Dr. Miller completed his undergraduate degree in biology at Stanford University, where he was active in development of microsurgical devices with the Department of Ophthalmology under the mentorship of Daniel Palanker, PhD and Mark Blumenkranz, MD. He completed his MD and PhD graduate work at University of California, San Francisco (UCSF), where he developed primary neuronal culture models of Huntington's disease under the mentorship of Steve Finkbeiner at the UCSF-affiliated Gladstone Institute of Neurological Disease. He completed his internal medicine internship in the Bay Area at Kaiser Permanente Oakland. Seeking to combine his post-graduate medical and scientific training, he became the inaugural awardee for the University of Michigan Kellogg Eye Center's Pre-Residency Research Fellowship. This fellowship allows for establishment of an independent research program prior to joining the ophthalmology residency. He completed the fellowship in 2016, joining the residency program in July 2016. His research program, which seeks to establish primary RPE culture models of dry AMD as a platform for testing therapeutic interventions, continues during residency through the help of lab members he trained during the fellowship. Numerous projects exist in the lab for interested residents or medical students.
Outside of work, Dr. Miller enjoys squash (co-founding the Stanford Squash intercollegiate program while an undergraduate), foreign policy debates (co-founding a national organization dedicated to addressing human rights violations in Sudan), and cooking with his wife.
Areas of Interest
Primary RPE culture models of dry macular degeneration; autophagy; RPE lipid biology
Age-related macular degeneration (ARMD) is the leading cause of blindness in the developed world. The disease comes in two forms - a slowly progressive degeneration called dry ARMD and a much more rapidly progressive degeneration involving abnormal blood vessel growth called wet ARMD. In the past 10-15 years, anti-blood vessel agents have led to a radical improvement in our ability to save vision in wet ARMD patients. However, for the 80+% of patients with dry ARMD, we lack any proven therapeutic intervention. We study the mechanisms driving dry ARMD.
Macular degeneration affects the retina, the layers of cells in the back of the eye that turn light into electrical signals that the brain can interpret. Humans and primates are unique in the structure and properties of their retina, and it has therefore been difficult to establish non-primate animal models of ARMD that truly recapitulate all features of the disease. We therefore seek to use cells that we collect from human retinas to build a model of ARMD in a culture dish. The cells most affected in macular degeneration come from a pigmented layer of the retina called the retinal pigment epithelium (RPE). Our experiments involve stressing human RPE grown in the lab with a range of insults (including the insult of just carrying out routine daily activities but over a prolonged period of time), testing whether the RPE responds to the stress in a way that looks like the human disease. In particular, the cells on top of the RPE, called photoreceptors, undergo a daily shedding of their cell tip. These jettisoned fatty debris are cleared each day by the RPE. When this clearance fails, the debris can accumulate inside and outside the RPE as "cellular trash," a first sign of dry ARMD. In our model system, we feed our RPE cultures photoreceptor cell tips, and track how the RPE successfully and unsuccessfully handles this fatty cargo. We are also manipulating RPE pathways involved in metabolism and cellular trash removal (termed autophagy) to improve the RPE's ability to handle photoreceptor cell tips or toxic debris. These manipulations should reveal drugs that improve the RPE's ability to "handle its trash" and therefore slow dry ARMD progression.
Honors & Awards
- Heed Fellow, appointed by The Heed Ophthalmic Foundation and the Society of Heed Fellows
- Resident and Fellow Research Forum Awardee, Association of University Professors of Ophthalmology (AUPO)/Research to Prevent Blindness (RPB)
- Resident Research Award, The Michigan Society of Eye Physicians and Surgeons (MiSEPS)
- Selected to attend the prestigious Heed Foundation Residents Retreat. Dr. Miller is one of 35-40 residents nationwide, nominated by their residency director or department chair, selected to attend the retreat.