L. F. Montgomery Laboratory

Physician

Hans E. Grossniklaus MD, MBA, director

The L.F. Montgomery Laboratory is a dynamic diagnostic, teaching, research and patient care service. The laboratory itself is a free-standing, independently licensed laboratory that was established in 1940 with a donation from Lafayette Montgomery, a Coca-Cola executive. The laboratory was directed by F. Phinizy Calhoun Jr. MD, who also served as chairman of the Department of Ophthalmology from 1950-1978. It was located in the old Grady Hospital in 1940, the Grady Clay Eye Clinic in 1949, the new Grady Hospital in 1955, and Emory Eye Center in 1984, it’s current location.

The laboratory was briefly directed by John D. Wright Jr. MD from 1981-1985, again by Dr. Calhoun Jr. from 1985-1988, and by Hans E. Grossniklaus MD, MBA, from 1989-present. Dr. Grossniklaus is board certified in both ophthalmology and anatomic pathology. The laboratory has accessioned and signed out over 50,000 ophthalmic pathology cases, with Dr. Grossniklaus personally signing out over 40,000 cases since he became director.

It serves as a training ground for ophthalmology and pathology residents, medical students and histotechnicians. Dr. Grossniklaus has trained 18 ophthalmic pathology fellows, including numerous international fellows. The laboratory uses the internet with the Internet Based Eye Pathology Teaching Initiative (IBETI) for teaching. IBETI was established with a teaching grant and has been in place since 2001. The laboratory accepts surgical specimens obtained by ophthalmologists, otolaryngologists, and plastic surgeons, including eyes, corneas, orbital tissue, eyelids, ocular cytology specimens and vitreous.

The laboratory includes the H. Talmage Dobbs Electron Microscopy Suite which houses transmission and scanning electron microscopes. The laboratory also includes a Nikon confocal scanning laser microscope. These instruments are primarily used for research, as this function of the laboratory has been served as the structural biology module for the departmental core grant for 20 years, under the direction of Dr. Grossniklaus. Additionally, the laboratory has participated as a review center for the NIH funded Collaborative Ocular Melanoma Study (COMS) and as the pathology center for the NIH funded Submacular Surgery Trials (SST).

The laboratory has been a national leader in ocular oncology and age-related macular degeneration research, including NIH R01 support for Dr. Grossniklaus. In addition to basic science research in ocular melanoma and age-related macular degeneration, Dr. Grossniklaus is conducting drug delivery research for posterior ocular diseases.

The laboratory is now serving as a base for applied ophthalmic pathology, in which what is learned from research in the laboratory is applied to patient care with a Clinical Eye Pathology Service. Dr. Grossniklaus sees patients on this translational science (bench to bedside) service. This service currently evaluates patients with ocular malignancies,  age-related macular degeneration, and other conditions.

Discoveries | Achievements

2000 Discovery that the spread of eye melanoma to the liver first occurs as small collections of cells, called micrometastases, leading to new understanding of the most common form of eye cancer.

2001 Started the Internet-Based Eye Pathology Teaching Initiative (IBETI) with a teaching grant. This was the first Web-based program for ophthalmology teaching of its kind in the United States.

2002 As director of the NIH funded Submacular Surgery Surgery Trials pathology laboratory, Dr. Grossniklaus discovers that vascular endothelial growth factor (VEGF) is produced by a type of inflammatory cell, the macrophage, in new blood vessel growth (choroidal neo-vascularization) in age-related macular degeneration, leading in part to new treatments for the disease.

2004 Evaluated 30,000 cases over the previous 15 years.

2008 Ocular melanoma service at Emory is recognized by Blue Cross/Blue Shield as a center of excellence for rare and complex cancers.

A clinical trial, the IATOM study (Interferon Alpha for the Treatment of Ocular Melanoma), utilizing Interferon as a treatment for ocular melanoma is initiated.