School of Medicine
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Clinical Instructor (Affiliated) [Vapahcs], Ophthalmology
Current Research and Scholarly Interests RESEARCH OVERVIEW
Dr. Smith’s primary professional interest is developing solutions for unmet clinical and surgical vitreoretinal needs. Beginning in medical school, one of his primary focuses has been improving treatment outcomes in patients with retinoblastoma (RB). During his second year in medical school Dr. Smith published a manuscript on a novel technique to reduce the risk of tumor spread following intravitreal drug delivery in patients with RB. His work summarizing published data on tumor spread following intravitreal injection therapy (IVT) for RB has resulted in multiple platform presentations at national and international meetings, including an invited lecture at ARVO 2014. The results of this study influenced the growing trend toward broader acceptance of intravitreal chemotherapy in pediatric patients with treatment-resistant retinoblastoma vitreous seeds. A primary active area of research has included studying and publishing on ocular toxicity that results from the use of intravitreal melphalan and other agents for RB. This work, and subsequent publications from leaders in the field, has led to an increased awareness of ocular toxicity caused by injecting chemotherapeutic agents into the eyes of young children. This highlighted the need for toxicity data on additional chemotherapeutic agents for local delivery. To answer this question, Dr. Smith assembled an excellent group of collaborators and consultants, including internationally known experts at Bascom Palmer, Mayo Clinic, and Emory University. As a resident he secured a highly competitive career starter grant from the Knights Templar Foundation and used that funding and the expertise of his collaborators to carry out preclinical ocular toxicity studies of combination intravitreal chemotherapy for RB. His work in RB has led to a broader recognition of the challenges facing patients with RB who receive IVT and has led to a continued search for optimal local injectable therapies for patients with this disease.
In addition to his work in retinoblastoma, Dr. Smith has been actively involved in developing technologies to improve outcomes for patients receiving intravitreal injection therapy (IVT) for macular degeneration, diabetic retinopathy, retinal vein occlusions and more. IVT has become the most common procedure performed by retina specialists in the United States, with an estimated 6 million injections given in the United States alone in 2016. Dr. Smith has co-developed technology that simplifies and streamlines the IVT process, removing barriers to treatment and improving patient outcomes. His work in innovation covers pre-clinical and clinical development work, and has given him expertise in diverse subject areas including fundraising, intellectual property portfolio development, team building, and business administration. He is a co-founder of iRenix Medical, a biotechnology and medical device start-up company committed to improving vision through optimization of the IVT process.
Dr. Smith remains dedicated to helping improve and restore vision and quality of life in patients with vitreoretinal disease. He is currently involved in both medical device and pharmaceutical innovation, and serves as a mentor for the Stanford University Biodesign Innovation Course.