before taking that next step, he’s making His primary focus will be studying a protein-to-protein the most of an opportunity to continue learning—and interaction within the noncanonical Polycomb Represcontributing— in the lab of Kellogg physician-scientist sive Complex 1.6. “The theory is that the members of Rajesh Rao, M.D. this complex work together to close The Rao translational off parts of the chromatin to THE THEORY IS THAT THE MEMBERS OF research lab focuses on ensure cells become their speciTHIS COMPLEX WORK TOGETHER TO the epigenetics of retinal fied type during development,” CLOSE OFF PARTS OF THE CHROMATIN development and disease he explains. “Within our organoid to identify new biomarkers, model, they are fated to become TO ENSURE CELLS BECOME THEIR therapeutic targets and SPECIFIED TYPE DURING DEVELOPMENT, retinal cells.” applications of stem cells Tyler credits Dr. Rao with WITHIN OUR ORGANOID MODEL, THEY for blinding diseases. inspiring him to pursue a career ARE FATED TO BECOME RETINAL CELLS. Tyler began assisting in as a physician-scientist. “Dr. Rao the lab as an undergraduate, is incredibly supportive of every— Tyler Carman, B.S. working with the retinal one in his lab, which has been organoid model under the direction of resident amazing to experience as an undergrad,” he says.

Dan Balikov, M.D., Ph.D., and graduate student Brian A highlight of his time with the team was observing Basinski, B.S. His assignments included supporting Dr. Rao perform a human RPE stem cell transplant as studies of retinal organoid vascularization with Dr. part of a first-of-its-kind Phase 1/2a clinical trial for the Balikov and the molecular drivers of North Carolina treatment of dry AMD. macular dystrophy, a rare congenital blinding disease, “What an opportunity,” Tyler recalls. “A big milewith Mr. Basinski. stone for me — observing my first eye surgery—also Tyler is already a recipient of NIH funding at this happened to be a significant scientific milestone.” early stage of his career—with support from the NIH

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Otana Jakpor, M.D., M.Sc.

2023-2024 Heed Fellows FOUR KELLOGG TRAINEES WERE APPOINTED TO THE PRESTIGIOUS 2023-2024 CLASS OF THE SOCIETY OF HEED FELLOWS, OUT OF A TOTAL OF 24 FELLOWS NATIONWIDE. NEW MEMBERS OF THE SOCIETY RECEIVE A MERIT AWARD FOR POSTGRADUATE STUDIES IN OPHTHALMOLOGY. Otana Jakpor, M.D., M.Sc., who has also been named a Global Ophthalmology Fellow at Kellogg for the 20232024 academic year, plans to apply her award to an upcoming study of factors associated with the incidence of cataracts in pediatric patients in the African nation of Ghana.

She is developing the research project in collaboration with colleagues at the Korle-Bu Teaching Hospital (KBTH) in Accra, Ghana.

“Pediatric cataracts can result from a number of factors, including genetics, metabolic conditions, infections and trauma,” she explains. “The pediatric ophthalmologists at KBTH want a deeper understanding of which of these causes are most strongly associated with cataract development in their patient population, and the role each may play in determining patient outcomes.”

Dr. Jakpor hopes to augment that analysis by assessing the impact of pediatric cataracts on quality of life, in both patients and their caregivers. “We would like to highlight the importance of addressing pediatric cataracts, not only for children’s physical health, but also for their overall well-being,” she says.

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Olivia Killeen, M.D., M.S.

Young children don’t know if they have vision problems.

That’s why pediatricians and primary care providers should make vision screening a standard component of every preschooler’s annual check-up.

Yearly vision testing is critical at ages three, four and five, and incrementally after that, flagging any abnormalities for referral to an ophthalmologist. Failure to do so could mean missing the development of conditions like amblyopia which can result in permanent vision loss.

Former Kellogg ophthalmology resident Olivia Killeen, M.D., M.S., A Research Fellow in the National Clinical Scholars Program, dedicates her research to improving vision health and eliminating avoidable blindness by addressing barriers to eye care and strengthening the delivery of ophthalmic services. For a snapshot of the real-world challenges of pediatric vision screening, Dr. Killeen piloted a study within the U-M Health System, combining a medical records review and interviews with providers at 17 clinics.

Screening rates did vary from clinic to clinic. Interviews revealed instances where high screening levels were linked to devoting resources to improved equipment, and where lower screening levels could be connected with Covid-19-associated staffing shortages.

In summer 2023, Dr. Killeen began a one-year pediatric ophthalmology fellowship at Duke University.

Before departing Kellogg, she was named a 2023/2024 Heed Fellow.

She plans to apply her Heed award to replicating the U-M study at Duke. “Learning from an additional site will test my theory that the issues we identified are not unique to Michigan,” she says, “but rather, signposts that point to a national public health issue.”

Rithambara Ramachandran, M.D

2023-2024 Heed Fellows While completing the second, research-focused year of a two-year glaucoma clinical research fellowship, Rithambara Ramachandran, M.D., is pursuing innovative ways to improve detection and outcomes for glaucoma patients, particularly those with socioeconomic barriers to screening and care.

“Unfortunately glaucoma is largely an asymptomatic disease,” she explains. “And nearly seven in ten patients don’t even know they have it. We need to be able to identify individuals before symptoms have developed and the disease has progressed to the point where they face irreversible blindness.”

Dr. Ramachandran’s research, which she is conducting while earning an M.S. in healthcare research at U-M, focuses on how to bring screening and diagnosis to at-risk populations earlier, before they present with late stage disease.

Through community-based participatory research, big data analysis, and implementation science, she is focusing on identifying the best tools, technologies and methodologies to improve access to eyecare screening, address disparities in eye disease screening, and diagnose and overcome eyecare barriers.

“My long term goal is to design, validate and implement a glaucoma screening program for high-risk communities that is clinically sound, scalable, cost effective and equitable.”

Tania Padilla Conde, M.D.

Tania Padilla Conde, M.D., a fellow in cornea and external disease, is involved in a number of initiatives to improve access to eye health care —specifically, cornea transplantation—in low resource populations in the U.S. and abroad.

The eldest daughter in a single parent Hispanic household, Dr. Padilla Conde grew up in a community with limited healthcare options. “That firsthand experience fuels my passion to improve vision care and treatment outcomes in underserved communities,” she explains.

Dr. Padilla Conde will apply her Heed Fellow award to an upcoming project in collaboration with colleagues at Eversight, a global nonprofit eye bank. “We are working to improve the delivery of preloaded Descemet Membrane Endothelial Keratoplasty (DMEK) tissue abroad, by validating a novel transport cartridge,” she says. “Our study will improve storage and shipping conditions to minimize endothelial cell loss, a very important marker to ensure these countries receive quality tissue for corneal transplantation.”

She is also conducting a study of refractive outcomes for DMEK triple procedures using a novel approach developed by her mentor, cornea specialist Nambi Nallasamy, M.D. The technique, which employs machine learning technology, aims to improve both preoperative planning and post-operative outcomes.

Dr. Padilla Conde is thankful for the Heed fellowship and hopes to focus her future work on helping advance novel techniques for corneal transplantation, including alternative approaches to endothelial cell replacement.

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David Antonetti, Ph.D., Shahzad Mian, M.D., David Zacks, M.D., Ph.D., Patrice Fort, Ph.D., M.S.

Institutional Grants Anchor Research Infrastructure, Training

The P30 center grant funds state-of-the-science instrumentation, services and training for vision researchers to connect and pursue cutting edge ideas.

The center has research cores, each supervised by faculty and staffed by technical experts:

Functional Assessment—This core, directed by P30 Kellogg researchers are among the most productive, Principal Investigator David Antonetti, Ph.D., provides grant-supported, published and cited in all of ophthaltraining and support to investigators performing nonmology. How do we attract and retain the best and the lethal measures of ocular structure and function, includbrightest? With a structure and culture that fosters ining optical coherence tomography, electroretinography, novation and collaboration. fundus imaging, and pupillometry.

“Our research program is designed to be both a magnet for the most creative minds, and an incubator Instrument and Electronics— for their most original ideas,” says Directed by James Weiland, Ph.D., OUR RESEARCH PROGRAM IS Kellogg Interim Chair Shahzad Mian, this core provides and maintains M.D. “We’re continuously improvDESIGNED TO BE BOTH A MAGNET specialized instrumentation — ing the fundamentals— our mix of FOR THE MOST CREATIVE MINDS, both commercially available and technologies and resources, training custom built—for use by NEIAND AN INCUBATOR FOR THEIR and support—to meet the changing funded investigators.

MOST ORIGINAL IDEAS. needs of researchers from dozens Molecular Biology— directed by of specialties, pursuing hundreds of — Shahzad Mian, M.D. Steven Abcouwer, Ph.D., this core lines of investigation.” offers services, equipment and support for projects Kellogg’s research enterprise is anchored by four involving molecular biology, statistical genetics, and interconnected institutional grants, supporting basic, bioinformatics. clinical and translational investigators at every career stage. All four grants were renewed this fiscal year, and a new core facility was added.

National Institutes of Health (NIH) / National Eye Institute (NEI) University of Michigan Vision Research Center (UMVRC) Grant (P30) The University of Michigan holds one of the longest standing P30 Center Grants in ophthalmology and visual sciences. Center grants provide resources and facilities for core services shared by researchers across the University that carry out vision research.

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“

“

Morphology and Imaging— this core, directed by Jillian Pearring, Ph.D., processes ocular and brain tissue samples for light microscopy, immunocytochemistry and in situ hybridization, and fixes specimens for electron microscopy. Assistance in analysis and presentation of imaging results is also available, and the core is a hub for training investigators in tissue processing, microtomy, staining and immunohistology techniques.

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FOLLOWING FAIR STANDARDS GUARANTEE THAT OUR DATA

IS OF THE HIGHEST QUALITY,

“

AND THAT IT IS GATHERED AND ANALYZED IN WAYS

THAT CAN BE SHARED AND REPRODUCED BY OTHERS. — Maria Woodward, M.D., M.S.

Maria Woodward, M.D., M.S., Chris Andrews, Ph.D., David Musch, Ph.D., M.P.H.

New Data Integrity Core—The renewal of Kellogg’s P30 grant coincides with the establishment of a fifth research core, dedicated to protecting Data Integrity from study design through publishing of findings. The addition of this core reflects the importance of protecting the reliability of the data generated in the course of research studies, as well as the methodologies and strategies used to analyze that data.

Launched by co-directors Maria Woodward, M.D., M.S., and David Musch, Ph.D., M.P.H., the core welcomed co-director Patrice Hicks, Ph.D., M.P.H. in 2024. The core is supported by senior biostatistician Chris Andrews, Ph.D., and biostatistician Amy (Ming-Chen) Lu, M.S. “Central to our mission is ensuring that Kellogg researchers are trained in and adhere to NIH FAIR principles– findability, accessibility, interoperability and reusability,” explains Dr. Woodward. “Following FAIR standards guarantee that our data is of the highest quality, and that it is gathered and analyzed in ways that can be shared and reproduced by others.”

As more researchers collaborate over open access platforms, the ability to reproduce and publicly share code is key. Experts in the data integrity core advise eye researchers on how to plan and monitor the use of datasets, algorithms, tools and pipelines (DATP), the building blocks of code sharing and duplication.

The team goes beyond reviewing a proposed statistical approach, offering independent, expert input to critique the feasibility of a study’s aims and hypotheses.

“There may be more than way to go about answering a question,” says Dr. Woodward. “This additional step ensures that diverse viewpoints have been considered.”

NIH/NEI Training Grant (K12)

One of only six U.S. ophthalmology programs to hold a K12, Kellogg was first awarded the grant in 2013.

The K12 funds the Michigan Vision Clinician-Scientist Development Program, which provides mentored training for ophthalmologists interested in developing research programs in tandem with their clinical practice.

Directed by Principal Investigator David Zacks, Ph.D., the K12 provides protected research time, core instruction and skill building for up to two scholars at a time, each for up to three years.

NIH/NEI Vision Research Training Program Grant (T32)

Under the supervision of Principal Investigator Patrice Fort, Ph.D., M.S., and Associate Director Sara Aton, Ph.D., this training grant supports graduate students and postdoctoral fellows launching careers in vision science. Primarily focused on basic and translational research tracks, it supports a diverse group of trainees in the completion of their theses or the development of research projects geared to help them progress towards independent positions. By providing extensive visioncentric education, mentoring and professional development, the T32 aims to train the next generation of vision science researchers.

Kellogg has held a T32 grant for more than 20 years.

Research to Prevent Blindness (RPB) Unrestricted Grant

This institutional grant provides maximum flexibility to develop and expand eye research programs in new and creative ways. Kellogg’s RPB grant, which automatically renewed for five years at the end of 2022, is overseen by Dr. Mian.

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“

IF WE CAN SEE MOLECULAR CHANGES WHILE THEY

ARE HAPPENING, INSTEAD OF JUST SEEING AN

“

EYE BLEED, WE CAN

RESPOND WITH THE RIGHT THERAPY IN TIME TO PRESERVE VISION. — Yannis Paulus, M.D.

Yannis Paulus, M.D.

Molecular Imaging of Macular Degeneration The development of new blood vessels underneath the retina— choroidal neovascularization—is the primary cause of vision loss in patients with several diseases including age-related macular degeneration (AMD).

Over time, AMD can progress from its dry form to the more advanced wet form. It is at this point that choroidal neovascularization does most of its damage. All too often, the diagnosis comes late, after a patient notices significant vision loss and has retinal bleeding. By that time, the effectiveness of the current standard treatment— intravitreal injections of anti-vascular endothelial growth factor (anti-VEGF)— can be limited.

With support of an NIH-R01 grant, retinal surgeon and biomedical engineering researcher Yannis Paulus, M.D., is developing a new molecular imaging platform with the potential to revolutionize the early diagnosis and treatment monitoring of AMD. Dr. Paulus’ new imaging system marries one established modality with two next-gen advances:

R01 Grant 26

Light — Optical Coherence Tomography (OCT), the standard non-invasive retinal imaging technology, creates cross-sectional images of the retina using light waves.

Sound—Low-energy Photoacoustic Microscopy uses nanosecond-duration laser pulses of light and captures the resulting sound from tissue. “Like thunder accompanying lightning,” he says.

Fluorescence—Dr. Paulus is also refining a new nanoparticle contrast agent to detect levels of VEGF in tissue more accurately and safely.

The eventual clinical goal: predicting which patient will benefit from a given treatment and which will not.

Another promising benefit: fine-tuning how often patients need treatment.

“Today’s anti-VEGF injections are not easy for patients, so we attempt to extend the time interval between treatments,” Dr. Paulus explains. “But that can be risky. Sometimes a change of just a week can lead to vision loss. If we can see molecular changes while they are happening, instead of just seeing an eye bleed, we can respond with the right therapy in time to preserve vision.”

Dr. Paulus’ new imaging system holds the promise of changing the AMD paradigm—accelerating the development of new treatments, facilitating earlier diagnosis, and making possible more individualized, personalized therapies and treatment planning.

Alumni Highlights

Optical Science (CUOS) at U-M, working on the femtosecond laser. Removing his safety goggles prematurely, Dr. Du suffered an eye injury. He had the eye examined Ron Kurtz, M.D., was part at Kellogg by Dr. Kurtz, who had just completed his first of a team that received year of residency. the Golden Goose Award Curious about a laser that etched such a precise from the American pattern on the retina, Dr. Kurtz visited the CUOS to learn Association for the more. A research collaboration developed, beginning Advancement of Science with Drs. Kurtz, Mourou and Du (who suffered no lasting in September 2022. effects from the injury), and eventually expanding to The award recognizes include Dr. Juhasz, who was concurrently researching scientists whose unsung, laser vision correction, and Dr. Strickland, co-developer federally-funded research of the femtosecond laser with Dr. Mourou (for which has led to breakthroughs they share the 2018 Nobel Prize in physics). of significant societal benefit.

Dr. Kurtz is reluctant to take credit for a ‘lightbulb Dr. Kurtz, who completed his ophthalmology resimoment’ that led to Femtosecond LASIK. “As a residency at Kellogg in 1994 and returned as an assistant dent, one of my first thoughts was that laser safety professor from 1995 to 2000, shares the award with might make a good topic for a grand rounds presentafour other investigators: U-M engineering alum Detao tion,” he recalls. “The CUOS was already exploring mulDu, Ph.D.; Tibor Juhasz, Ph.D., a tiple uses for the laser, including KELLOGG HAS ALWAYS PROVIDED former U-M research associate medical applications. I helped professor in ophthalmology and them see the possibilities for eye THE HIGHEST LEVEL OF CLINICAL biomedical engineering; Gérard surgery.”

INSTRUCTION AND EXPERIENCE, Mourou, M.Sc., Ph.D., the A.D. The trajectory of Dr. Kurtz’s INCLUDING PRIORITIZING RESEARCH Moore Distinguished University Procareer has evolved since his time AS PART OF A WELL-ROUNDED fessor Emeritus at U-M; and Donna at Kellogg, where his faculty Strickland, Ph.D., a professor at the appointment was in vitreoretinal CLINICAL EDUCATION. University of Waterloo in Ontario, diseases. Today, he is President — Ron Kurtz, M.D. Canada. and C.E.O. of California-based Together, this team developed Femtosecond LASIK, RxSight®, an ophthalmic medical technology corporaa vision correction procedure that employs a femtosection that has commercialized the world’s first and only ond (quadrillionth of a second) pulsing laser, rather than adjustable intraocular lens (IOL) that is customizable a scalpel, to help reshape the cornea. Since its launch in after cataract surgery.

2001, Femtosecond LASIK has revolutionized refractive “Kellogg has always provided the highest level of surgery, improving the vision of more than 30 million clinical instruction and experience, including prioritizing people. research as part of a well-rounded clinical education,” Femtosecond LASIK’s origin story is as extraordihe says. “I am no longer a practicing clinician, but I connary as the technology itself. In the early 1990s, tinue to draw on what I learned as a resident. In fact, Dr. Du was a graduate student in Dr. Mourou’s lab in the most of the front-of-eye clinical experience so essential National Science Foundation-funded Center for Ultrafast to my work today I gained at Kellogg.”

“

“

Lecture in Professionalism and Ethics Paul Lichter, M.D., M.S., past Chair and current Professor Emeritus of Ophthalmology and Visual Sciences, was invited to give the Allan and Claire Jensen, M.D., Lecture in Professionalism and Ethics at the 2023 Annual Meeting of the American Academy of Ophthalmology. The lecture was created in 2015 as a platform for a recognized ophthalmologist or member of the medical or bioethics community with demonstrated knowledge of ethical issues and professionalism to address these complex topics in an accessible and relevant format.

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Microneedles for Sustained Retinal Drug Delivery

Anna Momont, M.D., with trainee, Georges Guillaume, M.D.

Alumni Highlights Anna Momont, M.D., Associate Professor in the Department of Ophthalmology and Visual Sciences at the University of Wisconsin School of Medicine and Public Health, became Residency Program Director on July 1, 2023.

Dr. Momont, who previously served as the Associate Program Director, has been working to improve team morale and connectedness as the Resident Wellness Director. She has also led initiatives to increase the ophthalmology resident class from three to four trainees per year, and to recruit candidates that are underrepresented in medicine. In addition, Dr. Momont serves as the faculty lead for a free eye clinic that serves uninsured individuals in her community.

A glaucoma specialist, Dr. Momont completed both her residency and a glaucoma fellowship at Kellogg, including serving as Chief Resident in Ophthalmology.

“At Kellogg, my Residency Program Director was Dr. Mian,” she recalls, “so I learned from the very best. I knew that if I was fortunate enough to work in academic medicine, I wanted to be involved in residency training.”

Also an active member of Women in Ophthalmology, Dr. Momont will chair the group’s national meeting, the Summer Symposium, in Carlsbad, CA in 2024.

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For blinding eye diseases like macular degeneration and diabetic retinopathy, regular drug injections into the eye are the current standard of care. Translational investigators like Yannis Paulus, M.D., are developing alternative ways to administer treatments that are more effective, longer lasting, and less distressing for the patient.

His latest collaboration is with Roland Chen, Ph.D., a fellow pioneer in the development of miniaturized platforms for sustained, localized ocular drug delivery.

An expert in biomaterials and biotransport engineering, Dr. Chen, an adjunct faculty member at Kellogg, is an Associate Professor at Washington State University.

Separately, Dr. Paulus developed and continues to test a method to deliver treatment via an array of nanoneedles on a dissolvable contact lens. After delivering their medication, they dissolve. “The nanoneedle platform is a very promising option,” says Dr. Paulus, “but because diverse patients and diseases may respond better to different drug concentrations and penetrations, we need a variety of tools in our toolbox.”

Dr. Chen and Dr. Paulus are developing an alternative that utilizes an array of somewhat larger microneedles.

“The advantage of microneedles is that they can carry larger loads of medicine,” Dr. Paulus explains.

“However, they can be too large to dissolve, so another method is needed to attach and remove them. Dr. Chen’s novel solution is to use light.”

Dr. Chen has designed a light-responsive microneedle which swells when exposed to light of a certain wavelength, binding and locking it in place. Shining light of a different wavelength on the microneedles reduces the swelling, allowing them to be removed.

They have received a Peer Reviewed Medical Research Program Expansion Award— Funding Level 3 grant from the U.S. Department of Defense to develop and evaluate their new platform. Studies in their laboratories will validate the technology’s effectiveness, reliability, durability, and safety, and compare the treatment outcomes achieved with the platform’s sustained drug delivery to those of regular intravitreal injections.

“

IT’S ABOUT LEARNING FROM

EACH OTHER’S EXPERIENCES,

“

AND CELEBRATING WINS, BIG AND SMALL. IT’S A POSITIVE

WAY TO ENCOURAGE EVERYONE TO SPEAK UP FOR SAFETY. — Jennifer Weizer, M.D.

Beth Hansemann, B.S., COT, and Jennifer Weizer, M.D.

Applauding a Good Catch When it comes to ensure patient safety, flagging and addressing even the smallest concern can make a big difference. Making time to celebrate those ‘good catches’ helps build a culture that values respect, communication and teamwork.

In 2023, Kellogg’s Patient Safety Committee, led by Jennifer Weizer, M.D., initiated a High Reliability Award Program to recognize and reward staff members who take action to improve quality and safety.

The goal is to increase awareness and application of two Michigan Medicine human resource initiatives: Universal Relationship Skills and Universal Reliability Tools and Skills.

“Like all Health System employees, Kellogg faculty and staff receive training in constructive, respectful workplace communication and strategies to identify potential safety concerns before they lead to harm,” Dr. Weizer explains. “Our monthly High Reliability

Awards reinforce that training and encourage everyone to speak up for safety.”

Each time faculty or staff notice a colleague taking a proactive step for safety, they are encouraged to nominate that person for the month’s award. A random drawing each month rewards one nominee and one nominator with a prize for each—a $25 gift card from Zingerman’s, a legendary Ann Arbor culinary destination. A center-wide email announces the winners and showcases all the month’s submissions.

A wide variety of ‘good catches’ and high reliability skills have been highlighted since the program launched. Respectfully questioning a surgical or medication instruction, confirming transcriptions of measurements to ensure there are no errors, and checking the readiness of equipment, materials or work areas have all resulted in recognition and in some cases, timely corrections.

“The contest has been very well-received,” says Dr. Weizer. “It’s about learning from each other’s experiences, and celebrating wins, big and small. It’s a positive way to encourage everyone to speak up for safety.”

CELEBRATING KELLOGG'S ANNUAL FALL REUNION WEEKEND

Dr. Jonathan Trobe speaking with alumna presenter Melisa Nika, M.D.

Dr. Michael Petersen, resident class 1990

Dr. Richard Garfinkel, resident class 1990 29

Beyond the Electronic Health Record Combining the powerful number crunching capabilities of Big Data analytics with the information held in patient electronic health records (EHRs) has revolutionized health research. Investigators can now combine vast amounts of patient information and, using tools like machine learning, analyze the data to answer important questions about diseases, risk factors and treatment outcomes.

At the forefront of applying this approach to the study of ophthalmic diseases is Joshua Stein, M.D., M.S. A glaucoma specialist and health services researcher, Dr. Stein is Principal Investigator and Chief Data Officer of the Sight Outcomes Research Collaborative (SOURCE), a consortium of 14 leading academic ophthalmology departments that pool EHR and other ocular diagnostic data (removing protected health information) into a common research database housed at U-M. The SOURCE platform is utilized in two of Dr. Stein’s latest initiatives. Both aim to improve the quality of research into the most common vision-threatening diseases, and both are supported by NIH R01 grants.

R01 Grant 30

Improving Disease Identification To leverage the power of exciting tools such as machine learning and artificial intelligence (AI) to come up with new ways to improve the quality of eye care, enhance patient outcomes, and reduce disparities in care, it is essential to train these models using high quality data.

When researchers build these sophisticated models, if enough patients are misclassified as affected by a given ocular disease when indeed they do not have that condition, or vice versa, this can negatively affect the performance and usefulness of these models.

One way that a patient may be misclassified as having or not having an ocular disease is when researchers rely on administrative billing codes entered by clinicians during office visits to determine which patients are and are not affected by diseases of interest. Relying solely on billing codes to tell which patients have and do not have particular eye diseases poses a number of problems: certain eye diseases lack unique billing codes; some billing codes are not specific enough to distinguish between different conditions; and occasionally clinicians pick incorrect billing codes.

To address these problems, Dr. Stein and his team have developed a sophisticated approach that goes well beyond sole reliance on administrative billing codes. They incorporate information from multiple areas of the electronic health record to more accurately identify which patients have common sight-threatening

diseases such as glaucoma, diabetic retinopathy, and age-related macular degeneration. For patients who have these conditions, Dr. Stein’s team can accurately determine the type and severity of the condition, which eye or eyes are affected, and whether the condition is stable, improving, or getting worse.

Just because an eye disease is common does not mean every patient experiences it in the same way.

Similarly, different eye care professionals in different settings may document the same signs and symptoms of a condition differently in the electronic health record.

These factors make it very difficult to use electronic health records to build models that can accurately predict the likelihood of a patient having a particular condition. To overcome some of these challenges, Dr. Stein’s team uses tools such as natural language processing to dive deeper into the electronic health record to locate additional relevant details from the clinic visit.

As Dr. Stein explains, “for each of the four million patients in our SOURCE Ophthalmology Big Data repository, we are able to assign a probability from 0 to 100 percent as to whether they have glaucoma, diabetic retinopathy, or macular degeneration. With accurate classifications for these patients, researchers can integrate this information into the AI models they are building to predict, among other things, which patients are most likely to experience favorable or unfavorable outcomes.” Other applications of this enhanced disease identification approach include incorporating the predictions into studies of the epidemiology of these different eye diseases, using them to determine if disparities in care exist for patients of different sociodemographic characteristics, and helping identify patients who may be eligible for randomized clinical trials of new therapeutic interventions for these conditions.

Health Disparities in Utilization, Quality and Outcomes (HealthDOC) Dr. Stein and his team, in collaboration with researchers at Northwestern University, have also been leveraging the Sight Outcomes Research Collaborative (SOURCE) Ophthalmology Big Data Repository to study disparities and inequities in the receipt of eye care services and outcomes of eye care among racial and ethnicity minorities and other vulnerable groups. The main objective of this NIH-funded research is to determine the extent to which social determinants of health may affect quality of eye care and outcomes for patients with common sight-threatening eye diseases such as cataract, glaucoma, and diabetic retinopathy.

An innovative aspect of this project is the linking of clinical data from the electronic records of eye care recipients in SOURCE to other large pots of data.

This linking provides Dr. Stein and his team a more holistic view of patients and the array of factors that may affect their care quality and outcomes. For example, by incorporating information on race, ethnicity, level of education, marital status, income, household net worth, type of health insurance, primary language and even the number of family members living in the household, the team can see how these factors may be impacting the eye care patients are receiving.

“The first step in reducing or eliminating long standing inequities in eyecare that contribute to poorer outcomes among vulnerable populations is to identify the underlying factors that are most responsible,” explains Dr. Stein. “Once we can identify such factors, especially those which are modifiable, we can develop strategies to improve care quality and outcomes for these patients.”

Mining Big Data for Novel Glaucoma Genes Glaucoma and data analytics specialist Joshua Stein, M.D., M.S., and ocular geneticist Lev Prasov, M.D., Ph.D. share a 2023 Dr. David L. Epstein Award from the Association for Research in Vision and Ophthalmology (ARVO) Foundation for Eye Research.

The award recognizes a senior investigator distinguished in both glaucoma research and scientific mentorship (the mentor, Dr. Stein), and an early-career investigator (the mentee, Dr. Prasov), and is designated for a collaborative project between the two.

Drs. Prasov and Stein will partner on a proposal that combines Big Data analytics with familial studies to define novel glaucoma genes.

The origins of the project date back several years.

“Dr. Stein and I first became acquainted with a family of patients with glaucoma when I was still a medical student,” Dr. Prasov recalls. “About a dozen family members suffered from normal tension glaucoma that responded poorly to traditional therapies to lower interocular pressure (IOP).” To better characterize their disease and look for a genetic root cause, whole genome and exome sequencing was performed on that group, and about 50 extended family members underwent eye examinations and deep phenotyping.

Those analyses yielded a promising lead on a genetic mutation. But proving a gene/disease association is a high bar; more work is needed to characterize the mutation, and identify the same mutation and disease profile in other patients and families. This award will help fund those crucial next steps.

“More lab studies will validate the mutation and document its functional effects,” explains Dr. Prasov.

“Along with data from the initial family, we now have data from a second family.” William Pressley II, a Ph.D.

candidate in genetics and genomics in the Prasov lab, will spearhead this component.

To hunt for ‘the ‘needle in a haystack,’ Dr. Stein and Dr Prasov will use Big Data analytics to sift through highly detailed information from a large cohort of glaucoma patients, Joshua Stein, M.D., M.S., Lev Prasov, M.D., Ph.D. including, but not limited to Kellogg patients.

Their haystack: the Sight Outcomes Research Collaborative, or SOURCE, a database of information collected by a consortium of U.S. academic ophthalmology programs for use in members’ research. Dr. Stein is Principal Investigator and Chief Data Officer of SOURCE, which is housed at U-M. Drs. Stein and Prasov will flag patients with the same type of glaucoma, whose diseases are also unresponsive to IOP-lowering therapy. They will look at disease characteristics that track with those seen in the families, factors like corneal thickness and stiffness, and a particular pattern of visual field loss.

The group identified will provide DNA samples for gene sequencing, looking for the suspected mutation and any risk factors associated with it or other genes.

The goal is to establish whether one or more genetic mutations are the root cause of this type of glaucoma, and whether other factors shared by these patients distinguish them from other people with glaucoma.

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R01 Grant

Protecting Retinal Neurons from Diabetes Diabetic retinopathy (DR) is a common and sightthreatening disease driven largely by tissue inflammation and deterioration of the nerve cells of the retina.

While therapies like anti-VEGF injections can help slow the damage in the later stages of DR, new strategies are needed to intervene earlier in the disease process, protecting the retina before irreparable harm is done.

Biomedical researcher Patrice Fort, Ph.D., M.S., has been at the forefront of investigating targets for retinal neuroprotection. For more than a decade, the Fort lab at Kellogg has pursued the potentially protective role of the protein αA-crystallin.

First described in the lens, Dr. Fort’s team has also demonstrated that αA-crystallin/HspB4 plays a protective role in the retina, guarding neurons from the stressors associated with diabetes. They have also shown that one way this protein protects is by changing the environment that promotes inflammation. However, their studies have also demonstrated that, over time, diabetes weakens those protective effects.

“We believe that a specific modification of the protein — called phosphorylation—is key to αA-crystallin’s ability to protect retinal neurons and modulate inflammation,” explains Dr. Fort. “But the mechanisms regulating this process are unknown.”

Dr. Fort has been awarded an NIH R01 grant to close that knowledge gap.

His project has two aims. The first is to identify the key proteins that regulate the phosphorylation of αA-crystallin and describe how they work. The second is to apply the findings from previous studies to demonstrate the potential of using this protective mechanism as a novel treatment option for diabetes complication.

“Using retina cells in culture, we’ve shown that an enhanced form of αA-crystallin is highly protective,” he explains. “The next step is to find out whether it can protect the whole retina from conditions associated with diabetes—in the case of this study, reduced blood flow.”

The long term goal is to design treatments that harness the protective powers of this protein to control or prevent DR.

Mark W. Johnson, M.D., Honored with Heed-Gutman Award Mark Johnson, M.D., Professor of Ophthalmology and Visual Sciences and Director of the Retina and Uveitis Service, is the latest Kellogg leader to receive the Heed-Gutman Award from the Society of Heed Fellows of the American Academy of Ophthalmology (AAO).

The award recognizes extraordinary and distinguished clinical, research and/or educational leadership and service to the field. A leading clinician and investigator in the medical and surgical treatment of macular, vitreomacular and vitreoretinal disorders, Dr. Johnson has served as principal investigator on numerous 32

multicenter clinical trials. A prominent voice on retina topics, he has delivered more than 20 named lectures and 240 invited talks in the U.S. and internationally and authored or co-authored nearly 250 peer-reviewed papers and book chapters.

“I was humbled—and surprised—to learn about the award,” he says. “Over the years I’ve been in the audience to celebrate numerous Heed-Gutman awardees. Hearing about their accomplishments has always inspired me to keep learning and contributing. What an honor to find myself in such esteemed company.”

In addition to the Heed-Gutman Award, Dr. Johnson, a past president of both The Macula Society and The Retina Society, has received a U.S. Presidential Scholar Award and both the Senior Achievement Honor and Life Achievement Honor Awards from the AAO.

Susan Lane, Alan Sugar, M.D., Maria Woodward, M.D., M.S.

The Alan Sugar, M.D., Research Professorship in Ophthalmology and Visual Sciences Alan Sugar, M.D., a corneal transplantation specialist, Ophthalmological Society in 1988. He has received has served on the U-M Department of Ophthalmology the Eye Bank Association of America Paton Award, the and Visual Sciences faculty for more than 40 years, and Cornea Society Castroviejo medal, and the American is known for his compassionate care and determination Academy of Ophthalmology Lifetime Achievement to help his patients feel and see better.

Award. He is a medical director of Eversight Eye Bank.

Ophthalmology is in Dr. Sugar’s DNA. His twin When he learned his longtime patient, Susan brother, Joel, is also an ophthalmologist. Both were Lane, established a professorship in his honor, he was influenced by their ophthalmologist father, who surprised and touched. Ms. Lane has long dedicated her discussed his work at dinner each night. Growing up, time, expertise, and passion to her interests and causes.

Dr. Sugar’s youth is filled with other A retired teacher, she actively ties to the field, U-M, and the volunteers at a local school, tutorI RECEIVED EXPERT CARE FROM Kellogg Eye Center. The elder ing kids, and working in the library.

DR. SUGAR FOR MORE THAN 30 YEARS. Dr. Sugar was W.K. Kellogg’s Her appreciation to of Dr. Sugar for physician. He would bring his sons his care over the years inspired her I WANTED TO HONOR HIM AND on house calls so they could play to establish the professorship in SUPPORT INNOVATIVE SCIENCE. with the Kellogg’s dog—a relative his name, which was inaugurated — Susan Lane of TV’s Rin Tin Tin. Every Christon August 25, 2023. Recognizing mas, the Sugar family received a Ms. Lane’s generosity, Dr. Sugar case of their favorite Kellogg cereal. Coincidentally, the added his own significant gift to the professorship fund.

Sugars lived next door to the uncle of Paul R. Lichter, “I received expert care from Dr. Sugar for more than M.D., foreshadowing a future when Dr. Sugar and the 30 years. I wanted to honor him and support innovative former department chair and founder of the Kellogg science,” she said. In Maria Woodward, M.D., M.S., the Eye Center would be U-M colleagues. inaugural Sugar Professor, Ms. Lane sees someone who Dr. Sugar joined the U-M faculty in 1979 as an asis pursuing “great ideas” to better treat corneal diseases sociate professor, rising through the ranks to professor of all kinds, a meaningful way to honor Dr. Sugar’s many in 1984. He was associate and vice chair of the departcontributions to corneal disease. Ms. Lane’s father also ment from 1993 to 2019. The author of 235 papers, he played a role in her gift when he simply suggested she was associate editor of Ophthalmology and editor-insupport the people and the place that took such good chief of Cornea. He was president of the Cornea Society care of her. from 2004 to 2006 and elected to the American

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

Honoring the Visionary Leadership of Paul P. Lee, M.D., J.D. In January of 2023, Paul P. Lee, M.D., J.D., stepped Dr. Lee’s interest in health services research began down as chair of the University of Michigan Department when the field was new. His focus on developing best of Ophthalmology and Visual Sciences and director practices and broadening access to care has led to innoof the W.K. Kellogg Eye Center, to serve as executive vations such as better tools, technologies, treatments, director of the U-M Medical Group and senior U-M and methods enabling providers to reach more people.

Medical School associate dean for clinical affairs. As The benefits of health services research are many, the chair, Dr. Lee greatly impacted the department and the possibilities endless. field through his internationally recognized expertise “Dr. Lee was one of the key people in the field of in glaucoma, patient-centered care, health services ophthalmology health services research. Early on he research, innovative leadership, and successful recruitsaw its importance ahead of the industry. Back in 2005 ment of top health services researchers to U-M. to 2006, there were less than 10 people in this space.

He was instrumental in Today, there are dozens more — I BELIEVE THE WORK WE ARE SPEARHEADING raising the profile of health all thanks to Dr. Lee.” Joshua services research, a field that WILL INFLUENCE NOT JUST OPHTHALMOLOGY, Stein, M.D. encompasses many areas. In To honor Dr. Lee’s distinBUT HEALTH CARE MORE BROADLY AT ophthalmology, health services guished leadership and impact, MICHIGAN MEDICINE, IN THE STATE, ACROSS we created the Paul P. Lee, researchers focus on how eye THE NATION, AND AROUND THE GLOBE. care is accessed and delivered M.D., J.D., Chair’s Innovation in local, low- to middle-income Research Fund. It is the first — Angela Elam, M.D., M.P.H. communities as well as to step to establishing an enimpoverished populations around the world. Our faculty dowed professorship in his name which will ensure the are finding ways to help kids and older adults receive innovative research Dr. Lee has produced and champiregular vision screening to detect problems before they oned will continue in perpetuity, allowing future physibecome worse. We are using big data sets to identify cian-researchers to impact the field. trends and determine best practices. In addition to Please join us in honoring Dr. Paul Lee’s many vision care, our work influences all medical care, and contributions to ophthalmology and health services it is because of Dr. Lee that our foundation in this vital research while ensuring tomorrow’s leaders can carry area is solid. on his innovative efforts. To make a gift or get more “I believe the work we are spearheading will information, please contact our W.K. Kellogg Eye influence not just ophthalmology, but health care more Center development partners, Lindsay Baden at broadly at Michigan Medicine, in the state, across the 734-604-7977 or linmwell@umich.edu, or Amanda nation, and around the globe.” Angela Elam, M.D., M.P.H. Barnett at 734-274-3009 or akbarnet@umich.edu.

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John Chase, David Zacks, M.D., Ph.D., and Shahzad Mian, M.D.

The Edna H. Perkiss Research Professorship in Ophthalmology and Visual Sciences

sister and were married for 61 years. Later in life, Mrs. Perkiss lost her vision due to age-related macular degeneration. While forced to give up some of her favorite activities, she never lost her giving nature. She passed away in 2008, and this professorship honors her generosity of spirit through its intent to spare others the pain of losing their sight.

David Zacks, M.D., Ph.D., has long been committed to saving sight and improving vision through his innovaThe Edna H. Perkiss Research Professorship in tive research focusing on methods to prevent retinal Ophthalmology and Visual Sciences was established cell death and damage before it leads to blindness. in 2018 through an estate gift from Alvin Perkiss.

“We hope to develop core knowledge to allow for a Making the gift was a meaningful way for Mr. Perkiss greater understanding of how disease results in cell to honor the memory of his wife, Edna. It was also a death, allowing for the creation of new treatments to way he could provide future support for research aimed improve vision,” he says. at curing blinding vision diseases, like the age-related An internationally renowned retina specialist, macular degeneration Edna faced.

Dr. Zacks has identified key molecular pathways that Edna Perkiss was born control retinal cell health in Detroit in 1918. She was and therapeutic targets to WE HOPE TO DEVELOP CORE KNOWLEDGE known for her love of reading, help keep these cells alive.

TO ALLOW FOR A GREATER UNDERSTANDtravel, and for being a dediHe has published over 115 ING OF HOW DISEASE RESULTS IN CELL cated friend. “Helping others peer-reviewed articles,holds DEATH, ALLOWING FOR THE CREATION OF numerous patents, has was part of who she was,” said Mr. Perkiss. In addition, Mrs. received the Macula Society NEW TREATMENTS TO IMPROVE VISION. Perkiss is remembered for W. Richard Green and the — David Zacks, M.D., Ph.D. her long and distinguished Terry J. Bergstrom Faculty 32-year career at Ford Motor Company. Her work as a Teaching awards, and serves on the Executive Commitsecretary was very important to her, so much so that tee of the Retina Society. He is also co-founder of ONL she occasionally returned to work in the evening after Therapeutics, an Ann Arbor based biotech company dinner. During her tenure at the company, she worked developing a first-in-class neuroprotective agent for with several vice presidents. patients with retinal disease. Dr. Zacks joined U-M as Alvin Perkiss served in the U.S. Army during World an assistant professor in 2002 and was promoted to War II. The G.I. Bill enabled him to attend college and professor in 2015. He was inaugurated as the Edna H. build his automotive supplier business in Dearborn, Perkiss Professor of Ophthalmology and Visual Sciences Michigan. Alvin and Edna were introduced by Alvin’s on July 19, 2023.

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BA685 Kisii Student Team onsite in Kenya: Supriya Ellina, M.H.A., Bela Parekh, B.S., Geetika Rao, M.B.A., Dan Kiage, M.D., Christian Colon, M.B.A., Sarah Jahnke, M.B.A.

Partnership between U-M Med School, Business School, and the Kellogg Eye Center Drives Latest Kenya Initiative Kellogg has a longstanding partnership with the Kisii tional Program at Kellogg. “Together, we offer a variety Eye Hospital (KEH), located in southwest Kenya. Since of opportunities to get involved in effecting positive 2017, the collaboration has provided opportunities for change around the world.” mutually enriching training and high-impact clinical and The seeds of the current KEH project were planted epidemiological research. when a medical student learned about those opportuniKEH is one of the only tertiary eye hospitals servties at one of Kellogg’s International Night events. But ing a population of more than 10 million people. Under it really took root when she ventured across campus to the leadership of CEO and Medical Director Daniel take a class at the business school.

Kiage, M.D., a glaucoma specialBela Parekh first became ist, KEH has grown rapidly since interested in issues of global health THE REAL CHALLENGE FOR KISII its founding in 2013, in diagnostic equity while working for a top IS MAKING THESE AND FUTURE and surgical volumes as well as in management consulting firm after VISION CENTERS FINANCIALLY the number of ophthalmologists college. She brought that same INDEPENDENT, SUSTAINABLE and allied ophthalmic personnel passion for and commitment to receiving training. reducing health disparities to her AND POSITIONED TO DELIVER Recently, the hospital opened training at the U-M Medical School THE RIGHT CARE FOR THE its first satellite vision clinic, the (UMMS).

COMMUNITIES THEY SERVE. Keroka Vision Centre. As they After the completion of her contemplated opening another, core clinical year, she enrolled in —Bela Parekh they looked to their colleagues in a course through the William the University of Michigan community for guidance.

Davidson Institute (WDI) at the U-M Ross School of “Kellogg is one part of a strong, interconnected Business. The WDI leverages business expertise to cohort of U-M faculty and students from a number of build lasting economic and social prosperity in lowdepartments, schools and institutes, all engaged in and middle-income countries. The class, Healthcare international health issues,” says Joshua Ehrlich, M.D., Delivery in Emerging Markets, assigned each student a M.P.H., Co-director of the Jerome Jacobson Internabusiness case. Fate stepped in when Parekh, who was 36

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KELLOGG IS ONE PART OF A

STRONG, INTERCONNECTED COHORT OF U-M FACULTY AND STUDENTS FROM A

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NUMBER OF DEPARTMENTS,

SCHOOLS AND INSTITUTES, ALL ENGAGED IN INTERNATIONAL HEALTH ISSUES.

— Joshua Ehrlich, M.D., M.P.H.

Joshua Ehrlich, M.D., M.P.H.

Kenya Initiative (cont.) leaning toward specializing in ophthalmology, was given the KEH Vision Centre expansion case. She simultaneously traveled to Ghana on a research scholarship through Global REACH, a UMMS program that engages faculty and students in international health collaborations.

Dr. Kiage’s team opened a second clinic in March 2023 while Parekh and the rest of the student team were on the ground in Kenya conducting interviews.

Parekh presented the initial plan for the Vision Centres in May 2023 to Dr. Kiage and WDI President Paul Clyde, Ph.D. “When the project wrapped up, I felt like there was more to do,” says Parekh, now an M4. “The real challenge for Kisii is making these and future vision centers financially independent, sustainable and positioned to deliver the right care for the communities they serve.”

Parekh pitched the idea of developing a comprehensive vision center expansion strategy for Kisii to Drs. Ehrlich and Clyde, who embraced the concept right away.

With input from her Kellogg and WDI mentors, Parekh and others will work with Kisii staff to understand the financials and logistics of the enterprise, including revenues, resource allocation, and referral patterns between clinics and the main hospital. Just as important are clinical considerations like staffing, training and equipment.

“Dr. Kiage has assembled a talented, highly motivated team at KEH,” says Dr. Ehrlich. “Like every initiative we undertake with them, this project will be informed by the epidemiology and culture of the region.

Together, we’ll identify the vision health issues of greatest local concern, and determine how best to address their eyecare needs at a Kisii Vision Centre.”

CELEBRATING KELLOGG'S INTERNATIONAL NIGHT

Annamalai Odayappan, M.D., Joshua Ehrlich, M.D., M.P.H., Paul Lee, M.D., J.D., Christine Nelson, M.D., Paul Chan, M.D., M.S., M.B.A., Donna Donato, Nambi Nallasamy, M.D., Sangeeta Khanna, M.D., Jonathan Trobe, M.D., Neelam Pawar, M.D., Shahzad Mian, M.D. 37

2023 FIRST-YEAR RESIDENTS

James Ellis, M.D. B.S. – University of Utah M.D. – University of Utah School of Medicine

Kristine Nachbor M.D., M.S. B.A. – Carleton College M.S. – Michigan Technological University M.D. – University of Minnesota Medical School

Harry Levine, M.D., M.P.H. B.A., B.S., M.P.H., – University of Miami M.D. – University of Miami LM Miller School of Medicine

JoshuaOng, M.D. B.S. – The Ohio State University M.D. – University of Pittsburg School of Medicine

David Mundy, M.D. B.S. – Stanford University M.D. – Stanford University School of Medicine

Ahmed Owda, M.D., M.P.H. B.S. – University of Michigan M.D. – Columbia University College of Physicians and Surgeons M.P.H. – Columbia University

Jaqueline Stoutin, M.D. B.A. – The University of Chicago M.D. – Texas A&M HSC College of Medicine

2023 GRADUATING RESIDENTS

Anvesh Annadanam, M.D. Cornea Fellow Cleveland Clinic Cleveland, OH

Otana Jakpor, M.D., M.Sc. Pediatric Ophthalmology Fellow Kellogg Eye Center Ann Arbor, MI

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Daniel Balikov, M.D., Ph.D. Vitreoretinal Fellow Bascom Palmer Miami, FL

Omar Moinuddin, M.D. Vitreoretinal Fellow Associated Retinal Consultants Royal Oak, MI

Nikhil Bommakanti, M.D. Vitreoretinal Fellow Wills Eye Hospital Philadelphia, PA

David Skanchy, M.D. Pediatric Ophthalmology Fellow Kellogg Eye Center Ann Arbor, MI

Jeffrey Yu, M.D. Vitreoretinal Fellow Kellogg Eye Center Ann Arbor, MI

2023 GRADUATING CLINICAL FELLOWS

Nicholas Carducci, M.D. Medical Retina Brighton Vision Center Brighton, MI

Rebecca Edwards Mayhew, M.D., Ph.D. Pediatric Ophthalmology & Adult Strabismus University of Colorado Aurora, CO

Jennifer Enright, M.D., Ph.D. Cornea, External Disease & Refractive Surgery Washington University in St. Louis St. Louis, MO

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

Miles Greenwald, M.D. Global Ophthalmology University of Kansas Eye Center Kansas City, KS

Ahmad Halawa, M.D. Pediatric Ophthalmology & Adult Strabismus Truhlsen Eye Institute Omaha, NE

Olivia Killeen, M.D., M.S. National Clinical Scholar Pediatric Ophthalmology Fellowship Duke University Durham, NC

Brett Malbin, M.D. Retinal Dystrophy Kresge Eye Institute Detroit, MI

Justin Park, M.D. Glaucoma Cornerstone Eye Associates Rochester, NY

Chelsea Reighard, M.D. Pediatric Ophthalmology & Adult Strabismus Asheville Eye Associates Asheville, NC

Meari Taguchi, M.D. Neuro-Ophthalmology Renown Regional Medical Center Reno, NV

Alexa Thibodeau, M.D. Cornea, External Disease & Refractive Surgery Kaiser Permanente San Diego, CA

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KELLOGG'S NEW FACULTY

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Elaine Downie, M.D., is a fellowship trained oculoplastic surgeon. She earned her medical degree from the University of Minnesota. She then went on to complete her ophthalmology residency and ASOPRS fellowship at the University of Wisconsin. She cares for patients at the Ann Arbor and Brighton clinics as well as the VA.

Marguerite Weinert, M.D., earned her medical degree from Duke University. She then went on to complete her ophthalmology residency and chief residency year at Massachusetts Eye and Ear, and her fellowship in Pediatric Ophthalmology and Adult Strabismus at Boston Children’s Hospital. She provides pediatric ophthalmology and adult strabismus care in Ann Arbor and Brighton.

Emily Eton, M.D., earned her medical degree from Harvard Medical School. She then completed an ophthalmology residency followed by a vitreoretinal surgery fellowship at the University of Michigan Kellogg Eye Center. She will provide adult and pediatric retinal care in the Ann Arbor and Brighton offices.

Mark Draelos, M.D., Ph.D., ., earned his medical and doctoral degrees at Duke University as well as general surgery internship and postdoctoral training.

He holds appointments in the departments of Robotics and Ophthalmology. His lab focuses on image-guided medical robots with an emphasis on clinical translation and ophthalmic applications.

Charles Frank, M.D., returns to Ann Arbor after completing his ophthalmology residency at the University of Illinois at Chicago. He attended medical school at the University of Michigan.

He is practicing comprehensive ophthalmology at the Chelsea, Ypsilanti, and Wall St. offices.

Thanh Hoang, Ph.D., earned his PhD in Developmental Biology at Miami University and completed his postdoctoral training in Neuroscience at Johns Hopkins before joining the Kellogg Eye Center. His research goal is to develop cell-based therapies for neurodegenerative diseases.

Farida Hakim, M.D., earned her medical degree from the University of Chicago Pritzker School of Medicine and stayed at the University of Chicago for her residency training. She then went on the complete a cornea fellowship at the University of Pittsburgh Medical Center. She joins as a Clinical Assistant Professor and provides corneal, refractive and comprehensive care at the VA and at Kellogg’s Brighton, Ann Arbor, and Canton offices.

Qiang Li, Ph.D., completed his Ph.D. training (Surgical oncology) at Shanghai Jiaotong University School of Medicine in China. He competed his postdoctoral training at the University of Pittsburgh and Case Western Reserve University. His research interests focus on gene regulation and cell fate decisions in pluripotent stem cells.

Shilpa Kodati, M.B.B.S., completed medical school at Imperial College London, United Kingdom, followed by a postdoctoral research fellowship at Schepens Eye Research Institute, ophthalmology residency at the University of Pittsburgh Medical Center (UPMC), a uveitis fellowship at the National Eye Institute (NEI), and a vitreoretinal surgical fellowship at Baylor College of Medicine. She was a staff clinician at the NEI before joining Kellogg.

Elise Savier, Ph.D., earned her doctoral degree from the University of Strasbourg, France in 2016, during which she investigated the development of the visual system. She completed her postdoctoral training at the University of Virginia. As a faculty member of both the Department of Molecular and Integrative Physiology and Ophthalmology, her research focuses on the central processing underlying vision.

Brittany Simmons, M.D., received her medical degree at the University of Illinois at Chicago.

She completed an ophthalmology residency at the Flaum Eye Institute and ASOPRS fellowship at the University of Iowa. Her research interests span education, surgical outcomes, novel markers of periorbital malignancy, clinical decision-making and comparative outcome studies, and diversity and inclusion in healthcare.

Kyung No Son, Ph.D., attended Kyung Hee University, South Korea and completed postdoctoral training at the University of Illinois at Chicago. He previously served as Director of Preclinical Drug Development at the University of Illinois at Chicago. He focuses on ocular surface diseases and Niemann Pick Type C Disease.

Nita Valikodath, M.D., M.S., attended the University of Michigan Medical School and completed her ophthalmology residency at the University of Illinois at Chicago and surgical retina fellowship at Duke University. She cares for adult and pediatric retina patients in Ann Arbor and Northville. Her research focuses on novel technologies to improve clinical outcomes and quality of life.

Qitao Zhang, Ph.D., his Ph.D. at Peking University in Beijing, China. He works on myriad RPE projects, ranging from optimizing cell culture, developing RPE culture models of AMD, and testing promising therapeutic targets in mouse, rat, and rabbit animal models.

FACULTY HONORS AND RECOGNITION

Vinay Aakalu, M.D., M.P.H., F.A.C.S. • Top Doctor, Castle Connolly • Editorial Board Member, Orbit • Editorial Board Member, Translational Vision Science and Technology • Editorial Board Member, The Ocular Surface • Reviewer, Study Section: ZEY1 VSN (04) [NEI/NIH Mentored Clinician Scientist Grant Applications (K08, K23) and Conference Grants (R13)] • Assistant Chair, Written Qualifying Examination Working Group, American Society of Ophthalmic Plastic and Reconstructive Surgery • Chair, Awards Committee, American Society of Ophthalmic Plastic and Reconstructive Surgery • Member, Publications Committee, The Association for Research in Vision and Ophthalmology • Methodologist, Ophthalmic Technology Assessment Committee-Oculoplastics, American Academy of Ophthalmology Steven Abcouwer, M.D. • Chief Editor, Journal of Ophthalmology • Editorial Board Member, Investigative Ophthalmology and Vision Science • Editorial Board Member, Translational Vision Science & Tecnology • Editorial Board Member, Frontiers in Ophthalmology, Retina Section • Editorial Board Member, American Journal of Physiology: Endocrinology and Metabolism • Editorial Board Member, Frontiers in Immunology • Editorial Board Member, Frontiers in Neurology • Scientific Review Editor, Molecular Vision Journal • Chair, National Institutes of Health Neurotechnology and Vision (NV) Study Section ZRG1 NV-Q 91 (01) • Chair, National Institutes of Health Neurotechnology and Vision (NV) Study Section ZRG1 NV-Q 91 (02) • Member, National Institutes of Health Pathophysiology of Eye Disease 1 (PED1) Study Section • Member, National Institutes of Health Study Section ZRG1 MGG-G (70) R RFA-RM-22-015: Investigational New Drug-enabling Studies of Somatic Genome Editing Therapeutic Leads (U19) • Member, Department of Defense FY22 Peer Reviewed Medical Research Program for the Congressionally Directed Medical Research Programs Diabetes Treatment Clinical Trials Study Section • Reviewer (Ad Hoc), Czech Science Foundation Kari E. Branham, M.S., C.G.C. • Chair, Genetics Review Committee, Foundation Fighting Blindness Clinical Consortium • Member, Steering Committee for the National Ophthalmic Disease Genotyping and Phenotyping Network (eyeGENE®), National Eye Institute

JULY 1, 2022 — SEPTEMBER 30, 2023

Kari E. Branham, M.S., C.G.C. (cont.)

• Expert Review Panel Member, Early Onset Retinal Degeneration Variant Curation, ClinGen • Expert Review Panel Member, Retinal Disease Gene Curation, ClinGen • Member, Scientific Advisory Board, Foundation Fighting Blindness • Member, Evidence Based-Guideline for Retinal Dystrophies Workgroup, American College of Medical Genetics • Editorial Board Member, Investigative Ophthalmology & Visual Science • Community Engagement Award, National Society of Genetic Counselors Sherry Day, O.D., FAAO • Board Member, American Academy of Optometry Foundation • Vision Rehabilitation Committee Board Member, American Optometric Association • Co-Chair, Vision Rehabilitation Committee, Michigan Optometric Association Karen DeLoss, O.D., FAAO • Secretary, American Optometric Association Cornea and Contact Lens Section • Vice Chair, Global Specialty Lens Symposium Education and Planning Committee • Education Chair, Global Ophthalmic Women organization • Advisory Board, Gas Permeable Lens Institute Joshua Ehrlich, M.D., M.P.H. • Reviewer, Special Emphasis Panel, Fogarty International Center • Co-Chair, International Education Sub-Committee, American Glaucoma Society • Editorial board, Ophthalmic Epidemiology • Associate Director, Innovative External Networks Core, P30 Michigan Center on the Demography of Aging Angela Elam, M.D. • Secretariat Award, American Academy of Ophthalmology • National Medical Association Scientific Contribution Award • Advisory Committee, Center for Population and Vision Health, Prevent Blindness • Co-Chair, Taskforce on Disparities in Eye Care, American Academy of Ophthalmology • Scientific Contribution Award, National Medical Association • Reviewer, Merit Review Panel, Achieve Health Equity Broad Pragmatic Studies, Patient-Centered Outcomes Research Institute • Editor, Translational Vision Science and Technology Journal, Equity in Eye Care special issue

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FACULTY HONORS AND RECOGNITION

Peter Hitchcock, Ph.D. • Fulbright Specialist, United States Department of State; Bureau of Educational and Cultural Affairs • Invited Symposium speaker, Regulation of Müller glia-dependent neuronal regeneration in the damaged retina, 24th Biennial Meeting, International Congress of Eye Research, Gold Coast, Australia • Invited speaker, Annual Meeting of the Scientific Advisory Board for the ECaBox Project, Porto, Portugal.

Mark Johnson, M.D. • William S. and Grace Snyder Lecture, Vanderbilt University • Chandler Lecture, Mass Eye and Ear Infirmary, Harvard University • Heed Gutman Award, Society of Heed Fellows • Chair, Awards Committee, The Macula Society • Castle Connelly Top Doctor in Ophthalmology • Best Doctors in America • Associate Editor, American Journal of Ophthalmology • Editorial Board Member, Retina: The Journal of Retinal and Vitreous Diseases Ariane Kaplan, M.D. • Secretary, AUPO Directors of Medical Student Education Council • Member, AAO BCSC Update on General Medicine Book Committee • Member, WIO Academic Outreach Committee Shilpa Kodati, M.D. • Editorial Board Member, Scientific Reports • Member, Continuing Medical Education Committee Association for Research in Vision and Ophthalmology • Chair, Research Committee, Young Uveitis Society • Member, Young Uveitis Society Executive Committee • Invited lecturer, Journées Ophtalmologiques Universitaires de Québec Paul P. Lee, M.D., J.D. • Trustee-at-Large, President-Elect, Chair, Data Resource Committee, Association of University Professors of Ophthalmology • Invited Speaker, John and Suzanne Shore Lectureship, University of Texas • President, National Alliance for Eye and Vision Research/Alliance of Eye and Vision Research • Board of Directors, Ophthalmology Foundation • Invited Speaker, Richard D. Richards Symposium, University of Maryland • Board of Directors, Society of Heed Fellows Paul Lichter, M.D., M.S. • Best Doctors in America • Top Doctor, Castle Connolly • Top Doctor, US News and World Report

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JULY 1, 2022 — SEPTEMBER 30, 2023

Shahzad I. Mian, M.D. • Advisory Committee, American Academy of Ophthalmology • Examiner, Member, Writer, American Board of Ophthalmology • Member, American Ophthalmological Society • Best Doctors in America • Associate Editor, Cornea Open • Board of Directors, Secretary, Cornea Society • Board of Directors, Governance Committee, Big Data Task Force Medical Advisory Board, Eye Bank Association of America • Board of Directors, Eversight Eye Bank • Board of Directors, Secretary, Michigan Society of Eye Physicians and Surgeons Jason Miller, M.D., Ph.D. • David Hinton Scholarship, Ryan Initiative for Macular Research David Musch, Ph.D., M.P.H. • Scientific Reviewer: Health and Medical Research Fund, Government of Hong Kong SAR • Member, Editorial Boards: JAMA Ophthalmology • Member/Chair: numerous NEI/NIH and company-sponsored Data and Safety Monitoring Committees for ongoing, multicenter, randomized clinical trials Christine Nelson, M.D., FACS • Board of Directors, ASOPRS Foundation Committee • Board of Directors, Member, World Association of Eye Hospitals • Co-Chair, Fellowship Curriculum Project, International Council of Ophthalmology • Chair, Wendell Hughes Awards Committee • Awards Committee, Women in Ophthalmology • Fellowship Curriculum Project Committee, International Council of Ophthalmology • NASAOS Membership Committee • Senior Advisor, International Global Opportunities Committee, ASOPRS Paula Anne Newman-Casey, M.D., M.S. • Physician Scientist Award, Research to Prevent Blindness • Glaucoma Subcommittee Chair, Annual Meeting Program Committee, American Academy of Ophthalmology • Member, American Academy of Ophthalmology Community Health Center Taskforce Yannis Paulus, M.D. • Grant Reviewer, United Kingdom Research and Innovation Medical Research Council • Grant Reviewer, University of Maryland, Maryland Industrial Partnerships Program • Grant Reviewer, Food and Health Bureau of the Health and Medical Research Fund for The Government of the Hong Kong Special Administrative Region • Grant Reviewer, Israeli Ministry of Innovation, Science and Technology

FACULTY HONORS AND RECOGNITION

Yannis Paulus, M.D. (cont.)

• Review Committee, Study Section, NIH Council ZEY1 VSN 04 NEI Mentored Clinician Scientist Applications • Grant Reviewer, Dutch Research Council • Review Committee, Study Section Ad hoc member, Military Operational Medicine Research Program for the Department of Defense • Review Committee, Study Section Ad hoc member, National Science Foundation SBIR/STTR Phase II Panel Review Committee Digital Health Medical Devices and Diagnostics panel • Grant Reviewer, Swiss National Science Foundation • Grant Reviewer, Croatian Science Foundation • Massey Foundation TBI Grand Challenge Award • Editorial Board, Ophthalmic Surgery, Lasers & Imaging Retina • Editorial Board, Photonics • Editorial Board, Scientific Reports • Chair, Continuing Medical Education Committee, Association for Research in Vision and Ophthalmology Lev Prasov, M.D., Ph.D. • Epstein Award, Association for Vision Research and Ophthalmology Foundation • Gene Curation Expert Panel for Glaucoma/Neuro-Ophthalmology, ClinGen • Co-Chair, Variant Curation Expert Panel Anterior Segment Dysgenesis, ClinGen • Guest Editor, Frontiers in Neuroscience • Guest Editor, Genes • Schaffer Prize, Glaucoma Research Foundation • Member, International Society of Genetic Eye Disease and Retinoblastoma Rajesh Rao, M.D. • Election to The Club Jules Gonin • Secretariat Award, American Academy of Ophthalmology • Study Section Reviewer, Neurobiology-F VA Merit Grant Review Program • Study Section Member, The Aging and Development, Auditory, Vision and Low Vision Small Business Study Section (ETTN 12/ SBIR/STTR), Center for Scientific Review, National Institutes of Health James Weiland, Ph.D. • Bioengineering of Neuroscience and Vision Technologies study section, National Institutes of Health • Past Vice President, Medicine and Biology Society Conferences, Institute of Electrical and Electronics Engineers Kwoon Wong, Ph.D. • Associate Editor, Frontiers in Cellular Neuroscience • Grant reviewer, Hong Kong Research Grants Council

JULY 1, 2022 — SEPTEMBER 30, 2023

Sarah Wood, O.D., M.S., FAAO • Secretary, Optometric Glaucoma Society • Awards Committee, Women in Ophthalmology • Fellowship Curriculum Project Committee, International Council of Ophthalmology • NASAOS Membership committee • Membership Committee, Optometric Glaucoma Society • AAO Glaucoma Diplomate executive committee • Guest Reviewer, American Academy of Optometry Journal Maria A. Woodward, M.D., M.S. • Senior Achievement Award, American Academy of Ophthalmology • Deputy Section Lead, American Academy of Ophthalmology • Senior Editor, Cornea • Board Member, Cornea Society • Dermatologic and Ophthalmic Drugs Advisory Committee, Food and Drug Administration • Member, JAMA Ophthalmology Advisory Committee • Member, World Cornea Congress IX Program Committee Thomas Wubben, M.D., Ph.D. • Member, Retina Society • Assistant Editor, RETINA Round Up David Zacks, M.D., Ph.D. • Member, Data and Safety Monitoring NEI-sponsored NAC Attack trial – a Phase 3 multicenter clinical trial of oral treatment with N-acetylcysteine (NAC) in patients with retinitis pigmentosa.

Amy Zhang, M.D. • Invited Section Editor, Advances in Ophthalmology and Optometry Jason Zhang, M.D. • Member, Multimedia Subcommittee, Education and Communication Committee, American Glaucoma Society (AGS)

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

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

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UNIVERSITY OF MICHIGAN W.K. KELLOGG EYE CENTER FACULTY

V. Aakalu, MD, MPH

F. Abalem, MD

S. Abcouwer, PhD

R. Ali, PhD, BSc

S. Ali, MD

D. Antonetti, PhD

S. Archer, MD

B. Ayres, MD

A. Bass, OD

J. Cropsey, MD

J. Dalia, MD

S. Day, OD, FAAO

L. De Lott, MD, MS

M. Del Monte, MD

K. Deloss, OD, FAAO

H. Demirci, MD

T. Deveney, MD

C. Dewey, OD

C. Frank, MD

P. Fort, PhD

C. Foster, OD

B. Furr, CO, PhD

P. Gage, PhD

S. Gagnon, OD, FAAO

C. Gappy, MD

T. Gardner, MD, MS

D. Green, PhD

K. Jayasundera, MD, MS

V. Jeyaraj, MD

D. John, MD, FRCSC

M. Johnson, MD

A. Kaplan, MD

H. Kaur, MD

N. Khan, PhD

S. Khanna, MD

D. Kim, MD

C. Lin, PhD

X. Liu, MD, Ph.D

A. Maa, MD

M. McKee, MD

S. Mian, MD

J. Miller, MD, PhD

S. Moroi, MD, PhD

K. Mundy, MD

D. Musch, PhD, MPH

H. Petty, PhD

C. Podd, OD

L. Prasov, MD, PhD

D. Puro, MD, PhD

R. Rao, MD

J. Richards, PhD

A. Robin, MD

J. Rosenthal, MD, MS

M. Sans-Gili, PhD

W. Sray, MD

J. Stein, MD, MS

A. Sugar, MD

J. Sundstrom, MD, PhD

B. Tannen, MD, JD

S. Temple, PhD

D. Thompson, PhD

J. Trobe, MD

J. Weizer, MD

S. Werneburg, PhD

A. West, MD

D. Wicker, OD, FAAO

P. Williams, MD

K. Wong, PhD

S. Wood, OD, MS, FAAO

M. Woodward, MD, MS

THE DEPARTMENT OF OPHTHALMOLOGY AND VISUAL SCIENCES

C. Besirli, MD, PhD

A. Bicket, MD

J. Bixler, MD

B. Boland, OD

K. Branham, MS, CGC

R. Chen, PhD

G. Comer, MD, MS

T. Cooney, MD

W. Cornblath, MD

E. Downie, MD

M. Draelos, MD, PhD

J. Ehrlich, MD, MPH

A. Elam, MD

S. Elner, MD

V. Elner, MD, PhD

E. Eton, MD

A. Fahim, MD, PhD

C. Farkash, OD

P. Grenier, OD

F. Hakim, MD

S. Hansen, MD

P. Hitchcock, PhD

T. Hoang, PhD

C. Hood, MD

B. Hughes, PhD

M. Huvard, MD

A. Jacobson, MD

E. Klukas, OD

S. Kodati, MD

Z. Kresch, MD

A. Lagina, OD, FAAO

P. Lee, MD, JD

H. Leung, OD, PhD

Q. Li, MD, PhD

P. Lichter, MD, MS

N. Liles, MD, MPH

M. Nagashima, PhD

N. Nallasamy, MD

C. Nelson, MD

P. Newman-Casey, MD, MS

J. Nguyen, OD

S. Ono, PhD

G. Oren, MILS

Y. Paulus, MD

J.Pearring, PhD

T. Sassalos, MD

E. Savier, PhD

T. Seng, OD, FAAO

A. Shah, MD

R. Shtein, MD, MS

B. Simmons, MD

T. Smith, MD

K. Son, PhD

K. Soong, MD

M. Tucker, OD

N. Valikodath, MD

A. Verkade, MD

G. Wang, MD, PhD

E. Weh, PhD

S. Weidmayer, OD, FAAO

J. Weiland, PhD

M. Weinert, MD

A. Wu, MD

R. Wu, MD

T. Wubben, MD, PhD

G. Xu, PhD

D. Zacks, MD, PhD

A. Zhang, MD

J. Zhang, MD

Q. Zhang, PhD

2023 FACULTY OF THE DEPARTMENT OF OPHTHALMOLOGY AND VISUAL SCIENCES Vinay Aakalu, M.D., M.P.H. Fernanda Abalem, M.D. Steven Abcouwer, Ph.D. Robin Ali, Ph.D.B.Sc. Sameerah Ali, M.D. David Antonetti, Ph.D. Steven Archer, M.D. Bernadete Ayres, M.D. Audree Bass, O.D. Cagri Besirli, M.D., Ph.D. Amanda Bicket, M.D. Jill Bixler, M.D. Brittany Boland, O.D. Kari Branham, M.S., CGC Roland Chen, Ph.D. Grant Comer, M.D., M.S. Theresa Cooney, M.D. Wayne Cornblath, M.D. John Cropsey, M.D. Julia Dalia, M.D. Sherry Day, O.D., FAAO Lindsey De Lott, M.D., M.S. Karen Deloss, O.D., FAAO Monte Del Monte, M.D. Hakan Demirci, M.D. Tatiana Deveney, M.D. Courtney Dewey, O.D. Elaine Downie, M.D. Mark Draelos, M.D., Ph.D. Joshua Ehrlich, M.D.,M.P.H. Angela Elam, M.D. Susan Elner, M.D. Victor Elner, M.D., Ph.D. Emily Eton, M.D. Abigail Fahim, M.D., Ph.D.

Cherie Farkash, O.D Charles Frank, M.D. Patrice Fort, Ph.D. Carlton Foster, O.D. Bruce Furr, C.O., Ph.D. Philip Gage, Ph.D. Samantha Gagnon, O.D., FAAO Christopher Gappy, M.D. Thomas Gardner, M.D., M.S. Daniel Green, Ph.D. Paul Grenier, O.D. Farida Hakim, M.D. Sean Hansen, M.D. Peter Hitchcock, Ph.D. Thanh Hoang, Ph.D. Christopher Hood, M.D. Bret Hughes, Ph.D. Michael Huvard, M.D. Adam Jacobson, M.D. K. Thiran Jayasundera, M.D., M.S. Vanitha Jeyaraj, M.D. Denise John, M.D., FRCSC Mark Johnson, M.D. Ariane Kaplan, M.D. Harjeet Kaur, M.D. Naheed Khan, Ph.D. Sangeeta Khanna, M.D. Denise Kim, M.D. Erin Klukas, O.D Shilpa Kodati, M.D. Zvi Kresch, M.D. Amy Lagina, O.D., FAAO Paul Lee, M.D., J.D. Helios Leung, O.D., Ph.D Qiang Li, M.D., Ph.D.

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

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

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

Contributing Writers: Kristy Demas

Debra F. Weinstein, M.D. Executive Vice Dean for Academic Affairs, Medical School Chief Academic Officer for Michigan Medicine Steven L. Kunkel, Ph.D. Executive Vice Dean for Research, Medical School Chief Scientific Officer, Michigan Medicine The Regents of the University of Michigan Jordan B. Acker, Michael J. Behm, Mark J. Bernstein, Paul W. Brown, Sarah Hubbard, Denise Ilitch, Ron Weiser, Katherine E. White, Santa J. Ono (ex officio) © 2023 Regents of the University of Michigan A Non-discriminatory, Affirmative Action Employer

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Paul Lichter, M.D., M.S. Nathan Liles, M.D., M.P.H. Cheng-Mao Lin, Ph.D. Xuwen Liu, M.D., Ph.D. April Maa, M.D. Matthew McKee, M.D. Shahzad Mian, M.D. Jason Miller, M.D., Ph.D. Sayoko Moroi, M.D., Ph.D. Kevin Mundy, M.D. David Musch, Ph.D., M.P.H. Mikiko Nagashima, Ph.D. Nambi Nallasamy, M.D. Christine Nelson, M.D. Paula Anne Newman-Casey, M.D., M.S. Jacqueline Nguyen, O.D. Santa Ono, Ph.D. Gale Oren , M.I.L.S. Yannis Paulus, M.D. Jillian Pearring, Ph.D. Howard Petty, Ph.D. Colleen Podd, O.D. Lev Prasov, M.D., Ph.D. Donald Puro, M.D., Ph.D. Rajesh Rao, M.D. Julia Richards, Ph.D. Alan Robin, M.D. Julie Rosenthal, M.D., M.S Maria-Dolors Sans-Gili, Ph.D. Therese Sassalos, M.D. Elisa Savier, Ph.D. Thielen Seng, O.D., FAAO Anjali Shah, M.D. Roni Shtein, M.D., M.S. Brittany Simmons, M.D.

Terry Smith, M.D. Kyung No Son, Ph.D. H. Kaz Soong, M.D. William Sray, M.D. Joshua Stein, M.D. M.S. Alan Sugar, M.D. Jeffrey Sundstrom, M.D., Ph.D. Bradford Tannen, M.D., J.D. Sally Temple, Ph.D. Debra Thompson, Ph.D. Jonathan Trobe, M.D. Meagan Tucker, O.D. Nita Valikodath, M.D. Angela Verkade, M.D. Grace Wang, M.D., Ph.D. Eric Weh, Ph.D. Sara Weidmayer, O.D., FAAO James Weiland, Ph.D. Marguerite Weinert, M.D. Jennifer Weizer, M.D. Sebastian Werneburg, Ph.D. Adrienne West, M.D. Donna Wicker, O.D., FAAO Pamela Williams, M.D. Kwoon Wong, Ph.D. Sarah Wood, O.D., M.S., FAAO Maria Woodward, M.D., M.S. Annie Wu, M.D. Rebecca Wu, M.D. Thomas Wubben, M.D., Ph.D. Guan Xu, Ph.D. David Zacks M.D., Ph.D. Amy Zhang, M.D. Jason Zhang, M.D. Qiato Zhang, Ph.D.

Design and Art Direction: David Murrel Head Writer: Shelley Zalewski

Editorial Assistant: Jo Kristine Scott, Dani Shordt Photographers: Michigan Photography: Eric Bronson, Erin Kirkland, Daryl Marshke, Scott Soderberg

FOR PATIENT APPOINTMENTS, PLEASE CALL 734.763.8122 For additional copies, please contact: University of Michigan Department of Ophthalmology and Visual Sciences W.K. Kellogg Eye Center 1000 Wall Street Ann Arbor, Michigan 48105 www.umkelloggeye.org

INNOVATION TEAMWORK INCLUSIVITY CARING INTEGRITY

Department of Ophthalmology and Visual Sciences 1000 Wall Street Ann Arbor, MI 48105

Kellogg Among Nation’s Best in Eye Care #

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OPHTHALMOLOGY IN THE NATION

The University of Michigan Kellogg Eye Center is proud to be ranked in the top 10 in the country by U.S. News & World Report—recognizing our outstanding care for patients with complex eye conditions.

Last year we celebrated 150 years of excellence in ophthalmology. Kellogg has seen extraordinary growth in all aspects of patient care, research and education since the department was established in 1872. Every day, our clinicians, scientists, trainees and staff work together to shape the future of eye care and vision science. We are proud to be part of Michigan Medicine.

~ Our Purpose ~

2023 U.S. NEWS & WORLD REPORT’S “BEST HOSPITALS”

To improve lives through curing, preventing and treating eye disease