Associate Professor Department of Ophthalmology Loyola University Medical Center Section Chief, Ophthalmology,Edward Hines, Jr. VA Hospital jay.perlman@va.org Phone: (708) 216-3833 Biographical Data: Medical School: Albert Einstein College of Medicine Residency: Bronx-Lebanon Hospital Center Affiliate of Albert Einstein College of Medicine, Bronx, NY Fellowships: Ophthalmic Pathology Armed Forces Institute of Pathology, Washington, DC Ophthalmic Pathology University of Illinois Chicago, Chicago, IL Graduate School: MS and PhD Purdue University, West Lafayette, IN Research Interests: Role of glutamate and free radicals in retinal disease Select Publications: View a partial list of Dr. Perlman's publications through the National Library of Medicine's PubMed online database. Curriculum Vitae

Dr. Perlman is a board certified ophthalmologist and Chief of Ophthalmology with Surgical Service at Edward Hines Jr. VA Hospital. He is currently an Associate Professor of Ophthalmology and Pathology at Loyola University of Chicago Stritch School of Medicine.

Dr. Perlman’s primary research interests are focused on understanding the pathophysiology of glaucoma and advancing therapeutic strategies for the management of primary open angle glaucoma (POAG), a leading cause of blindness in the United States and worldwide. Dr. Perlman’s research programs have been funded by the Department of Veterans Affairs, and numerous other granting foundations including Fight-for-Sight, Midwest Eye Banks, and Illinois Society for the Prevention of Blindness.

Animal studies of glaucomatous neuropathy
POAG is a slowly progressive optic neuropathy with characteristic optic nerve degeneration and progressive visual field loss. The prevalence of POAG in the US population 40 years and older is approximately 1.86% or nearly 2 million individuals. Over 60 million cases of blindness can be attributed to glaucoma worldwide. The personal, social, and medical burden of this disease is experienced globally and remains a significant concern. Rehabilitative studies designed to treat POAG are extremely important and are currently under represented.

Elevated intraocular pressure (IOP) is considered a primary risk factor for the initiation and progression of glaucomatous neuropathy. As such, current therapeutic options for the glaucomatous patient are limited to the management of IOP. Adequate IOP control in many patients, however, is insufficient to prevent further progressive loss of vision. Thus, the development of more selective therapeutic strategies that address the molecular defects responsible for optic nerve injury are critically needed to advance the care of the glaucomatous patient.

Statins are a group of potent hydroxymethylglutaryl coenzyme A (HMG-CoA) reductase inhibitors that are widely used clinically as lipid-lowering agents for the management of hypercholesterolemia and coronary atherosclerosis. The beneficial effects of statins may, however, extend beyond their efficacy in reducing serum cholesterol. A number of pleiotropic affects have been described for both naturally occurring and synthetic statins, including important neuroprotective properties. Recent data suggests that statins can ameliorate neurologic damage specifically by providing neuroprotection to brain tissue following an ischemic stroke. As a result of these and related experimental and clinical studies, statins are now being evaluated as therapeutic agents for the management of a wide variety of neurologic disorders. Our own experience with the application of statins as a novel therapeutic strategy extends this list to include inflammatory peripheral neuropathies. Vision-related disorders are no exception, as statins are reported to be beneficial for the management of macular degeneration and glaucoma. Using high intraocular pressure as a glaucomatous model, we recently reported that prophylactic administration of simvastatin to rats may protect against ischemic-reperfusion retinal injury. Statins have therapeutic value in the early treatment of glaucoma, possibly by protecting against chronic ocular hypertensive retinal nerve injury.

The mechanism by which statins promote neuroprotection in vision disorders, including glaucoma, remains unclear. By inhibiting HMG-CoA reductase, statins reduce the availability of key isoprenoid intermediates necessary for the membrane localization and activation of small Rho GTPases involved in actomyosin regulation of aqueous humor outflow. Statin inhibition of Rho GTPase signaling may exert retinal protective effects without directly altering intraocular pressure; this may occur by eliciting dilation of retinal microvessels through nitric oxide and mevalonate-rho kinase pathways. A better understanding of how statins influence aqueous humor outflow and affect retinal function is, in our opinion, critically needed before the development of more specific and effective therapeutic options for the glaucomatous veteran can be realized.

Ophthalmic Pathology Virtual Microscopy
Virtual microscopy is a novel method of posting microscope images on, and transmitting them over, computer networks for the purpose of facilitating collaborative interaction among colleagues across diverse geographical locations. It involves a synthesis of microscopy technologies and digital technologies. With recent advances in virtual microscopy, it is now possible to achieve image resolutions approaching that visible under the optical microscope.

An ophthalmic pathology virtual microscopy workgroup has been established in order to create an Ophthalmic Pathology Collaborative and Educational Resource (OPCER) for ophthalmologists, ophthalmology residents, and medical students. Additional benefits include Continuing Medical Education for ophthalmologists and eye pathologists, and Quality Assurance programs for practicing eye pathologists.

High quality histopathologic specimens for ophthalmic pathology are scanned using technology available from Aperio. We currently have a large data base of scanned specimens which are in the process of being archived onto the Aperio website. Specimens are annotated with educational information. Ultimately, the goal of this project is to provide an invaluable ophthalmic pathology resource which will be made available to interested individuals worldwide.