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radiation, ultrasound imaging, anti-VEGF therapy, small incision biopsy
I started my research career as a Tulane University medical student. Work there led me to co-invent a microwave applicator for intraocular hyperthermia along with Robert Paglione from the RCA Corporation. Taking this work from the bench, at Brookhaven National Laboratory and Memorial Sloan Kettering Cancer Center, to bedside at North Shore–Weill Cornell, I found it could save sight and life.
Subsequent highlights of my innovations include the discovery of palladium-103 plaque therapy for intraocular tumors, topical chemotherapy (mitomycin and interferon) “eye drops” for conjunctival melanoma, and new eye and vision sparing radiation methods and devices for cancers located anteriorly in the iris or posteriorly around the optic nerve. In 2007, I first reported anti-VEGF treatment to suppress radiation retinopathy and anterior optic neuropathy. This method is widely used, saving vision around the world.
In terms of new methods of diagnosis, my published research efforts include 3D-ultrasound techniques to reveal previously obscure areas of the eye, optic nerve, and orbit. Out of necessity, I established normative high frequency ultrasound measurements for the iris and ciliary body. Other contributions were typically published to support my fellows and residents. We have published on whole-body PET-CT to diagnose and stage ocular melanoma, orbital lymphoma, sebaceous carcinoma, and conjunctival melanoma as well as evaluated SUV as a biomarker for choroidal melanoma metastasis. In other works, we showed that PET-CT can be used to discover and stage systemic metastasis to the eye, reveal oculosystemic sarcoidosis, and evaluate choroidal melanoma response to ophthalmic radiation therapy. Separately, I recognized that using available small-gauge aspiration cutter technology would allow for safer, self-sealing micro-incisional biopsies. This clinical research generated publications on the “Finger Iridectomy Technique (FIT)” as well as the “Finger Aspiration Cutter Technique (FACT)” for orbital tumors.
Survey of ophthalmology. 2020 Jul - Aug; 65(4):421-437
Ophthalmology. 2021 May ; 128(5):740-753