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- Member Highlights - Philip Rosenfeld
Member Highlights - December 2024
Philip Rosenfeld, MD, PhD
What motivated you to join this society, and how has being part of this society
supported your professional growth or interests?
Joining IntRIS was a no-brainer. If you’re a retina specialist with an interest in imaging, and you learn that Vas Sadda, Bailey Freund, and David Sarraf are starting a society that will focus solely on imaging, then of course you’ll want to join. With their leadership and the exploding interest in imaging among retina specialists, I knew IntRIS would be a success, and it has been. Anyone who wants to keep abreast of the cutting-edge developments in retinal imaging should be a member of IntRIS, attend the IntRIS annual meetings, and partake in all the other educational opportunities offered by IntRIS
What is a recent project or case you’ve worked on that excited you?
I get excited by all the ongoing advances in OCT and OCT angiography (OCTA) imaging. Using the latest OCT technologies, we’ve been able to re-define macular diseases. My primary focus is on AMD, and while there’s no question that OCT and OCTA now dominate the clinics and have replaced dye-based angiography for wet AMD, I predict the same dominance will occur in dry AMD. The combination of dense raster scans, en face imaging, and selective B-scan imaging will replace the current multi-modal imaging strategy used for dry AMD. We’ve greatly enhanced our understanding of disease onset and progression by using longitudinal layer-specific OCT imaging of eyes with dry AMD.I’m most excited about what we’re learning after the use of the complement inhibitor Syfovre for the treatment of geographic atrophy. For several years, we’ve been studying normal disease progression using swept-source OCT (SS-OCT) and SS-OCTA, and now we’ve introduced a novel reagent that allows us to perturb this progression. Not only are we gathering a wealth of information about the role of complement in disease progression, but the use of SS-OCTA imaging is helping us understand who the best patients are to treat and the best ways to assess treatment efficacy. We’re observing a great convergence of technologies. By introducing a therapy to our patients who have no current treatment option, we are using novel imaging strategies to study the drug’s effects, to improve our management of these patients, and to develop novel ideas on how to design better clinical trials for the future so we can detect treatment benefits at an earlier stage with the goal of helping our patients.
Who has been a mentor or role model for you in ophthalmology, and what’s the best advice they’ve given you?
All of us in retina stand on the shoulders of the giants who have preceded us. I haven’t had a specific role model, but many role models throughout my career. Over the years I’ve learned to always associate myself with people that are smarter than me and to learn from them. My most profound role model was Thomas Kelly, my thesis advisor at Johns Hopkins. He taught me how to perform bullet-proof research. I learned to always pay attention to the design of your study, especially the controls. That’s true whether you’re in the lab or in the clinics. If more clinical research paid more attention to the controls, then fewer clinical trials would fail. In ophthalmology, my interest in retina was inspired by Stuart Fine, my fascination with the genetics of retinal diseases inspired by Ted Dryja and Johanna Seddon, my love affair with OCT imaging by Carmen Puliafito, my desire to develop novel pharmacotherapies by Joan Miller, Tony Adamis, and Neil Bressler, my appreciation for biostatistics in designing clinical studies by Bill Feuer, and my appreciation of OCT optical engineering by Ricky Wang. But it was the academic freedom I experienced at the Bascom Palmer Eye Institute that allowed me to integrate both my clinical and research interests.
However, another important life lesson was best expressed by Quincy Jones, the famous musician, composer, and arranger who died recently. He said, “God walks out of the room when you’re thinking about money”. To paraphrase Quincy Jones, my advice to the younger generation would be that you’ll lose sight of what’s really important, and you may even lose your soul, if money takes priority in your clinical and research work. This is especially true even when dealing with industry. Our best industry partners are the ones that prioritize patients over money and performing the best research. If a drug or treatment succeeds, then the money and profits will follow.
If you could give your younger self any advice about the career, what would it be?
One of the advantages I had starting off was that no one told me what to do. When I started at Bascom Palmer, I was following in the footsteps of the great Don Gass. Everyone thought I wanted to be another Don Gass, but I didn’t. I wanted to build on Don’s accomplishments by using OCT imaging, and I also received Don’s support. He saw OCT as a way to validate his own observations. He said to me “finally the residents and fellows will see what I’ve been trying to teach them to see”. If I could pull my younger self aside, I would tell myself to have confidence in my own judgement and not let other people tell me what to do. I’d say, “you’ve got this”. I remember, early in my career, a leader in retina pulled me aside at a meeting and told me “Don’t be a one-trick pony. You’ve got to get involved in many different diseases, not just AMD”. I knew at that time he was wrong, since I had learned earlier in my research career that I always did my best work when focused on a single objective.
How do you support or mentor younger members or trainees in the field?
I’m quite fortunate in having best of both worlds. I mentor clinical fellows on how best to take care of patients, and I mentor research fellows on how to ask the important questions and think about the best way to answer those questions. I also encourage both the clinical and research fellows to challenge dogma and think for themselves. We’ve always had “influencers” in retina, but I’m particularly satisfied when I watch my fellows push back against those “influencers” when they don’t agree. What greater reward, whether you’re a mentor or a parent, than to watch your fellows or your children think for themselves. I try to put them in a position to succeed.
What’s something people might be surprised to learn about you?
I’m a “cat daddy”. According to Chat GPT, a “cat daddy” is an affectionate term for a man who has a close bond with his cat or cats. I wasn’t always a “cat-daddy”, but we recently adopted a majestic black-panther-like rescue cat that has captured my heart. Her name is Jilly, and she’s the most affectionate animal I’ve ever had, and I’ve had plenty of dogs and cats. She’s my study-buddy, my Zoom-buddy, my movie-buddy, and my nap-buddy. She also gives great massages and head-bumps. She even adores OCT imaging, as you can see by her desire to get close to my SS-OCT PowerPoint.
