Note From the Chairman
Many years ago, the American Academy of Ophthalmology focused forward on the year 2020 as the symbolic target date to stamp out preventable blindness: a laudable goal. Who would have guessed that 2020 would come to represent something much less hopeful?
Yet, here at the Eye Center, strength, cooperation, team work and dedication to our patients and each other emerged as the themes of 2020. Our team continued to see patients through the Spring while many concurrently volunteered in the COVID testing area and on the floors teaching the proper donning and doffing of PPE.
As a result of COVID, our world has changed. There are many things that we may never go back to doing, but at NEEC one thing will never change: our patients come first.
I want to thank Astrid Werner, MD and Laurel Vuong, MD for reviving this newsletter after over a decade of lapse. We hope to update you on a quarterly basis on activity here at the New England Eye Center and welcome your feedback and comments.
-Jay Duker, MD
Chairman of Ophthalmology at the Tufts Medical Center
Nadia K. Waheed, MD, MPH was honored this year by the Macular Society when she was awarded their prestigious Young Investigator Award. Every year since 1991, this award has been presented to an individual under 50 years of age whose work gives high promise of a notable advance in the clinical treatment of disorders of the eye.
Dr. Waheed has been an Associate Professor in Ophthalmology at the Tufts University School of Medicine in Boston and a surgical Retina specialist at the New England Eye Center since 2011. In addition, she has been the Director of the Boston Image Reading Center (BIRC) and director of the OCT Research Fellowship since 2014. Her research interests include novel imaging modalities in the eye, OCT and OCTA, clinical trial endpoint development and the applications of these to non-exudative AMD and diabetic retinopathy. She has published over 100 papers in peer reviewed journals, over 100 abstracts, book chapters and editorials and is the co-author on three books, including “Handbook of Retinal OCT,” the “Atlas of Retinal OCT,” and “OCT Angiography of the Eye.” She is an editorial board member of the journals “Retina” and “IOVS.”
Dr. Waheed received her medical degree summa cum laude from the Aga Khan University Medical School, Pakistan, and a MPH from the Harvard School of Public Health. She completed both her ophthalmology residency and surgical retina fellowship training at Harvard Medical School/Mass Eye and Ear Infirmary. Prior to coming to Tufts New England Eye Center, Dr. Waheed worked at Cleveland Clinic Cole Eye Institute in Ohio and Shifa College of Medicine in Pakistan.
Congratulations to Dr. Waheed on all of her achievements and this recent award!
NEEC Research Spotlight
NEEC will participate in an investigational gene therapy clinical trial for the treatment of dry AMD.
Age-related macular degeneration (AMD) is the leading cause of vision loss in people 50 and older. It is classified as early, intermediate, or advanced, with two subtypes in the advanced group: neovascular AMD and geographic atrophy (GA). While the use of anti-vascular endothelial growth factor (VEGF) agents have been a remarkable advancement in the treatment of neovascular AMD, there is still no FDA-approved therapy for dry AMD, specifically GA.
Chronic local inflammation and activation of the complement cascade has been implicated in the pathogenesis of AMD. It has been suggested that mutations in complement factor genes correlate with the likelihood of developing AMD. Sponsored by Gyroscope Therapeutics Ltd., NEEC will be participating in TELESCOPE, a study to genetically define patients with GA secondary to AMD. The purpose of the study is to evaluate patients by sequencing selected genes associated with AMD that may play a role in the progression of GA.
Gyroscope is also currently investigating GT005, a one-time adeno-associated virus-based (AAV) investigational gene therapy delivered under the retina, designed to restore balance to an overactive complement system by increasing the production of Complement Factor I protein. Initial patients in their Phase I/II FOCUS trial were administered gene therapy using subretinal injection involving vitrectomy and the creation of a retinotomy and enrollment in these cohorts is ongoing. Additional cohorts are using the OrbitTM subretinal delivery system to deliver GT005 to the subretinal space via the suprachoroidal space, eliminating the need for vitrectomy. Starting in early 2021, NEEC will be participating in Gyroscope’s Phase II clinical trial, EXPLORE, to help evaluate the safety and efficacy of subretinal GT005 in patients with GA secondary to AMD. Gene therapy is a promising treatment for numerous retinal diseases, from acquired diseases such as AMD to less common but still devastating inherited retinal diseases. Continued research into these genetic defects, viral vectors, and improved surgical techniques for vector delivery will hopefully help treat and slow the progression of macular degeneration and other blinding diseases.
Michelle Liang, MD, a member of the NEEC Retina Department, will act as principal investigator for both the TELESCOPE and EXPLORE trials at NEEC.
Welcome to our new NEEC doctors!
Yosbelkys Martin Paez, M.D. joins NEEC as a member of the Neuro-Ophthalmology Department. Dr. Martin previously completed an ophthalmology residency and neuro-ophthalmology fellowship in Havana, Cuba. She then moved to the United States, where she completed her neurology residency at the University of Florida, and a neuro-ophthalmology fellowship at the University of Colorado in Denver. She specializes in the evaluation and treatment of diseases causing vision loss due to damage of the optic nerve and visual pathways. Specifically, she focuses on inflammatory and autoimmune disorders such as neuromyelitis optica (NMO), myelin oligodendrocyte glycoprotein (MOG) antibody disease, and multiple sclerosis. She also treats motility disorders.
Diana Green, O.D. joins NEEC as a member of the Optometric and Contact Lens Service. She is a graduate of the New England College of Optometry and has experience working in primary care, in settings with a pediatric focus, and with specialty contact lenses. Dr. Green currently provides primary optometric care at our Brighton office.
Pediatric Ophthalmology and Strabismus Service at NEEC
Located in Tufts Children’s Hospital, the Pediatric Ophthalmology and Strabismus service at the New England Eye Center in Boston, Massachusetts is currently comprised of four ophthalmologists, one optometrist, and one orthoptist who see over 5500 patients annually. Approximately 250 surgeries are performed each year, including strabismus surgery in children and adults, as well as cataract, eyelid and nasolacrimal duct surgeries in children. Ophthalmology residents rotate through the service during their second year of ophthalmology training, learning to examine and treat children and adults with strabismus. Medical students, pre-medical students, pediatric residents, optometry students, and pediatric optometry residents also rotate through the pediatric eye clinic during their training.
Dr. Vicki Chen, who joined the New England Eye Center in 2008 after completing her fellowship at Boston Children’s Hospital, is the current director of the Pediatric Ophthalmology and Strabismus service. Dr. David Reese returned to the New England Eye Center in 2005 after many years treating children at his private practice in Waltham. I joined in 2014 following my fellowship at Wilmer Eye Institute, and Dr. Catherine Choi arrived in 2015 after completing her fellowship at Kellogg Eye Center at the University of Michigan. In 2021, Dr. J.P. Gorham, who is currently completing his training in pediatric ophthalmology and strabismus, also at Kellogg Eye Center, will start at the New England Eye Center and assume the role of screening for retinopathy of prematurity at Tufts Medical Center. In 2018, Dr. Mitchell Strominger, who joined in 2002 from SUNY Downstate and then became director of the service, departed New England for Reno, Nevada, where he is practicing at Renown Health.
Since 2010, the orthoptic service at the New England Eye Center has been led by Shelley Klein, CO when she was recruited from her solo practice in the Lions Orthoptic Clinic in western Massachusetts. Ms. Klein is immediate past president of the American Association of Certified Orthoptists and recently established a combined orthoptic fellowship program in Boston in November 2018 (for more on this, see the next section in the newsletter). Dr. Nicole Quinn, who completed her pediatric optometry residency under the supervision of Dr. Strominger, joined the team in 2002 and provides evidence-based convergence therapy and contact lens services, as well as training of future pediatric optometrists through the New England College of Optometry, where she is Professor of Optometry.
The pediatric eye clinic is adjacent to the pediatric otorhinolaryngology clinic, which is one of the many pediatric specialty services at Tufts Children’s Hospital with whom we work closely for the care of our patients. We provide comprehensive eye care for pediatric patients and also work closely with the rest of the ophthalmology department in the Biewend Building. Adult strabismus patients are also seen at Tufts Children’s Hospital for orthoptic evaluations of diplopia and strabismus. In addition to the clinic in Boston, pediatric and adult strabismus patients are seen by me and Dr. Chen in Framingham, MA. This office moved to a newly renovated space in 2014. Dr. Justine Grier, who completed her pediatric optometry residency with Dr. Quinn in Boston, also provides pediatric optometric care in the Framingham office. In addition, Dr. Reese sees pediatric patients in the Wellesley satellite office, and Dr. Choi sees patients at private practices in Tewksbury and Wellesley, Massachusetts
Dr. Chen has spearheaded more recent pediatric ophthalmology research efforts, including basic science research on epidermolysis bullosa and histologic analysis of cataracts, as well as clinical research on pharmacologic myopia control and dichoptic amblyopia treatment. We are members of the Pediatric Eye Disease Investigator Group (PEDIG), a collaborative network that conducts multicenter clinical research on eye disorders that affect children and is funded by the National Eye Institute (NEI). We are very excited and proud to have received the 2020 institutional grant from the Massachusetts Lions Eye Research Fund, which funded a Cirrus 6000 optical coherence tomography machine and equipment for an additional exam lane, which will provide greater access to specialized pediatric eye care at the New England Eye Center for the children of Massachusetts.
I cannot end this article without including a note about how the COVID-19 pandemic affected our practice. The pediatric eye clinics slowed to nearly a standstill for several weeks in spring 2020 due to the pandemic, until telemedicine was up and running for the hospital, followed by a slow ramping up of clinic volumes, which are now back to pre-pandemic numbers but with drastically different clinic flow and protocols. The resilience of the staff and their exemplary teamwork through this difficult time have allowed the us to continue providing excellent care for patients and families in the greater Boston area. Additional details of my own experience as a pediatric ophthalmologist in the first few months of the pandemic in our country can be found here: https://www.aappublications.org/news/2020/08/21/covidimpact081920.
Special thanks to Jenny Mateo, Pediatric Ophthalmology Supervisor, and Dr. Catherine Choi for their help with this article.
Assistant Professor of Ophthalmology
Boston Orthoptic Fellowship Program’s First Graduate
On November 1st, 2018, the Boston Orthoptic Fellowship Program (BOFP), a combined effort between NEEC and Boston Children’s Hospital (BCH), became the 12th orthoptic fellowship program accredited by the American Orthoptic Council (AOC). The creation of the school has helped reinforce the position of NEEC in the world of pediatric ophthalmology as there are currently only 15 AOC-accredited fellowship programs in the entire United States. Here at NEEC, Catherine Choi, MD is the Medical Director and Shelley Klein, CO is the Program Director. At BCH, David Hunter, MD is the Medical Director and Sarah MacKinnon, CO is the Program Director.
The history of orthoptic training at Tufts dates back to the 1970s, when it was started by Elizabeth Shaterian, CO as the Program Director. That tradition continued for 20 years with Certified Orthoptists Virginia Karlsson and then Barbara Brown. Unfortunately, the program was suspended in 1990 when the Pediatric Ophthalmology department was going through some staffing changes that resulted in the lack of an in-house orthoptist. Mitchell Strominger, MD brought back orthoptic services in 2005, when he hired Nikki Batra, CO. Shelley Klein joined NEEC in 2010 and was fundamental in bringing the orthoptics training program back to life in 2018. 28 years after the first school closed, NEEC has come full circle and is proud to be part of this great tradition of teaching orthoptists.
During the two-year post-graduate program, our students rotate between NEEC and BCH to specialize in the evaluation and treatment of binocular vision disorders, eye movements, and how they relate to the visual system. We accept two students each year and we currently have four enrolled.
May Chan-Ho was our first orthoptic student. If her name sounds familiar, that is because she joined Tufts in July of 2016 as the surgical coordinator in the Pediatric Ophthalmology department. While working in pedi-ophthalmology, May learned about the profession of orthoptics and volunteered to be a study patient in an Adult Strabismus study. The more she observed, the more she became interested and ultimately approached Shelley Klein to ask how to become an orthoptist. It was May’s desire to become an orthoptist that inspired Shelley to start the program at Tufts. Knowing it would be very difficult to do this as a solo orthoptist, she approached BCH and after a year of working on accreditation, the BOFP was born! May was an incredible first student, setting the bar high for future students. She passed her written boards in June and successfully completed her oral and practical boards last month. Sadly for NEEC, May has returned to New York City, where she is from and where her husband is completing a Rheumatology Fellowship at NYU.
NEEC residents selected for 2020 Heed Foundation Retreat
The Heed Ophthalmic Foundation was formally established in 1946 by Mr. Thomas Heed, a successful business man in Chicago, who had been afflicted with uveitis as a young man. Years later, his wife suffered a retinal detachment that was successfully treated. Mr. and Mrs. Heed’s personal experiences with sight-threatening conditions, for which they received excellent care, led them to form the Heed Ophthalmic Foundation to assist young ophthalmologists pursing postgraduate studies in ophthalmology.
Each year, the foundation, in conjunction with the American Ophthalmological Society and Research to Prevent blindness, host a two-day resident retreat for selected residents nominated by their programs to discuss careers in academic ophthalmology.
Nisha Dhwalikar, MD, MPH and Allison Coombs, DO, MS both from the class of 2022) were selected to participate in the 15th Annual Heed Foundation Residents Retreat that took place by Zoom on October 5 and 6, 2020. They were inspired by the stories that faculty participants shared, including stories of serendipity, overcoming hardships, and personal and professional successes.
Congratulations to Dr. Coombs and Dr. Dhwalikar for being selected to this prestigious retreat. We look forward to seeing where your careers take you in the future.
Meet our current residents and fellows
Donate to the Ophthalmology Teaching Fund!
The Ophthalmology training program at NEEC is exceptional because we support our residents every step of the way. We embrace the challenge of improving education, but many initiatives require funding. Your help is vital in maintaining and elevating the strong reputation of NEEC Alumni. Please click here to support out trainees by donating to our Ophthalmology Teaching Fund: http://go.tufts.edu/ophthalmologyteaching.
From the Archives at NEEC:
Neuro-Ophthalmology at Tufts Medical Center
In 1968 one of the first people Bernard Schwartz recruited for the newly created Department of Ophthalmology was Samuel Sokol, a Ph.D. and expert in electrophysiology. Sam’s research focused on infant and child visual development. Although he was not a clinical neuro-ophthalmologist, he was a pioneer in the development of visual evoked potentials, not only to test children, but also for neuro-ophthalmic purposes. The first clinical neuro-ophthalmologist at Tufts was John Gittinger who joined the staff in the 1970s. John continues to edit The Survey of Ophthalmology which was developed by Dr. Schwartz into a premier review journal. In 1981 Dr. Gittinger went on to become chief of Ophthalmology at the University of Massachusetts and was replaced by me, Thomas R. Hedges III, TUSM class of ‘75. I was joined by Laurel N. Vuong, an MIT graduate, who first came to Tufts to do research on multifocal visual evoked potential recording. Laurel stayed to get her M.D. and complete her ophthalmology residency at Tufts. She returned after fellowship at Emory in 2014. Yosbelkis Martin-Paez just joined us after training in ophthalmology in Cuba, neurology in Gainesville and neuro-ophthalmology in Denver.
However, there is another individual who might be considered the very first neuro-ophthalmologist at Tufts, Josef Igersheimer. Igersheimer was best known internationally as a retina specialist, having worked with Gonin on the first successful retinal detachment procedures. He was forced to leave Germany when the Nazis took power and went to Turkey where he is still remembered as modernizing ophthalmology. Igersheimer wrote a textbook on ophthalmology in Turkish and a classic book, Syphilis and the Eye. He instituted arsphenamine for treating ocular syphilis. When a jealous ophthalmologist tried to poison him, and the Turkish government prohibited his family from immigrating, Igersheimer decided to move to Boston. He was welcomed by Tufts along with other emigre’ physicians and was accepted to the staff of The New England Medical Center and Boston City Hospital. At that time, he developed a strong interest in neuro-ophthalmology along with a friendship with David Cogan in the early development of neuro-ophthalmology as a subspecialty. Some of Dr. Igerscheimer’s publications include “Serious visual difficulties caused by unusual circulatory disturbances in the region of the optic nerve” and “Atrophy of the optic nerve in tabes and dementia paralytica.” Apparently, he was also a great clinician. I once asked an older Tufts alumnus if he remembered Dr. Igerscheimer. “Oh yes,” he said. “He was a neuro-ophthalmologist! I recall that once he asked a child to pick up little balls of cotton spread over black cloth. When the child missed those in both temporal visual fields, Dr. Igerscheimer diagnosed a hypothalamic glioma!”
Thomas Hedges, MD
Director, Neuro-Ophthalmology Service