Kathryn A. Colby, MD, PhD, looks to the future in ophthalmology and at NYU

David Hutton of Ophthalmology Times talks with Kathryn A. Colby, MD, PhD,Elisabeth J. Cohen Professor and Chair, NYU Langone Department of Ophthalmology, about the year the department had in 2023 as well as an outlook at advancements in the field of ophthalmology moving forward.

Video Transcript

Editor's note - This transcript has been edited for clarity.

David Hutton:

I'm David Hutton of Ophthalmology Times. Joining me today is Kathryn A. Colby, MD, PhD, Elisabeth J. Cohen Professor and Chair, NYU Langone Department of Ophthalmology. Dr. Colby, thanks for joining us. And tell us about the last year. What are some of the achievements in the department in 2023 that you're most proud of?

Kathryn A. Colby, MD, PhD:

Thank you, David. It's a pleasure to be here. Well, today's Match Day. So we just had the best match that we've ever had, we matched 5 incredibly talented medical students. And that is a real testament to where the NYU Department of Ophthalmology is, that we can get such great residents who are excited to come in and train at what we believe is the best program in New York City.

Because not only do we have a fabulous culture, but we have a really excellent faculty, group practice, we have our own VA, and we have Bellevue, which is the the the mother of all public hospitals. So it offers our residents a tremendous opportunity to not only serve the underserved, but to train at a variety of sites where they'll see many different types of patients.

David Hutton:

And if you look ahead, what's your outlook for 2024? You know, what new things are in store? What can everybody look forward to?

Kathryn A. Colby, MD, PhD:

Personally, I'm hoping that we go back to in-person resident interviews, but I know that that's a topic with many, with several sides on it. We we have really some really exciting research going on in the department using state of the art technology that is not available at other centers. To really give us a better understanding of, for example, in the retina, looking at layers that were not previously able to be visualized as potentially a biomarker for early dry macular degeneration.

You know, we have these drugs that are approved now. I think it's safe to say the clinical response to those have been underwhelming. So there's still a great unmet need in dry macular degeneration. But what we need is really a better biomarker to know which patients are going to progress and one of our researchers Vivek J. Srinivasan and who has a PhD and an engineer, has developed, has built a prototype visible light OCT where he can actually image the rods really for the first time.

David Hutton:

Interesting. And beyond that, what's your overall outlook for ophthalmology say over the next year or two?

Kathryn A. Colby, MD, PhD:

Well, we have a very popular profession. I'm sure you saw the article that just came out in ophthalmology about the predictions that we're going to have workforce problems in the not too distant future. So I think there is really a drive to make sure that we're training our residents and fellows to be the best ophthalmologists they can be. I just recently participated in the ACGME stakeholder meeting. Because of the 10 year review of ophthalmology program requirements and we've had a tremendous number of things go on in the last 10 years.

You know, telemedicine, artificial intelligence, we have to be mindful about how we incorporate these not only into our clinical care but into our training. And we also have to keep an eye on you know, do we need to train more residents? We certainly need more diversity in ophthalmology. David, you know, I've been a proponent for women in ophthalmology for my entire career. And I'd say women have made some strides. We still really are falling behind though. And we really have made not enough progress in terms of people who are under represented in medicine.

David Hutton:

And as you look out across the landscape, what are some of the advances in ophthalmology be it AI or something else that you're most excited about?

Kathryn A. Colby, MD, PhD:

Well, I don't know whether to be excited or terrified about AI, honestly. Right. I think there's tremendous promise there. Um, you know, I think I'm, as you know, I'm a cornea specialist. And I think back over the course of my career, when I learned to be a cornea specialist in the 90s, all we did was full thickness transplantation. And now we're at a stage where we do layer for layer replacement of the cornea, right, endothelial keratoplasty, which is great. But what's really even more exciting is there's a lot of interest in other therapies for endothelial dysfunction, for example, cultured endothelial cells.

Two companies are currently in human trials. So I expect, if those are successful, that, you know, these therapies will be approved. You know, I don't know what the timeframe is maybe five years. But that's very exciting, because you can imagine a situation where you could deliver cultured cells to someone with failed with a transplant who's whose graft has failed for endothelial dysfunction. There was also a number of institutions and companies looking at medical therapy for Fuchs' dystrophy, which is, you know, again, back in the 90s, we used to let people go blind with Fuchs' before we did a full thickness transplant. And while that was a fun operation, it took a long time to get back to better vision and to think that, you know, in the not too distant future, we could have the ability to administer a small molecule that would prevent the endothelial cells from degenerating or in the case of certain types of Fuchs' potentially even do gene editing to get rid of the bad gene. It's really quite exciting.

And, you know, I'm a cornea specialist. So clearly, those are the things I know best, but there's, in glaucoma, there's so many new devices. Understanding you know, really the the implications of the retinal ganglion cell dysfunction and what actually causes that, to be able to create ways to to stop that from happening, you know, we lower pressure, but it's likely that there's something better that we can do besides that.

David Hutton:

As a cornea specialist, do you think things like 3D printed corneal material are realistic? Or are they just science fiction?

Kathryn A. Colby, MD, PhD:

I think for certain things, where you don't necessarily need the cells, I don't think you're going to, you're going to replace endothelial transplantation. But if you just need a substrate for a stromal scar or something, there's been lots of work going on there. And whether printed corneas are the way to go or bioengineered corneas.

So I think that that's probably the lowest hanging fruit. At you know, I mean, we're we're so fortunate here in the United States for many reasons. So we don't lack for tissue, corneal tissue. But clearly, in other parts of the world, that's not the situation.

David Hutton:

You're a shining example to young women in ophthalmology that they can reach for leadership roles in this field, what pearls would you offer to these young woman entering the field today?

Kathryn A. Colby, MD, PhD:

So my most most critical leadership lesson is applicable to everyone, male or female, or any other way that you'd like to describe yourself and that is, you have to really know yourself, you have to know your why. You know, to be a successful department chair, which is the leadership role I know best, it's about other people, it's a service role. It's not about you know, another notch on your belt or another framed print on your wall or something like that. It's about ensuring the success of other people. So I would say you know, figure out what gives you joy, figure out what, doesn't necessarily give you joy, but you can tolerate doing and then figure out what you really don't like doing. Right? And try to craft your job that way.

There's so many, there's so many great mentors mentorship opportunities, that really have evolved over the last 20 years. AUPO, the Association of University Professors of Ophthalmology, I'm the Senior Director for their academic leadership development program, which is trying to ensure that there's a steady supply of people who are trained to be chairman and understand what the job entails. But every other organization has something similar to that. So take advantage of that. And, and then specifically for women, I'd say, it's important, if you throw your hat in the ring, be ready to take a position if it's offered. You know, it's that is really critical because when when we're out of position where we're being interviewed for chairmanships, things like that, you know, if you get to that point, and then you're like, well, not really. You know, it just it makes it harder for the for the folks who come behind you. And again, that's true of men and women, but I, I feel like it's more of a challenge with with women