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news from the Massachusetts Eye and Ear Infirmary
Musician-Researcher Orchestrates
A M O D E R N S C I E N T I F I C L A B O R AT O RY
Music that comes forth from a
pipe organ can range from gentle,
flute-like notes to the sternumshaking chords of a Bach prelude.
In the early 1970s, it was this versatility that especially appealed to
Harvard undergraduate M. Charles
S P R I N G / S U M M E R
2 0 0 2
Liberman Ph.D., who describes
himself as a “serious classical organist” in those days.
This love of music, including dabbling in piano, banjo and
guitar, grew into a fascination with sound and hearing. Dr.
Liberman embarked on further study and a career that has
led him to his current position as Director of the Eaton-
Attacking AMD on New Fronts:
continues on page 4 >>>
JOAN MILLER, M.D.
Joan
Miller,
M.D.,
and
her
A Brighter Future
colleagues continue to make
important progress in the battle
against
age-related
FOR CHILDREN WITH HEARING LOSS
macular
degeneration (AMD). AMD is
The Children’s Hearing Challenge
the leading cause of blindness
is on, and your help is needed. A
in people over age 55. It currently
foundation, which has asked to
affects more than 13 million
remain anonymous, has part-
people in the United States alone.
nered with the Massachusetts Eye
and Ear Infirmary to help build a
Dr. Miller is a retina specialist who collaborates and shares
brighter future for children with
research space with a group of researchers under the
hearing loss.
umbrella of the Retina Research Institute (RRI). Their work
focuses on new treatments, diagnostic methods and preven-
“Raising a $1 million endowment for the Infirmary’s Auditory
tion of the two leading causes of adult-onset blindness —
Rehabilitation Center has seemed like a dream. But thanks to the
macular degeneration and diabetic retinopathy.
commitment of this foundation, that goal is now within reach,”
said Barbara Herrmann, Ph.D., Clinical Associate, Audiology.
”These are devastating diseases that can take away an otherwise healthy person’s ability to read, drive, see the faces of
Last fall, when the Infirmary surpassed the halfway point in
family members – to simply function,” says Dr. Miller. “We
raising
continues on page 10 >>>
continues on page 3 >>>
a
$1
million
endowment
for
the Auditory
Achievement Awards Go To…
Memories from Last Year’s Dinner
C . E V E R E T T K O O P, M . D . , A N D C H R I S K A U D E R S , E S Q .
The 16th Annual Reynolds Society Dinner and Achievement
Awards will be held at The Fairmont Copley Plaza in Boston
on Friday, Oct. 25. Named for Edward Reynolds, M.D., cofounder of the Infirmary, the Reynolds Society honors friends
who contribute $2,000 or more to the Infirmary in a given
year (October 1 to September 30).
The evening will be filled with noteworthy and inspirational
speakers and awardees. One of this year’s Reynolds recipients is former Surgeon General, C. Everett Koop, M.D., an
advocate for newborn hearing screening. Another award
recipient is Christopher P. Kauders, Esq. Mr. Kauders is a pioneer in developing mediation as a means for more quickly
resolving legal disputes. For more information about joining
the Reynolds Society, contact Melissa Paul at 617-573-4168 or
Reynolds Society members (pictured from left to right) JoAnn
visit www.meei.harvard.edu. The photographs on the right
McGrath, Solomon and Georgette Boucai.
are from last year’s awards dinner.
Reynolds Society Achievement Award recipient Barry Scheur.
Mrs. Albert E. Sloane and many
members of the Sloane family
attended a reception to unveil a
portrait of her late husband, Albert
E. Sloane, M.D. The portrait is
prominently
displayed
in
the
Sloane Teaching Room on the third
floor of the Infirmary, which was
named in his honor. Dr. Sloane
was a highly respected ophthalmologist, champion of low vision
services,
prolific
revered teacher.
author
and
Reynolds Society Achievement Award recipient Gordon Gund
(left), pictured with Eliot Berson, M.D.,(right).
2
Children’s Hearing continues from page 1 >>>
Rehabilitation Center, this foundation enthusiastically issued
a challenge – if the Infirmary can raise $250,000 by the end
of November 2002, the foundation will make a matching
$250,000 gift.
Infirmary physicians, nurses and audiologists have been caring for children with hearing problems for more than 177
years. Two decades ago, Infirmary audiologists developed
technology to screen for and to diagnose hearing loss in
newborn babies. It has been proven that with early diagnosis
and intervention, such as hearing aids and language and
speech therapy, children with hearing loss can develop normal speech and language abilities. Without immediate intervention, however, children with hearing loss can lose precious time, making it far more difficult to develop the communications skills needed to succeed in a hearing world.
Trustee Gene Seamans and Infirmary Chairman
Sheldon Buckler, Ph.D.
T H E
G U A R D I A N
O F
A N G E L
A U D I T O R Y
R E H A B
“Trustee Gene Seamans has been our
guardian angel of the Auditory Rehabilitation
Center,” said Infirmary President, F. Curtis
Smith. “We can’t thank her enough for her
Since newborn hearing screening was initiated, Infirmary
audiologists have diagnosed and delivered the upsetting
news to parents. “Unfortunately, in the past, we could do little more than refer parents to other organizations to seek
help for their child,” says Dr. Herrmann. “Few organizations
were equipped with programs for newborns. Many parents
and their children were not able to quickly get the help they
needed and their child’s development sadly suffered.”
leadership in securing the future of our Center
through an endowment. Gene’s determination
to help children with hearing loss and their
parents is truly extraordinary, and for that we
will always be grateful,” he said.
On October 15, the Infirmary held a reception
in honor of Trustee Gene Seamans and her
To address this need, the Massachusetts Eye and Ear
Infirmary established the Auditory Rehabilitation Center in
1997 to advise and counsel parents and provide hearing aids
and speech language therapy to children suffering from hearing loss. The Center has had an immeasurable affect on the
lives of many families and children with hearing loss who are
now communicative, well-adjusted children attending mainstream schools.
husband Dr. Robert C. Seamans, Jr., to thank
them
for
being
champions
in
raising
$500,000 for the Auditory Rehabilitation
Center endowment. Mrs. Seamans, and her
son Toby, described their experiences when
Toby was diagnosed with hearing loss at age
3, more than 50 years ago. With help from
Helen Patten, a teacher at the Infirmary, Toby
If you would like to help build a brighter future for children
with hearing loss, please call Melissa Paul in the
Development Office at 617-573-4168.
was able to develop spoken language skills
despite his hearing loss. He has led a full and
productive life with a successful career and a
large family of his own.
The Seamans have always been fascinated
with the infant screening program. “We realize that Toby’s struggle to learn the spoken
language would have been far easier and less
frustrating had he been diagnosed earlier,”
says Mrs. Seamans. They understand what
parents go through upon learning of their
child’s hearing loss fear, denial and a sense of
tremendous loss. Yet with education, counseling and speech-language therapy, parents
adjust to their initial shock and take comfort
in knowing that their child can get the extra
Pictured from left to right: Toby Seamans, Bob Seamans,
help they need to have a healthy future.
Gene Seamans, Cheryl Bakey and Barbara Herrmann, Pd.D.,
at a reception to honor the Seamans.
3
Orchestrating a Laboratory continues from page 1 >>>
DISCOVERIES IN
Peabody Laboratory of Auditory Physiology (EPL) at the
P R O G R E S S AT T H E
E AT O N - P E A B O D Y L A B O R AT O R Y
Under the leadership of M. Charles Liberman,
Ph.D., scientists at the Eaton-Peabody
Massachusetts Eye and Ear Infirmary and Professor of
Otology and Laryngology at Harvard Medical School.
“When I was a student, I wanted to understand how music
was perceived by the brain,” says Dr. Liberman, “but there
were no courses on hearing at Harvard.” As a doctoral stu-
Laboratory at the Massachusetts Eye and Ear
dent in physiology at Harvard, he met Nelson Yuan-sheng
Infirmary are conducting research in two key
Kiang, Ph.D., then-Director of the Lab. Dr. Kiang was willing
areas that will make important contributions
to help Liberman pursue his special interest independently.
to the understanding and treatment of hearYears later, Dr. Liberman realizes he has found the perfect
ing loss:
stage for his talents. “There isn’t anyplace else on earth like
> PROTECTION
OF
SENSORY
CELLS
Individuals vary in their susceptibility to
noise-induced hearing loss. By studying
the Eaton-Peabody Lab for a scientist who is interested in
hearing,” he says. “The fusion of physiology, molecular biology and genetic study is unbelievably powerful! It is exciting
and daunting at the same time.”
why some people have “tough” ears that
are resistant to acoustic injury and others
With the recent explosion of cellular and gene-level informa-
have “tender” ears more likely to suffer
tion and the complexity of modern scientific inquiry,
from injury, scientists hope to learn how to
scientists can no longer work alone in the laboratory, says Dr.
Liberman. The expert and specialized input of colleagues,
minimize hearing loss.
both through formal peer review processes and lessstructured “down the hall” discussions, is essential. These
> T R A N S P L A N TAT I O N
OF
NERVE
FIBERS
meetings of the minds lead to multidisciplinary study of the
Researchers hope to use cell transplanta-
basic science behind diseases, with the ultimate objective of
tion to regenerate auditory nerve fibers.
new clinical treatments. The EPL, a longstanding partnership
Sensory cells in the inner ear — called
among the Infirmary, the Massachusetts Institute of
“hair cells’ because of their hair-like
Technology, Harvard Medical School and Massachusetts
appendages — convert sound into electrical
General Hospital, is ideally positioned to pursue this collab-
impulses, which these restored auditory
nerve fibers will carry to the brain for
decoding.
orative approach to science.
As Lab director, mentor and a researcher himself, Dr.
Liberman’s responsibilities can often be as complex as a
Bach fugue. There are 15 senior level researchers in the EPL,
One study, by Dr. Liberman and Sharon
each with fellows, trainees, and technical and support staff.
Kujawa, Ph.D., Director of Audiology at the
He must attend to the administrative duties of this large
Infirmary, and a colleague in molecular
organization, including manuscript editing, grant manage-
genetics at the University of Washington, is
ment and oversight of academic affiliations.
creating particular excitement in the “tough”
vs. “tender” ears arena.They have discovered
a strain of mice that is remarkably resistant
His directorship also requires constant thinking about the
future, including the search for the staff and equipment necessary to ensure the Lab successfully pursues its goal of
to hearing loss. By studying the biology of
understanding hearing and hearing disorders. As a $4.2 mil-
this type of mouse at a molecular level, the
lion campaign to expand the Laboratory proceeds, Dr.
research team hopes to identify the gene
Liberman seeks a molecular biologist who is interested in the
responsible for making the ear resistant to
genes that guide degeneration and regeneration of the cells
noise trauma.
and nerve fibers involved in age-related hearing loss. Such a
scientist will complement the expertise of EPL molecular
biologist Stefan Heller, Ph.D., whose areas of study include
the role of genes in inherited hearing loss.
4
In addition to serving as Director, Dr. Liberman regularly
guides five or more graduate and postdoctoral students as
they design, conduct and publish their research. His own
research on sensory and feedback pathways continues, and
he often drops in to his lab to look at slides or consult on a
procedure. He finds that regularly devoting day-long blocks
of time to his research is most effective. Other than these
occasional research days, he has an open-door policy to all
who seek his expertise.
How does Dr. Liberman accomplish it all? “It helps to get in
early,” he chuckles. “I find that scientists are usually night
owls, so I gain some uninterrupted time in the morning.” He
says that his wife and four children, now ages 7 to 24, are
used to seeing him return to his Milton, Mass., home in the
evenings with an armful of papers.
Leahey Legacy Endures
WITH ENDOWED FUND
He says he often sees his two loves of music and science
reflected in his children. One son, an accomplished jazz
Claes Dohlman, M.D., was, in his own words, a timid
pianist, is thinking of studying economics. “It reminds me of
research fellow when he first met Brendan Leahey, M.D., in
what I realized long ago: that I could keep music as a hobby,
1959. “He was extraordinarily generous to me, and I admired
but I couldn’t pursue science as a hobby,” says Dr. Liberman.
him greatly for his clinical work,” Dr. Dohlman said. “He was
Still, having chosen science, he admits that he wouldn’t mind
known not only for his clinical style and judgment, but for his
finding some time in the future to become reacquainted with
nurturing and mentoring. I would say Brendan was one of
a grand pipe organ.
the greatest clinicians of all times affiliated with the
Massachusetts Eye and Ear Infirmary.”
Although Dr. Leahey passed away a decade ago, his legacy
and generosity lives on. Mary Jo Leahey, wife of the late Dr.
Leahey, recently established the Mary Jo and Brendan D.
Leahey Fund for Corneal Diseases. This endowed fund will
support new or evolving corneal surgical techniques, teaching and research at the Infirmary.
Mrs. Leahey said she established the fund because of her
late husband’s and her son’s commitment to corneal work.
Dr. Leahey performed the first successful corneal transplant
in New England at the Infirmary. Their son, Alan B. Leahey,
M.D., has followed in his father’s footsteps and is a cornea
surgeon in Pennsylvania.
“I wanted to give because my husband was a pioneer in
corneal transplant surgery,” Mrs. Leahey explains. “He was
on the teaching staff at Harvard Medical School in addition to
having his private practice. He admired Dr. Dohlman and his
work. It is my hope that family, friends and colleagues at the
Infirmary will be interested in supporting this fund.”
M. Charles Liberman, Ph.D., shares his love of music with his
daughter, Rebecca.
For more information about the Mary Jo and Brendan
D. Leahey Fund for Corneal Diseases, or to set up your
own named endowment, please contact Melissa Paul at
617-573-4168.
5
Walk for Vision Nets More Than $25,000
FOR UVEITIS RESEARCH
Six-year-old Demi Miller personally raised $300 for uveitis
research by participating in the 14th Annual Team with a
Vision 5K Walk and Run held in Boston on Sept. 29. “Kids
‘get it,’” said Glen Miller, Demi’s father. “Demi really wanted
to do something. She went door to door, asking people to
sponsor her in the Walk. I was amazed at what she accomDemi Miller and C. Stephen Foster, M.D., are part of the Team
plished.”
with a Vision.
Demi travels to Boston with her family from their home in
Pennsylvania every six weeks for treatment by C. Stephen
Foster, M.D., Director of the Immunology and Uveitis Service
at the Massachusetts Eye and Ear Infirmary. She knows
about the effects of uveitis firsthand. Uveitis is a destructive
The Winthrop Family’s Dedication
inflammatory disease that attacks the inside of the eye; it is the
third leading cause of blindness in the United States and is estimated to afflict 2,359,242 people worldwide, 10 percent of
whom will go blind if current trends hold.
Patients and friends of the Infirmary formed the Uveitis
Research Team for the event. Demi was one of 78 walkers on
the team that collected 753 pledges targeted for research support at the Infirmary for uveitis and other ocular inflammatory
diseases (OID). More than $25,000 was raised, and while most
of it was for uveitis research, other gifts and pledges were
received for Vision Rehabilitation, general ophthalmology
research and for unrestricted support of the Infirmary. In addition to the funds raised, the event brought attention to this little understood disease. Fifty uveitis patients from around the
world walked at precisely the same time, in spirit with the
effort in Boston.
ENRICHES MANY LIVES
For one family, giving is in their genes. For more than 60
years, the Winthrop Family has contributed generously to
Infirmary physicians and researchers to aid in their efforts to
understand and treat hearing disorders.
In 1944, the late Frederic Winthrop, Sr., began the decadeslong friendship between the Infirmary and the Winthrop
Family. The Winthrops have been instrumental in the establishment of one of the first clinics for hearing-impaired children, proving that young children with hearing loss could
learn to communicate through spoken language.
Dedicated to keeping up with medical advancements, the
Winthrops used the Fund to equip a laboratory for Stefan
Heller, Ph.D., in the Eaton-Peabody Laboratory. His research
aims to identify genes underlying hearing loss. A small
reception was held to thank the Winthrop family for their
generosity, and a plaque was unveiled in their honor.
Dr. Foster founded the Immunology and Uveitis Service at
the Infirmary 26 years ago. He is the author of over 600 scientific publications and is widely recognized by his colleagues and patients as having revolutionized the science
and standard of care for patients with uveitis. In addition to
“We cannot thank the Winthrop family enough for their generosity over the years, which has already resulted in improvements in the way we treat hearing problems,” said Joseph B.
Nadol, Jr., M.D. “I hope the future will enable us to prevent or
even reverse deafness of the inner ear,” he says.
his clinical practice, Dr. Foster directs the Infirmary’s Hilles
Immunology Laboratories, where much of the world’s cutting
edge research into blinding ocular inflammatory disease is
conducted. Dr. Foster is a founding member of the
Uveitis/OID Support Group, a resource for anyone living with
ocular inflammatory disease. The Uveitis/OID Support Group
has over 350 members worldwide. For information about
these free support resources, or for more information about
the
fund-raising
efforts
of
its
members,
go
to
www.uveitis.org. For more information about supporting
uveitis research at the Infirmary, contact Barbara Erickson at
617-573-3303.
Angela Winthrop and Frederic Winthrop, Jr., were among
those present at a reception to unveil a plaque in the
Winthrop family’s honor.
6
New Research Labs
PROVIDE HOPE
The grand opening of the state-of-the-art Hearing Research
Laboratories in the Eaton-Peabody Laboratory marked the
continuous
growth
of
research
in
the
Infirmary’s
Otolaryngology Department. This newly renovated research
space in the Connecting Building greatly expands investigator capacity in the area of cellular and molecular approaches.
Stefan Heller, Ph.D., Edmund Mroz, Ph.D., and William
Sewell, Ph.D., are researching causes of the most common
form of hearing loss: sensorinerual hearing loss. This broad
term encompasses age-related, noise-induced, infectious
and otoxic hearing losses. Infirmary researchers are trying to
identify the genes that lead to sensorineural hearing loss.
They hope to develop treatments to preserve and even
restore hearing to people suffering with hearing loss.
Edmund Mroz, Ph.D., describes his work at the grand opening
Significant progress has been made in understanding hear-
of the Hearing Research Laboratories.
ing, thanks to the generosity of many Infirmary friends who
share a commitment to this research.
Richard Baldwin, Knights Templar
Right Eminent Grand Generalissimo,
presented
research
grants
to
investigators
Infirmary. The
grants,
four
eye
at
the
totaling
$120,000, will be used for research to
help treat and prevent blindness.
Pictured at a recent awards ceremony (left to right): Richard Baldwin, F.
Curtis Smith (Infirmary President),
and Ellen Yu, Ph.D. Other grant recipients include Harkryul Jo, Ph.D.,
Katherine Strissel, Ph.D., and Don
Hong, Ph.D.
7
Murphy Family Supports Cancer Research
AT T H E I N F I R M A RY
When Laurence Murphy first came to the Massachusetts Eye
daughter, established the Laurence A. Murphy Fund for Head
and Ear Infirmary, his physicians could not have predicted the
and Neck Cancer Research in memory of her father. This trust
profound effects the encounter would eventually have on their
is a Charitable Lead Annuity Trust that supports Dr. Varvares’
careers and on the community of head and neck cancer
research. “It gives me the flexibility to perform research one
patients in New England.
day a week. It has allowed us to set up a tissue engineering lab,
to buy equipment and other supplies, and to do research,” Dr.
Mr. Murphy came to the Infirmary in 1996 under less than opti-
Varvares said.
mum circumstances. He had developed an advanced skin cancer, probably as a result of extensive sun exposure in his child-
On Nov. 3, 15 members of the Murphy family, including Mr.
hood. The skin cancer had invaded his parotid gland and sub-
Murphy’s brothers Albert and Arthur Murphy, daughter Jane
sequently spread to lymph nodes in his face and neck. He
Buehner, son-in-law Richard Buehner, and granddaughter
underwent aggressive surgery and post-operative radiation,
Kerry Wallace, gathered at the Infirmary for the unveiling of a
but developed a recurrence that would eventually become
plaque in honor of Laurence and Eleanor Murphy within the
fatal.
Head and Neck Oncology Clinic. The family also took part in a
champagne toast delivered by Dr. Varvares, who described his
“It was his courage in the face of recurrent disease and the
admiration for Mr. Murphy and said his friendship will not be
tremendous support from his daughter and granddaughter
forgotten. Finally, the family received a presentation by Dr.
who set Mr. Murphy apart from many patients that find them-
Varvares about the advancements he is making in understand-
selves in similar circumstances,” said Mark Varvares, M.D.
ing and treating head and neck cancer.
Today, the Murphy family is contributing toward a brighter
“Helping to find a cure for head and neck cancer is the reason
future for other cancer sufferers by supporting head and neck
I do research,” Dr. Varvares said. “Gifts like this give me the
cancer research at the Infirmary. Jane Buehner, Mr. Murphy’s
time to spend in this quest.”
Members of the Murphy family
attended a plaque-unveiling ceremony and reception at the Infirmary in
November.
8
Olympic Spirit Warms the Infirmary
TWO FUNDRAISERS HELD
It was a chilly day in late December when the Olympic torch
passed through Braintree and Boston, but the weather
couldn’t have stopped the cheers from the crowds and the
generosity of many people. Massachusetts Eye and Ear
Infirmary patient Bridget Quirk and a father of a patient, Chris
Mehmel, were both honored with the task of carrying the
Olympic Torch, and both were instrumental in raising money
for the Infirmary.
Infirmary patient, Bridget Quirk (right), and sister Meredith take
part in the passing of the Olympic Torch in Braintree, Mass.
A fund-raising event was held at Quirk Chevrolet in Braintree.
Thanks to the generosity of Infirmary friends, local area businesses, and Dan and Mary Jo Quirk of Quirk Chevrolet in
Braintree, more than $132,725 was raised for the Bridget and
Meredith Quirk Fund at a special fund-raising event. Bridget
Quirk suffers from uveitis, an inflammation inside the eye.
photo courtesy of ATT Broadband
“With the care Bridget is receiving at Mass. Eye and Ear,
they’re virtually saving her eyesight,” Mr. Quirk said.
Funds raised were used to purchase a Heidelberg Scanning
Laser Ophthalmoscope and Angiograph for C. Stephen
Foster, M.D., who is fighting pediatric blindness by focusing
research on causes and treatments of childhood uveitis.
Chris Mehmel (left) and son Matthew enjoy an emotional
Uveitis is the third leading cause of blindness in the United
moment after Mr. Mehmel carried the Olympic Torch over the
States, after diabetes and macular degeneration.
Longfellow Bridge in Boston, Mass.
Chris Mehmel, who has a below-knee prosthesis, carried the
torch over the Longfellow Bridge in an effort to raise money
to combat the blinding eye disease Retinitis Pigementosa
(RP), a degenerative disease of the retina. Mr. Mehmel’s
Infirmary Offers Convenience
son, Matthew, was diagnosed with RP last year, and most
recently his daughter, Rachel, was diagnosed. In addition to
coming to terms with the fact his children are suffering
from this devastating disease, Mr. Mehmel wanted to raise
money for RP research efforts.
“My kids have always been the focus of my life, and now it’s
just an undeniable fact,” he says. “We were directed to the
Infirmary for help, so it was only natural to see what I could
do for the Infirmary. My wife Lizzie and I are realists, but we
do have hope that Eliot Berson M.D.’s five-year study (combining vitamin A with an additional supplement) will be inde-
ONLINE GIVING OPTION ADDED
You can shop on-line; you can bank on-line; now you can
even support the Massachusetts Eye and Ear Infirmary
on-line, through its web site: www.meei.harvard.edu.
The Infirmary’s web site recently added an option through
which people can make credit card gifts to the Infirmary online through a secure server. “Online giving can be quicker
and easier than sending in a check,” said Bruce Jordan, Vice
President of Development and Public Affairs. “The internet
is ‘open’ 24 hours a day, seven days a week, and you can
designate the fund to which the gift is made.”
pendently verified as positive in the control of RP.”
Mr. Mehmel was successful in a raising more than $3,300 for
RP and continues his fund-raising efforts on behalf of his children. The Infirmary is extremely grateful to donors such as
the Quirks and Mr. Mehmel.
Acknowledgement letters are sent for online gifts, just as
they are for more traditional gifts. Donors can designate their
gifts for specific funds.
To access the online giving section, visit the Infirmary’s web
site, www.meei.harvard.edu, then click on “How to Give” on
the main toolbar. This section will explain how you can make
your online gift.
9
Miller continues from page 1 >>>
are investigating treatments that, if applied early enough,
sitive dye that concentrates in newly grown blood vessels. A
may be able to halt vision loss.”
low-density laser is then used to destroy the dyed area, leaving the rest of the retinal tissue intact.
The so-called “wet” form of age-related macular degeneration (AMD) and diabetic retinopathy are diseases of the reti-
As more experience is gained with PDT, Dr. Miller and her
na characterized by abnormal growth of new blood vessels,
colleagues are analyzing patient data to study the differences
known as angiogenesis. The disease process begins when
among patients’ responses to the treatment and are explor-
the interaction among the natural progression of aging, a
ing how to make PDT more effective. “The more precisely we
disease such as diabetes, or other factors create a lack of
can target the cells of the vessels we want to destroy,” says
oxygen or an injury in the thin, light-sensitive layer at the
Dr. Miller, “the less likely we are to damage healthy tissue.”
back of the eye known as the retina. Sensing a lack of oxygen
or an injury, substances within the eye appear to stimulate
Perhaps one of the most promising areas of AMD research is
new blood vessel formation. Problems occur when these
in testing a combination of PDT and growth inhibitors, as
new blood vessels, which are fragile, leak blood and other
described below.
fluids into the jelly-like area of the eye called the vitreous. The
fluid causes scar tissue to form, which in turn pulls or tears
GROWTH, INHIBITION AND COMBINATIONS
the retina, sometimes causing it to detach.
Several years ago, Dr. Miller and Anthony Adamis, M.D.,
were the first investigators to discover the action of a natu-
In AMD, the light-sensing cells that form the center of the
rally occurring protein, called vascular endothelial growth
retina, known as the macula, are damaged over time, making
factor (VEGF), that appears to stimulate new blood vessel
detailed work such as reading or working on a keyboard vir-
formation in the eye. Since then several pharmaceutical
tually impossible.
companies have been synthesizing and testing antibodies to
block the activity of VEGF.
REFINING PDT
Dr. Miller and Evangelos Gragoudas, M.D., pioneered the
Building on the growing body of knowledge about anti-VEGF
first FDA-approved treatment for AMD, called photodynamic
and PDT treatments, researchers are now studying a combi-
therapy (PDT), in the 1990s. This treatment uses a photosen-
nation of the two treatments. “Are they better together?”
asks Dr. Miller. “It is possible that combining the two treatments may enable us to decrease the number of treatments,
while improving repair of the retinal damage. Anti-VEGF
agents may also be effective in decreasing leakage in the
vessels and, essentially, making vessel cells more sensitive
to PDT.”
contact
is produced by the Office of Development
As these studies continue, John Loewenstein, M.D., is part of
and Public Affairs, (617) 573-3340.
a multi-center clinical trial of a different type of blocking
http://www.meei.harvard.edu
agent, called an aptamer, that binds to VEGF, making it
unable to stimulate vessel growth.
© 2002 Massachusetts Eye and Ear Infirmary
Another study by Dr. Miller and colleagues, published this
F. Curtis Smith, President
Bruce C. Jordan, Vice President for
Development and Public Affairs
past March in the Archives of Ophthalmology, shows that
another, smaller molecular substance, called an antibody
fragment, has proven to be successful in blocking VEGF function. Studies are also in progress to examine a substance
called PEDF, pigment epithelium derived factor. PEDF is a
Mary E. Leach, Editor
naturally occurring angiogenesis inhibitor. When PEDF is
Michele P. Gorham, Barbara Erickson, Liz Irvin,
absent, there is no check on substances, like VEGF, that stim-
Melissa Paul and Cindy Whitcome,
ulate vessel growth.
Contributing Writers
Eric Antonio, Public Affairs Staff and AT&T
Broadband 3, Photography
Marc Harpin, rhumba, Design
Why study more than one growth inhibitor? Because
researchers are always looking for the treatment or combination of treatments that will be most effective in the long
run, says Dr. Miller. “Questions always remain. Will this substance stop vessel re-growth? Will this one prevent growth of
10
additional vessels? Will we be able to administer this one effectively? This area of study continues to be complex, but full of
P R E S E R V I N G
O N E
P A T I E N T ’ S
V I S I O N
promise,” she says.
Anne Kane knew that long life and a risk of
METHODS OF DELIVERY
severe vision problems were common on her
As researchers navigate the complexities of developing new
mother’s side of the family. So when Mrs.
treatments, they are also studying better ways of delivering
Kane experienced vision difficulties of her
them. Currently, growth inhibitors and other treatments are
own, she was willing to try a new therapy at
injected into the eye. Although the risk is small, there is the
age 77, hoping to preserve her vision for what
possibility of bleeding, infection, and retinal detachment, par-
she hoped would be many years to come.
ticularly for patients who receive regular treatments –for example, those treated every six weeks for two years.
“I was willing to take a chance, not only for
myself, but also for the future benefit of my
The protective barrier of the cornea (the surface of the eye) and
children and grandchildren,” says Mrs. Kane
the eye’s natural drainage system make eye drops alone inef-
of her decision three years ago. She became
fective for delivering anti-angiogenic medications. Retina spe-
a patient of retina disease expert Joan Miller,
cialists are looking to successes in HIV patients, who receive
M.D., when Mrs. Kane was referred to the
treatments for virus-related eye disease through small,
Massachusetts Eye and Ear Infirmary after
implanted devices that dissolve after a period of time.
cataract surgery at Brigham and Women’s
Translating that delivery system for use in retinal disease is a
Hospital. After the surgery, Mrs. Kane noticed
challenge, however. Molecular size and structure can make it
that edges of windows and mirrors and other
difficult for one substance to pass through a device, while
straight lines were becoming “wavy.” Dr.
other substances may pass with ease. Researchers are busy
Miller diagnosed the “wet” form of macular
working on this possible treatment method, says Dr. Miller. In
degeneration in her new patient’s right eye.
addition, Drs. Miller, Adamis and Gragoudas, in collaboration
with Draper Labs, are examining the feasibility of drug delivery
“I had read that macular degeneration could
through the sclera, the white coat of the eye, to the retina and
come on suddenly sometimes, and that it
other structures at the back of the eye.
can get worse fast,” says Mrs. Kane, a Boston
resident. “I had no hesitations about partici-
GENETIC SCREENING AND PREVENTION
In addition to treatment advances, Dr. Miller reports that other
researchers within the RRI are focusing on understanding who
is at risk for AMD and why. For example, one study is looking
at the less severe “dry” form of AMD, which results in slowly
developing retinal damage without the abnormal growth
of blood vessels. Because it can be a precursor of the
more severe “wet” form, researchers are trying to determine
what signals progression from the dry form to the wet form
of the disease.
In another important study, molecular geneticist Thaddeus
Dryja, M.D., and Dr. Miller are studying the disease-free older
siblings of patients with “wet” AMD, looking for cellular differences that could indicate who is at risk for the disease. Studies
by Johanna Seddon, M.D., are examining the protective role of
vitamins and minerals, and other factors that could help slow
or prevent AMD. Donald D’Amico, M.D., is developing new
laser technology that may significantly improve laser-based
treatments for AMD. Ephraim Freedman, M.D., is exploring the
hypothesis that AMD is an atherosclerotic condition, in which
stiffening of the sclera is instrumental in blood vessel leakage
in the retina; if his hypothesis is correct, then treatment that
would lower the rigidity of the eye may reduce or prevent the
wet form of AMD.
pating in Dr. Miller’s clinical study. She is so
skilled and conscientious. I can’t imagine
having a better doctor.”
This study treatment, now an FDA-approved
treatment for macular degeneration, is photodynamic therapy (PDT), which was pioneered by Dr. Miller and her colleague
Evangelos Gragoudas, M.D. Mrs. Kane came
to the Infirmary for treatments every three
months until August 2000. She continues to
return to Dr. Miller’s office every six months
for check-ups.
Although she is not able to read as much as
she used to, Mrs. Kane is still able to enjoy
her favorite classic movies, walk to the post
office and market from her Prudential Center
home, and indulge in her love of cooking. “I
am very pleased that the degeneration
seems to have been stopped with this new
treatment,” says Mrs. Kane. “I feel extremely
fortunate to have been at the right place at
the right time.”
11
Pediatric patients at the
Infirmary
Entrepreneur Supports Children’s Care
thank Trustee
Richard Aldrich for his gift
of an aquarium.
What does an entrepreneur and a 177-year-old hospital have in
kids, and with the children
common? Both are committed to the health of children.
so excited, it was great to
have it delivered in time for
Richard H. Aldrich, a biotech entrepreneur and investor,
the holidays.”
became a Trustee of the Massachusetts Eye and Ear Infirmary
in 2000. Earlier this year, Mr. Aldrich pledged his generous
The
support to the Caring About Children program. In addition, he
second highest pediatric
surprised the pediatric unit with an aquarium during the holi-
surgical volume in the
days. For 16 years, the Infirmary's caring and skilled pediatric
Boston area. It is the only hospital in the city that offers
staff has been helping children and their parents feel more
individualized tours and allows a parent to be present in the
comfortable with the hospital experience. The Caring About
operating room prior to induction of anesthesia. For someone
Children program, the first of its kind in New England, offers
who believes in the future of children, selecting the Infirmary
individualized preoperative tours and arranges for parents to
to support was an easy decision.
Infirmary
has
the
be present during anesthesia induction and recovery.
The Infirmary is a center of excellence in several areas, Mr.
In addition to ensuring a more positive and successful hospital
Aldrich said. “The Caring About Children program combines
experience, the Caring About Children program is designed to
medical and scientific excellence with superb care and
provide a colorful, warm and child-friendly atmosphere to
service,” he continued. “I wanted to help ensure that every
promote comfort and well-being.
child who visits the Infirmary will receive this great care and
comfort. I hope others will think about doing the same.”
“The nurses and staff work very hard to make the pediatric unit
a comfortable place for children,” Mr. Aldrich explained. “I
For more information on how you can support the Caring About
wanted to help further this by purchasing an aquarium for the
Children program, contact Barbara Erickson at 617-573-3303.
Non profit Org.
U.S. Postage
243 Charles Street
Boston, Massachusetts 02114-3096
www.meei.harvard.edu
P A I D
Boston MA
Permit No. 51711