Ronald Silverman

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Ronald H. Silverman is an American ophthalmologist. He is currently Professor of Ophthalmic Science at Columbia University Medical Center. He is currently the director of the CUMC Basic Science Course in Ophthalmology, which takes place every January at the Harkness Eye Institute. He departed Weill Cornell Medical College in 2010, where he was Professor of Ophthalmology as well as a Dyson Scholar and the Research Director of the Bioacoustic Research Facility, Margaret M. Dyson Vision Research Institute at Weill Cornell.

Contents

Education

Dr. Silverman holds an M.S. in Bioengineering from the Polytechnic Institute of New York, and a Ph.D. in Computer Science from Polytechnic University. He is also a Member of the Research Staff at the Frederic L. Lizzi Center for Biomedical Engineering, Riverside Research Institute.

While working full-time at Cornell, Dr. Silverman spent his evenings studying Computer Science at Polytechnic University for a PhD. Following his interest in multivariate analysis, he became interested in the then obscure field of neural networks – simulated non-linear interconnected processing units designed to perform pattern recognition in a manner loosely connected to how the brain performs such tasks. Dr. Silverman implemented a new technique called 'back-propagation'. As part of his dissertation, he demonstrated how a multiscaled non-linear neural net could be used for automatic pattern recognition to localize tumors in ultrasound B-scans, and then to access the underlying echo data and then perform a non-linear multidimensional analysis to classify the tumor type. This work represented the first use of neural nets in medical imaging and the first use of neural nets for medical diagnosis. Dr. Silverman received his doctorate for this work in 1990. [1]

Career

Early high frequency ultrasound systems

In the early 1990s, Dr. Silverman was instrumental in the development and clinical application of one of the first very high frequency ultrasound systems. He developed a system for acquisition of a series of parallel scan planes with a 50 MHz transducer, allowing 3-D reconstruction of the anterior segment of the eye with an axial resolution of about 30 micrometres. Working with Dan Reinstein, Dr. Silverman developed software for processing 3-D scans of the cornea that allowed measurement and mapping of corneal thickness as well as the thickness of the stroma and epithelium. [2] They also found that they could detect and measure the flap interface in LASIK-treated eyes, and demonstrated epithelial thickening associated with regions where the stroma had been ablated. [3] [4] While a major achievement, the linear 3-D scan system could only obtain data in the 3 mm zone of the central cornea due to its specularity.

3-D scan system

Silverman then developed a new 3-D scan system with 5-degrees of freedom. This system allowed the cornea to be scanned in a series of arcs such that the beam axis was maintained orthogonal to the corneal surface and the focal point maintained on the surface. This system allowed demonstration of the importance of arc-scanning for corneal analysis [5] and led to the subsequent development of a far simpler arc-scan device with just two programmable axes. This system led to a commercial system (Artemis-2, Ultralink, LLC), manufactured under license from Cornell University.

Statistics

He developed a multivariate statistical model based on ultrasound spectral parameters to differentiate metastatic carcinoma, and two subtypes of uveal malignant melanoma. Publication of these findings in 1983 [6] represented one of the first reports in the literature of medical diagnosis based on multivariate statistical analysis and one of the earliest applications of ultrasound tissue characterization.

Therapeutic ultrasound for glaucoma

Dr. Silverman was involved in the development of the use of high-intensity ultrasound for treatment of glaucoma. [7] [8] [9] This project involved direction of an intense focused ultrasound beam at the region of the ciliary body to cause cyclodestruction. This project eventually led to a commercial device (Sonocare, Inc.) manufactured under license by Cornell, and a multicenter clinical trial. Silverman was instrumental in compiling and providing statistical analysis of treatment results from over a thousand patients treated for refractory glaucoma by this device at over 20 centers. The device became the first FDA-approved high-intensity focused ultrasound (HIFU) system. (Several commercial HIFU systems are now in clinical use, although laser techniques based on this groundbreaking effort have supplanted this technique.)

Eye blood flow measurement

Dr. Silverman, working with Katherine Ferrara, developed a new technique called swept mode for imaging of slow flow in the microvasculature. [10] [11] This technique was demonstrated in the iris and ciliary body and was eventually patented.

High-resolution imaging of eye tumors

Dr. Silverman described the first use of 20 MHz ultrasound to obtain improved high resolution of retinal and choroidal pathologies such as nevii and small tumors in 2004. [12]

Acoustic radiation force

Dr. Silverman has explored the use of acoustic radiation force for characterization to ocular tissue properties. He has demonstrated measurement of force-induced displacements in the rabbit cornea during exposures of a few milliseconds, and that such displacements correlated with corneal stiffness. [13] He also applied this technique to the retina/choroid in the rabbit and demonstrated not only force-induced displacements in these tissues and in the orbit, but also alteration in choroidal backscatter under conditions of elevated intraocular pressure where blood-flow was impeded. [14]

Organizational affiliations

Dr. Silverman is a Fellow of the American Institute for Medical and BIological Engineering. [15] He also is a Fellow of the American Institute of Ultrasound in Medicine, past President of the American Society of Ophthalmic Ultrasound and is on the Advisory Boards of the National Institutes of Health Transducer Resource and the Ocular Oncology Research Society. He has served on numerous grant review panels, is a frequent reviewer for scientific journals and conferences, has given many invited lectures and has often served as a moderator at scientific conferences.

Related Research Articles

<span class="mw-page-title-main">Cornea</span> Transparent front layer of the eye

The cornea is the transparent front part of the eye that covers the iris, pupil, and anterior chamber. Along with the anterior chamber and lens, the cornea refracts light, accounting for approximately two-thirds of the eye's total optical power. In humans, the refractive power of the cornea is approximately 43 dioptres. The cornea can be reshaped by surgical procedures such as LASIK.

<span class="mw-page-title-main">Eye surgery</span> Surgery performed on the eye or its adnexa

Eye surgery, also known as ophthalmic or ocular surgery, is surgery performed on the eye or its adnexa, by an ophthalmologist. Eye surgery is synonymous with ophthalmology. The eye is a very fragile organ, and requires extreme care before, during, and after a surgical procedure to minimize or prevent further damage. An expert eye surgeon is responsible for selecting the appropriate surgical procedure for the patient, and for taking the necessary safety precautions. Mentions of eye surgery can be found in several ancient texts dating back as early as 1800 BC, with cataract treatment starting in the fifth century BC. Today it continues to be a widely practiced type of surgery, with various techniques having been developed for treating eye problems.

<span class="mw-page-title-main">Radial keratotomy</span> Refractive surgical procedure to correct myopia (nearsightedness

Radial keratotomy (RK) is a refractive surgical procedure to correct myopia (nearsightedness). It was developed in 1974 by Svyatoslav Fyodorov, a Russian ophthalmologist. It has been largely supplanted by newer, more accurate operations, such as photorefractive keratectomy, LASIK, Epi-LASIK and the phakic intraocular lens.

<span class="mw-page-title-main">Refractive surgery</span> Surgery to treat common vision disorders

Refractive eye surgery is optional eye surgery used to improve the refractive state of the eye and decrease or eliminate dependency on glasses or contact lenses. This can include various methods of surgical remodeling of the cornea (keratomileusis), lens implantation or lens replacement. The most common methods today use excimer lasers to reshape the curvature of the cornea. Refractive eye surgeries are used to treat common vision disorders such as myopia, hyperopia, presbyopia and astigmatism.

<span class="mw-page-title-main">Phakic intraocular lens</span> Lens implanted in eye in addition to the natural lens

A phakic intraocular lens (PIOL) is a special kind of intraocular lens that is implanted surgically into the eye to correct myopia (nearsightedness). It is called "phakic" because the eye's natural lens is left untouched. Intraocular lenses that are implanted into eyes after the eye's natural lens has been removed during cataract surgery are known as pseudophakic.

<span class="mw-page-title-main">Corneal endothelium</span>

The corneal endothelium is a single layer of endothelial cells on the inner surface of the cornea. It faces the chamber formed between the cornea and the iris.

<span class="mw-page-title-main">Red eye (medicine)</span> Eye that appears red due to illness / injury. It is a common diseases

A red eye is an eye that appears red due to illness or injury. It is usually injection and prominence of the superficial blood vessels of the conjunctiva, which may be caused by disorders of these or adjacent structures. Conjunctivitis and subconjunctival hemorrhage are two of the less serious but more common causes.

<span class="mw-page-title-main">Fuchs' dystrophy</span> Medical condition

Fuchs dystrophy, also referred to as Fuchs endothelial corneal dystrophy (FECD) and Fuchs endothelial dystrophy (FED), is a slowly progressing corneal dystrophy that usually affects both eyes and is slightly more common in women than in men. Although early signs of Fuchs dystrophy are sometimes seen in people in their 30s and 40s, the disease rarely affects vision until people reach their 50s and 60s.

<span class="mw-page-title-main">Ocular tonometry</span>

Tonometry is the procedure eye care professionals perform to determine the intraocular pressure (IOP), the fluid pressure inside the eye. It is an important test in the evaluation of patients at risk from glaucoma. Most tonometers are calibrated to measure pressure in millimeters of mercury (mmHg), with the normal eye pressure range between 10 and 21 mmHg (13–28 hPa).

<span class="mw-page-title-main">Iris cyst</span>

Iris cysts are hollow cavities in the eye filled with secretion. They come in various sizes, numbers, shapes, pigments and can be free-floating, attached to the pupillary margin or within the posterior chamber. Most frequently iris cysts don't cause any issues, but they can cause problems like: “fly biting” behavior, corneal endothelial pigment, lens capsular pigmentation, altered iris movement, decreased aqueous outflow with subsequent glaucoma or block the vision when grown too big. They can be acquired or innate. Possible causes are inflammation, drug-induced, uveitis, a trauma, tumor-induced, parasitic or implantation. Most frequently iris cysts are benign and need no treatment. Sometimes iris cysts are causing problems and need to be deflated. Iris cysts can be treated with trans corneal diode laser treatment, fine-needle aspiration or surgical excision. For the treatment of iris cysts is a conservative approach favored.

<span class="mw-page-title-main">Stroma of cornea</span> Lamellated connective tissue of cornea

The stroma of the cornea is a fibrous, tough, unyielding, perfectly transparent and the thickest layer of the cornea of the eye. It is between Bowman's membrane anteriorly, and Descemet's membrane posteriorly.

<span class="mw-page-title-main">Corneal epithelium</span>

The corneal epithelium is made up of epithelial tissue and covers the front of the cornea. It acts as a barrier to protect the cornea, resisting the free flow of fluids from the tears, and prevents bacteria from entering the epithelium and corneal stroma.

<span class="mw-page-title-main">Axenfeld–Rieger syndrome</span> Medical condition

Axenfeld–Rieger syndrome is a rare autosomal dominant disorder, which affects the development of the teeth, eyes, and abdominal region.

ReLExSmall incision lenticule extraction (SMILE), second generation of ReLEx Femtosecond lenticule extraction (FLEx), is a form of laser based refractive eye surgery developed by Carl Zeiss Meditec used to correct myopia, and cure astigmatism. Although similar to LASIK laser surgery, the intrastromal procedure is novel in that it uses a single femtosecond laser referenced to the corneal surface to cleave a thin lenticule from the corneal stroma for manual extraction and SMILE. It has been described as a painless procedure. For candidates to qualify for this treatment, they have their corneal stroma thickness checked to make sure that post operative thickness won't be too thin.

D. Jackson Coleman is a Professor of Clinical Ophthalmology at New York-Presbyterian Hospital at The Edward S. Harkness Eye Institute of Columbia University. He is the former John Milton McLean Professor of Ophthalmology and Chairman Emeritus at Weill Cornell Medical Center where he served as Chairman from 1979–2006. His specialties are retinal diseases and ultrasound, working with patients at Columbia University Medical Center. Coleman is also engaged in research involving ultrasound, which he has pursued throughout his career with colleague Ronald Silverman in the Department of Ophthalmology at the Columbia University Medical Center.

<span class="mw-page-title-main">Corneal pachymetry</span>

Corneal pachymetry is the process of measuring the thickness of the cornea. A pachymeter is a medical device used to measure the thickness of the eye's cornea. It is used to perform corneal pachymetry prior to refractive surgery, for Keratoconus screening, LRI surgery and is useful in screening for patients suspected of developing glaucoma among other uses.

<span class="mw-page-title-main">Corneal keratocyte</span>

Corneal keratocytes are specialized fibroblasts residing in the stroma. This corneal layer, representing about 85-90% of corneal thickness, is built up from highly regular collagenous lamellae and extracellular matrix components. Keratocytes play the major role in keeping it transparent, healing its wounds, and synthesizing its components. In the unperturbed cornea keratocytes stay dormant, coming into action after any kind of injury or inflammation. Some keratocytes underlying the site of injury, even a light one, undergo apoptosis immediately after the injury. Any glitch in the precisely orchestrated process of healing may cloud the cornea, while excessive keratocyte apoptosis may be a part of the pathological process in the degenerative corneal disorders such as keratoconus, and these considerations prompt the ongoing research into the function of these cells.

<span class="mw-page-title-main">Gholam A. Peyman</span> Iranian-American ophthalmologist and retina surgeon known for inventing LASIK eye surgery

Gholam A. Peyman is an ophthalmologist, retina surgeon, and inventor. He is best known for his invention of LASIK eye surgery, a vision correction procedure designed to allow people to see clearly without glasses. He was awarded the first US patent for the procedure in 1989.

Dua's layer, according to a 2013 paper by Harminder Singh Dua's group at the University of Nottingham, is a layer of the cornea that had not been detected previously. It is hypothetically 15 micrometres thick, the fourth caudal layer, and located between the corneal stroma and Descemet's membrane. Despite its thinness, the layer is very strong and impervious to air. It is strong enough to withstand up to 2 bars of pressure. While some scientists welcomed the announcement, other scientists cautioned that time was needed for other researchers to confirm the discovery and its significance. Others have met the claim "with incredulity".

Pre Descemet's endothelial keratoplasty (PDEK) is a kind of endothelial keratoplasty, where the pre descemet's layer (PDL) along with descemet's membrane (DM) and endothelium is transplanted. Conventionally in a corneal transplantation, doctors use a whole cornea or parts of the five layers of the cornea to perform correction surgeries. In May 2013, Dr Harminder Dua discovered a sixth layer between the stroma and the descemet membrane which was named after him as the Dua's layer. In the PDEK technique, doctors take the innermost two layers of the cornea, along with the Dua's layer and graft it in the patient's eye.

References

  1. Silverman RH, Noetzel AS. Image processing and pattern recognition in ultrasonograms by backpropagation. Neural Networks 3:593-603, 1990.
  2. Reinstein DZ, Silverman RH, Rondeau MJ, Coleman DJ. Epithelial and corneal thickness measurements by high-frequency ultrasound digital signal processing, Ophthalmology, 101: 140-146, 1994.
  3. Reinstein DZ, Silverman RH, Trokel SL, Allemann N, Coleman DJ. High-frequency ultrasound digital signal processing for biometry of the cornea in planning phototherapeutic keratectomy. Arch Ophthalmol 111: 431-431, 1993.
  4. Reinstein DZ, Silverman RH, Trokel SL, Coleman DJ. Corneal pachymetric topography. Ophthalmology 101:432-438, 1994.
  5. Reinstein DZ, Silverman RH, Raevsky T, Simoni GJ, Lloyd HO, Najafi DJ, Rondeau MJ, Coleman, DJ. Arc-scanning very high-frequency ultrasound for 3-D pachymetric mapping of the corneal epithelium and stroma in laser in situ keratomileusis. J Refract Surg. 16:414-430, 2000.
  6. Coleman DJ, Lizzi FL, Silverman RH,, Rondeau MJ, Smith ME, Torpey JH. Acoustic biopsy as a means for characterization of intraocular tumors. American Academy of Ophthalmology, Acta: XXIV International Congress of Ophthalmology, edited by Paul Henkind, MD, J.B. Lippincott Company, Philadelphia, PA, 1983, pp. 115-118.
  7. Coleman DJ, Lizzi FL, Driller J, Rosado A, Burgess SEP, Torpey JH, Smith ME, Silverman RH, Yablonski ME, Chang S, Rondeau MJ. Therapeutic ultrasound in the treatment of glaucoma: II. Clinical applications. Ophthalmology 92:347-353, 1985.
  8. Burgess SEP, Silverman RH, Coleman DJ, Yablonski ME, Lizzi FL, Driller J, Rosado A. Dennis PH. Treatment of glaucoma with high-intensity focused ultrasound. Ophthalmology 93:831-838, 1986.
  9. Silverman RH, Vogelsang B, Rondeau MJ, Coleman DJ. Therapeutic ultrasound for the treatment of glaucoma. Am J Ophthalmol. 111:327-337, 1991.
  10. Silverman RH, Kruse D, Coleman DJ, Ferrara KW. High-resolution ultrasonic imaging of blood-flow in the anterior segment of the eye. Invest Ophthalmol Vis Sci. 40:1373-81, 1999.
  11. Kruse D, Silverman R, Erickson S, Coleman DJ, Ferrara K. Optimization of real-time high frequency ultrasound for blood flow imaging in the microcirculation. IEEE Ultrasonics Symposium:1461-1464, 2000.
  12. Coleman DJ, Silverman RH, Chabi A, Rondeau MJ, Shung KK, Cannata J, Lincoff H. High Resolution Ultrasonic Imaging of the Posterior Segment, Ophthalmology 111:1344-1351, 2004.
  13. Urs R, Lloyd HO, Silverman RH. Acoustic radiation force for noninvasive evaluation of corneal biomechanical changes induced by cross-linking therapy. J Ultrasound Med. 2014 Aug;33(8):1417-26.
  14. Silverman RH, Urs R, Lloyd HO. Effect of ultrasound radiation force on the choroid. Invest Ophthalmol Vis Sci. 2013 Jan 10;54(1):103-9.
  15. "Ronald H. Silverman, Ph.D. COF-1474 - AIMBE" . Retrieved 2022-08-09.

External sources