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Colton Green
Colton Green

Clinical Ophthalmic Oncology: Basic Principles

Written by internationally renowned experts, the 3rd edition of this six volume textbook provides detailed practical guidance and advice on the diagnosis and management of the complete range of ocular cancers. Supplying the reader with state-of-the-art knowledge required in order to identify these cancers early and to treat them as effectively as possible, this book is divided into six volumes: Basic Principles, Eyelid and Conjunctival Tumors, Orbital Tumors, Uveal Tumors, Retinal Tumors, and Retinoblastoma. The information presented enables readers to provide effective patient care using the latest knowledge on ophthalmic oncology and to verify diagnostic conclusions based on comparison with numerous full-color clinical photographs from the authors' private collections, histopathologic microphotographs, imaging studies, and crisp illustrations.

Clinical Ophthalmic Oncology: Basic Principles

As the understanding of the biology and tumorigenesis of head and neck cancer has advanced, including identification of specific biomarker expression in tumor cells, upregulated metabolic activities, and the variations in tumor microenviroment, new diagnostic methods and instruments have developed. Optical imaging permits real-time diagnosis and margin discrimination, which would be most helpful to surgeons in the minimally invasive setting when physical cues like visualization and palpation are absent.4 Optical imaging or light based imaging techniques, uses specific properties of light to image anatomical or chemical characteristics of tissue. Analogous to many radiolabeled agents, imaging of optical contrast is performed using ligands conjugated to an optically active reporter to target a recognized disease biomarker.5 Optical imaging in the head and neck has been reported using autofluorescence imaging (AFI),5 targeted fluorescence imaging (TFI),5 high-resolution microendoscopy (HRME),6 narrow band imaging (NBI),7 and the Raman spectroscopy (RS).8 Besides these, other optical imaging modalities, such as optical coherence tomography, elastic scattering spectroscopy, confocal laser endomicroscopy, and confocal reflectance microscopy, have also been widely applied in the head and neck region and were nicely reviewed elsewhere.9,10,11 In this study, we specially reviewed the basic theories and clinical applications of AFI, TFI, HRME, NBI, and RS for the diagnosis and treatment of head and neck cancer with the goal of identifying limitations and facilitating future advancements in the field.

At the heart of the program is the unparalleled diversity of learning opportunities. This starts with the rich clinical learning environment that is made up of world-class institutions such as New York Presbyterian Hospital, Memorial Sloan Kettering Cancer Center, Hospital for Special Surgery, and New York Presbyterian Queens. Our residents care for a diverse cohort of patients, exposing them to a wide breadth of ophthalmic pathology and treatment options that span from the very common to the extremely rare. Additionally, the social, cultural, and economic diversity of practicing medicine in New York City allows for the development of critical skills in patient communication, compassionate care, and professionalism.

Each incoming resident will begin their PGY-1 year in the Department of Ophthalmology at Weill Cornell to orient them to the Department, New York Presbyterian Hospital, Weill Cornell Medical College, and New York. A total of three months will be spent in in Ophthalmology learning the fundamentals and principles of the ophthalmic exam, patient workup, and basic ophthalmic surgical technique. The remaining months include judiciously selected rotations with allied specialties. These include rotations in Emergency Medicine, Otolaryngology/Head and Neck Surgery, Neurology, Neuro-Radiology, Dermatology, and Internal Medicine, including Endocrinology, Infectious Disease, and Rheumatology (at the Hospital for Special Surgery, one of the top rheumatology hospitals in the country).

The second year of residency represents a concentrated introduction to the basic principles and theories of general ophthalmology and ophthalmic surgery. First-year residents master the basic techniques of ophthalmic exam, as well as the diagnosis and management of a variety of ocular diseases, while rotating on our comprehensive eye service. First-year residents have the opportunity to assist with and perform under supervision minor surgical procedures including chalazia and pterygia excisions as well as minor eyelid procedures and temporal artery biopsies. While on our cornea rotation, first-year residents participate in care, workup and surgical assistance for both routine and complex refractive, cataract, cornea and external disease patients.

Participation in scholarly activity is an integral component of the Weill Cornell Medicine Ophthalmology Residency Program. Our NIH-grant funding is among the highest of any program in the U.S., with diverse research initiatives range from basic retinal and corneal pathophysiology science to a multitude of ongoing prospective studies organized by our in-house clinical trials unit. We also engage in translational projects with biomedical engineering colleagues at Cornell University's Ithaca, NY campus.

The Department of Ophthalmology is one of 23 clinical and basic science departments within Duke School of Medicine and is one of the leading eye institutions in the world. For more than 30 years Duke Ophthalmology has been consistently ranked in the Top 10 best ophthalmology hospitals by the US News and World Report. Our internationally-renowned clinical and research faculty are dedicated to curing eye disease worldwide though excellence in research, teaching, and patient care. We take pride in living Duke's guiding principles of trustworthiness, respect, diversity, learning and teamwork.

Clinician-scientists and basic researchers at the Byers Eye Institute at Stanford have a rich tradition in ophthalmic innovation. Over the past several decades Stanford Ophthalmology faculty have led the way toward a number of ground breaking discoveries and technologies, many of which have been out-licensed through the Stanford Office of Technology Licensing and served as the foundation for the establishment of innovative Silicon Valley companies that translated them into practice-altering commercial products. These technologies are in various stages of evolution ranging from pre-clinical studies to full FDA approval, and have provided the roots for a number of free-standing, venture-backed companies, including Optimedica (which developed the PASCAL and Catalys laser and was acquired by AMO), PEAK Surgical (plasma-mediated surgical tools, acquired by Medtronic), Oculeve (neurostimulation devices for dry eye, acquired by Allergan), Adverum Biotechnologies (gene therapy, NASDAQ:ADVM), Pixium (artificial retinal prosthesis) and Verana Health (data science). Millions of patients worldwide have been impacted by technologies developed by inventors from Stanford Ophthalmology.

Candidates should be familiar with the basic principles of physical and geometrical optics and the operation of standard optical instruments. They should understand the essentials of visual physiology including visual acuity, light and dark adaptation, accommodation, and colour vision. They should know the various forms of ametropia, principles and techniques of refraction, principles of lens design, and methods of correction of ametropia including spectacles, contact lenses, intraocular lenses and refractive surgery. Candidates should be familiar with the methods for prescribing protective lenses, absorptive lenses, and aids for low vision.

Candidates should be familiar with diseases affecting the eyes of infants and children and with associated systemic abnormalities. They should understand the anatomy, physiology and pathology of visual development and of the neuro-muscular mechanisms serving ocular motility and binocular vision. Candidates should be familiar with the methods of examination for the detection and assessment of sensory and ocular motor disorders. They should also know the clinical features, differential diagnosis, natural course and management of the various types of comitant and incomitant deviations. They should be familiar with the principles and the complications of surgery upon the extraocular muscles.

Candidates should know the anatomy of the orbit and the neuro-anatomy of the afferent and efferent visual systems. They should understand the principles of examination and investigation, including visual field testing, visual evoked responses, ultrasonography, conventional radiograms, CT, and MRI scanning. Candidates should be familiar with the clinical features, pathology, differential diagnosis and management of disorders of the orbit, visual pathways, oculomotor system and pupillomotor pathways, including the indications for, principles and complications of orbital surgery.

I am a board-certified ophthalmologist with specialty training in ophthalmic oncology: the care of people with cancers in, on, and around the eye. I understand the impact that cancer can have on our patients and their families. My goal is to provide the best treatment for each patient with the fewest side effects. At Memorial Sloan Kettering, we have the advantage of working closely with a team of specialized doctors such as radiation oncologists, medical oncologists, pathologists, neurologists, and pediatric oncologists to create a coordinated plan of care for our patients.

The purpose is to bridge neuroanatomy and neurophysiology with clinical neuroscience. This is a major update from the prior edition, with new discoveries in basic neuroscience and novel correlations with clinical neurology and neurosurgery.

GoalsWe aim to increase our understanding of the basic science principles that govern these cells and then exploit these findings to develop improved therapies for patientsWe are particularly focused on pediatric non-malignant bone marrow transplantation with a strong interest in genetic blood/immune diseases and bone marrow failure, but do complementry work on solid tumors with marrow disease, solid organ tolerance induction, autoimmune diseases and gene therapy/gene editing. 041b061a72


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