1 2 3 4 Page 2  |  Summer 2017  |  DOHENY UPDATE A lfredo A. Sadun, MD, PhD, joined Doheny in 1984. Given his long history with the organization, we wanted to get his thoughts, too, about the most important happenings in our 70-year history. Dr. Sadun has been a Doheny Eye Institute physician, researcher, and educator for nearly his entire career and for half of Doheny’s lifetime. He holds our institutional memory. In other words, he’s a repository of the facts, beliefs, and experiences that formed our identity. Institutions spend a lot of time and resources developing an identity. Some of it becomes concretized, say in a logo or a never-to-be-missed annual conference, but most of it resides in the memory of the people who experienced the process in real time. Hence, the special insights Dr. Sadun brings to the forefront. So we asked him: Dr. Sadun, in your opinion, what are the top five key events, discoveries, or people that helped secure Doheny’s future? Like Dr. Sadda, Dr. Sadun started by first citing Dr. Stephen J. Ryan’s development of experimental models that changed the understanding and treatment of age-related macular degeneration and other retinal disorders. Dr. Sadun highlighted Dr. Ryan’s discovery of the role of blood in the eye’s vitreous in causing retinal detachment in cases of traumatic eye injury. “This was an incredible breakthrough,” says Dr. Sadun, “and revolutionized medical and surgical treatments for preventing retinal detachment and preserving eyesight in patients with serious eye injury. “ Second, he named the Baerveldt Glaucoma Implant by George Baerveldt, MD, as a major event that put Doheny on the map. The device decreases damaging eye pressure in glaucoma patients by shunting fluid from the inside of the eye outward to the eye’s surface. It’s been a vision-saver for patients with difficult-to-treat cases, even children. “The success of the Baerveldt Glaucoma Implant is related to its larger surface area compared to other drainage devices,” says Sadun, “which improves the fluid drainage and, for many grateful patients, reduces their dependence on glaucoma medications.” Third on the list for Dr. Sadun was the finding in 1990 by then Doheny pathologist, Narsing Rao, MD, of early signs of retinal pathology, caused by cytomegalovirus (CMV), in patients with acquired immunodeficiency syndrome (AIDS). His work changed the outcome for patients worldwide. CMV can affect other organs, too, but it was difficult to diagnose from traditional blood or urine tests. Dr. Rao led research showing that routine ophthalmic examination could easily and reliably detect CMV infection in the retina and that early diagnosis and treatment of ocular CMV resulted in less frequent multi-organ involvement and longer survival for AIDS patients. Fourth, and with a nod to his own pivotal work, Dr. Sadun described his early research revealing telltale signs of Alzheimer’s disease (AD) in the eye. He and his colleagues were the first to show that Alzheimer’s disease significantly affects the optic nerve, retinal cells, and retinal nerve fibers that normally process and convey visual information from the eye to the brain. The prestigious New England Journal of Medicine published the findings in 1986, setting the stage for the eye as a surrogate for studying the brain in patients with Alzheimer’s disease. Newer technologies continue to reveal smaller and smaller details about AD in the eye. One is optical coherence tomography (OCT), an advanced technology capable of quantitating changes in the optic nerve and retina in AD. “Physicians and scientists are now using retinal OCT to monitor progression of Alzheimer’s disease,” says Dr. Sadun. He expects OCT to be used to track AD treatments, too. Dr. Sadun has carried the ball in AD retinal research since the beginning. He’s currently KEY SUCCESSES THAT SECURED OUR FUTURE, II Five Major Events in the History of Doheny Eye Institute as told by Alfredo Sadun, MD, PhD  Dr. Ryan’s experimental model of age-related macular degeneration.  The development of the Baerveldt Glaucoma Implant by George Baerveldt, MD.  The discovery by Narsing Rao, MD, in 1990 of early signs of retinal pathology in AIDS patients.  His own early research revealing telltale signs of Alzheimer’s disease in the eye.  The unrelenting commitment at Doheny to understand and advance treatments for age-related macular degeneration. Dr. Alfredo Sadun