UPFRONT

Innovation and Persistence

JASON S. SLAKTER, MD

Very often, when we hear about new inventions or new approaches to treatment for diseases, we are tempted to say, "Why didn't I think of that?" Some of us, at times, actually may be saying, "Wait: I did think of that; why didn't I do something about it?" Without doubt, much credit has to be given to individuals who have the fund of knowledge, intellect, and creativity necessary to push forward new and innovative approaches to solve problems we face every day, both in our personal and professional lives. In fact, coming up with a new idea or a new concept is just the first step in a long and difficult process of bringing thought into reality.

One of the early examples of this in our field was the groundbreaking work by Novotny and Alvis in the late ’60s, which introduced the concept of angiography using sodium fluorescein in an attempt to image retinal pathology. What we now recognize as a critical milestone in diagnostic testing for retinal disease was, at the time, dismissed by the ophthalmic establishment. As most of you know, the publication of the earliest work on fluorescein angiography was actually rejected by the ophthalmic journals and appeared in the journal Circulation instead. Another example is the early work of Dr. Judah Folkman in the area of angiogenesis, which was pronounced inconsequential or meritless by the medical community until persistent hard work and research efforts proved this position to be far from accurate.

Sometimes early research suggests that a particular therapeutic approach may be ineffective, and therefore there is a tendency to dismiss the concept and move on to something else. This may have been the case for the use of radiation in the treatment of macular disease, were it not for the continued efforts of a small group of researchers who felt strongly about the potential application of this modality in treating neovascular disease. In this issue of Retinal Physician, we see positive interim results using an intraocular approach for direct delivery of radiation to the macular region in an attempt to control neovascular proliferation. While the results are still preliminary, they point to the potential application of a therapy that many had dismissed as useless a few short years ago.

Unfortunately, in the real world, hard work, dedication, and persistence may not be enough to move forward new and potentially valuable concepts. In many cases, smaller biotechnology companies are put in the difficult position where the short-term needs of their investors are in conflict with the intellectual curiosity and desire to advance therapeutic options of the scientists and inventors involved in the project. It is to the great credit of the medical and research teams that they are able to push forward on new treatments despite sometimes stiff opposition from the individuals who control the funding for their work.

So the next time you administer or prescribe a new medication, or even reach out for a new instrument in the operating room, take a moment to think about not only the intellect and creativity required to come up with the concept, but also the dedication and persistence that went into turning it into a reality.