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Olympic Spirit Warms the Infirmary > page 9 contact The Guardian Angel of Auditory Rehab > page 3 Entrepreneur Supports Children’s Care > page 12 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