SUMMARY
Michael W. Stewart, M.D., conducts research at Mayo Clinic on ophthalmic conditions and has published about the cornea, glaucoma, oculoplastics and neuro-ophthalmic spaces. His primary interests include chorioretinal vascular diseases such as age-related macular degeneration, diabetic retinopathy, retinal vein occlusion and macular telangiectasia. He also focuses on infectious retinitis and vitreoretinal surgery for retinal detachments and diabetic retinopathy. Dr. Stewart studies mathematical modeling of ocular pharmacology and vitreoretinal diseases.
Focus areas
- Age-related macular degeneration. Meta-analysis shows the importance of the fluid compartments in eyes with neovascular age-related macular degeneration. Dr. Stewart authored the early-phase manuscripts regarding the use of a systemic anti-angiogenesis drug for the treatment of macular degeneration.
- Diabetic retinopathy. Dr. Stewart published a monography titled "Diabetic Retinopathy: Current Pharmacologic Treatment and Emerging Strategies." He authored manuscripts that compared anti-vascular endothelial growth factor (VEGF) monotherapy with combination anti-VEGF and corticosteroid therapy for difficult-to-treat diabetic macular edema and retinal vein occlusions.
- Complex vitreoretinal surgery. Dr. Stewart published the age-related profile of posterior vitreous detachments in a population. He wrote studies demonstrating the efficacy of vitrectomy for the treatment of diabetic macular edema.
- Mathematical modeling. In several studies, Dr. Stewart modeled the relative durations of action of the drugs approved for exudative macular degeneration. He used data from the literature to estimate the intravitreal half-lives of drugs used to treat chorioretinal vascular conditions. He worked with industry to estimate durability of newly introduced drug release devices. His modeling provided the mathematical rationale for newly introduced frequent dosing of anti-VEGF drugs.
Significance to patient care
Dr. Stewart's research on the treatment of neovascular age-related macular degeneration (ARMD) shows that stable, persistent subretinal fluid may be tolerated and is associated with better visual acuity or, at worst, does not have adverse effect on vision. This allows for fewer injections, thereby lowering cost and risk without compromising outcomes. His work with ziv-aflibercept has enabled many people in the developing world to receive a more potent anti-VEGF drug without paying the cost of a branded drug. Dr. Stewart's mathematical work with companies developing ARMD drugs will allow for long-duration injectables, something that the original developers predict is necessary for long-term compliance.
Professional highlights
- Knights Templer Eye Foundation Inc. Professor of Ophthalmology Research, Mayo Clinic, 2023.