Ophthalmic Surgery, Lasers and Imaging Retina

8 Questions with OSLIR 

8 Questions with OSLIR

David Huang, MD, PhD

Abstract

Interview with David Huang, MD, PhD

OSLIR: Who has had the greatest influence on your career?

David Huang, MD, PhD: There are many people who have influenced my career. But if I had to pick one, that would be Dr. James G. Fujimoto. Jim was my doctoral thesis advisor at MIT. I learned a great deal about lasers and optics in his lab — knowledge that I still use in my research. I had the opportunity to participate in a wide variety of research projects from femtosecond laser generation, to picosecond laser tissue ablation, to the invention of optical coherence tomography (OCT). He had the unique ability to unleash the creative energy of his students by challenging them with difficult but solvable problems. I still collaborate with Jim today in our research and learn from the way he approaches problems and organizes projects.

OSLIR: What was the defining moment that led you to your field?

Dr. Huang: That would be the day Dr. Fujimoto gave me the project to look into measuring the distance between eye structures using an interferometer. This quickly led to success in measuring cornea thickness and anterior chamber depth. By the time we were measuring retinal thickness, the idea hit me that what we really had was a new imaging technology: OCT. Research in OCT imaging of the eye has been the most important part of my career ever since.

OSLIR: What area of research in ophthalmology most interests you right now and why?

Dr. Huang: I am interested in taking OCT beyond structural imaging and into probing the function of the eye. My research group started working on Doppler OCT about 8 years ago and OCT angiography (OCTA) about 5 years ago. We have also looked into the retinal blood flow response to light stimulation or physiologic challenges such as hyperoxia. Using OCT to image oxygen saturation is also an interesting area. All of these research topics are very interesting as opportunities for technical innovation, but OCTA in particular is going to be very important clinically. Our research group was among the first to demonstrate the usefulness of OCTA in retinal diseases and glaucoma about 3 years ago. Already the technology is being offered by at least six commercial companies that I know of and being used in hundreds of clinics. I think this new modality will spur a new burst of energy in ophthalmic imaging research, akin to the original introduction of OCT, and then the second stage of growth with the introduction of Fourier-domain OCT.

OSLIR: What advice would you offer a student in medical school today? (Or what advice would you offer residents and fellows considering a career in academic ophthalmology or vitreoretinal surgery?)

Dr. Huang: For those interested in academic ophthalmology, I would say find your special niche of research interest or clinical practice and invest the time to become the leading expert in that area. Often the best areas for innovation are at the intersection of disciplines. For me, this was the intersection between optical engineering and ophthalmology. For others, it would be different. But it is at the boundary between disciplines where there is opportunity to apply new approach to unsolved problems. The approach does not have to come from basic science or engineering. An example is Dr. Mark Terry, a corneal surgeon just across town from us who has taken the idea of lamellar surgery very far in the form of Descemet's stripping automated endothelial keratoplasty and Descemet's membrane endothelial keratoplasty. Another piece of advice is to make friends and collaborate with pioneers in your field. I have picked up many ideas for new projects from casual conversation with smart people.

OSLIR: Have you ever been fortunate enough to witness or to have been part of medical history in the making? If so, please explain.

Dr. Huang: I witnessed the creation of the first OCT scans. I had built an OCT prototype to scan specimens in vitro and used it on several types of tissue such as retina, gastric mucosa, and coronary artery plaque. At that time Professor Fujimoto had an ongoing collaboration with Dr. Carmen Puliafito at Harvard/MEEI. Dr. Puliafito let Dr. Joel Schuman come over to work on scanning the retina. Joel cut the globe in half and we scanned the retina with the open-sky approach. This was done in the evening, and I didn't know if the signals we were getting would make any sense until the next day when I created a false-color map that was the first retinal OCT image. We knew this was the beginning of something significant — a new medical imaging modality with much better depth resolution than anything before it. After this, Dr. Fujimoto introduced me to Eric Swanson, who was the leader of the optical communications group at MIT Lincoln Laboratories. Eric and I built the first fiber optic Michelson interferometer-based OCT system for in vivo imaging. That was also an exciting part of OCT history.

OSLIR: What are your hobbies outside of practicing medicine?

Dr. Huang: I play tennis, swim, and dabble in photography when I have the chance.

OSLIR: What do you enjoy doing to relax?

Dr. Huang: I like to walk in the green hills and woods in my neighborhood in Portland. I also like soaking in a hot tub, reading books, and drinking wine.

OSLIR: What's up next for you?

Dr. Huang: I would like to apply the quantitative OCT and OCTA tools we have developed in studying glaucoma and diabetic retinopathy to neurodegenerative and cerebrovascular diseases. The idea of using the eyes as windows in to the brain and brain circulation has resonance with a lot people in neurology. I'd like to cross-fertilize the field of neurology with what we have learned from imaging of the eye.

Abstract

Interview with David Huang, MD, PhD

OSLIR: Who has had the greatest influence on your career?

David Huang, MD, PhD: There are many people who have influenced my career. But if I had to pick one, that would be Dr. James G. Fujimoto. Jim was my doctoral thesis advisor at MIT. I learned a great deal about lasers and optics in his lab — knowledge that I still use in my research. I had the opportunity to participate in a wide variety of research projects from femtosecond laser generation, to picosecond laser tissue ablation, to the invention of optical coherence tomography (OCT). He had the unique ability to unleash the creative energy of his students by challenging them with difficult but solvable problems. I still collaborate with Jim today in our research and learn from the way he approaches problems and organizes projects.

OSLIR: What was the defining moment that led you to your field?

Dr. Huang: That would be the day Dr. Fujimoto gave me the project to look into measuring the distance between eye structures using an interferometer. This quickly led to success in measuring cornea thickness and anterior chamber depth. By the time we were measuring retinal thickness, the idea hit me that what we really had was a new imaging technology: OCT. Research in OCT imaging of the eye has been the most important part of my career ever since.

OSLIR: What area of research in ophthalmology most interests you right now and why?

Dr. Huang: I am interested in taking OCT beyond structural imaging and into probing the function of the eye. My research group started working on Doppler OCT about 8 years ago and OCT angiography (OCTA) about 5 years ago. We have also looked into the retinal blood flow response to light stimulation or physiologic challenges such as hyperoxia. Using OCT to image oxygen saturation is also an interesting area. All of these research topics are very interesting as opportunities for technical innovation, but OCTA in particular is going to be very important clinically. Our research group was among the first to demonstrate the usefulness of OCTA in retinal diseases and glaucoma about 3 years ago. Already the technology is being offered by at least six commercial companies that I know of and being used in hundreds of clinics. I think this new modality will spur a new burst of energy in ophthalmic imaging research, akin to the original introduction of OCT, and then the second stage of growth with the introduction of Fourier-domain OCT.

OSLIR: What advice would you offer a student in medical school today? (Or what advice would you offer residents and fellows considering a career in academic ophthalmology or vitreoretinal surgery?)

Dr. Huang: For those interested in academic ophthalmology, I would say find your special niche of research interest or clinical practice and invest the time to become the leading expert in that area. Often the best areas for innovation are at the intersection of disciplines. For me, this was the intersection between optical engineering and ophthalmology. For others, it would be different. But it is at the boundary between disciplines where there is opportunity to apply new approach to unsolved problems. The approach does not have to come from basic science or engineering. An example is Dr. Mark Terry, a corneal surgeon just across town from us who has taken the idea of lamellar surgery very far in the form of Descemet's stripping automated endothelial keratoplasty and Descemet's membrane endothelial keratoplasty. Another piece of advice is to make friends and collaborate with pioneers in your field. I have picked up many ideas for new projects from casual conversation with smart people.

OSLIR: Have you ever been fortunate enough to witness or to have been part of medical history in the making? If so, please explain.

Dr. Huang: I witnessed the creation of the first OCT scans. I had built an OCT prototype to scan specimens in vitro and used it on several types of tissue such as retina, gastric mucosa, and coronary artery plaque. At that time Professor Fujimoto had an ongoing collaboration with Dr. Carmen Puliafito at Harvard/MEEI. Dr. Puliafito let Dr. Joel Schuman come over to work on scanning the retina. Joel cut the globe in half and we scanned the retina with the open-sky approach. This was done in the evening, and I didn't know if the signals we were getting would make any sense until the next day when I created a false-color map that was the first retinal OCT image. We knew this was the beginning of something significant — a new medical imaging modality with much better depth resolution than anything before it. After this, Dr. Fujimoto introduced me to Eric Swanson, who was the leader of the optical communications group at MIT Lincoln Laboratories. Eric and I built the first fiber optic Michelson interferometer-based OCT system for in vivo imaging. That was also an exciting part of OCT history.

OSLIR: What are your hobbies outside of practicing medicine?

Dr. Huang: I play tennis, swim, and dabble in photography when I have the chance.

OSLIR: What do you enjoy doing to relax?

Dr. Huang: I like to walk in the green hills and woods in my neighborhood in Portland. I also like soaking in a hot tub, reading books, and drinking wine.

OSLIR: What's up next for you?

Dr. Huang: I would like to apply the quantitative OCT and OCTA tools we have developed in studying glaucoma and diabetic retinopathy to neurodegenerative and cerebrovascular diseases. The idea of using the eyes as windows in to the brain and brain circulation has resonance with a lot people in neurology. I'd like to cross-fertilize the field of neurology with what we have learned from imaging of the eye.

�A;David Huang

David Huang

Interview with David Huang, MD, PhD

OSLIR: Who has had the greatest influence on your career?

David Huang, MD, PhD: There are many people who have influenced my career. But if I had to pick one, that would be Dr. James G. Fujimoto. Jim was my doctoral thesis advisor at MIT. I learned a great deal about lasers and optics in his lab — knowledge that I still use in my research. I had the opportunity to participate in a wide variety of research projects from femtosecond laser generation, to picosecond laser tissue ablation, to the invention of optical coherence tomography (OCT). He had the unique ability to unleash the creative energy of his students by challenging them with difficult but solvable problems. I still collaborate with Jim today in our research and learn from the way he approaches problems and organizes projects.

OSLIR: What was the defining moment that led you to your field?

Dr. Huang: That would be the day Dr. Fujimoto gave me the project to look into measuring the distance between eye structures using an interferometer. This quickly led to success in measuring cornea thickness and anterior chamber depth. By the time we were measuring retinal thickness, the idea hit me that what we really had was a new imaging technology: OCT. Research in OCT imaging of the eye has been the most important part of my career ever since.

OSLIR: What area of research in ophthalmology most interests you right now and why?

Dr. Huang: I am interested in taking OCT beyond structural imaging and into probing the function of the eye. My research group started working on Doppler OCT about 8 years ago and OCT angiography (OCTA) about 5 years ago. We have also looked into the retinal blood flow response to light stimulation or physiologic challenges such as hyperoxia. Using OCT to image oxygen saturation is also an interesting area. All of these research topics are very interesting as opportunities for technical innovation, but OCTA in particular is going to be very important clinically. Our research group was among the first to demonstrate the usefulness of OCTA in retinal diseases and glaucoma about 3 years ago. Already the technology is being offered by at least six commercial companies that I know of and being used in hundreds of clinics. I think this new modality will spur a new burst of energy in ophthalmic imaging research, akin to the original introduction of OCT, and then the second stage of growth with the introduction of Fourier-domain OCT.

OSLIR: What advice would you offer a student in medical school today? (Or what advice would you offer residents and fellows considering a career in academic ophthalmology or vitreoretinal surgery?)

Dr. Huang: For those interested in academic ophthalmology, I would say find your special niche of research interest or clinical practice and invest the time to become the leading expert in that area. Often the best areas for innovation are at the intersection of disciplines. For me, this was the intersection between optical engineering and ophthalmology. For others, it would be different. But it is at the boundary between disciplines where there is opportunity to apply new approach to unsolved problems. The approach does not have to come from basic science or engineering. An example is Dr. Mark Terry, a corneal surgeon just across town from us who has taken the idea of lamellar surgery very far in the form of Descemet's stripping automated endothelial keratoplasty and Descemet's membrane endothelial keratoplasty. Another piece of advice is to make friends and collaborate with pioneers in your field. I have picked up many ideas for new projects from casual conversation with smart people.

OSLIR: Have you ever been fortunate enough to witness or to have been part of medical history in the making? If so, please explain.

Dr. Huang: I witnessed the creation of the first OCT scans. I had built an OCT prototype to scan specimens in vitro and used it on several types of tissue such as retina, gastric mucosa, and coronary artery plaque. At that time Professor Fujimoto had an ongoing collaboration with Dr. Carmen Puliafito at Harvard/MEEI. Dr. Puliafito let Dr. Joel Schuman come over to work on scanning the retina. Joel cut the globe in half and we scanned the retina with the open-sky approach. This was done in the evening, and I didn't know if the signals we were getting would make any sense until the next day when I created a false-color map that was the first retinal OCT image. We knew this was the beginning of something significant — a new medical imaging modality with much better depth resolution than anything before it. After this, Dr. Fujimoto introduced me to Eric Swanson, who was the leader of the optical communications group at MIT Lincoln Laboratories. Eric and I built the first fiber optic Michelson interferometer-based OCT system for in vivo imaging. That was also an exciting part of OCT history.

OSLIR: What are your hobbies outside of practicing medicine?

Dr. Huang: I play tennis, swim, and dabble in photography when I have the chance.

OSLIR: What do you enjoy doing to relax?

Dr. Huang: I like to walk in the green hills and woods in my neighborhood in Portland. I also like soaking in a hot tub, reading books, and drinking wine.

OSLIR: What's up next for you?

Dr. Huang: I would like to apply the quantitative OCT and OCTA tools we have developed in studying glaucoma and diabetic retinopathy to neurodegenerative and cerebrovascular diseases. The idea of using the eyes as windows in to the brain and brain circulation has resonance with a lot people in neurology. I'd like to cross-fertilize the field of neurology with what we have learned from imaging of the eye.

David Huang, MD, PhD, can be reached at huangd@ohsu.edu.

Disclosure: Dr. Huang receives patent royalties from Carl Zeiss Meditec and has stock ownership in and receives patent royalties, speaker travel support, and research grant and material support from Optovue.

Authors

David Huang, MD, PhD, can be reached at huangd@ohsu.edu.

Disclosure: Dr. Huang receives patent royalties from Carl Zeiss Meditec and has stock ownership in and receives patent royalties, speaker travel support, and research grant and material support from Optovue.

10.3928/23258160-20160601-18

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