Shakeel Shareef, MD
Clinical Assistant Professor, Case Western Reserve University School of Medicine
Dr. Shakeel Shareef, MD, joined the University Hospitals Eye Institute July 1, 2019 and serves as the director of the Glaucoma Service and oversees the Glaucoma Fellowship Program. He performs a variety of complex anterior segment surgeries including traditional and micro-invasive glaucoma surgeries, complex cataract procedures, traumatic iris and cyclodialysis cleft repair.
Dr. Shareef was born in Bangalore, India and settled in Flushing Queens, N.Y., at the young age of 5. After completing his primary and secondary education, he graduated from Queens College of the City University of New York with a focus in Chemistry and was a recipient of the Merck Index Award. He completed his medical school and residency at the New York Medical College training in several hospitals in Manhattan, Bronx and Westchester County. While a medical student, he engaged in glaucoma research and worked on establishing a rat glaucoma model with neuroscientist Professor Sansar Sharma, PhD, in the Department of Cell Biology and Anatomy. This model was the first to demonstrate that the death of retinal ganglion cells (RGC) in glaucoma was not a passive but an active process known as apoptosis.
His work led to him pursuing a glaucoma research fellowship at Washington University Department of Ophthalmology and Visual Sciences in St. Louis, Mo. Dr. Shareef worked on characterizing a family of enzymes known as nitric oxide synthase (NOS) in the rat glaucoma model. His work led to the identification of one isoform, NOS 2 found in close proximity to the RGC axons only within the optic nerve of glaucomatous eyes compared to normal controls. It was postulated that NOS 2 plays a toxic role in the death of these ganglion cells by producing a signaling molecule nitric oxide. This opened the door to explore pharmacologic intervention to counter the toxic effects of NOS 2 in halting glaucoma progression. His work was selected for a travel fellowship grant from the Retina Research Foundation.
Dr. Shareef completed an additional year as a glaucoma fellow at Barnes Hospital at the same institution. He subsequently joined the Department of Ophthalmology at Geisinger Medical Center in Danville, Pa., in 1998 caring for patients and teaching eye residents. He continued his clinical research and conducted a survey and chart review of 120 consecutive glaucoma patients to determine the prevalence of avoidance of over the counter (OTC) medications with warning labels for narrow angle glaucoma. The majority (83 percent) had open angles and of those avoiding OTC drugs, 82 percent did so unnecessarily, emphasizing the need to better educate such patients due to their fear of going blind if they did consume such drugs. This work was presented at the annual meeting of the American Academy of Ophthalmology (AAO) and was featured in their magazine.
Dr. Shareef also collaborated with his medical school mentor in isolating and harvesting 13-day fetal rat embryonic spinal cord stem cells (SCSC). Following mechanical injury to the adult rat retina, subsequent injection of fluorescent-labeled SCSC into the vitreous demonstrated at 5 weeks post-injection their capacity to migrate and differentiate within the ganglion and inner nuclear layers in response to the initial injury within the host retina compared to controls. These findings suggested that SCSC have the potential for replacement therapy for a variety of eye diseases in adults (i.e. macular degeneration, retinal ganglion cell loss in glaucoma). This work was presented during the annual Association for Research in Vision and Ophthalmology (ARVO) meeting.
In 2005, Dr. Shareef joined the Flaum Eye Institute (FEI) at the University of Rochester School of Medicine, in Rochester N.Y. He conducted a literature search to determine the prevalence of drug induced secondary angle closure glaucoma (sACG) from medications that had a warning label for ‘glaucoma’. In four decades, anti-seizure, anti-depressants and bronchodilators were the most frequent drug class reported. Recommendations were made for physicians to take a good medical history to rule out a drug-induced etiology if patients present with bilateral sACG and to warn them of this risk prior to prescribing these classes of drugs. The findings were presented at the annual ARVO scientific meeting.
He also served as the study site principal investigator in an American Academy of Ophthalmology (AAO) sponsored prospective multi-center observational study comparing the effectiveness of treatment strategies utilized by glaucoma specialists in caring for patients with open angle glaucoma. At the invitation of a journal editor, He wrote a major review paper on the important role of intraoperative gonioscopy in the burgeoning field of micro-invasive glaucoma surgery (MIGS). This publication formed the basis for the proposal and acceptance of a two-hour instructional course by the American Academy of Ophthalmology. These efforts led to the creation of an educational website dedicated to teach this skill set.
This skill set empowered him to expand his surgical armamentarium beyond glaucoma and cataract surgery in becoming a complete anterior segment surgeon by performing iris repair, and traumatic cyclodialysis clefts using innovative techniques. Based upon this work, he has been invited annually at several national meetings as a guest speaker, panelist, moderator, course instructor and wet lab surgical instructor. These educational efforts and achievements have culminated in his promotion to the rank of professor at the University of Rochester School of Medicine in June 2018.