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The Current Face of Ophthalmic Pathology
Patricia Chévez-Barrios, MD
Arch Ophthalmol. 2009;127(8):1048-1049.
In the last 150 years, ophthalmic pathology as a defined discipline has taken shape thanks to the organized efforts of both ophthalmologists and pathologists. Ophthalmic pathology has steadily contributed to the advancement of the understanding of ocular diseases and the origin, behavior, prognosis, and treatment of ocular and periocular tumors. The practice of ophthalmic pathology has undergone changes mandated mostly by external circumstances and also by the advancement of science and technology.1-2 In the early stages of the specialty, pioneers in the field like Dr James Wardrop were clinicians who had a special interest that took them beyond the clinical presentation into the pathologic processes of disease. Dr Wardrop studied the pathology of retinoblastoma in the late 18th and early 19th centuries in the United Kingdom.1-2 Frederick Verhoeff and Jonas Friedenwald were notable pioneers of the eye pathology field in the first half of the 20th century. In the second half of the 20th century, there were both ophthalmologists and pathologists who worked full time in ophthalmic pathology and contributed to most of the knowledge we currently have for the discipline. In America, Professor Lorenz E. Zimmerman of the Armed Forces Institute of Pathology, Washington, DC, trained many great ophthalmic pathologists, some of whom are currently practicing. In Europe, Professor Norman Ashton from London, England, also trained many in the field. All helped shaped what we now know as the basis of ophthalmic pathology by describing their findings, publishing peer-reviewed manuscripts and books, and most importantly sharing their knowledge and experience with many physicians interested in ocular pathology and the study of tumors of the eye.
Now at the beginning of the 21st century, new generations of ophthalmic pathologists are ideally trained in both ophthalmology and pathology and with an ophthalmic pathology fellowship. They practice ocular pathology as well as either ophthalmology or pathology. In the current era, the specialty faces many challenges: there is a shortage of fully trained ocular pathologists, and a lack of support by ophthalmology departments threatens even the educational and research missions of the ocular pathologist.2 Adding to these, the changing face of medicine in the current environment with enormous challenges in the health care system has made it almost impossible for the ophthalmic pathologist to practice only the subspecialty. On the other hand, in the last few decades, science and especially biotechnology have advanced at an accelerated pace. Molecular diagnosis, nanotechnology, and imaging have been incorporated as essential tools in patient care. Contemporary ophthalmic pathologists have a unique opportunity to integrate the fundamental, well-founded knowledge of ophthalmic pathology with these new modalities and successfully impact the treatment of their patients.
It is encouraging for those dedicated to ophthalmic pathology to see the quality and number of articles published in this ophthalmic pathology joint issue between Archives of Ophthalmology and Archives of Pathology & Laboratory Medicine. Both journals, Archives of Ophthalmology (published since 1869) and Archives of Pathology & Laboratory Medicine (published since 1926), were recently named in the top 100 most influential journals in biology and medicine of the past 100 years by the BioMedical and Life Sciences Division of the Special Libraries Association, and each was the only representative of its specialty. Although the articles appear in both journals, those with an emphasis on pathology or diagnostic pathology techniques can be found in Archives of Pathology & Laboratory Medicine (http://arpa.allenpress.com/arpaonline/?request=index-html), whereas the more clinically oriented papers appear in Archives of Ophthalmology.
In this joint issue, the original articles, case reports, resident reviews, and research letters reflect the evolution, challenges, and contemporary practice of ophthalmic pathology. Original articles explore new prognostic factors, report validation of molecular tests, and describe molecular techniques in the diagnosis and prognosis of tumors and infectious diseases. There is an article on the use of nanotechnology in preclinical studies for the treatment of retinoblastoma, and other articles relate new imaging techniques for the histopathologic analysis of certain diseases. A series of articles on the ophthalmic sites that will appear in the American Joint Committee on Cancer–International Union Against Cancer TNM Staging Manual, seventh edition, detail the changes and new prognostic factors and in some cases integrate molecular factors and clinicopathologic correlation. I invite you to look at the articles in both journals as they are different from each other, although all are related to ophthalmic pathology and the study of tumors.
It is revitalizing to witness the great response that this joint issue has had among established ophthalmic pathologists as well as new contributors around the world. No less impressive is the work put forth by ophthalmic pathologists and others in related fields who served as reviewers for both journals for the many manuscripts submitted for the joint issue. Our challenge is to continue advancing the field by keeping up with the progress in science and technology and by integrating the technologies to our well-founded knowledge of ocular disease so that we can shape the new and evolving face of ophthalmic pathology.
AUTHOR INFORMATION
Correspondence: Dr Chévez-Barrios, Department of Pathology and Laboratory Medicine, Weill College of Cornell University at The Methodist Hospital, 6565 Fannin St, Houston, TX 77030 (pchevez-barrios{at}tmhs.org).
Financial Disclosure: None reported.
Additional Information: This editorial is being published simultaneously in the August issue of Archives of Pathology & Laboratory Medicine.
REFERENCES
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1. Klintworth GK. Ashton lecture: ophthalmic pathology from its beginning to the high technology of this millennium. Eye. 2001;15(pt 5):569-577.
ISI
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2. Apple DJ, Werner L, Mamalis N, Olson RJ. The "demise" of diagnostic and research ocular pathology: temporary or forever? Trans Am Ophthalmol Soc. 2003;101:127-139.
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