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CASEY EYE INSTITUTE C E L E E D U C I N N O B R A A T E V A T ANNUAL T E E REPORT 2002 C A S E Y E Y E I N S T I T U T E A N N U A L R E P O R T 2 0 0 2 TABLE OF CONTENTS The Casey Eye Institute Letter from the Chairman page 1 (CEI) is an academic Research To Prevent Blindness page 2 regional eye center Cornea page 4 dedicated to preventing Donor Profile: The Pettis page 6 blindness through Genetics page 7 research, and to Glaucoma page 8 bringing the highest Uveitis and Inflammatory Diseases page 10 quality patient care Retina/Macular Degeneration page 12 and advanced technology Donor Profile: Bula “Bea” Arveson page 14 to the Pacific Northwest. Low Vision page 15 Ophthalmic Plastic and Reconstructive Surgery page 16 Pediatrics Elks Children’s Eye Clinic page 18 Neuro-Ophthalmology page 20 Casey Ophthalmic Associates page 21 Clinical Trials page 22 Honors and Awards page 29 Clinical and Research Faculty page 30 Fellows and Residents page 33 Residency Program page 33 Contributions to the Casey Eye Institute page 34 1 Dear Friends: In this, our first annual report, we celebrate our successes and share the good news of innovation in science and clinical care. We also mark a new era in Casey history: in 2001, we celebrated ten years in our own freestanding institute, and last year we kicked off a $26 million campaign to expand the building. Our rapid growth makes it imperative to enlarge our facility. Since we first opened our doors in 1991, our federal research funding has more than tripled. Funding from the National Institutes of Health places OHSU in 9th place among all institutes receiving support from the National Eye Institute. Clinical growth has been extraordinary – a 100% increase in outpatient visits since 1991 (over 44,000 in 2002). Our staff has increased to 270 people, most still housed in the original, 120,000-square foot building. This report highlights many of the accomplishments of our researchers and educators. Their achievements span a gamut that ranges from unraveling the genetic mysteries of glaucoma and macular degeneration, the leading causes of visual loss among the elderly in this country, to advances in online education. There are many numbers that could be quoted. For example, our uveitis service, a small division in this department, has seven NIH grants. Our residency training program is more sought-after than ever. We now have 80 applicants for every available position. But an academic department is much more than numbers or specific achievements. It is a community which hopefully provides a unique constellation of resources in a supportive and collaborative environment that advances our knowledge, cares for the sick and improves our future. Our greatest accomplishment at Casey is developing the type of community that I just described. I am particularly proud to report that the Casey spirit is thriving. It embodies the values of academic medicine that we all cherish. It promises us a bright future. I want to conclude this introductory statement with comments about a venture that is a major source of pride for me. In 1999, we formed a partnership with Legacy’s Devers Eye Institute on the Good Samaritan campus in northwest Portland, emphasizing cooperation rather than competition. Together, we can better allocate scarce resources and benefit the entire region. This affiliation adds to our talent pool and enriches the residency experience. We share an eye bank and jointly host Grand Rounds, strengthening our commitment to learning, patient service and the local community. 2002 was a watershed year in the history of the Casey Eye Institute, one whose promise will be fulfilled in the years ahead. As you read, I know you will come to share our sense of excitement at what the future holds. Sincerely, Joseph E. Robertson, M.D., M.B.A. Professor and Chairman 2 RPB ADDS CRITICAL FUNDING Research to Prevent Blindness is the Institute has become one world’s leading organization of the leading eye research in support of eye research. facilities in the world. foresight has proven prophetic: The Casey Eye In 1982, New York-based RPB selected the Department This interactive relationship of Ophthalmology in the is further evidenced by Oregon Health & Science ongoing collaboration with University as its seventh RPB. RPB has awarded the regional eye center, and Casey Eye Institute nearly played a major role in con- $3 million over the years. ceiving and developing the According to Joe Robertson, Casey Eye Institute. This M.D., chairman of the included mobilizing financial Department of Ophthalmology, resources and procuring “Many of our advances can essential laboratory space, be linked directly to our equipment and scientific long-term relationship with personnel. RPB.” According to RPB chair- RPB funding, both restrict- man David Weeks, OHSU ed and specific grant was chosen because its awards, has allowed the ophthalmology department department to pursue had the talent to attract, research in uveitis, glauco- train and inspire ma, macular degeneration, researchers of the highest cataracts, and retinal and caliber. And now, more corneal diseases. than 20 years later, Weeks’ (l to r) David Weeks, Dr. Kenneth Swan and Dr. Fritz Fraunfelder during the Casey’s construction. Winner of the prestigious Career Development Award from RPB, Justine Smith, M.B.B.S., Ph.D., is studying uveitis. Using new molecular biology technology known as microarray, she initiated a project designed to show how Toxoplasma gondii influences the gene expression of cells within the eye during toxoplasmic retinochoroiditis. 3 John C. Morrison, M.D., received the Lew Wasserman Award from RPB, and is studying the cellular response of the optic nerve head. His findings have led to a hypothesis that explains why early damage in human glaucoma characteristically occurs in the superior and inferior optic nerve head. William D. Mathers, M.D., recipient of the RPB Physician-Scientist Award, investigates the interaction of the surface of the eye and the regulation of tear production in the lacrimal gland. 2002 recipient of the Robert E. McCormick Scholar Award, Tim Stout, M.D., is developing ways to genetically modulate the process of intraocular cellular proliferation. This is done to prevent the blinding complications of diseases such as age-related macular degeneration, proliferative diabetic retinopathy, retinopathy of prematurity, and post-cataract extraction posterior capsular opacification. Mary Wirtz, Ph.D., an RPB Dolly Green Scholar, is using RPB funding to support several glaucoma genetic projects. By analyzing DNA samples, Wirtz and her team mapped the third and sixth gene of the six now associated with glaucoma. RPB Senior Scientific Investigator Ted Acott, Ph.D., focuses on understanding how the trabecular meshwork senses intraocular pressure changes and responds to maintain it within acceptable levels to avoid glaucoma in the healthy eye. Understanding the normal functions of this tissue should provide keys for correcting the changes, which result in elevated intraocular pressure and trigger optic nerve damage in glaucoma. Stephen Planck, Ph.D., recipient of the James S. Adams Scholar Award from RPB, is using a multifaceted approach to studying ocular inflammation. His team is culturing cells from the lining of the blood vessels and studying their role as gatekeepers for the white blood cells. Videomicroscopy is used to track the different kinds of cells that initiate and execute immune and inflammatory responses. 4 CORNEA Stem cell transplants give the gift of sight. Larry F. Rich, M.D. Cornea service director effectiveness of antibiotics Larry F. Rich, M.D. treats in treating acanthamoeba. some forms of corneal By allowing researchers to disease with epithelial stem watch cells interact, the cell transplants. The trans- microscope can speed plants can help regenerate assessment of whether— cells—and sight—damaged and which—antibiotics by disease, adverse drug work against disease. We reactions, or burns. Dr. Rich also use confocal recalls a gift of epithelial microscopy in refractive cells from one identical surgery (to determine the twin to another that allowed thickness of LASIK flaps), a woman to regain sight to diagnose infectious after 30 years of blindness. disease and to collaborate Used as a precursor to on immunologic research whole-cornea grafts, prolif- with James T. Rosenbaum, erating stem cells can M.D., director of Casey’s sometimes even preclude uveitis service. the need for a transplant, and grafts of stem cells Casey Eye Institute’s and conjunctival tissue can cornea service is home to keep pterygia from recurring. the National Registry of Drug-Induced Ocular Side Damien Macaluso, M.D. Another tool for treating Effects, the only resource corneal disease is Casey’s of its kind in any subspe- confocal microscope, cialty. Founded by F.T. which William Mathers, M.D. “Fritz” Fraunfelder, M.D. in is using to evaluate the 1976, the Registry went 5 F.T. “Fritz” Fraunfelder, M.D. Rick Fraunfelder, M.D. online in 2002 under the The Casey cornea team available on the Web. direction of Rick Fraunfelder, continues working to make Special technology will M.D. (www.eyedrugreg- refractive surgery safer make lectures easy to istry.com). The father-son and more successful, download even without a team has written extensive- using our substantial high-speed connection, ly on ocular pharmacology, patient database to evalu- and a series of questions recently reviewing side ate and improve outcomes. at each lecture’s end will effects of high-profile drugs In bench research, Dr. allow viewers to earn CME like Gleevec and Zyrtec. Mathers and Yuan Fang, credits for virtual atten- Log on to the Registry to M.D., Ph.D. are studying dance. According to report cases or request molecular interactions Dr. Macaluso, not only information on a particular between the lacrimal gland virtual Grand Rounds but drug. and other organ systems, also Web-based telecon- working toward a possible ferences are in Casey’s Casey is currently the only genetic explanation for the future. site in the country treating persistent problem of dry ocular surface tumors with eye. Damien Macaluso, liquid nitrogen cryotherapy. M.D. is also collaborating At -196°C, tumors are with Tim Stout, M.D. of our quickly frozen. “The treat- retina service on gene ther- ment is less damaging to apy for corneal disease. the eye than radiation,” notes Rick Fraunfelder, M.D., To disseminate the insights adding that this high-tech gained in the laboratory surgery is also quicker and and clinic, Macaluso plans more cost-effective than to make the joint Casey/Devers other methods. Eye Institute Grand Rounds 6 Giving Well: The Story of August and Margaret Petti Owners of the Portland Casey Eye Institute’s fourth- landmark Henry Thiele’s floor atrium, named for the Restaurant, August Petti and Pettis, incorporates the his wife Margaret Thiele Petti world’s largest glass floor. sought help at OHSU in the Made of brilliant blue glass late 1980s when August’s blocks, it is a stunning eyesight began to fail. The reminder of this generous pair saw Kenneth Swan, couple. M.D. in early 1990. He referred them to corneal spe- The Pettis created three cialist Larry Rich, M.D., who endowments at Casey: performed a corneal transplant that allowed the 98-year-old The Chair of Ophthalmology gentleman to regain his sight in honor of Kenneth C. and enjoy life again. Later, Swan, M.D., currently held Margaret Petti had cataract by Joseph E. Robertson, M.D. surgery at Casey, and saw Michael Klein, M.D., and The Chair for the David Wilson, M.D., for Director of Corneal Service treatment of her diabetic in honor of Larry F. Rich, retinopathy. Both August and M.D., who holds the chair. Margaret Petti were also patients of F.T. “Fritz” The Research Fund for Fraunfelder, M.D. corneal and diabetesrelated diseases. 7 OPHTHALMIC GENETICS CENTER “We are entering an era of being able to make more precise diagnosis more quickly through testing at the molecular level.” Richard Weleber, M.D. The Ophthalmic Genetics Center at Many genetically linked syndromes was diagnosed with retinitis pigmen- Casey Eye Institute is one of few in include eye problems in their medical tosa. However, Smith felt she needed the country devoted to diagnosing landscape. In the past, making a more answers and found Dr. Weleber. complex genetic diseases with asso- specific diagnosis was a difficult and ciated ophthalmic problems. lengthy process, but that scenario After extensive testing and exploring Director Richard Weleber, M.D., is is changing. As Weleber states, her family medical history, Weleber a founding member of the American “We use laboratories across the diagnosed autosomal dominant neo- Board of Medical Genetics. He country where specialized genetic vascular inflammatory vitreoretinopathy offers a unique set of qualifications tests have been developed, (ADNIV). The rare disease had been since he is both a board certified enabling us to diagnose diseases traced to one family in Iowa and ophthalmologist and medical previously very difficult to pinpoint.” Ohio. Smith recalled a paternal geneticist. Like a master sleuth, Weleber care- grandfather who had lost vision. fully assembles all the pieces of the “Looking for more answers, I called puzzle. When fitted together, they a second cousin who is a Midwest often form a picture of a specific physician. She explored our family genetic syndrome. genealogy and found early family lineage linked to this same family in Karmen Trzupek, M.S., assists Iowa.” Weleber by providing genetic counseling to patients and their families. Knowing a specific diagnosis, Smith “Having a genetic counselor is a will be able to mitigate conditions great advantage,” Weleber continues, associated with this disease, includ- “Often, we are able to establish the ing a greater likelihood of cataracts presence of an inherited disease and glaucoma. She continues, previously unknown in a family.” “I have been so impressed seeing Richard G. Weleber, M.D. research in action. Even though the Chrystal Smith, who lives in Juneau, Casey is two plane flights and two Alaska, is grateful for Weleber’s thousand miles away, every visit is expertise. Two years ago, she very much worth the effort.” began experiencing vision loss and 8 GLAUCOMA John R. Samples, M.D. Glaucoma model brings closer understanding of how elevated pressure causes glaucoma. CEI researchers are working Approaching the problem hard to improve treatment from a genetic perspective, for this devastating eye John Samples, M.D., and disease, to understand its Mary Wirtz, Ph.D., have causes, and ultimately, to discovered the third and find a cure. sixth (out of six) known John Morrison, M.D., and genetic loci for open angle Elaine Johnson, Ph.D., glaucoma in a study of have developed a glaucoma several large families. The model that highlights the third locus, GLC1C, was focal nature of optic nerve the first to be clearly delin- damage, bringing us eated for adult high-pres- several steps closer to sure, open-angle glaucoma. understanding how elevat- This study, derived from ed intraocular pressure Samples’ practice and causes glaucoma. funded by several NEI Morrison and Johnson grants, was carried on in have found a distinct, both Portland and Greece. repeatable pattern of injury, Samples is also working allowing them to pinpoint with other collaborators to the injury site in a specific determine whether there is region of the nerve head. value in testing glaucoma Morrison’s work was genes commercially at recently recognized with present. the Lew R. Wasserman Merit Award for Glaucoma In another approach to Research from Research to elevated IOP, Samples and Prevent Blindness. He is Al Eisner, Ph.D., are using also the recipient of a four- psychophysical testing to year NIH grant, “Studies in evaluate the neuroretinal Glaucomatous Optic Nerve damage caused by elevated Damage.” IOP and drugs (most 9 John C. Morrison, M.D. recently, tamoxifen). In Researchers John Bradley, from throughout the world. addition, Samples is Ph.D., Ted Acott, Ph.D., It covers basic science, collaborating with Paul and Samples are evaluat- clinical diagnosis and man- Knepper, M.D., Ph.D., of ing it, both in patients and agement of all forms of Northwestern University to in the laboratory, with the glaucoma, and includes study specific molecules, goal of further refining the important new details on termed CD44, which are mechanism by which it etiology, genetics, and epi- only elevated in primary works. In addition, demiology as well as a dis- open-angle glaucoma. Samples is working with a cussion of neuroprotection. These molecules seem to small California company Samples is presently work- be highly toxic to the out- called Glaukos to develop ing on a book on ophthalmic flow structures and to reti- an entirely new type of out- genetics for W.B. Saunders. nal and optic nerve cells, flow device for lowering as well as to the trabecular IOP. Clinical trials are meshwork. He also has a planned for mid-2003. meshwork’s extracellular matrix and is examining the presence of certain enzymes (interleukin related kinases, or IRAK) in the trabecular meshwork associated with reaction to the cytokines. co-investigators on “Visual Adaptation Limits of Age- longstanding interest in the effects of cytokines on the Eisner and Samples are Related Disease” (the two Both Morrison and Samples continue to make important contributions to the literature. Working with Irvin P. Pollack, M.D., of the Wilmer Eye Institute, Morrison has edited a new, comprehensive text, also hope to begin an NIHfunded study this year on female hormones and vision.) Samples, who currently serves on the AAO’s Technology Assessment committee as well as the committee charged with Glaucoma: Science and rewriting the association’s Practice. This textbook, glaucoma text, is co-direc- As of this writing, the only released by Thieme selective laser trabeculo- Medical Publishers in plasty unit in the state of November 2002, contains Oregon is housed at the contributions from more Casey Eye Institute. than 35 recognized experts tor of a national glaucoma symposium to be held in Las Vegas in mid-2003. 10 UVEITIS and INFLAMMATORY DISEASES “Uveitis researchers are looking to the needs of the future.” Directed by James T. Rosenbaum, Suhler and Rosenbaum, M.D., holder Smith are investigating of the Edward T. infliximab (Remicade), a Rosenbaum Chair in monoclonal antibody Inflammatory Diseases, the against tumor-necrosis factor service includes co-director alpha, for treatment of Eric B. Suhler, M.D., chief vision-threatening, non- of ophthalmology at the infectious uveitis that is Portland Veterans Affairs refractory to other systemic Medical Center; Justine immunosuppressants. Smith, M.B.B.S., Ph.D.; Though Remicade has Roger George, M.D., and already been proved effec- Daryl Kurz, M.D. tive in the treatment of Rosenbaum is the current other systemic inflammatory president of the American diseases (such as Crohn Uveitis Society. disease and rheumatoid arthritis), this is the first trial James T. Rosenbaum, M.D. with his father, Edward T. Rosenbaum, M.D. The Casey Eye Institute is of the drug specifically for an important part of new ocular inflammation. uveitis therapy studies. Patients come from all over Since 1985 the NIH has the Pacific Northwest for generously supported specialized care, some- OHSU’s basic research into times including experimental the pathogenesis of uveitis drugs. For example, and ocular inflammation. 11 Uveitis/Inflammatory Diseases research staff CEI researchers, including and Europe. The Casey is in eye-related research. In Stephen R. Planck, Ph.D., the only center in the world the past, this program has were among the first to to publish on the isolation convinced several talented study cytokines and adhe- and characterization of scientists to take up oph- sion molecules in ocular microvascular endothelial thalmic research. Faculty inflammation. CEI is also a cells from the iris. The members are also continu- world pioneer in using endothelial cell is a gate- ing their own education: intravitreal microscopy to keeper in inflammation, Smith returns in July from a watch cells at work in the and CEI researchers are research fellowship with eyes of living rodents and characterizing its role in Yvonne DeKozak, M.D., people, monitoring immune uveitis as well as in other Ph.D., at the Centre de system activity in and diseases, such as diabetic Recherches Biomedical around individual blood retinopathy. Finally, we are des Cordeliers in Paris, vessels or cells as a dis- also investigating how a while Suhler will soon com- ease progresses. slight change in a protein plete his master’s in public called NOD2 results in health with an emphasis in CEI researchers led by Blau syndrome, a rare, epidemiology and Tammy Martin, Ph.D., have inherited form of uveitis. biostatistics. also embarked on a project to identify the genes that CEI’s uveitis researchers increase uveitis risk, col- are looking to the needs of lecting family histories and the future, as Rosenbaum blood for DNA analysis administers a training grant from patients throughout that supports seven pre- the United States, Canada doctoral graduate students 12 MACULAR DEGENERATION TREATMENT POSSIBILITIES EXPAND “We will now have the opportunity to deliver therapeutic genes directly to a patient’s cells.” Timothy Stout, M.D., Ph.D. Tim Stout, M.D. (r.) with research staff “Of all the recent research to repair eye disease damage. developments in the realm of We will now have the opportunity retinal disorders, the most to deliver therapeutic genes exciting is in the field of macular directly to a patient’s cells.” degeneration,” states Joseph Michael Klein, M.D. (l.) with Mitch Schain Robertson, M.D., M.B.A., pro- Using this master map of the fessor and chairman of the 30,000 genes in the human department of ophthalmology. body, Casey researchers have “Five to ten years ago, we had already pinpointed genes very limited treatment options. responsible for macular degen- Today, we are involved in clini- eration and glaucoma. As cal trials exploring multiple Stout explains, “We know the modes of therapy that existed development of many serious only in our imaginations until eye diseases is influenced by now. We can now offer hope of one or more abnormal genes. vision stabilization in many of When we locate all the genetic our patients and the promise of players in each disease, we vision improvement for all can then look at what goes seems close at hand.” wrong inside the cell and work on altering those chemical For the first time, researchers processes at the cellular level, are learning how to treat eye halting the disease process disease at the cellular level. before it even gets started.” Tim Stout, M.D., Ph.D., enthusi- Andreas Lauer, M.D. astically details how last year’s Although still in its infancy, the completion of the Human ability to deliver therapeutic Genome Project is impacting genes directly to the retina will his life as a retina physician expand the spectrum of possi- and researcher. “In the past, ble treatments for age-related I have only had mechanical macular degeneration, or AMD. tools such as laser or surgery Nationally, AMD is the leading 13 cause of irreversible vision loss Stout and Michael Klein, M.D., in preventing new blood vessel in the U.S., currently affecting are in the early phase of a growth. It is being compared to 1.7 million people over the age multi-center clinical trial spon- photodynamic therapy, a major of 65. An increasing aging sored by GenVec, a biotech medical breakthrough population is propelling company developing anti- approved in the spring of 2000 researchers at Casey Eye angiogenic drugs designed to for the treatment of wet AMD. Institute and other institutions deliver medication directly to Although this approach does across the country to try to the retina by means of an not restore vision lost to AMD, understand the causes and injection behind the eye. it can slow the progression of develop effective treatments for This approach to treating AMD the disease. this often-debilitating disease. is not completely new. Beginning two years ago, Other types of laser treatment A major underlying cause of Klein, director of the Macular are also being studied. Klein macular degeneration is known Degeneration Center, began a and his team are conducting to be angiogenesis, the growth study in conjunction with the Complications of Age- of unwanted new blood vessels. Eyetech Pharmaceuticals Related Macular Degeneration These can bleed and scar, involving an investigative drug Trial (CAPT) to learn if a specif- damaging light-sensitive cells named Macugen, also ic laser treatment can prevent and destroying a person’s cen- designed to block new blood the advanced complications of tral vision. This same process vessel growth. An expanded AMD and the associated vision occurs in diabetic retinopathy study is now underway. loss. Stout continues, “How these In tandem with gene therapy, The most recent faculty addi- blood vessels grow is a complex researchers are moving closer tion to the retina service, Lauer process. Researchers have to identifying specific genes has immersed himself in isolated 22 different chemicals responsible for AMD. In the research as a co-investigator in encoded in genes responsible Genetics of AMD study led by several studies, including the for growing new blood vessels. Klein and Dennis Schultz, Age-Related Eye Disease We know gene-containing pro- Ph.D., the DNA of more than Study (AREDS) at Devers Eye teins like vascular endothelial 100 families affected by the Institute. He also serves as the growth factor (VEGF) promote disease is being analyzed. residency program coordinator. vascular growth and others like Four years ago, Klein and his pigment epithelial derivative team localized the first gene Interest in the carotenoids, factor (PEDF) inhibit growth. In linked to AMD in several mem- lutein and zeaxanthin, pig- a healthy eye, these two factors bers of a large family. ments found in green, yellow and retinopathy of prematurity. remain in balance. In the dis- and orange fruits and vegeta- eased eye, biological signals Klein, along with Andreas bles evolved into two studies. instruct new vessels to grow, Lauer, M.D., is also conducting Klein and his team are con- overpowering those that would a study of the steroid anacor- ducting the Carotenoid Study, typically prevent the process.” tave acetate and its effectiveness sponsored by the Foundation 14 Macular Degeneration Treatment (continued) Fighting Blindness, to determine whether consuming large amounts Generosity Advances Macular Degeneration Research of carotenoid-containing foods will possibly decrease the risk of devel- director of the center and Arveson’s oping wet AMD. The Carotenoids physician. “The center has already in Age-Related Eye Disease Study been instrumental in advances in drug (CAREDS), sponsored by NIH as therapy, genetics research and nutrition part of the Kaiser Women’s Health to prevent and treat this disease, but Initiative, is looking at how environ- this kind of transformative gift can lead mental factors such as diet, sunlight to greater things.” exposure and family history may influence AMD. Bula “Bea” Buck Arveson’s voice sparkled with Born in 1902 to a pioneering family in David Wilson, M.D. and Robert resolve about helping researchers find Arveson in 1925 and moved to Watzke, M.D., are nearing completion a cure for age-related macular degen- Portland. Her husband, who died in of the NIH-sponsored Collaborative eration, the leading cause of severe 1988, spent 35 years as vice president Ocular Melanoma Study (COMS), vision loss in people older than 65. and western manager of U.S. Epperson which began in 1987. Wilson is Because she and two siblings had Underwriting Company. Arveson devoted also the principal investigator and experienced vision loss from AMD, she much of her life to public service, vol- a writing committee member of the had a personal interest in this disease. unteering for organizations such as Submacular Surgery Trial (SST), During a 1995 interview, she spoke of Head Start and the Portland Veterans which will conclude in September her desire to assist researchers in find- Affairs Medical Center. In the early 2003. In conjunction with Oculex, ing a cure for AMD. “Something has to 1930s, she was instrumental in getting he is testing a new delivery system be done and I think OHSU researchers the first black woman admitted to the with a self-dissolving pellet implanted can do it. I want to help make that possible.” nursing program at the University of under the conjunctiva designed to treat cystoid macular edema. In Idaho Falls, Idaho, she married Charles Oregon Medical School, now the Although Arveson died last year at the OHSU School of Medicine. addition, Wilson recently completed age of 98, she left a clear directive with his thesis for membership in the a $5 million gift to the OHSU Casey Bea Arveson spent a lifetime caring for American Ophthalmological Eye Institute, establishing the Bula others. Her generous legacy will continue Society involving glucose uptake in Buck and Charles C. Arveson to make a huge difference in conquer- the inner retina. Endowment Fund. This is one of the ing AMD, a disease that can greatly largest private gifts ever given to help impact a person’s vision and subse- fight macular degeneration. quently their quality of life. Sigrid Button, a former administrator of the David Wilson, M.D. A patient at Casey for more than a Casey Eye Institute recalls Arveson. decade, Arveson also served on the “She always had tremendous foresight board of its Macular Degeneration and understood this gift would be the Center. “Her generous gift will allow us very best investment for her own family to dramatically accelerate our as well as reaching many lives far into research,” said Michael Klein, M.D., the future.” 15 MAKING THE MOST OF LOW VISION “It is essential to find ways to help (patients) maintain a satisfying lifestyle...” John Boyer, O.D. The Casey Eye Institute’s “People tend to scale down Low Vision Rehabilitation their lives when faced with Clinic provides an invalu- vision loss, which can be able service to patients devastating,” Boyer notes. referred by ophthalmolo- “It is essential to find ways gists and optometrists in to help them maintain a Oregon and from many satisfying lifestyle and other states. Clinic director activity level.” Something John Boyer, O.D., evalu- as simple as proper light- ates patients with low ing or as complex as the vision as a supplement to latest video technology can their medical ophthalmolo- help patients return to gy needs. The clinic helps work, school or daily activi- patients find ways to pur- ties. Even more importantly, sue their interests and low vision rehabilitation activities despite the need helps people recover the for vision assistance. independence, autonomy and optimism they may have lost. 16 OPHTHALMIC PLASTIC and RECONSTRUCTIVE SURGERY “Our research is ultimately all done to benefit our patients.” Roger A. Dailey, M.D. Roger Dailey, M.D. (r.) and fellow, Stan Saulny, M.D. Our oculoplastics division is ultimately all done to benefit continues to lead the way in our patients.” On the academic both cosmetic and reconstructive side, Dailey is coauthor, with procedures. Roger A. Dailey, John Wobig, M.D., of M.D., has developed new tech- Oculoplastic Surgery: Face, niques in lacrimal surgery Lacrimal System, and Orbit, (Instat for hemostasis), ptosis expected from Thieme Medical surgery (transconjunctival fascia Publishers in the fall of 2003. late sling), and orbital surgery (LeFort I Orbitotomy). He also recently designed a globe retractor (now sold by Bausch & Lomb) used in optic nerve sheath decompression and orbital tumor removal. Currently, he is working with a company called Ocular Concepts to produce irisenhanced conformers for postoperative enucleation patients, with collaborative trials underway. In addition, clinically based research continues to flourish at CEI. Allergan Pharmaceuticals is sponsoring a new clinical trial of Botox, set to begin in early 2003. “After all,” notes Dailey, “our research Lester T. Jones, M.D. Holder of the Lester T. Jones Chair of Ophthalmic Facial Plastic Surgery - the only endowed chair in oculoplastics in the country - Dailey is also preceptor of CEI’s two-year, ASOPRS-sponsored fellowship program, which offers training in all aspects of ophthalmic plastic and reconstructive surgery. As one of just 28 such fellowships (only seven west of the Mississippi), it has been extremely competitive nationwide. Recently, CEI matched its first choice yet again for the fellowship beginning in July 2003. 17 John Ng, M.D. and Nancy Campbell, P.A.-C. John D. Ng, M.D., covers the hypoplastic eye socket disorder. In addition to his clinical inno- trauma, reconstructive and He was the first in the country vations, Ng plays an active role pediatric portions of CEI’s to implant these devices in academic medicine. He is Division of Ophthalmic Facial (which were developed in associate preceptor for Plastic Surgery. Because Germany and only recently Casey’s ASOPRS fellowship, Casey Eye Institute is the FDA-approved), bilaterally and helping train the next genera- Pacific Northwest’s eye trauma simultaneously. For Graves dis- tion of oculoplastics specialists. center, he serves patients from ease, Ng does small incision He is also co-editor and co- Oregon, Washington, Idaho orbital decompression, using a author of the textbook and northern California. Ng is 1-cm lateral canthal skin inci- Evaluation and Treatment currently developing new sion (orbit only). Finally, he is o f Orbital Fractures: A orbital implants using Medpor developing new approaches to Multidisciplinary Approach, Bioglass, a porous polyethyl- orbital reconstruction using 3-D to be published by ene/silicone blend that has stereolithographic technology W.B. Saunders. been shown to promote blood to build custom orbital vessel growth. By stimulating implants. Using a 3-D model growth, this new material can based on CT imaging of a decrease the time necessary to patient’s head, Ng can shape a complete vascularization by custom implant from putty that one-third to one-half. Ng also is then built by the company. uses Bioglass to repair orbital Among his research interests, implants. Ng is exploring ways to improve local anesthetic In pediatric surgery, Ng is refining his technique for implantation of a new, selfexpanding orbital and socket implant, used to treat congenital administration in office-based oculoplastic surgery and refining techniques to address ocular problems in patients with facial nerve paralysis. 18 PEDIATRICS - ELKS CHILDREN’S EYE CLINIC Since Casey opened its doors, the number of children seen has doubled and the volume of research has tripled. The Oregon State Elks patients, working on projects have been integral in the success for staff, and providing informa- of the Elks Children’s Eye tion to the public with a smile. Clinic. This special relationship The Elks also funded up-to-date between the Department of equipment for the pediatric Ophthalmology and the Elks ophthalmology exam room at dates back to 1949, when OHSU’s Doernbecher Children’s Dr. Kenneth Swan needed an Hospital, which is staffed by oximeter for a baby whose the faculty of the Elks Children’s father was an Oregon Elk. Eye Clinic. The Elks raised $2000 for the oximeter, and soon after, their From the beginning, it was the continued generosity estab- Elks’ critical philanthropic lished our pediatric clinic. support that allowed Casey’s founder Kenneth C. Swan, M.D., In the years since, the Elks to recruit top faculty. “They’ve have contributed enormously given us an edge,” notes Earl to eye care at OHSU. They Palmer, M.D., head of the Elks helped pay for the nation’s first Children’s Eye Clinic. Our microscope for ocular surgery, pediatrics service has also the Northwest’s first ophthalmic been blessed with significant, excimer laser, and Oregon’s ongoing support from the first photokeratoscope for Annie E. Casey Foundation, children. Today, the Oregon which has allowed us to State Elks Association con- expand our services. tributes over $500,000 per year to the Elks Children’s Eye For more than 50 years, the Clinic and the Oregon School Elks Children’s Eye Clinic has for the Blind. conducted cutting-edge eye research and provided superior Oregon Elks donate thousands eye care for children in the of hours volunteering at the Pacific Northwest. Dr. Palmer is Casey Eye Institute—assisting principal investigator and chair 19 David T. Wheeler, M.D. Earl A. Palmer, M.D. of the NIH-sponsored, multi- safety monitoring committee for Since Casey Eye Institute center trial “Cryotherapy for a multicenter consortium, the opened its doors in 1991, the Retinopathy of Prematurity”(ROP). Pediatric Eye Diseases number of pediatric patients Begun in 1986, this nationwide, Investigative Group (PEDIG). seen here has doubled, and landmark study was designed Wheeler is an investigator for the volume of research has to help physicians determine this group, working on the now tripled. As a major Pacific when and how to treat ROP in complete Congenital Esotropia Northwest referral center, the order to save as many chil- Observational Study as well as Elks Children’s Eye Clinic treats dren’s vision as possible. The on several amblyopia studies. approximately 8,000 children study’s results have revolution- He is also an investigator in the each year. The four current ized ROP management and Infant Aphakia Treatment Study faculty- Palmer, Laurie inspired more research. (IATS), researching the best Christensen, M.D., Stout, and way to care for infants younger Wheeler- plan to add one more Today Dr. Palmer serves on the than 6 months who develop a member to the department executive committee for a cataract in one eye. He partici- through a pediatric multicenter trial that will help pates in OHSU’s Human fellowship program that will identify infants at high risk for Investigations Program, one of begin in the near future. ROP earlier than in the past. only five such programs in the David T. Wheeler, M.D., is country designed by the NIH to Oregon’s principal investigator stimulate physician leadership and Ann U. Stout, M.D., is a in clinical research. co-investigator in this “early treatments” study, while researcher Michael Powers, M.D., is studying retinal vessel development in a parallel effort to better understand ROP. Our pediatrics faculty participate in several other clinical trials, all federally funded by the National Eye Institute. Palmer belongs to the data and 20 NEURO-OPHTHALMOLOGY Our team sees patients with the entire spectrum of neuro-ophthalmic disorders. Robert Egan, M.D., and blood vessel behind the W. Thomas Shults, M.D., patient’s eye, and clot- form a critical team of clini- busting medication is used cian investigators who see to dissolve clots that have patients with the entire blocked the blood supply spectrum of neuro- to the retina. ophthalmic disorders. These include ischemic As in the other subspecialties optic neuropathy, optic at the Casey Eye Institute, neuritis, optic atrophy, the neuro-ophthalmology stroke, multiple sclerosis, unit actively participates in cranial nerve palsies, brain several research projects. tumor, myasthenia gravis, Subjects diagnosed with thyroid eye diseases, psy- Leber’s hereditary optic chiatric disorders and neuropathy in one eye are unexplained visual com- being studied to determine plaints. if treatment with an eye drop medication will Robert Egan, M.D. Through a dynamic collab- decrease their risk of oration between the neuro- developing this condition in ophthalmology service, the the other eye. Oregon Stroke Center, and the Dotter Interventional The relationship between Institute in the OHSU neuro-ophthalmologic School of Medicine, signs and stroke is also patients are being evaluated being investigated, as is and treated for acute reti- the link between optic nal artery occlusion. A nerve hypoplasia and catheter is inserted into a epilepsy. 21 CASEY OPHTHALMIC ASSOCIATES Physicians Bring Diverse Backgrounds to Patient Care Casey Ophthalmic Associates ophthalmologists working in con- cares for a wide-ranging popula- junction with the American Academy tion as the general ophthalmology of Ophthalmology on the Systematized service at the Casey Eye Institute. Nomenclature of Medical Reference The staff includes Kelly Chung, Terminology (SNOMED) project. M.D., William Farr, M.D., and Devin This collaborative endeavor Gattey, M.D., who recently joined between the United Kingdom and the group to accommodate grow- the United States is producing a ing numbers of patients. Tammie comprehensive medical terminolo- Krisciunas, O.D., specializes in gy database to be used worldwide contact lens care. With the assis- as the basis for all medical software. Devin Gattey, M.D., recently joined tance of the OHSU Translation & As Chung states, “This terminology Casey Ophthalmic Associates. Interpreter Services, care is provid- is much different than say, ICD or Having served in the Peace Corps ed to patients speaking some 40 CPT, because it is modeled using in Nepal, his interests gravitate different languages. artificial intelligence, so information toward international medicine. searches are very robust. For During his inaugural medical mis- instance, a search for all patients sion, he accompanied a team to with open angle glaucoma would Peru, performing cataract retrieve not only patients with surgery on native Indians living at “POAG,” but also pigmentary glau- an elevation of over 14,000 feet. In coma, low tension glaucoma and May of this year, Gattey will journey pseudo-exfoliation glaucoma with- to Guatemala as part of another out the user specifying or knowing medical team. “My long term goal is that these conditions are types of to establish an international clinic open angle glaucomas. That knowl- where Casey providers can have edge is built into the system.” Also, this kind of experience. Despite since SNOMED has been translat- the monumental task of putting a Chung blends a busy clinical and ed into several languages, it will team together, it is a life-changing surgical practice with her interest truly give physicians a common experience.” in medical informatics, the science medical language. Kelly Chung, M.D. of developing and using information technologies to improve health care. Nationally, she is one of two Devin Gattey, M.D. 22 CLINICAL TRIALS and STUDIES CORNEA NE-91: Hyperopia and Hyperopic Astigmatism (H-LASIK) with the Nidek EC-5000 Excimer Laser System Principal Investigator: Larry Rich, M.D. Sponsor: Nidek Purpose: To compare the safety and predictability of PhotoRefractive Keratectomy (PRK), PhotoAstigmatic Refractive Keratectomy (PARK), Laser in Situ Keratomileusis (LASIK), and Astigmatic Laser in Situ Keratomileusis (A-LASIK) excimer laser methods in reducing nearsightedness and nearsightedness with astigmatism. Clinical trials are used to determine whether new drugs or treatments are safe and effective. The following studies are currently underway at the Casey and Devers Eye Institutes. Excision and Cryotherapy for Pterygia Principal Investigator: Rick Fraunfelder, M.D. Purpose: To study the recurrence rate of pterygia treated with excision and cryotherapy. GLAUCOMA Clinical Study to Evaluate the Effectiveness and Safety of Oral Memantine in Patients with Chronic Open-Angle Glaucoma Principal Investigator: John Samples, M.D. (Casey Eye Institute) Sponsor: Allergan Principal Investigator: Steven Mansberger, M.D., M.P.H. (Devers Eye Institute) Purpose: To investigate the safety and efficacy of memantine supplied in tablets for the treatment of certain types of open angle glaucoma. The study drug has been sold in Europe for treatment of dementia syndrome and spastic disorders, such as Parkinson’s disease, and is not yet marketed in any country for use in glaucoma. Chronology of Functional Deficits Principal Investigator: Brad Fortune, O.D., Ph.D. Sponsor: Legacy Research Advisory Council Purpose: This study considers the hypothesis that a generalized retinal neurodegeneration involving glial cells and metabolic dysfunction exists in glaucoma. Memantine Visual Field Reading Center Principal Investigators: G.A. Cioffi, M.D. and C.A. Johnson, Ph.D. Sponsor: Allergan Purpose: To receive, analyze and interpret visual field data collected from worldwide study sites and perform statistical analysis of data transferred from such sites. Anterior Chamber to Schlemn’s Canal Shunts in the Surgical Treatment of Glaucoma Principal Investigator: John R. Samples, M.D. Sponsor: Glaukos Corporation Purpose: A new device which shunts aqueous directly from the anterior chamber to Schlemm’s canal is being studied and appears to have some promise in lowering intraocular pressure without surgical complications. 23 Genetic Studies of Glaucoma Patients Principal Investigators: Mary Wirtz, Ph.D. Sponsor: National Eye Institute Purpose: To study the genetics of families with five or more affected individuals with primary open angle glaucoma, drusen of the optic nerve, congenital glaucoma, and selected other secondary glaucomas. Aquaflow™ Collagen Glaucoma Drainage Device Principal Investigator: John R. Samples, M.D. Sponsor: Staar Surgical Purpose: To assess the efficacy and safety of the Aquaflow™ Collagen Glaucoma Drainage Device compared to existing surgical methods of draining fluid from inside the eye, such as trabeculectomy. The Aquaflow device is made from collagen derived from pigs, and is designed to be inserted into the outer tissues of the eye (sclera). Evaluation of Multifocal Electroretinogram (MERG) for Use in Glaucoma Principal Investigators: Brad Fortune, O.D., Ph.D., G.A. Cioffi, M.D. Sponsor: Murdock Trust Purpose: To evaluate and optimize a new diagnostic procedure known as Multifocal Electroretinography (MERG). MERG will be compared to standard diagnostic procedures as well as to other new, highly sensitive diagnostic instruments for detection of early vision damage caused by glaucoma. Intraocular Hypertension: A Multi-Center, Open Label Study to Determine if AntiGlaucoma Eye Drop Medicines Prevent or Delay Onset of Glaucoma in Patients with Intraocular Hypertension Principal Investigator: George Cioffi, M.D. Purpose: To determine whether lowering high eye pressure with eye drop medication prevents or delays glaucoma in patients with increased eye pressure. Short Wavelength Automated Perimetry in the OHTS Trial Principal Investigator: C.A. Johnson, Ph.D. Sponsor: National Eye Institute Purpose: To determine the effects of intraocular pressure lowering treatment versus no treatment on SWAP deficits in ocular hypertension patients. OHTS Visual Field Reading Center Principal Investigator: C.A. Johnson, Ph.D. Sponsor: National Eye Institute Purpose: To process visual field data for the OHTS trial Objective Perimetry in Glaucoma: Objective Perimetry Evoked Response Analysis (OPERA) Principal Investigator: Brad Fortune, O.D., Ph.D. Purpose: To evaluate a new visual screening device that may provide earlier detection and better monitoring of glaucoma. Perimetry and Psychophysics in Glaucoma Principal Investigator: Chris A. Johnson, Ph.D. Purpose: To evaluate several new test procedures that are believed to detect the earliest changes produced by glaucoma. 24 CLINICAL TRIALS and STUDIES MACULA and RETINA Genetics of Age-Related Macular Degeneration Principal Investigator: Michael Klein, M.D. Sponsor: National Eye Institute Purpose: To find the genes that cause age-related macular degeneration. Identifying these disease-causing genes will lead us directly to the cause of the disease. Nutrition and Age-Related Macular Degeneration Principal Investigator: Michael Klein, M.D. Sponsor: Casey Eye Institute/Clinical Nutrition, OHSU/Tufts University Center of Aging Purpose: To find out if increasing amounts of foods containing carotenoids, lutein and zeaxanthin will increase the level of pigment in the macula and protect against macular degenerative changes. Evaluation of Intravitreal Injections of EYE 001 (Anti-VEGF Aptamer) in Patients with Exudative Age-Related Macular Degeneration (AMD) Principal Investigator: Michael Klein, M.D. Sponsor: Eyetech Pharmaceuticals Purpose: To establish the safety and efficacy of intravitreal injections of EYE001 given in 6 week intervals. Evaluation of Anecortave Acetate versus Visudyne in Patients with Subfoveal Exudative Age-Related Macular Degeneration (AMD) Principal Investigator: Michael Klein, M.D. Sponsor: Alcon Purpose: To evaluate the safety and effectiveness of anecortave acetate in preventing the growth of blood vessels under the retina in subjects with AMD as compared to treatment with PDT and Visudyne. A Study of ADGVPEDF.11D in Neovascular Age-Related Macular Degeneration (AMD) Principal Investigators: Michael Klein, M.D. and Timothy Stout, M.D., Ph.D. Sponsor: GenVec, Inc. Purpose: To evaluate the safety and effectiveness of this gene therapy medication in slowing the growth of the blood vessels or improving vision. Submacular Surgery Trials (SST) Principal Investigator: David Wilson, M.D. Sponsor: National Eye Institute Purpose: To determine whether surgical removal of subfoveal choroidal neovascularization (CNV) and associated hemorrhage in patients with age-related macular degeneration (AMD), the ocular histoplasmosis syndrome (OHS), or idiopathic CNV stabilizes or improves vision more often than observation. Complications of Age-Related Macular Degeneration (CAPT) Principal Investigator: Michael Klein, M.D. Sponsor: National Eye Institute Purpose: To determine whether application of low-intensity laser treatment of eyes with drusen in the macula can prevent later complications of age-related macular degeneration and thereby preserve visual function. 25 AREDS: Age-Related Eye Diseases Study Principal Investigator: Michael Klein, M.D. Sponsor: National Eye Institute Purpose: To assess the clinical course, prognosis, and risk factors of age-related macular degeneration (AMD) and cataract; to evaluate the effects of antioxidants and zinc on the progression of AMD and antioxidants on the development and progression of lens opacities. CAREDS: Carotenoids in Age-Related Eye Disease Principal Investigator: Michael Klein, M.D. Sponsor: NIH Kaiser Permanente Women’s Health Initiative Purpose: To look at environmental factors (diet, dietary supplements, sunlight exposure, family history) and their role in age-related eye disease. Oculex Pharmaceutical Study of Macular Edema Principal Investigator: David Wilson, M.D. Sponsor: Oculex Pharmaceuticals Purpose: To determine the efficacy of a new dexamethasone implant delivery system in the treatment of persistent macular edema associated with diabetic retinopathy, uveitis, retinal vein occlusion or Irvine Gass syndrome. This clinical research study evaluates the safety and effectiveness of an investigational medication to treat macular edema that persists despite current treatment methods. Optical Coherence Tomography in Diabetic Macular Edema Principal Investigator: Robert Watzke, M.D. Purpose: To determine the value of optical coherence tomography (OCT) in the clinical assessment of diabetic macular edema. Clinical, Electrophysiological, and Molecular Evaluation of Retinitis Pigmentosa and Allied Disorders Principal Investigator: Richard Weleber, M.D. Sponsor: Foundation Fighting Blindness Purpose: To evaluate patients with retinitis pigmentosa and allied disorders, provide genetic counseling, and perform DNA candidate gene screening to search for a molecular basis for these diseases. Multifocal Electroretinographic Values of the Normal Eye Principal Investigator: Robert Watzke, M.D. Purpose: To perform multifocal electroretinographic testing on human eyes to test the electrical response of groups of retinal nerve cells in the posterior pole. This is a new method of testing, and this study proposes to establish a standard of normal values in patients with normal eyes, older patients, and those with refractive errors. Long-Term Sequellae in Parafoveal Telangiectasia Principal Investigator: Robert Watzke, M.D. Purpose: Parafoveal telangiectasia (PFT) is an ocular vascular disease characterized by abnormal retinal vessels. The purpose of this study is to determine the long-term results of untreated PFT and its effect on vision. A secondary goal is to determine whether it is associated with existing systemic disease, particularly diabetes. 26 CLINICAL TRIALS and STUDIES NEURO-OPHTHALMOLOGY Multi-Center Study of the Safety and Efficacy of Brimonidine-Purite 0.15% Ophthalmic Solution Administered to Patients with Leber’s Hereditary Optic Neuropathy Principal Investigator: Robert Egan, M.D. Sponsor: Allergan Purpose: Leber’s hereditary optic neuropathy causes severe and permanent visual loss. To date, no effective treatment has been identified. This study hypothesizes that brimonidine purite 0.15% is effective in reducing visual acuity loss. Retinal Emboli in Acute Ischemic Stroke Principal Investigator: Robert Egan, M.D. Purpose: To determine the significance of emboli in the eyes to help determine the cause of the stroke. Optic Nerve Hypoplasia and Epilepsy Principal Investigator: Robert Egan, M.D. Purpose: To determine whether patients with seizures or epilepsy have an increased incidence of optic nerve hypoplasia. ONCOLOGY Collaborative Ocular Melanoma Study (COMS) Principal Investigator: David Wilson, M.D. Sponsor: National Eye Institute Purpose: 1) To evaluate therapeutic interventions for patients who have choroidal melanoma, and to assess the potential life-preserving as well as sight-preserving role of radiation therapy. 2) To determine which of two standard treatments, removal of the eye or brachytherapy, is more likely to prolong survival of eligible patients with medium-sized choroidal melanoma. 3) To determine whether preoperative radiation prolongs life for patients whose eyes with large choroidal melanoma are enucleated. Breast Cancer and Vision Principal Investigator: Al Eisner, Ph.D. Sponsor: Oregon Cancer Institute Purpose: To assess how the drug, tamoxifen, affects the visual system. The protocol consists of experimental tests of visual sensitivity plus conventional ophthalmologic assessment. Decreased Tumor Recurrence after Excision and Cryotherapy for Suface Eye Malignancies Principal Investigator: Rick Fraunfelder, M.D. Sponsor: Collins Medical Trust Purpose: To perform excision and cryotherapy on surface eye tumors and analyze results of tumor recurrence, visual morbidity, tumor metastasis, and patient mortality. This research will serve as a basis for future studies into treatment and prognosis of surface eye tumors. 27 PEDIATRICS Outcome Study of Cryotherapy and Retinopathy of Prematurity Principal Investigator and National Chairman: Earl A. Palmer, M.D. Sponsor: National Institutes of Health/National Eye Institute Purpose: Originally launched in 1985 to determine the safety and efficacy of trans-scleral cryotherapy of the peripheral retina in certain low-weight infants with retinopathy of prematurity (ROP) for reducing blindness from ROP. Outcome study is to determine the long-term outcome for eyes that had severe (“threshold”) ROP, both with and without cryotherapy. Early Treatment for Retinopathy of Prematurity Study (ETROP) Principal Investigator: David Wheeler, M.D. Sponsor: National Eye Institute Purpose: To test the hypothesis that earlier treatment in carefully selected cases will result in an overall better visual outcome than treatment at the conventional CRYO-ROP threshold point in the disease. “Early” treatment means the eye is treated before the disease becomes severe. Follow-up Study of the Early Treatment of Retinopathy of Prematurity Trial (ETROP) Principal Investigator: David Wheeler, M.D. Sponsor: National Eye Institute Purpose: Because the vision in babies and young children changes significantly, it is believed that there may be longterm differences between the earlier treated eyes and the eyes treated after ROP became severe. This study will follow the vision of the children who were in the original ETROP study up to age 6. Infant Aphakia Treatment Study (IATS) Principal Investigator: David Wheeler, M.D. Sponsor:: Emory University Purpose: This is a pilot study which explores intraocular lens implantation in infants with monocular cataracts. The purpose of this project is to find out which treatment will result in better vision for babies who are born with a cataract in one eye: babies who have the cataract removed to the vision of babies who have the cataract removed and have an intraocular lens put in. Amblyopia Treatment Studies (ATS) Principal Investigator: David Wheeler, M.D. Sponsor: National Eye Institute Amblyopia Treatment Study 1 Purpose: To determine whether the success rate with drug treatment (atropine) of amblyopia is equivalent to the success rate with occlusion (patching) therapy; to develop more precise estimates of the success rates of amblyopia treatment; to identify factors that may be associated with successful treatment of amblyopia; and to collect data on the course of treated amblyopia to provide more precise estimates of treatment effects than are now available Amblyopia Treatment Study 2: An Evaluation of Patching Regimens for Amblyopia Purpose: ATS 2 evaluates patching regimens for amblyopia. The treatment of choice for amblyopia is patching the good eye. However, we do not know how many hours per day the patch should be worn for the best results. Depending on the severity of the amblyopia, the patch will be worn either all day or for 6 hours per day. 28 CLINICAL TRIALS and STUDIES PEDIATRICS (continued) Amblyopia Treatment Study 3: Evaluation of Treatment of Amblyopia in 7 to < 18 yr olds Purpose: ATS3 assesses the effectiveness of amblyopia treatment in 7 to <18 year olds. If amblyopia is treated by the time a child is 6 years old, vision usually improves. In older children, we do not know how often improvement can occur with treatment, and we do not know the best treatment to prescribe. This study explores whether treatment with patching plus an activity to force the child to use his or her weak eye will improve the child’s vision. Amblyopia Treatment Study 4: A Randomized Trial Comparing Daily Atropine Versus Weekend Atropine for Moderate Amblyopia Purpose: The primary objective of this study is to compare the visual acuity outcome in the amblyopic eye after 17 weeks of daily use of atropine versus weekend only use of atropine. UVEITIS/INFLAMMATORY DISEASES Genetics of Uveitis Study Principal Investigator: Tammy Martin, Ph.D. Sponsor: National Eye Institute Purpose: To search for genes or genetic factors that contribute to the development of acute anterior uveitis (or iritis). Many patients with uveitis have family members that also have uveitis. Our ultimate goal is to be able to treat or even prevent uveitis by better understanding the genetics of this disease. Use of Remicade in the Management of Vision-Threatening Uveitis Principal Investigator: James Rosenbaum, M.D. Sponsor: Centocor, Inc. Purpose: To test the hypothesis that inhibition of binding between tumor necrosis factor alpha and its receptors using infliximib (Remicade®) is clinically useful in patients with uveitis that is refractory to other forms of systemic immunosuppressive therapy. Infliximab is given by infusion every 2 months after a loading schedule. It is well tolerated. Recently, the increased risk of infection has been publicized. Intravitreal Fluocinolone Acetonide Implant in Patients with Non Infectious Uveitis Principal Investigator: James Rosenbaum, M.D. Sponsor: Bausch & Lomb Pharmaceuticals Purpose: To evaluate the safety and efficacy of intravitreal fluocinolone acetonde implants in the management of patients with non infectious uveitis affecting the posterior segment of the eye. This study also compares the safety and efficacy of 2 doses of fluocinolone acetonide delivered by an intraocular/intravitreal implant in patients with non infectious uveitis affecting the posterior segment of the eye. This trial involves implantation of a device which slowly releases corticosteroid over a period of 3 years. 29 HONORS AND AWARDS Elizabeth Cottle, C.P.C., Casey Eye Institute’s Larry F. Rich, M.D., holds the August Petti and coding and compliance officer, received the Pinnacle Award (large practice division) from the American Society of Ophthalmic Administrators, the administrative branch of the American Society of Cataract & Refractive Surgeons (ASCRS). The award was presented at the ASCRS-ASOA meeting in June 2002. Margaret Thiele Petti Chair for the Director of Corneal Service. This chair was created in his honor. Roger A. Dailey, M.D., holds the Lester T. CEI director Joseph E. Robertson, M.D., M.B.A., holds the August Petti and Margaret Thiele Petti Chair of Ophthalmology, created in honor of Kenneth C. Swan, M.D. He received the 2002 Dean’s Award from the OHSU School of Medicine. Jones Chair in Ophthalmic Facial Plastic Surgery, the only endowed chair in the country in this subspecialty. James T. Rosenbaum, M.D., holds the Frederick T. “Fritz” Fraunfelder, M.D., former CEI chair, was recently named to the Scientific Advisory Panel of Research to Prevent Blindness. He also received the International Society of Ocular Toxicology’s Scientific Award at its 2002 meeting in Lindau, Germany. Edward E. Rosenbaum Chair in Inflammation Research. Elected president of the American Uveitis Society, he also received a Discovery Award from the Medical Research Foundation and won a Faculty Excellence in Education Award from the OHSU School of Medicine in 2002. Justine Smith, M.D., Ph.D., received a Rachael Garrett, O.D., was named Young Optometrist of the Year for 2002 by the Oregon Optometric Physicians Association. She was also president of the Portland Metropolitan Optometric Society in 2001-02. William Mathers, M.D., was recently honored with the Physician-Scientist Award from Research to Prevent Blindness. Career Development Award from Research to Prevent Blindness. J. Timothy Stout, M.D., Associate Professor of Ophthalmology, is the recipient of a McCormick Scholar Award from Research to Prevent Blindness. He also won the Casey Eye Institute Resident Teaching Award in 2002. Richard G. Weleber, M.D., received a 1.5 John C. Morrison, M.D., won the Lew R. Wasserman Merit Award for Glaucoma Research from Research to Prevent Blindness. John D. Ng, M.D., received an Achievement Award from the American Academy of Ophthalmology. million grant from the Foundation Fighting Blindness to benefit the Oregon Retinal Degeneration Center. He is vice president for the Americas of the International Society for Clinical Electrophysiology. In 2002, he delivered the Franceschetti Lecture at the International Society for Genetic Eye Disease (published in the Journal of Ophthalmic Genetics). Earl A. Palmer, M.D., was named to Who’s Who in America for 1999-2002 and Who’s Who in the West for 2001-02. He was listed as one of “America’s Top Doctors” in 2001 and one of the “Best Doctors in America” in 2002. Mary Wirtz, Ph.D., discovered (with John Samples, M.D.) the sites for two of the six known genes for primary open-angle glaucoma, evaluating them both in Portland and in Greece. 30 C L I N I C A L a n d R E S E A R C H F A C U LT Y Cornea and External Disease Frederick T. (Fritz) Fraunfelder, M.D. Professor of Ophthalmology Interests: Anterior segment disease, ocular cancer, ocular pharmacology and toxicology. Frederick W. (Rick) Fraunfelder, M.D. Assistant Professor of Ophthalmology Interests: Cornea and external disease, anterior segment oncology, cataract and refractive surgery, corneal transplantation, anterior segment reconstruction. Rachael L. Garrett, O.D. Instructor Interests: Pre- and postoperative refractive surgery evaluation. Damien Macaluso, M.D. Assistant Professor of Ophthalmology Interests: Cornea and external disease, refractive surgery, corneal transplantation, complicated cataract and anterior segment surgery. William D. Mathers, M.D. Professor of Ophthalmology Interests: Corneal transplantation, refractive surgery, corneal diseases, tear film abnormalities, dry eye, confocal microscopic detection of corneal infections. Larry F. Rich, M.D. Professor of Ophthalmology Interests: Refractive surgery, corneal transplantation, treatment of corneal diseases. General Ophthalmology Kelly D. Chung, M.D. Assistant Professor of Ophthalmology Interests: Cataract/IOL surgery, medical informatics, education for primary care providers and residents. William F. Farr, M.D. Clinical Associate Professor of Ophthalmology Interests: Comprehensive ophthalmology, aviation medicine. Devin M. Gattey, M.D. Assistant Professor of Ophthalmology Interests: Comprehensive and hospital-based ophthalmology, cataract and IOL surgery, international ophthalmology. Tammie Krisciunas, O.D., M.Ed. Instructor Interests: Contact lenses. Kenneth C. Swan, M.D. Professor Emeritus of Ophthalmology Interests: Comprehensive ophthalmology. Glaucoma Ted S. Acott, Ph.D. Professor of Ophthalmology, Biochemistry & Molecular Biology Interests: Understanding the molecular causes of primary open-angle glaucoma and the molecular mechanism of laser trabeculoplasty. Elaine C. Johnson, Ph.D. Assistant Professor of Ophthalmology Interests: Developing physiologically relevant human glaucoma models. Discovering mechanisms of glaucomatous neuropathy and testing potentially neuroprotective therapies. Mary Kelley, Ph.D. Assistant Professor of Ophthalmology Interests: Primary open angle glaucoma. John C. Morrison, M.D. Professor of Ophthalmology Interests: Evaluation and treatment of difficult glaucomas, glaucoma and cataract surgery, understanding the mechanism of glaucomatous optic nerve damage. 31 Low Vision John R. Samples, M.D. Professor of Ophthalmology Interests: Glaucoma diagnosis and therapeutics, pediatric glaucoma, use of anti-metabolites, setons and combined cataract and glaucoma surgery. Cell biology of the eye, particularly trabecular meshwork. Facial movement disorders. Mary K. Wirtz, Ph.D. Associate Professor of Ophthalmology, Molecular and Medical Genetics Interests: Identifying genes involved in the pathogenesis of glaucoma. Uveitis and Inflammatory Diseases Tammy Martin, Ph.D. Research Assistant Professor of Ophthalmology Interests: Analysis of genetic susceptibility to anterior uveitis. Stephen Planck, Ph.D. Research Associate Professor of Ophthalmology, Cell & Developmental Biology, and Medicine Interests: Intercellular regulation of ocular inflammation and injury responses. James T. Rosenbaum, M.D. Professor of Ophthalmology, Medicine and Cell Biology Interests: Ocular inflammatory disease, uveitis, scleritis, orbital pseudotumor, ocular cicatrical pemphigoid, systemic inflammatory diseases with ocular manifestations. Justine R. Smith, M.B.B.S., Ph.D. Assistant Professor of Ophthalmology Interests: Mechanisms of uveitis and related diseases, and the design and testing of therapies that specifically inhibit these mechanisms. Eric B. Suhler, M.D. Assistant Professor of Ophthalmology Interests: Uveitis and ocular inflammatory diseases, evidence-based ophthalmology, and the eye in systemic disease. John M. Boyer, O.D. Assistant Professor of Ophthalmology Interests: Low vision, vision impairment, vision rehabilitation. Neuro-Ophthalmology Robert A. Egan, M.D. Assistant Professor of Ophthalmology and Neurology Interests: Neuro-ophthalmology, stroke, ocular motor disturbances, ischemic optic neuropathy, pseudotumor cerebri, optic neuritis. William T. Shults, M.D. Clinical Professor of Ophthalmology and Neurology Interests: Neuro-ophthalmology, optic neuritis, and other optic nerve diseases. Ophthalmic Plastic and Reconstructive Surgery Roger A. Dailey, M.D. Associate Professor of Ophthalmology Interests: Cosmetic and reconstructive surgery, lacrimal surgery, endoscopic and laser surgery, orbital surgery. John D. Ng, M.D. Assistant Professor of Ophthalmology Interests: Reconstructive eyelid surgery, lacrimal surgery, orbital and facial trauma, facial nerve palsy rehabilitation, orbital reconstruction. Pediatric Ophthalmology and Strabismus (Elks Children’s Eye Clinic) Laurie E. Christensen, M.D. Assistant Professor of Ophthalmology and Pediatrics Interests: Strabismus, diplopia and ocular motility disorders (children and adults), ocular torticollis, retinoblastoma, general pediatric vision care. 32 C L I N I C A L a n d R E S E A R C H F A C U LT Y Pediatric Ophthalmology and Strabismus (Elks Children’s Eye Clinic) continued Earl A. Palmer, M.D., F.A.A.P. Professor of Ophthalmology and Pediatrics Interests: Strabismus, diplopia and ocular motility disorders of adults and children. Ocular torticollis, ocular sequelae of premature birth, general pediatric vision evaluation and care. Ann U. Stout, M.D. Assistant Professor of Ophthalmology Interests: Strabismus and ocular motility disorders of adults and children, pediatric glaucoma, pediatric cataracts, general pediatric vision evaluation and care. David T. Wheeler, M.D. Associate Professor of Ophthalmology Interests: Pediatric cataract removal and lens implantation, pediatric glaucoma, strabismus in children and adults, pediatric ocular trauma, pediatric tearing, general pediatric vision evaluation and care. Retina and Vitreous Disease Alvin Eisner, Ph.D. Associate Professor of Ophthalmology and Behavioral Neuroscience Interests: Visual psychophysical techniques. Michael L. Klein, M.D. Professor of Ophthalmology Interests: Macular degeneration, diabetic retinopathy, macular and retinal vascular diseases. Andreas Lauer, M.D. Assistant Professor of Ophthalmology Interests: Vitreoretinal disease and surgery, ocular trauma and ocular trauma surgery, macular degeneration. Joseph E. Robertson, M.D., M.B.A. Professor and Chair of Ophthalmology Interests: Macular surgery, ultrasound, trauma, retinopathy of prematurity, surgical diseases of the retina and vitreous. Dennis W. Schultz, Ph.D. Research Assistant Professor of Ophthalmology Interests: Macular degeneration research. J. Timothy Stout, M.D., Ph.D. Associate Professor of Ophthalmology Interests: Pediatric vitreoretinal disease and surgery, ocular gene therapy, ocular trauma, macular surgery. Robert C. Watzke, M.D. Professor of Ophthalmology Interests: Research and treatment of diseases of the retina and vitreous. David J. Wilson, M.D. Professor of Ophthalmology Interests: Ocular oncology, macular degeneration, ophthalmic pathology, retinal and vitreous surgery, ocular trauma and ocular trauma surgery. Retinal Dystrophies and Ophthalmic Genetics Richard G. Weleber, M.D. Professor of Ophthalmology Interests:Ophthalmic genetic disease, retinitis pigmentosa, retinal dystrophies and degenerations, syndromes with retinal degeneration, juvenile or early adult-onset macular dystrophies. 33 FELLOWS Daryl Kurz, M.D. Uveitis and ocular immunology CASEY’S RESIDENCY PROGRAM Affiliated with the Oregon Health & Science University School of Medicine and directed by Andreas K. Lauer, M.D., the Casey Eye Raghu C. Murthy, M.D. Vitreoretinal disease and surgery Stanley M. Saulny, M.D. Ophthalmic plastic and reconstructive surgery Institute’s residency program is one of the most sought-after in the United States. In 2002 we received more than 300 applications for four positions starting in July 2004. One reason for this popularity may be CEI’s high faculty-to-resident Jonathan Yoken, M.D. Vitreoretinal disease and surgery RESIDENTS First-Year (2002-2005) Dustin Heringer, M.D. University of North Dakota, 2001 ratio, which affords residents the opportunity to observe many different practice styles and allows a healthy balance between supervision and graded responsibility. Casey’s proximity to Devers Eye Institute and the Portland Veterans Administration Medical Center (conveniently linked to OHSU Hospital by a skybridge), means additional clinical and surgical experience for residents; our status as a “top ten” national research center, with over $10 million per Thuy Ha Nguygen, M.D. Oregon Health & Science University, 2001 year in external funding, means an abundance of scientific opportunities. In fact, Casey residents have a dedicated research rotation during their first year. Our curriculum also includes courses in prac- Carrie A. Lucidi Phillipi, M.D. University of California at Davis, 1999; Ph.D., University of California at San Diego (neurosciences) tice management designed to help prepare residents for a future in either academic medicine or private practice. In our 120,000-square foot, state-of-the art facility, residents receive Eric Alan Steele, M.D. Baylor College of Medicine, 2001 excellent training in comprehensive ophthalmology and exposure to all of the generally recognized ophthalmology subspecialties. Second-Year (2001-2004) Christopher Barone, M.D. Albany Medical College, 1999 Sandy Lifan Chen, M.D. University of California at Davis, 2000 Christen K. Richard, M.D. University of North Dakota, 2000 Jonathan Solomon, M.D. Temple University, 2000 Third-Year (2000-2003) Jane Gilbert, M.D. University of Arizona, 1999 Susan Bony, Residency Program Coordinator Thomas D. Myers, M.D. University of Utah, 1999 Andrew S. Westfall, M.D. Oregon Health & Science University, 1999 34 C o n t r i b u t i o n s t o C a s e y Ey e In s t i t u t e i n 2 0 0 2 The faculty and staff of Casey Eye Institute thank the following individuals, foundations, corporations and groups that made charitable contributions to OHSU Foundation in support of Casey in 2002. Gifts were made for both unrestricted and restricted purposes. We are grateful for the many and generous gifts we receive, and for those who have included Casey in their estate plans. Names followed by an asterisk indicate deceased donors. We have endeavored to make this list as accurate and complete as possible, but should you find an error, or wish to be listed differently, please let us know. Anonymous (9) Mr & Mrs Mark W Bailey Mr & Mrs John L Blackwell Thomas Burk Jr Bernita Abel Mr & Mrs Stephen M Bailey David G Blake Dorothea L Burke Don E Abraham Mr & Mrs Wesley K Bailey Eileen R Blaser Mr & Mrs Thomas C Burnard Ellen Abraham Lorraine H Bajus Dorothy L Blattner Ruth K Burns Mr & Mrs Tom Accettura Mr & Mrs Benjamin J Baker Mr & Mrs Keith D Bleich Robert E Bush Alice Julia Adams Estate Bud Baker Margery W Bloomfield Michael E Butry Marian P Ahlberg Joanne F Baldasar Dr & Mrs Lewis E Blue Mr & Mrs Donald M Cades Virginia A Ahrens Mr & Mrs Bradley C Barclay Bluebird Properties Cahn Family Trust Sheldon W Ainslie Mr & Mrs James E Barnard Mr & Mrs William H Boatman Mr & Mrs Marvin S Cahn Alcon Foundation Mr & Mrs Eldon H Barnes Mr & Mrs Gordon E Bock Dr & Mrs Douglas T Campbell Sherry E Allen Dr & Mrs Richard Barrar Mr & Mrs John F Bohler Mr & Mrs John A Campbell Allergan Corleen M Barrett Mr & Mrs Carl E Bond Mr & Mrs Raymond U Cappelli Mr & Mrs Kermit S Alskog Mary M Bartholomew Annette R Boslar Mr & Mrs Billy D Carder Dorothy C Ambrose* Ronald L Bartlett Lawrence P Bouchard Mr & Mrs Milton Carl Thomas L Ambrose Jr Mr & Mrs Benjamin F Barton Anna Belle Bowen Mr & Mrs Claude W Carlile Bernice E Anderson* Mr & Mrs Thomas W Bartosz Sally B Bowerman Douglas M Carney MD Bonnie B Anderson Richard D Bartsch John M Boyer DO Frank P Carraher Mr & Mrs Elven V Anderson Mr & Mrs Noble D Bashor Jean Braden Brent R Carreau Mr & Mrs Douglas W Anderson Marie C Bates Mr & Mrs John M Bradley John A & Helen M Cartales Mr & Mrs Frederick J Anderson Marlys Jean Bauer Carol L Brashear Mr & Mrs Gordon A Anderson Betty J Bauman Mr & Mrs Fred J Breidenbach Mr & Mrs Rodney B Carter James C Anderson Mary L Bauman Jerome B Brem MD The Annie E Casey Foundation Margaret A Anderson Mr & Mrs Harold J Beal Beth and Chris Brentlinger Myrna A Casono MD Richard D Anderson Chester Becker Brobeck Phleger & Harrison LLP George H Caspar MD Robert H Anderson Erna G Beggs Mr & Mrs Murlin J Brock Mr & Mrs Ted W Cauthorn Mr & Mrs William C Anderson Mr & Mrs Barry H Belau Patricia G Brodkorb Susie M Cawley Mr & Mrs Duane Andrews Alma J Belenski Ida M Brooks Mr & Mrs Leonard L Cebula Androsia International Trade Mr & Mrs Matt Benedict Mr & Mrs Bobb F Brown Mr & Mrs William H Chaffee Captain & Mrs Phillip E Appleton Elizabeth A Bennett Christopher H Brown Alan L Chaimov MD Mr & Mrs Will B Arndt Paul H Benninghoff Gordon E Brown Mr & Mrs Vutha Chau Charles A Arnold Mr & Mrs Elmo S Benton Jean E Brown Alyce R Cheatham Bula Buck Arveson Estate Mr & Mrs Donald I Berkey Mr & Mrs John H Brunke Mr & Mrs J M Checkoway Mr & Mrs John C Ashton Mr & Mrs George Bernards Elia J Buckles Mr & Mrs John D Chenoweth Jean L Aslakson Henny Bernstein Janice I Budworth Evelyn Christensen Mr & Mrs Ray B Auel Harry L & Renata Berry Mr & Mrs L L Budzak Laurie E Christensen MD The Autzen Foundation Mr & Mrs Mark S Bessette William E Burch Kelly D Chung MD Aventis Pharmaceuticals Inc Leslie Bevan PhD Ella Munro Burdin Fund at Mr & Mrs Michael Clarenbach Mr & Mrs Edmund J Aziz Claire E Beyer Oregon Community Foundation Clarendon National Insurance Eleanore P Baccellieri Mr & Mrs Everett E Bieger Jr Elizabeth A Burgess Annette Backous Mary & Brot Bishop Mr & Mrs Robert C Burgess Clark Foundation Mr & Mrs Victor Backstrom John R Bjoin Mr & Mrs Kenneth E Burgus George L Clark Mr & Mrs Warren R Bacon Mr & Mrs Norman E Bjorklund Gretchen A Burk James B Clark Nadia R Badawi Mr & Mrs Jack L Bjorkman Mr & Mrs Randal T Burk Mr & Mrs Jerry J Clark Foundation Company 35 Leona M Clark Charles J Custer Mr & Mrs Craig R Duvall Mr & Mrs Brian D Fitzgerald Mrs Mary Clark Mr & Mrs W G Custer Joanne L Earle Helen D Fitzgerald Maurie D Clark* Ellen B Dagan Emma Early John D Flanagan MD Mr & Mrs Mike Clark Raymond H Dahl Colonel & Mrs Frank Easley Mrs Doris M Floura Mr & Mrs W Lewis Clark Mr & Mrs A Dennis Dahlin Marilyn S Easly Helen C Fong Nancy L Clary Betsy W Dailey Martha Eaton Eunice G Forinash Mr & Mrs Patrick J Clary Roger A Dailey MD Ronald G Ebel MD Hazel Forty Mr & Mrs Judson B Clifton Barbara Dalman Jill Edelson Mr & Mrs Walter W Foster Darin B Closson OD Maude Daniels Richard H Edelson MD The Foundation for Fighting Mr & Mrs Donald A Cobert Stanley E Danill Lynnell Edwards Dr & Mrs William Cohen Patricia A Darby Pleasant L Edwards Carolyn Fowler Hilda Cohrs Beatrice Darlington Mr & Mrs Edward C Egan Geoffrey G Fowler Jesse L Colbert Evan T Davies Robert A Egan MD Cluff E Francis* Mr & Mrs Albert D Cole Mr & Mrs N D Davis Mr & Mrs Merle T Egge Irene M Francis Ethel L Cole Mr & Mrs James E Davis Lester H Eisendorf MD Dr & Mrs Frederick T Fraunfelder Doris H Coles Mr & Mrs Mark D Davis Sylvia Eisendorf Rick Fraunfelder MD Vicki L Coles Marvel D Davis Robert M Eisinger Percy F Freeman Jr Collins Medical Trust Mr & Mrs Ralph M Davis Mr & Mrs Jerry L Ekstrom Mr & Mrs George J Freiberg D J Collins Mary A De Witt Smith MD Janice G Elder Don & Emilie Frisbee Judy M Collins Beverly DeAngelo Mr & Mrs Harrison W Elgin Jr Shirley P Frisz Maribeth W Collins George R Dederyan Mr & Mrs James H Elgin Mr & Mrs John N Fullenwider Gerald V Colombo Robert DeGallery Mr & Mrs Robert C Elgin Mr & Mrs Oliver H Funk Jr Joyce F Colwell Richard & Mary Deich Robert Eliason Lloyd M Gabriel Community Bargain Counter Dr & Mrs James Rodney Delp Elk-On-Wheels Travel Club Wayne L Gannon Community Health Charities Mr & Mrs Thomas P Delsman Mr & Mrs Harold C Ellicott Gap Foundation Gap Giving Mr & Mrs Randy Compton Ruth M Demers Sachiko T Ellis Consolidated Auto Works Hattie A Dennis Ellis-Ranian Travel Inc Mr & Mrs Burton S Garbow Mr & Mrs John A Conway Janet L Dennis H C Enloe Melvin C Garbow William V Cook Mr & Mrs John E Depweg Mr & Mrs Thomas M Ensman Mr & Mrs Pat E Garcia Mr & Mrs William N Cooper Elizabeth Descamps Jean Epstein Rachael L Garrett OD Albert S Copeland Desert Camera Club Mr & Mrs George E Erickson Goldie Gaska Ruth Copenhagen Desert Grove Mobile Estates Raymond L Erickson MD Mr & Mrs J Peter Gaskins Barbara J Cordill David Dethlefsen Mr & Mrs Charles W Ertelt Mr & Mrs Daniel K Gassner Wade W Cornwell Donald Dickey Elizabeth C Evans Devin M Gattey MD Lionel Correia Marjorie Dickman Mark S Evans Marcile M Gatzke Elizabeth D Cottle William C Dietz DMD Sandra L Evans Janet Gefre Mr & Mrs John A Courtney E Jean Dillard ExxonMobil Foundation Mr & Mrs Charles T Geldaker Mr & Mrs Donald G Cowgill Gail W Dils Mr & Mrs Stanley E Farr Carolyn S Gentry Mr & Mrs William F Cowning Tuan Anh Do William F Farr MD Mr & Mrs Theodore Gerson Janice Cramer Rachel Dohanian Jennifer Farrer Mr & Mrs Richard J Gibler Loy E Cramer MD Viola A Donahue Ruth A Fasbinder William J Gibler Jennie M Crane John Dooley John N Fax Evelyn E Gieszler William C Crane Mr & Mrs Donald D Doran Ruby E Fax* Mr & Mrs Dale Gilkison Janet L Crawford Mr & Mrs Benjamin Dortch Mr & Mrs George Ferrington Mr & Mrs R A Girton Crestwood Construction DPR Construction Myra L Ferris Shirley Gittelsohn Edward L Crockett Aileen M Duckwall Mr & Mrs Michael A Fiasca Mr & Mrs Vernon D Gleaves Edith B Cross Mr & Mrs Maurice L Dufault Dolores Fielder Antonio J Glokner Rosemary Crowder Mr & Mrs Dominic A Dulcich Allen Figone Arlene W Glueck Bernice Crump Dr & Mrs David G Duncan William S Findlay CLU ChFC Helen Goffin Mr & Mrs Carl L Cunningham Mr & Mrs John H Dunkak Mr & Mrs Roy E Finley Mr & Mrs M M Goldhamer Margaret M Curran Donald A Durand Rose M Finn Norma J Goldsby Current/Paper Direct Fern Durbin Debbie H Fisher Mr & Mrs Jay Goldstein Irja V Curtis Fred W Durbin Mr & Mrs James W Fisher George & Carolyn Goodall Helen F Cushing Mr & Mrs Clark Duvall Fishhawk Fisheries Inc Blindness Program Foundation 36 C o n t r i b u t i o n s t o C a s e y Ey e In s t i t u t e i n 2 0 0 2 Mr & Mrs Robert L Goodman Marilyn A Hart Jo Ann Jacobsen John B Kiefer Shawn Goodman MD Davis A Harvey Estate Robert P Jacobsen Jr Heather K Killough Mr & Mrs Tom Gordon Mr & Mrs Kirby B Haskell Thelma M Jacobsen Mr & Mrs Robert L Kimmel Sarah L Gore Milton Hasson DMD Benjamin G Jacobson Mr & Mrs Eugene C Kinder LaVerda J Goudge Dorothy I Hay John Jaksic Mr & Mrs Allen R King Dr & Mrs Jack A Gow Mr & Mrs Gary M Haynes Mr & Mrs George James Mr & Mrs Keith R Kingsley Ruth A Grady Mr & Mrs Harry E Hearn Mr & Mrs Don G Jefferys Barbara Kirkhart Mr & Mrs Leal W Graham Mr & Mrs Dan Heimbuck Kelley S Jensen Audrey & Joe Kirshenbaum Mr & Mrs Thomas M Graham Mr & Mrs Joseph L Heinz Val & Mary Ellen Jensen Donor-Advised Fund Mr & Mrs Elden R Gray Mr & Mrs Eugene H Helgerson Bonnie R Jepsen Stephen M Kiser Victor R Greb Marion Hembling Irene Jessen Mr & Mrs Kenneth S Klarquist Mr & Mrs Lester D Green Alexander Henderson Insurance Mr & Mrs Henry N Jinings Michael L Klein MD Mr & Mrs Ronald W Griffin V Carol Johns Mr & Mrs Robert Klein Eileen A Grigsby Mr & Mrs Roger B Henderson Services Mr & Mrs Dale E Johnson Fran Knapp Mr & Mrs Howard A Grimes Margaret M Hendricks David S Johnson Pamela K Kniffin Mr & Mrs Cal R Grimmer Emma B Henell Gloria A Johnson Karen Knippling Mr & Mrs Robert S Grove Margaret W Henzi Mr & Mrs Marvin L Johnson Robert Knockaert Jr Stanley Gruszka Josephine V Herman Roger J Johnson Edith E Knouff Maruth G Gruver Mr & Mrs Bertram J Hermens Mr & Mrs Stanley B Johnson Harley Koch Mr & Mrs Anthony J Gubanc Kathryn A Hibbard Mr & Mrs Weston W Johnson Karen G Koch Gerry R Guest Mr & Mrs Jim Hibbert Jack F Johnston Jr Richard W Kohl Sandra G Guilfoil Mr & Mrs Howard R Hickam Evelyn L Jones Estate Mr & Mrs August Kollom GVNW Consulting Inc Richard A Hiersche Edeltrude Jones Mr & Mrs William C Kolzow Mardell M Gwinn Dorothy Hiley Dr & Mrs Richard T Jones Mr & Mrs Joseph E Kordic Bette B Hagman Erland V Hill Mr & Mrs Michael R Jordan Kay E Kowitt Stephanie A Hahn Mr & Mrs Jeffrey A Hill Harry S Joseph Mr & Mrs Sanford Kowitt Mr & Mrs Brian S Hair Frederick A Hirsch Mr & Mrs Thomas R Joste Lloyd B Kozera* Mary A Haisch Mr & Mrs Harry K Hoard Frances W Jubitz Mr & Mrs Herman E Kraft Guinivere B Hall Mr & Mrs Philip M Hoefer Marcia Kahn MD & Howard S Mr & Mrs Calvin Krahmer Mr & Mrs Kirby Hall Mr & Mrs Charles Hoehner Charlotte Hallowell Michael G Holmes Kaiser Permanente Mr & Mrs Gary F Krahmer Mr & Mrs Raymond W Haman Margaret W Honeyman Mr & Mrs Calvin L Kaser Mr & Mrs Steven W Krake Mr & Mrs Timothy Hamilton Mr & Mrs Andrew J Honzel Mr & Mrs Richard Kathrens Claudine Kratzberg Mr & Mrs Michael Hammack Hooper Holmes Ethel K Katz Mr & Mrs Fred N Krecklow Mr & Mrs J C Hammond J A Houghton Margaret Kearney Tammie Krisciunas OD Mr & Mrs Robert H Hango Mr & Mrs Raymond M Hovee Lewis G Kearns Mr & Mrs Keith Kruchek Michael C Hankins Mr & Mrs Robert W Howe Mr & Mrs George E Keep Mr & Mrs Kenneth R Kruger Joseph J Hanna Jr Mr & Mrs Howard L Hubbard Keller Foundation Susan Kuckenberg Arthur Hansen Harry E Hudson* Esther G Kelley Hilda Kullberg Betty Q Hansen Mary S Hudson Mr & Mrs Cyrus H Kelly Robert W Kullberg MD* Jean C Hansen Mr & Mrs Michael B Huffman Fern A Kelly Mr & Mrs Vincent E Kurpan Mr & Mrs Donald O Hanson Mr & Mrs Dave Huffstutter Mr & Mrs Robert V Kelly Mr & Mrs Howard D Kyle Lumier E Hanzel MD Louise Hults Tamara L Kelly RoJene LaBarbera Mr & Mrs Cleo A Harding Mr & Mrs Kenneth C Hume Judith L Kennedy Lachenmeier Enloe & Rall Mr & Mrs James A Harper Robert L Hurst Louis J Kennedy Dorothy E Lakaff Sherris Harrell Muriel Hyman Grace Kent Edward P LaKaff* Bertha L Harris Mr & Mrs John R Hyslop Mr & Mrs Oscar F Kern Mr & Mrs Richard E Lakeman Diane Harris The IFC Foundation Mr & Mrs Donald E Kernutt Mr & Mrs Ronald E Lambert Mr & Mrs Wayne O Harris Edgar F Imle Samuel R Kerr Anthony Landriscina C Allan Hart Estate Mr & Mrs John J Inskeep Mr & Mrs Charles L Kibby Mr & Mrs Donald H Landwehr Rosenbaum MD Donald L Krahmer Sr 37 Frank V Langfitt III Helen G Marks Virginia A Millerup Enid Newman Frank V Langfitt Jr Mr & Mrs Dale J Marshall Eugene C Mintkeski Sandra W Newton Violet L Langfitt* Arleen A Martin Paul S Minty John D Ng MD Cynthia A Larsen Robert A Martin Farhad Mirhady PhD Mr & Mrs Jim Nicolaisen Mr & Mrs J Brad Larsen Gwendolyn S Mason Nancy L Mitchell Mr & Mrs Verne A Nielsen Mr & Mrs Len R Larson Mr & Mrs Donald E Mast Rose Mitchell Mr & Mrs Carl A Nolte Eileen M Lassiter Phyllis Master-Cohen Mr & Mrs Richard Miyahira Mr & Mrs James E Norem Andreas Lauer MD William D Mathers MD Patricia L Mobley Sharon L Norene Mr & Mrs E E Lavier Jr Mr & Mrs Leslie E Matson Jr Barbara Modey Mr & Mrs W A North Jr Mr & Mrs C Rex Layton Phyllis J May Mr & Mrs Zoltan Mokrai Mary E Nousanen Annie Leap Mayfair School Sunshine Club Mr & Mrs Gerald L Mongillo Guy Nowels Ruth C Lear Mr & Mrs Elmer C Mays Irvin W Monk Mr & Mrs Robert H Noyes Jr Robert O Lee Estate Mr & Mrs C W McBride Mr & Mrs Alexander S Moore Nu Master Chapter # 440 Beta Susan L Lehr Mr & Mrs Blair D McCabe Mr & Mrs Darmond L Moore Sigma Phi Mr & Mrs James H Leiper Edmund B McCall Jack L Moore Susan D Nunn David A Leith Andrew J McCann PE Mr & Mrs Jerome A Moore NW Natural Lematta Foundation Mr & Mrs John S McCormac Mr & Mrs Richard B Moore Kathryn Nyberg Herman Lenz Ms Elizabeth T McCoy & Mrs Mary W Moreland Mr & Mrs Harold Nygaard Mr & Mrs Noel A Lesley Anne McCoy Dolores D Morelli Dolores Oaklief Betty B Leuthold Kay McCoy Patrick Morgan Mr & Mrs Homer E Oblander Richard Lee Levy Estate Mr & Mrs John M McCullen Mr & Mrs V H Morgan Mr & Mrs George Okita Violet Lewis Living Trust Mr & Mrs Marvin G McEldowney Dorothy N Morrison Fumiko Okubo Anita J Lewis James C McFarland John C Morrison MD Mr & Mrs Donald Oldemeyer Max E Lewis Mr & Mrs Robert L McFarlane Lynne H Morrison MD Mr & Mrs Michael Z Olds Eleanor L Liefke Mr & Mrs J R McGinnis Jr Mr & Mrs Todd H Morrison Mrs Virginia E Oliver Judith C Lillestol Mr & Mrs Paul E McGovney Paula T Morrow Helen N Olson Joanne M Lilley Mr & Mrs W S McGuire Jean Morse Oliver D Olson Mr & Mrs Willis Lilliquist Mr & Mrs George I McInroy Christopher R Moser Mr & Mrs William F O'Neil Mr & Mrs Robert M Lindahl Mr & Mrs Donald H McIntyre Mr & Mrs Kenneth A Moss Peter & Claire Opton Fund of the Eva V Lindsay Jessie E McKenzie Mr & Mrs R S Moss Mr & Mrs Robert D Lindsey Mark McKinney Patricia Mueller* Joecile Orcutt Mr & Mrs Edward S Lohr Mr & Mrs Paul F McMahon Robert L Mueller MD OHSU Medical Group Inc Mr & Mrs Howard W Long Claudia Lacey McNeil Evelyn V Mullin Oregon State Elks Association - Karen M Lotz Mary C McNulty Mr & Mrs David M Munro Mr & Mrs A S Lough Ferne C McPhee Patra Murdock Oregon State Elks Visual Mr & Mrs E Russell Love Susan I Means & Gene R Francis S Murphy Program Mr & Mrs John W Murphy Raymond O'Reilly Mr & Mrs Richard S Love Osborne Oregon Community Foundation Elks Youth Eye Services (EYES) Marlene A Lowe Gilbert Meigs Mr & Mrs Tim R Murphy Preston H Orem Mr & Mrs Robert R Lowry Mr & Mrs George H Meistrell Helen E Murray Mr & Mrs Laimons Osis Mr & Mrs Fred Lukasavage Mr & Mrs Frank A Mena Jr Mr & Mrs Robert J Murray Susan K David Oswald Mr & Mrs Scott B Lukins Merck & Company Inc Mr & Mrs Louis Nadell Mr & Mrs W Scott Overton Mr & Mrs Christopher A Lulay Merck Company Foundation Bernard H Naftalin Mr & Mrs Alphonse J Pacella Kenneth A Lundeberg MD Mr & Mrs Dotson T Merritt Doris S Naudain The Honorable Robert W Lt Col & Mrs Stanley R Luther Mr & Mrs Matthias H Mesdag John T Naylor* Mr & Mrs James J Lydon Joann M Metcalf John V Naylor Evelyn J Page Mr & Mrs Myron H Maas Metropolitan Pediatrics LLC Ruth T Naylor Richard M Page DDS Damien C Macaluso MD Mr & Mrs James T Meyer Diana L Nead Earl A Palmer MD Elizabeth A Macaulay Mr & Mrs Donald G Meyers Mr & Mrs Clyde W Needham Ruth E Palumbo Maybelle Clark Macdonald Fund Mr & Mrs Stanley Michalek Terrence P Neiman Erna Pamer Mr & Mrs Ian Mackenzie Miix Insurance Company Dorothy F Nelsen Pamplin Foundation Enid J Mackin Delia E Miller Mr & Mrs B T Nelson Papé Family Foundation Mr & Mrs Haakon T Magnussen Mr & Mrs Richard G Miller Ruth Nero Mr & Mrs Santino Paperini Jack Majors Mr & Mrs Steven C Miller Mr & Mrs Wilfred N Neth Dr & Mrs Brent M Parker Thalia Malone Estate Vera Miller Frank L Newell Mr & Mrs W L Parker Packwood 38 C o n t r i b u t i o n s t o C a s e y Ey e In s t i t u t e i n 2 0 0 2 Mr & Mrs Bob L Parnell Nicholas L Rains Joan G Rosenbaum Mr & Mrs Gilbert L Schroff Mr & Mrs A Donald Parr Joan A Randall Robert A Rosenbaum MD Schwabe Williamson & Wyatt Marilyn J Pate Joan L Ratliff Thomas J Rosenbaum MD Agnes E Schwarzin Estate Thomas G Paterson Sr Margaret Rawlinson Stanley & Madelle Rosenfeld Mr & Mrs Willard C Schwenn Mr & Mrs Rolland E Patterson Robert P Ray Fund of Oregon Jewish Linda F Schwerdt Karol Peck Louvera H Raymond Meadow Pederson Mr & Mrs William Reade Mr & Mrs Mark H Rosenthal Yvonne Scroggins Mr & Mrs Morton D Pelzner Mr & Mrs William L Reagan Brenda Lynn Ross Vision Fund of Mr & Mrs Lee Seeger Mr & Mrs William Pendarvis Martin W Reeves Kathleen E Percell Mr & Mrs Douglas S Rehwoldt Helen Ross Kenneth W Self Mr & Mrs Albert D Perpuse Mr & Mrs John W Reiley Thelma M Ross Robert K Semans Chuck Perrott Richard G Reiten Editha Rowell Lt Col & Mrs Richard W Sexton Vesna Persun Allen Reiter Peter P Rowell MD* Dorothy A Shannon Sally N Peters Laura M Reith Eileen C Royster Sharkey Family Charitable Mr & Mrs Douglas L Peterson Gertrude F Rempfer Trelba L Rubenser Foundation Margarett D Peterson Mr & Mrs William T Rennie Mr & Mrs Randall Rubenstein Mr & Mrs John E Shaw Jr Mr & Mrs Paul L Pettry Research to Prevent Blindness Ronald L Rubin Dr & Mrs Russell D Shelden Mr & Mrs Jack D Pfeifer Yancey Reser Muriel H Ruble Yandle Mr & Mrs Robert W Shepard Ruth C Phalen Jean S Reynolds Mr & Mrs Roy J Rucker Thomas Sheppard William H Phalen* Margaret D Rhodes Mr & Mrs Rollie Ruehlman Mr & Mrs Charles H Sherwood Mr & Mrs Robert W Philip Larry F Rich MD Mr & Mrs Alexander Runciman Mr & Mrs Yoshiro Shintani Margaret F Phillips Michael E Richl Geneva Runciman Shook Hardy & Bacon LLP Mr & Mrs Michael G Phillips Mr & Mrs David Richlen 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Foundation Donald E Thorpe Mr & Mrs Marion R Warner Kathleen Wrightson Anne V Stewart Lucille E Thronson Neil O Warner* Mr & Mrs Fred D Wristen Jenifer Stewart Charlotte Thuemmel Washington County Council William W & Janet E Wyse Loran L "Stub" Stewart Bettymae Todrank Mr & Mrs Dale W Stewart Jacqueline V Tompkins Mr & Mrs Glenn W Watkins Irene A Yamada Mr & Mrs Virgil A Stiger Rena Tonkin Robert Watzke MD Mr & Mrs Dan Yates Mr & Mrs David A Stockton Mrs Moe M Tonkon Fund at Esther G Wayne Kenneth G Yee Mr & Mrs Byron W Webb Juan Young Fund at Mr & Mrs Herbert G Stoenner Oregon Community Foundation on Aging Dr & Mrs Kan Yagi Betty Stone Tooze Duden Creamer Frank & Teresa M Webb Mr & Mrs Richard L Stoner Hutchison Rosmary Wegert Janet E Young Myrtha Storm Theodora M Topp Mr & Mrs Irving B Weinstein Mr & Mrs Roy A Young J William Stortz Mr & Mrs Michael D Towers LaDona M Welch Mrs Pearl Yu Ann U Stout MD Carmelita R Tri Dr & Mrs Richard G Weleber Mr & Mrs Jack Zidell J Timothy Stout MD Darlene M Tri WELfund Inc Mr & Mrs Carl W Zikeli Mr & Mrs Sam L Stovall Glenn L Tri Mr & Mrs Grover Welty Marvin Zink Suzanne R Strahan Patricia A Tritz Bettie Wennevold Susan L Ziolko Mr & Mrs Wesley C Strahm Louise Tucker Rita West Mr & Mrs Robert E Zuck Mr & Mrs Gregory T Straub Toshikiyo Uchida DMD* Mr & Mrs Jack A Westing Mr & Mrs Gary E Zumwalt Cynthia S Strawn Muriel K Unkeles Mr & Mrs Chris L Wheeler Faith R Strong Mr & Mrs Thomas R Uphaus David Timothy Wheeler MD Juanita B Struble Barbara Uyesugi Mr & Mrs Eldridge H White Margaret M Sudduth Mr & Mrs George Van Biber Leal Daly Whittlesey Eric B Suhler MD Mr & Mrs L E Van Buskirk Mrs Louise C Wicks Scot A Sullivan MD David N Van Camp Noel F Wicks* Mr & Mrs Herbert H Sundby Kenneth F Van Duyn Marta Widman Sharon A Susanka Jane Van Dyke Barbara J Wilkins David C Sutherland Mr & Mrs David Vanasche Jane H Wilkins Dr Kenneth C Swan Fund at George N Vigeland Jr MD & Cora Wilkinson Oregon Community Foundation Karen M Vigeland MD Mr & Mrs Gary E Will Dr & Mrs Kenneth C Swan Charles A Viltz Dr & Mrs Elvin T Williams Mr & Mrs Barry J Swanson Mr & Mrs Gary C Vogel Mr & Mrs J Robert Williams Mr & Mrs Wallace J Swanson Paul R Vogt CPA Mr & Mrs Raymond C Williams Swedish Society Linnea Mr & Mrs Phillip F von Feldt Mr & Mrs Dain A Wilmarth A William Sweet Mr & Mrs James Voytko David J Wilson MD Virginia Sweetland Mr & Mrs Robert Wack Reverend & Mrs Doyle E Wilson Leslie J Swope USA Ret Joelle K Waddle James H Winkler Darl L Synoground Dennis S Wagner DMD Jeanne L Winn Margaret J Taft Karol C Wagner Lawrence Winthrop Mary A Talbott Dorothy Waite Dr & Mrs Calvin Wipf James A Tammaro MD Mr & Mrs H G Waite Richard G Wirtz Stephen G Tandy Dr & Mrs James R Waldman Mr & Mrs Richard Witzany Dr & Mrs Eugene E Taylor Mary M Walker Gabriel Wolff Mr & Mrs John C Taylor Jr William T Walker Women of the Moose # 1184 Mr & Mrs Randy L Taylor Mr & Mrs Dennis H Wallace Mr & Mrs Bruce L Wong S H & A M Tebbets Estate Patricia Wallace Mr & Mrs John S Wood Jr Margaret E Teufel Mr & Mrs Henry J Wallaert John W Wood MD Oregon Community Foundation 40 C a s e y Ey e In s t i t u t e Re s o u r c e s a n d Re f e r r a l Se r v i c e s INFORMATION & COMMUNITY SERVICES 503.494.3000 ADMINISTRATION 503.494.7890 Fax: 503.494.4286 LOW VISION SERVICE 503.494.3098 Fax: 503.494.2282 CODING AND COMPLIANCE 503.494.6107 Fax: 503.494.6864 NATIONAL REGISTRY OF DRUG INDUCED OCULAR SIDE EFFECTS 503.494.5686 Fax: 503.494.4286 CONTACT LENS SERVICE 503.494.5536 Fax: 503.494.5372 COUNSELING/SOCIAL SERVICES 503.494.1618 Fax: 503.494.5347 DIAGNOSTIC OPHTHALMIC ECHOGRAPHY 503.494.7693 Fax: 503.494.5188 ELECTRORETINOGRAPHY SERVICE 503.494.8386 Fax: 503.494.5347 ELKS LIAISON 503.494.3557 Fax: 503.494.2282 NORTHWEST CENTER FOR EYE ALIGNMENT 503.494.1952 Fax: 503.494.5347 OPTICAL SERVICES 503.494.3030 Fax: 503.494.0588 ORTHOPTICS 503.494.4961 Fax: 494.5372 PHARMACY 503.494.3933 Fax: 503.494.0048 PATHOLOGY 503.494.7881 Fax: 503.494.7233 PHOTOGRAPHY 503.494.7693 Fax: 494.5188 EYE BANK 503.413.7523 KENNETH C. SWAN LIBRARY 503.494.3380 MACULAR DEGENERATION CENTER 503.494.3537 Fax: 503.494.7233 SURGERY SCHEDULING 503.494.3943 Fax: 503.494.3349 VISUAL FIELD AND HRT STUDIES 503.494.7667 Fax: 503.494.3017 WEBSITE: www.ohsucasey.com This 2002 Casey Eye Institute Annual Report was produced by the Oregon Health & Science Unversity Department of Ophthalmology at the Casey Eye Institute. Co-Editors and Writers: Genevieve Long, Ph.D., Nancy Mitchell, B.A., C.O.T., Joan Randall, MPH Designer: Buck Winston A special thanks to the Casey Eye Institute Ophthalmic Photography Department. Photographers: Mark Evans, Chris Howell, Peter Steinkamp, Pat Wallace C A S E Y 3 3 7 5 S . W. T E R W I L L I G E R E Y E B LV D . I N S T I T U T E P O R T L A N D , O R E G O N 9 7 2 3 9 - 4 1 9 7