February 28, 2013
Dallas custom home builder Mickey Munir remembers vividly the day he looked up at the mini blinds in his office and saw the normally straight rows move in a wave in the middle.
“As an architect, I live in a world of straight lines,” shares Munir. “All of a sudden the blinds on my office window were distorted. They appeared to be curving and then straightening right before my eyes. I knew immediately something was wrong.”
Munir was no stranger to eye issues. He had watched his mother suffer from age-related macular degeneration (AMD), a disease that results in damage to the tissue responsible for a person’s central vision and is the leading cause of vision loss in older adults. AMD eventually robbed his mother of her quality of life, rendering her unable to drive and stealing away her favorite pastime -- reading.
Mickey, however, was only 48. AMD was not even on his radar. His optometrist at the time knew there was an issue with his right eye and referred him to a neuro-ophthalmologist who determined Munir had a retina issue. Gary Edd Fish, M.D., at Texas Retina Associates (TRA) had cared for Munir’s mother so Mickey made an appointment with him.
During the exam, Munir remembers asking Dr. Fish point blank, “So, have I got something weird?”
Dr. Fish responded, “You know all those people you saw in the waiting room? They have the same thing. What’s weird, is that most of them are over 70, and you are 48.”
Not one to miss a beat, Munir quickly began laser treatments on his right eye -- the best treatment available for AMD at the time. It kept the disease from progressing and restored his vision to 20/20 for about eight or nine years. Then, about two years after the diagnosis in his right eye, the disease began attacking Munir’s left eye.
The damage in the left eye was too close to his central vision to safely administer the laser treatment so the TRA team tried a new development in AMD treatment at the time -- photodynamic therapy. Unfortunately, it did nothing for Munir.
Luckily, new treatments continued to emerge, and Munir was eager to try each one. Munir began eye injections of the breakthrough drugs Avastin and then later Lucentis. Each worked for awhile, but neither was the answer.
“My eyes and vision were like a yo-yo,” he remembers. “The injections would work initially and then wear off.”
About that time, another new AMD drug -- Eylea -- was showing promise, and TRA vitreoretinal specialist Karl Csaky, M.D., Ph.D., was one of the leading researchers in its use for AMD. Once again, Munir was one of the first to try the treatment, and it worked. Eylea has kept Munir’s vision stabilized at 20/25 - 20/30 in his right eye and 20/30 - 20/40 in his left eye, allowing him to maintain his quality of life and active career. However, he knows it is not a long-term solution.
“I am the poster boy for Eylea,” Munir quips. “The question now is how long will it last?”
That is why Munir has made it his personal mission to do all he can to advance AMD research, investing his time, talents and financial support. Luckily, one of the leading organizations in that quest -- the Retina Foundation of the Southwest (RFSW) -- calls Dallas home.
Established in 1975, RFSW is an independent, non-profit research institute that has grown into one of the leading independent vision research centers in the United States, with a staff of 28 dedicated to finding the causes, treatments and potential cures for blinding eye diseases. Patients are referred to RFSW by ophthalmologists from Dallas, around the U.S., and even throughout the world. And the Foundation has made numerous groundbreaking discoveries over the past three decades, including that DHA in mother’s milk is necessary for infant eye and brain development. As a direct result, enhanced formula containing DHA is now sold worldwide.
“One day I was driving down Central Expressway, and I saw the Retina Foundation sign,” Munir remembers. “I said wait a minute, I have an eye problem, and I need to make friends with these folks. I called from my car and said I was interested in serving on the board.”
And Munir has not stopped helping RFSW since. Most recently, he played in integral role in the construction of the new shared home for RFSW and Texas Retina Associates (TRA) in Central Dallas. The new facility is expected to serve as a national model for patient-centered medical research and was the longtime dream of another Dallas leader -- retina specialist William Snyder, M.D., a founder of both RFSW and TRA.
William Snyder, M.D., Helps Establish Dallas as a Hub for Retina Care and Research
The child of two physicians, vitreoretinal specialist William Snyder, M.D., came to Dallas in 1966 to join the faculty at the University of Texas Southwestern Ophthalmology Department. He soon met his predecessor at the medical school, retina physician Albert Vaiser, M.D., and in 1968, the two decided to go into private practice together. About five years later, they recruited another retina specialist they had met at the medical school, William Hutton, M.D., to join them. The three became lifelong business partners and friends. Anxious to advance care in their emerging field of medicine, they established Texas Retina Associates (TRA) which has grown to 13 offices throughout the state with 17 retina-fellowship-trained physicians.
By the 1970’s, Dr. Snyder and his TRA partners realized that while they had significantly advanced surgical techniques in their field, there was still a need to better understand the root causes and progression of retina diseases as well as uncover new treatment options. They sought out the best medical scientists in their field, and soon they were successful in recruiting David G. Birch, Ph.D., and his wife Eileen E. Birch, Ph.D., to Dallas to help establish the Retina Foundation of the Southwest (RFSW).
During this time, Dr. Snyder’s personal life took a heartbreaking twist. First, one of his sons began experiencing vision problems and presented with the classic symptoms of an inherited and incurable retinal eye disease -- retinosa pigmentosa -- in which the photoreceptor cells in the eye die, causing a gradual decline in vision. Then, just a few years later, his wife developed the same disease and now at age 81, is completely blind.
“Life is full of irony,” said Dr. Snyder.
As a retina physician and active volunteer leader within the RFSW, Dr. Snyder became even more determined to better understand this disease.
“We still don’t have a cure, but we have made great strides in finding new treatments that slow the progression, and we’re still working at it,” he explains.
A humble man, Dr. Snyder does not talk much about his accomplishments in saving sight, but others do.
“He has always been involved behind the scenes at both Texas Retina and the Retina Foundation, making sure things keep moving forward,” shares TRA physician and RFSW board member David Callanan, M.D. “He has been a driving force from day one.”
RFSW’s Dr. Birch agrees. “Dr. Snyder’s leadership at the Retina Foundation has been evident for 35 years. He was instrumental in bringing my wife and me to Dallas and has been an important part of our decision to spend our careers here. His personal experience and passion along with his curiosity and thirst for knowledge make him appreciate the importance of research. While he has chosen to dedicate his energy to his patients, he has willingly fostered research through his leadership in the Foundation.”
A New Model for Medical Research Takes Root in Dallas
Thanks to the tireless work and passions of Dr. Snyder, Mickey Munir and countless others at both RFSW and TRA, Dallas continues to raise the bar for eye research to uncover new treatments and better understand diseases like AMD and retinosa pigmentosa, along with many others. They recently opened their new state-of-the-art offices under the same roof at 9600 N. Central Expressway, at the southeast corner of N. Central Expressway and Walnut Hill Lane in Central Dallas.
The goal of sharing this recently renovated building is to provide patients with more immediate, expanded and direct access to breakthrough treatments and clinical trials. Both facilities were custom-designed for optimal patient care and research utility, allowing the two organizations to work more collaboratively and efficiently, attracting additional research studies to the Dallas community, especially from pharmaceutical companies developing promising new treatments.
Karl Csaky, M.D., Ph.D, serves as a vitreoretinal specialist at TRA as well as the T. Boone Pickens Senior Scientist and Director of the Molecular Ophthalmology Laboratory at the RFSW.
“In the last five to 10 years, as medicine has become more efficient, a void has emerged in patient-oriented research,” explains Dr. Csaky. “Many of the traditional academic research institutions have been forced to cut back, and they also face great challenges in meeting pharmaceutical company’s demands for efficiency. We will now be better able to meet those demands, and can more quickly and easily translate research from the lab to patient care. I think others are going to look to us as a new model to replicate across the country.”
Dallas Remains an Epicenter of Emerging Developments in Retina Care
While the field of retina care and research has evolved tremendously in the past 20 years with patients like Mickey Munir receiving treatments unheard of even a decade ago, both TRA and RFSW leaders believe they still have a lot of work to do to fulfill the dreams of Dr. Snyder and their other founders.
“In our field, there are so many unmet needs, and as a physician, one of the most frustrating things is to have to tell a patient there is nothing we can do,” said Dr. Csaky. “Now we have a facility right here in Dallas that allows us to push the envelope on our knowledge and understanding of retina diseases, as well as how to treat those conditions in the most efficient manner.”
And patients like Mickey Munir can’t wait to see what lies ahead.
“Eye diseases are not discriminatory,” said Munir. “We all know someone who has struggled with the real fear of losing their sight. Dallas has always been a ‘can do’ town, and I for one am excited about the vision-saving research happening right here in our community and what it holds for our future.”