Arnall Patz

Abstract

Pioneering ophthalmologist who specialised in retinovascular disease. Born on June 14, 1920, in Elberton, GA, USA, he died of heart disease on March 11, 2010, in Pikesville, MD, USA, aged 89 years. Arnall Patz's pioneering research on retinopathy of prematurity and his development of laser treatment for retinovascular disease left an enduring mark on ophthalmology. But colleagues say he will be remembered most for his commitment to mentoring the hundreds of students and fellows he trained throughout his career. If he called on a student in one of his ophthalmology courses at Johns Hopkins University—where he led the Wilmer Eye Institute from 1979 to 1989 and was an active professor emeritus until the time of his death—the result was almost always the same, according to colleagues. “If you were correct, he'd praise you effusively. If you were incorrect, he would never ridicule you”, says Gerard Lutty, a professor of ophthalmology at Johns Hopkins University who began his career as a laboratory technician in Patz's laboratory and then, with Patz's support, pursued his PhD. During his ophthalmology residency at Gallinger Municipal Hospital in Washington, DC, USA, in the late 1940s, Patz observed that 18 of the 21 premature infants who had retinopathy of prematurity, then known as retrolental fibroplasia, received continuous oxygen in levels four to five times the necessary clinical amount. He applied for funding from the National Institutes of Health (NIH) to study the relation between the level of oxygen being given to the infants and the disease. But his proposal was rejected because the reviewers said there was “nothing scientific whatsoever about the possibility of oxygen, which these babies breathe with every breath, that it could possibly be so damaging to the eye to destroy the retina and blind these babies”, Patz later recalled in an interview. So with private funding, Patz and his colleagues did a prospective controlled study and, in an article published in the American Journal of Ophthalmology in 1952, they reported that seven of 28 infants who received high levels of oxygen developed severe retinopathy of prematurity, whereas none of the infants who received low levels of oxygen did. A subsequent multicentre prospective NIH study designed with Patz's help confirmed that high amounts of oxygen routinely given to premature infants were a risk factor for retinopathy of prematurity and that reducing the level of oxygen administered reduced incidence. This work earned Patz an Albert Lasker Medical Research Award, presented to him by Helen Keller in 1956. For the next five decades, Patz continued to study retinovascular disease and train young researchers and clinicians. He pioneered the use of argon laser treatment for controlling the leaking and overgrowth of blood vessels in the retina, which is associated with diabetic retinopathy, age-related macular degeneration, and other retinovascular diseases. “He had a tremendous influence on the treatment of diabetic retinopathy through his clinical studies, research, fellowship programs, publications, and lectures”, says Stuart Fine, a professor of ophthalmology at the University of Pennsylvania who was one of the first fellows Patz trained. “Not only was he innovative in terms of developing new treatments, but also in how one evaluates those treatments”, says Rick Ferris, director of the Division of Epidemiology and Clinical Applications at the US National Eye Institute. Patz's initial study on retinopathy of prematurity was the first randomised clinical trial in ophthalmology and he was a proponent of cooperative clinical trials and collaborative authorship. Ferris, who worked with Patz when he co-chaired an NIH clinical study of diabetic retinopathy in the early 1970s, says that Patz's “selfless ability to look for the greater good really helped launch collaborative clinical trials in ophthalmology. His leadership in ophthalmology made a huge difference in how we approach group research.” Patz graduated from Emory University medical school in 1945, then served in World War II. He joined the faculty at Johns Hopkins part-time in 1955 and did research in the evenings after seeing patients in his practice; he became a full time professor in 1970 and established the Retinal Vascular Center. In addition to the Lasker Award, he received the Presidential Medal of Freedom in 2004 and the first Helen Keller Prize for Vision Research in 1994. He is survived by his wife, Ellen, five children, and eight grandchildren.