Chairman, Duke Eye Center

Joseph A.C. Wadsworth Clinical Professor of Ophthalmology, Glaucoma Service

Medical school

Johns Hopkins University Medical School

Residency

Massachusetts Eye and Ear Infirmary

Fellowship(s)

Massachusetts Eye and Ear Infirmary, Glaucoma

Background

In addition to being Chairman, David Epstein, MD, maintains an active glaucoma research program in collaboration with Pratap Challa, MD, Pedro Gonzalez, PhD, Vasanth Rao, MD, and Dennis Rickman, PhD. He has had more than 20 years of continuous National Eye Institute funding for his studies of fundamental aspects of aqueous humor outflow and glaucoma. His research is focused on understanding how the fluid inside the eye, the aqueous humor, normally leaves the eye through the trabecular meshwork-Schlemm's canal outflow pathway, and how abnormality in this process can cause both primary and secondary types of glaucoma. He has developed novel drugs for the trabecular meshwork that have the potential to cure the abnormality in aqueous outflow that leads to the fundamental hydrodynamic pathology of glaucoma. His goal is to develop a once- or twice-a-year eye drop or other drug treatment for glaucoma that is potentially curative. Prototype drugs that are exceptionally active in the outflow pathway have already been developed. Current efforts involve required optimization of drug delivery to the active site. Epstein strongly believes that glaucoma is a disease of two sites in the eye: the outflow pathway and the optic nerve. The above aqueous outflow program is focused on curing the abnormality that causes elevation of intraocular pressure, but he hopes in the future, to expand the Duke program to include fundamental studies of the optic nerve in glaucoma, along with collaborators, Rickman and Fulton Wong, PhD.

Phone

919.684.5846

Fax

919.681.6343

Research Interests

• Glaucoma physiology and biochemistry.
• Ocular pharmacology (glaucoma): to develop novel medications/treatments that can potentially cure the abnormality in outflow in glaucoma.

  Representative Publications

  1. Liton PB, Liu X, Stamer WD, Challa P, Epstein DL, Gonzalez P. Specific Targeting of Gene Expression to a Subset of Human Trabecular Meshwork Cells Using the Chitinase 3-Like 1 Promoter. Invest Ophthalmol Vis Sci 2005:46(1):183-190.
  2. Rao PV, Deng PF, Sasaki Y, Epstein DL. Regulation of Myosin Light Chain Phosphorylation in the Trabecular Meshwork: Role in Aqueous Humor Outflow Facility. Exp Eye Res 2005:80:197-206.
  3. Rao PV, Deng P, Maddala R, Epstein DL, Li CY, Shimokawa H. Expression of Dominant Negative Rho-Binding Domain of Rho-Kinase in Organ Cultured Human Eye Anterior Segments Increases Aqueous Humor Outflow. Mol Vis 2005:11:288-297.
  4. Shimazaki A, Ichikawa M, Rao PV, Kirihara T, Konomi K, Epstein DL, Hara H. Effects of the New Ethacrynic Acid Derivative SA9000 on Intraocular Pressure in Cats and Monkeys. Biol Pharm Bull 2004:27(7):1019-1024.
  5. Shimazaki A, Suhara H, Ichikawa M, Matsugi T, Konomi K, Takagi, Hara H, Rao PV, Epstein DL. New Ethacrynic Derivatives as Potent Cytoskeletal Modulators in Trabecular Meshwork Cells. Biol Pharm Bull 2004:27(6):836-850.
  6. Caballero M, Liton PB, Challa P, Epstein DL, Gonzalez P. Effects of Donor Age on Proteasome Activity and Senescence in Trabecular Meshwork Cells. Biochem & Biophysical Res Comm 2004:323:1048-1054.
  7. Mettu PS, Deng PF, Misra UK, Gawdi G, Epstein DL, Rao PV. Role of Lysophospholipid Growth Factors in the Modulation of Aqueous Humor Outflow Facility. Invest Ophthalmol Vis Sci 2004:45(7):2263-2271.
  8. McGwin G, McNeal S, Owsley C, Girkin C, Epstein DL, Lee PP. Statins and Other Cholesterol-Lowering Medications and the Presence of Glaucoma. Arch Ophthalmol 2004;122(6):822-826.
  9. Gonzalez P, Caballero M, Liton PB, Stamer WD, Epstein DL. Expression Analysis of the Matrix GLA Protein (MGP) and VE-Cadherin (VE-Cad) Gene Promoters in the Outflow Pathway. Invest Ophthalmol Vis Sci 2004;45(5):1389-1395.
  10. Caballero M, Liton PB, Epstein DL, Gonzalez P. Proteasome Inhibition by Chronic Oxidative Stress in Human Trabecular Meshwork Cells. Biochem Biophys Res Commun 2003; 308(2):346-52.