Josef Flammer

Professor Dr. Josef Flammer

Josef Flammer (born April 21, 1948) is a Swiss ophthalmologist and long-time director of the Eye Clinic at Basel University Hospital. Flammer is a glaucoma specialist who developed a new pathogenetic concept of glaucomatous damage according to which unstable blood supply leads to oxidative stress, which in turn plays a major role in apoptosis (cell death) of cells in optic nerve and retina in glaucoma patients.[1]

Life and medical training

Josef Flammer was born on a farm near the village of Bronschhofen in the Canton of St. Gallen. He attended secondary school in Wil and boarding school in Gossau. In 1968 he began to study medicine, first in Fribourg, then in Berne. Flammer spent his junior doctor years in the fields of internal medicine, neurology and ophthalmology - he finally decided to become an ophthalmologist and completed his education at the Department of Ophthalmology of the University of British Columbia in Vancouver before returning to the University of Berne. In 1984 he was appointed chief physician of the University Eye Clinic Berne, in 1987 he accepted an appointment as chair of ophthalmology and director of the University Eye Clinic Basel, over which he presided until his retirement in December 2013.

Scientific works

Flammer's scientific and medical endeavors were generally interdisciplinary. His first research focus was automatic perimetry for which he established normal values;[2] he studied short term and long term fluctuations of the human visual field and described influencing factors.[3] Together with Hans Bebie he developed the so-called Bebie curve, which plays a major role in the diagnosis of visual field loss due to glaucoma, he introduced the visual field indices. Flammer was one of the first researchers to demonstrate systemic side effects of locally administered beta blockers (i.e. eye drops) in ophthalmology. Flammer and his collaborators found that intraocular pressure variation is as important for the development of glaucoma, one of the main causes of blindness worldwide, as a constantly elevated intraocular pressure,[4] long considered the main, if not the only, cause of glaucoma. In numerous research projects he demonstrated that glaucoma could be caused by a dysregulation of ocular blood flow, even at normal levels of intraocular pressure. Flammer discovered that vasospasms in the eye are a manifestation of a general vasospastic syndrome. Later, he noted that such spasms are only the tip of the iceberg and an indication of a much more generalized vascular dysregulation in the human body.[5] This increases the risk of eye disease, in particular of normal tension glaucoma. Flammer noted that people with a primary vascular dysregulation have other symptoms and signs; this led to the establishment of the term Flammer syndrome. Flammer also demonstrated the relationship between eye disease and heart disease.[6][7] In numerous laboratory studies, he contributed to the understanding of the role of endothelin - which according to his studies regulates retinal venous pressure - and nitric oxide in ocular perfusion.[8]. He also described the pathogenic role of ocular blood flow in retinitis pigmentosa.[9]

Publishing and education

In addition to hundreds of original papers, Flammer is the author of several books. His book "Glaucoma", intended for the general public, has so far been published in 22 languages and went through 30 different editions; "Glaucoma" is thus considered the world's most widely used non-fiction book on this ocular disease.[10] His "Basic Sciences in Ophthalmology" has received praise for demonstrating the role of chemistry and physics in modern ophthalmological diagnostics and therapies.[11] The Basel Eye Clinic organizes each year - as initiated by Flammer - one of the most renowned conferences for ophthalmologists in Europe, the Basel Ophthalmo Meeting.[12]

Writings (selection)

  • Josef Flammer, Maneli Mozaffarieh, Hans Bebie: Basic Sciences in Ophthalmology: Physics and Chemistry. Springer, Heidelberg and New York 2013. ISBN 978-3-642-32260-0.
  • Josef Flammer: Glaucoma: A Guide for Patients, An Introduction for Care Providers, A Quick Reference. Hogrefe and Huber Publishing, Berne, Switzerland 2006. 978-0889373426
  • Flammer J, Konieczka K, Bruno RM, Virdis A, Flammer AJ, Taddei S. The eye and the heart. Eur Heart J 34,1270-1278 (2013) [Epub 2013]
  • M. Mozaffarieh, J. Flammer: New insights in the pathogenesis and treatment of normal tension glaucoma. Curr Opin Pharmacol 2013 Feb;13(1):43-49.
  • Josef Flammer: The role of ocular blood flow in the pathogenesis of glaucomatous damage. US Ophthalmic Review 4(2):84-87 (2011)
  • Maneli Mozzafarieh, Josef Flammer: Ocular Blood Flow and Glaucomatous Optic Neuropathy. Springer, Heidelberg und New York 2009, ISBN 978-3-540-69442-7


References

  1. ↑ Flammer J, Mozaffarieh M.: What is the present pathogenetic concept of glaucomatous optic neuropathy? Surv Ophthalmol. 2007 Nov;52 Suppl 2:S162-173
  2. ↑ A. Haas, J. Flammer, U. Schneider: Influence of age on the visual fields of normal subjects. Am J Ophthalmol 101:199-203 (1986)
  3. ↑ J. Flammer, S.M. Drance, M. Zulauf: Differential light threshold. Short- and long-term fluctuation in patients with glaucoma, normal controls and patients with suspected glaucoma. Arch Ophthalmol 102:704-706 (1984)
  4. ↑ P. Niesel, J. Flammer: Correlations between intraocular pressure, visual field and acuity, based on 11 years observations of treated chronic glaucomas. Int Ophthalmol 3:31-35 (1980)
  5. ↑ Flammer J, Konieczka K, Flammer AJ. The primary vascular dysregulation syndrome: implications for eye diseases. EPMA 7;4(1):14 (2013)
  6. ↑ M. Pache, J. Flammer. A Sick Eye in a Sick Body? Systemic Findings in Patients with Primary Open-angle Glaucoma. Surv Ophthalmol 51(3):179-212 (2006)
  7. ↑ Flammer J, Konieczka K, Bruno RM, Virdis A, Flammer AJ, Taddei S. The eye and the heart. Eur Heart J 34,1270-78 (2013)
  8. ↑ Haefliger IO, Flammer J, Bény JL, Lüscher TF: Endothelium-dependent vasoactive modulation in the ophthalmic circulation. Prog Retin Eye Res. 2001 ;20(2):209-25.
  9. ↑ Konieczka K, Flammer AJ, Todorova M, Meyer P, Flammer J: Retinitis pigmentosa and ocular blood flow. EPMA J. 2012 Dec 3;3(1):17. doi: 10.1186/1878-5085-3-17. (Open access article)
  10. ↑ Josef Flammer: Glaucoma: A Guide for Patients, An Introduction for Care Providers, A Quick Reference. Hogrefe and Huber Publishing, Berne, Switzerland 2006. 978-0889373426
  11. ↑ Josef Flammer, Maneli Mozaffarieh and Hans Bebie: Basic Sciences in Ophthalmology: Physics and Chemistry. Springer, Heidelberg/ New York 2013, ISBN 978-3-642-32260-0.
  12. ↑ Glaucoma Meeting
  • Website on Flammer syndrome
  • "Josef Flammer". www.glaucomaresearch.ch. Retrieved 2016-02-11.
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