It was little more than a decade ago that Phyllis Warner, who will turn 90 on September 9, first noticed she was having trouble with her vision. It happened while she was playing the organ, as she had every Sunday for years, at her church in Fawn Grove, Pennsylvania.
“I was suddenly having a hard time reading some of the smaller notes,” she says. “It wasn’t bad at the time, but that was the beginning.”
Sometime after that her ophthalmologist referred her to Akrit Sodhi, M.D., Ph.D., the Branna and Irving Sisenwein Professor of Ophthalmology at the Wilmer Eye Institute. Sodhi specializes in the management of complex vitreoretinal diseases, including conditions like macular degeneration, that affect the retina and the vitreous fluid around it.
“I like to go to the best doctors, and Dr. Sodhi is the best,” she says. “He is also a very nice person and has always been there for me when I’ve needed him.”
Sodhi says Warner was initially referred to him because she had developed scar tissue on the surface of the retina of her left eye — a not uncommon occurrence with age — which he removed. “She did very well,” he says.
But then Warner developed wet macular degeneration, first in the left eye, and then in her right eye. Sodhi treated her with anti-VEGF (vascular endothelial growth factor) injections, which target a protein that promotes the growth of abnormal blood vessels in the eye, causing vision loss.
When introduced in the mid-2000s, anti-VEGF injections revolutionized patient outcomes for the treatment of age-related wet macular degeneration (AMD) and today they are the standard of care for that disease. Approximately 30 to 35 percent of people with AMD who receive anti-VEGF injections experience significant improvement in vision — which is life-changing for many people.
“The treatment did work to preserve her vision in her right eye, which has made it possible for Warner to remain independent,” says Sodhi. “Her eyes have been relatively stable,” he says. “We’re continuing to focus on preserving the vision.”
Warner, who has lived alone since her husband, Austin, died in 2003, can see well enough to get around and do things like cook for herself and clean her home. “I really appreciate being able to read,” she says, “and pay bills” — with the help of bright lights and magnifying equipment. She is thankful for her old friends in her small town of fewer than 500 people who help get her to appointments, to church, to her polling place, to the grocery store. She is also grateful to be able to simply take in the world.
“I really enjoy seeing bright red roses and when the trees bloom with white flowers,” she says. “But I am hoping Dr. Sodhi will come up with new ways to treat this.” Her hope is not misplaced. Sodhi is looking beyond anti-VEGF to the next generation of AMD medicines. His research focuses on a protein called hypoxia-inducible factor, or HIF, which guides how cells sense and respond to low oxygen levels. Sodhi collaborates with Gregg Semenza, M.D., Ph.D., who won the Nobel Prize for his discovery of HIF. They are developing drugs called HIF inhibitors to treat cancer and certain eye conditions — specifically diseases such as AMD that involve the rapid development of blood vessels.
Warner has participated in Sodhi’s research efforts. He is using fluid from her eyes as part of his investigation into differences between the eyes of people whose vision is improved by the anti-VEGF injections and those whose eyes don’t respond as well. Already Sodhi’s team has identified a new protein that may explain the difference and perhaps be used both to identify patients who won’t respond to anti-VEGF treatments and to help develop an alternative therapy. He is also investigating potential treatments for dry macular degeneration.
She has supported his research in other ways as well. Every year she has donated money to fund Sodhi’s research at Wilmer, and this year donated a large lump sum in the form of a charitable gift annuity (CGA). A CGA is a giving vehicle that is tax deductible and pays her interest income while she is alive. Warner’s CGA is earmarked to fully support Sodhi’s research after she dies.“Most research grants do not fund the initial steps toward identifying a target, so we couldn’t do this work without gifts like Mrs. Warner’s,” Sodhi says. And Phyllis Warner says Sodhi’s research gives her hope. “I pray every day that he comes up with a new treatment.”