Douglas Rhee, MD

About

Douglas J. Rhee, MD, arrived at the University Hospitals Eye Institute in 2013 as the Chair of the Department of Ophthalmology & Visual Sciences. He is a glaucoma specialist, molecular biologist and board-certified ophthalmologist. In 2016, Dr. Rhee was voted by The Ophthalmologist as one of the Power 100 (the most influential people in ophthalmology worldwide). Prior to UH, Dr. Rhee was an associate professor at Harvard Medical School serving the associate chief of operations for the Department of Ophthalmology at the Massachusetts Eye & Ear Infirmary (MEEI).

Education and Training

Dr. Rhee was born in Buffalo, N.Y., and raised in Detroit. After graduating valedictorian of his high school, he entered the combined pre-medical/medical program at the University of Michigan Medical School. After graduating in the top 10 percent of his class (Alpha Omega Alpha), he then finished an internship at the University of Michigan affiliated Oakwood Hospital. Dr. Rhee completed his ophthalmology residency at Wills Eye Hospital (ranked No. 2 U.S. News & World Report) where he also served as co-chief resident. He was awarded a competitive Heed Fellowship award and completed a clinical glaucoma fellowship at the Bascom Palmer Eye Institute (ranked No. 1 U.S. News & World Report) and a post-doctoral laboratory fellowship at the National Eye Institute of the National Institutes of Health (Bethesda, Md.) investigating the molecular biology of eye pressure regulation. Dr. Rhee went on to serve as an attending physician on the glaucoma service of Wills Eye Hospital for four years, concurrently serving as a clinical consultant of the National Eye Institute for five years, and Massachusetts Eye & Ear Infirmary and Children’s Hospital Boston for eight years prior to coming to the UH Eye Institute.

Clinical Interests and Contributions

Dr. Rhee cares for both adult and childhood glaucomas. He has an interest in complex and high-risk cases, rare clinical syndromes, as well as the more common forms of glaucoma. Some of Dr. Rhee’s clinical research interests include the outcomes of both traditional and novel/advanced surgical procedures. Dr. Rhee is often credited as being one of the few early pioneers that ushered in a new era of the surgical management of glaucoma – what has now become known as minimally invasive glaucoma surgeries (MIGS). He was one of the first five surgeons in the world to perform the Trabectome procedure, which would later become recognized as the first MIGS procedure. He developed technique aspects for the procedure and his clinical outcomes research helped determine Trabectome’s place in our surgical armamentarium. Dr. Rhee is regarded as a key opinion leader in the surgical space and has often been first to bring new commercial technologies to the region or new investigational devices allowing early access to these technologies as part of FDA approved study protocols – e.g. first to perform Trabectome in New England and Northeast Ohio, first to implant commercially available iStent in New England, first to implant commercially available CyPass in Northeast Ohio, first to implant Hydrus device in Northeast Ohio (first as part of an FDA trial, later commercially available), first Glaukos G3 Supra in Northeast Ohio (FDA trial). Dr. Rhee has numerous publications evaluating these and other surgical techniques and technologies that impact for clinical practice.

Dr. Rhee is one of the few surgeons in the Midwest who also offers deep sclerectomy, an alternative to traditional glaucoma filtration surgery trabeculectomy. With the resources of the glaucoma service of UH Cleveland Medical Center, Dr. Rhee can offer the widest array of surgical procedures and implant devices available in the Midwest. Dr. Rhee has been included in the prestigious Best Doctors (Boston) since 2007 and has been recognized by Boston magazine as one of its “Best Doctors 2007-2008,” as well as Cleveland magazine since 2015.

Dr. Rhee has also contributed to our understanding of rare clinical syndromes, such as plateau iris, medication-induced (sulfonamide, corticosteroid, etc.), and idiopathic elevated episcleral venous pressure associated glaucoma. Dr. Rhee discovered that plateau iris syndrome is a familial condition and described the autosomal dominant inheritance pattern in 50 percent of affected individuals. He was one of the first to describe the rare condition of bilateral acute angle closure glaucoma that can be caused by the medication topiramate; Dr. Rhee went on to describe the only effective treatment for severe cases of topiramate-induced angle closure. Dr. Rhee has also furthered the knowledge base of medication-induced (sulfonamide, corticosteroid, etc.) and idiopathic elevated episcleral venous pressure associated glaucoma.

The UH Eye Institute glaucoma service participates in numerous FDA phase 3 device and implant studies to include sustained release medication platforms and novel microshunts to lower eye pressure.

At the UH Eye Institute, Dr. Rhee receives regional, national and international referrals of patients seeking his care or expertise. Dr. Rhee sees patients at UH Eye Institute’s main facility as well as our Landerbrook and Westlake satellites.

Laboratory Research Interests

In addition to his main interest of caring for patients, Dr. Rhee’s scientific research is aimed at determining the cellular and molecular causes of glaucoma while developing disease modifying as a novel treatment approach. His laboratory investigates the molecular mechanisms of extracellular matrix (ECM) regulation as it pertains to the health and disease of the drains of the eye i.e. trabecular meshwork (TM) and ciliary body. They first gained recognition in the mid-2000s by settling a long-standing debate on the mechanism of action of the most commonly prescribed medication class for the treatment of glaucoma – prostaglandin analogues (PGAs). One group felt that PGAs worked exclusively through the accessory drain of the eye, the ciliary body, while another group believed that PGAs had a significant effect on TM drainage as well. Dr. Rhee’s group found that PGAs effect both tissues and found that the balance of matrix metalloproteinases (MMPs) and their kinetic inhibitors, tissue inhibitors of metalloproteinases (TIMPs), correlates to IOP lowering potency with PGAs. He was also able to explain that both groups were correct, and the differences they were observing were primarily an artifact of the model systems they were using. Their studies expanded to examine the synthesis/deposition aspect of ECM homeostasis.

It had been long believed that ECM homeostasis in the drains of the eye are critical to the normal physiology and that dysregulation is the only known primary pathophysiology of primary open-angle glaucoma. However, the molecular controls of ECM homeostasis in the TM have remained elusive. Dr. Rhee believes that proteins that control ECM in other tissues would have a regulatory effect on ECM and hence, IOP, in the TM. His group was first to define the expression pattern, intracellular, and ultrastructural localization of SPARC, considered the prototypical matricellular protein, within the TM. We were also first to demonstrate that SPARC-null mice have a lower IOP than their corresponding wild-type mice due to enhanced aqueous outflow. Additionally, they demonstrated that SPARC overexpression increases IOP in perfused cadaveric human anterior segments corresponding to a qualitative change to the ECM of the juxtacanalicular TM. Furthermore, the cytokine transforming growth factor beta-2, which is heavily implicated in POAG, is unable to elevate the IOP in SPARC -/- mice. These findings strongly implicate SPARC as a pivotal regulatory node in ECM synthesis / accumulation. His lab is credited as having elucidated this key regulatory protein for outflow drainage and IOP control; to date, less than 10 proteins have achieved this level of recognition.

His work continues with SPARC with the hopes of developing new treatment for glaucoma. However, their work to reveal a previously unknown mechanism of SPARC, and potentially matricellular proteins as a class, are potentially generalizable to the numerous pro-fibrotic systemic diseases in which SPARC has been implicated e.g. hepatic fibrosis, renal nephrosis, scleroderma, etc. His research been supported the National Institutes of Health as well as several foundation (e.g. the American Glaucoma Society, Research to Prevent Blindness, Lions Research Fund) and industry grants.

Trainees in Dr. Rhee’s laboratory have won the James Shipman Award in 2003, Fight for Sight Student Fellowships in 2004, 2007, 2008, 2009, 2010 (2), 2011, 2014, Ohio Research to Prevent Blindness in 2016, and been supported by the extremely competitive and prestigious Howard Hughes Medical Research Fellowships in 2011 (two separate students) and 2012.

Because of Dr. Rhee’s scientific achievement, leadership and vision, he was selected to serve on the very select and prestigious National Eye Advisory Council of the National Eye Institute, National Institutes of Health (2015-2019) which assists, consults, and advises the NEI Director on matters related to activities carried out by and through the Institute.

Because of both his clinical and scientific background, Dr. Rhee is often asked to consult for numerous pharmaceutical and device manufacturers for activities ranging from collaborative research to clarify pharmacologic mechanisms of action to educating the physicians who will eventually train other ophthalmologists on novel technologies and pharmaceuticals.

Publications and Awards

Dr. Rhee has published over 95 scientific articles in peer-reviewed journals. He has received the competitive American Glaucoma Society’s Clinician-Scientist award in 2004 and 2005 (the maximum number allowed by the society). In 2008, the American Glaucoma Society honored Dr. Rhee with the inaugural the Mid-Career Physician-Scientist Award. In 2008, Dr. Rhee was awarded the competitive Research to Prevent Blindness Physician-Scientist Award from the Research to Prevent Blindness organization. These awards were given to support his research into eye pressure regulation.

Regional, National and International Leadership

Dr. Rhee is on the Executive Committee of the American Society of Cataract and Refractive Surgery (2019 – present), currently serving as the role of secretary. He has served as the president-elect and president of the Cleveland Ophthalmological Society (2015-2017), president of the Korean-American Ophthalmologic Society (2012-2016), Chair of the Glaucoma Clinical Committee for the American Society of Cataract and Refractive Surgery (2006-2013) the vice president of the Massachusetts Society of Eye Physicians and Surgeons, on the board of directors of the American Glaucoma Society (2015-2017), the governing board for the American Society of Cataract and Refractive Surgery (2013-2019), and one of the selected few on the National Advisory Eye Council (a.k.a. “Council”) for the National Eye Institute (2015-2019).

Other Notable Achievements

Dr. Rhee has a long history of administrative leadership. While at Wills Eye Hospital, he served as the Medical Director of the Glaucoma Service Diagnostic Laboratory from 2004 through late 2005. He was awarded the Norman Knight Leadership Development Award in 2006 by Mass. Eye & Ear. In early 2007, Dr. Rhee began service as the Medical Director of the Mass Eye and Ear suburban centers in Stoneham and East Bridgewater, Mass. In 2008, Dr. Rhee’s duties expanded to serve as medical director of strategic network development. In 2010, his responsibilities at Mass Eye & Ear expanded to become the associate chief of practice development and finally in 2011 to associate chief of operations and practice development. In addition to serving as director of the University Hospitals Eye Institute and chairman of the Case Western Reserve University Department of Ophthalmology and Visual Sciences, Dr. Rhee chaired the UH Medical Group Access Committee which has span over patient access across the entire University Hospitals health care system and now chairs the UH Medical Group Finance Committee.

Dr. Rhee is a leading educator of ophthalmologists. He serves on various scientific or curriculum committees for the American Academy of Ophthalmology, National Institutes of Health, American Glaucoma Society, American Society of Cataract and Refractive Surgeons, and American Board of Ophthalmology (the certifying organization for ophthalmologists). Dr. Rhee has served as an examiner for the American Board of Ophthalmology since 2006 and served one year in 2007 as a special examiner. In 2007, his contributions to the American Academy of Ophthalmology were recognized by the Achievement Award and in 2013 by the Senior Achievement Award; he was again recognized for the American Academy of Ophthalmology for distinguished educational contributions to the field by the Secretariat Award in 2014. Dr. Rhee has organized and developed the curricula for numerous regional and national meetings for the continuing education of his colleague ophthalmologists. In 2013, Dr. Rhee was named the chair of the Glaucoma Curriculum Committee for the American Society of Cataract and Refractive Surgery which oversees the glaucoma content for all ASCRS activities. Dr. Rhee participates in the teaching of glaucoma to medical students, residents and fellows. He has been an invited speaker to over 270 meetings regionally, nationally and internationally. Dr. Rhee is an accomplished writer having co-authored the Wills Eye Drug Guide (first edition 1998, second edition 2001) and was the lead editor for the third edition of the Wills Eye Manual (2001). He authored the Ophthalmic Drug Guide (first edition 2007, second edition 2010). Dr. Rhee authored and edited Color Atlas & Synopsis of Clinical Ophthalmology: Glaucoma (first edition 2003, second edition 2012, third edition 2017). His has served as a co-editor of the Shields’ Textbook of Glaucoma (6th ed, 2011). Additionally, he contributed over 30 chapters to other textbooks whose target audience ranged from the general public, general medicine, comprehensive ophthalmologists and glaucoma specialists. Dr. Rhee began as a consultant for the Physician’s Desk Reference for Ophthalmology in 1997 and had been the lead medical editor for that publication from 2002 - 2012. He reviews for several ophthalmologic journals, and in 2006, Dr. Rhee began serving as a contributing editor for the trade publication Ocular Surgery News, served as an editor for the journal Lasers in Medicine from 2009-2015, and International Glaucoma Review from 2011-2014.

Dr. Rhee has participated in the training of over 150 residents, 40 clinical fellows, as well as mentored 4 post-doctoral research fellows, 15 medical and 9 undergraduate students in the lab. His fellowship trainees have gone onto leadership positions to include a department chair and residency program directors. Approximately half of his clinical fellowship and laboratory trainees are faculty in numerous ophthalmology departments nationally and internationally. Dr. Rhee inaugurated the first glaucoma fellowship at University Hospitals in 2016.

Patient Advocacy and Education

Dr. Rhee has served to advocate for patient safety issues at the legislative level. Dr. Rhee served as vice president of the Massachusetts Society of Eye Physicians and Surgeons from 2009-2013 having testified before the Massachusetts House of Representatives. Aside from numerous citations in ophthalmology trade journals, Dr. Rhee has been interviewed for local newspapers, radio programs and the Wall Street Journal.