Clinical Focus


  • Ophthalmology
  • Cataract
  • Cataract Surgery
  • Laser Cataract Surgery
  • Femtosecond Laser

Academic Appointments


  • Clinical Professor, Ophthalmology

Administrative Appointments


  • Ophthalmology Delegate, Stanford OR Committee (2008 - Present)
  • Director, Cataract Surgery Service (2010 - Present)
  • Clinic Chief, Department of Ophthalmology (2007 - 2022)
  • Director, Byers Eye Surgery Center at Stanford (2012 - Present)

Professional Education


  • Medical Education: Yale School Of Medicine (2001) CT
  • Residency: Stanford University Ophthalmology Residency (2005) CA
  • Internship: St Mary's Medical Center Internal Medicine Residency (2002) CA
  • Board Certification: American Board of Ophthalmology, Ophthalmology (2006)
  • MD, Yale University (2001)
  • PhD, Yale University, Neuroscience (1999)
  • BA, Amherst College, Neuroscience (1991)

Community and International Work


  • US Eye Care and Cataract Surgery, Fiji

    Partnering Organization(s)

    SMA

    Location

    International

    Ongoing Project

    No

    Opportunities for Student Involvement

    No

  • International Cataract Surgery, Guatemala

    Partnering Organization(s)

    SEE International

    Location

    International

    Ongoing Project

    No

    Opportunities for Student Involvement

    No

  • Thimphu Hospital, Bhutan

    Topic

    International Ophthalmology Instruction

    Partnering Organization(s)

    Health Volunteers Overseas

    Populations Served

    Bhutan

    Location

    International

    Ongoing Project

    No

    Opportunities for Student Involvement

    No

  • Arbor Clinic

    Topic

    Ophthalmology

    Populations Served

    under-served

    Location

    Bay Area

    Ongoing Project

    Yes

    Opportunities for Student Involvement

    No

Current Research and Scholarly Interests


Multicenter Catalys Consortium Trial - To compare femtosecond laser assisted cataract surgery with conventional cataract surgery

2023-24 Courses


All Publications


  • Liquid-biopsy proteomics combined with AI identifies cellular drivers of eye aging and disease in vivo. Cell Wolf, J., Rasmussen, D. K., Sun, Y. J., Vu, J. T., Wang, E., Espinosa, C., Bigini, F., Chang, R. T., Montague, A. A., Tang, P. H., Mruthyunjaya, P., Aghaeepour, N., Dufour, A., Bassuk, A. G., Mahajan, V. B. 2023

    Abstract

    Single-cell analysis in living humans is essential for understanding disease mechanisms, but it is impractical in non-regenerative organs, such as the eye and brain, because tissue biopsies would cause serious damage. We resolve this problem by integrating proteomics of liquid biopsies with single-cell transcriptomics from all known ocular cell types to trace the cellular origin of 5,953 proteins detected in the aqueous humor. We identified hundreds of cell-specific protein markers, including for individual retinal cell types. Surprisingly, our results reveal that retinal degeneration occurs in Parkinson's disease, and the cells driving diabetic retinopathy switch with disease stage. Finally, we developed artificial intelligence (AI) models to assess individual cellular aging and found that many eye diseases not associated with chronological age undergo accelerated molecular aging of disease-specific cell types. Our approach, which can be applied to other organ systems, has the potential to transform molecular diagnostics and prognostics while uncovering new cellular disease and aging mechanisms.

    View details for DOI 10.1016/j.cell.2023.09.012

    View details for PubMedID 37863056

  • Biobanking of Human Aqueous and Vitreous Liquid Biopsies for Molecular Analyses. Journal of visualized experiments : JoVE Wolf, J., Chemudupati, T., Kumar, A., Rasmussen, D. K., Wai, K. M., Chang, R. T., Montague, A. A., Tang, P. H., Bassuk, A. G., Dufour, A., Mruthrunjaya, P., Mahajan, V. B. 2023

    Abstract

    A critical challenge in translational research is establishing a viable and efficient interface between patient care in the operating room (OR) and the research laboratory. Here, we developed a protocol for acquiring high-quality liquid biopsies for molecular analyses from the aqueous humor and the vitreous from patients undergoing eye surgery. In this workflow, a Mobile Operating Room Lab Interface (MORLI) cart equipped with a computer, a barcode scanner, and lab instruments, including onboard cold storage, is used to obtain and archive human biological samples. A web-based data privacy-compliant database enables annotating each sample over its lifetime, and a cartesian coordinate system allows tracking each barcoded specimen in storage, enabling quick and accurate retrieval of samples for downstream analyses. Molecular characterization of human tissue samples not only serves as a diagnostic tool (e.g., to distinguish between infectious endophthalmitis and other non-infectious intraocular inflammation) but also represents an important component of translational research, allowing the identification of new drug targets, development of new diagnostic tools, and personalized therapeutics.

    View details for DOI 10.3791/65804

    View details for PubMedID 37747194

  • Immunoprofiling of Nonarteritic Anterior Ischemic Optic Neuropathy. Translational vision science & technology Mesentier-Louro, L. A., Stell, L., Yan, Y., Montague, A. A., de Jesus Perez, V., Liao, Y. J. 2021; 10 (8): 17

    Abstract

    Purpose: Nonarteritic anterior ischemic optic neuropathy (NAION) is a common acute optic neuropathy in those older than 50 years. There is no blood diagnostic test or efficient treatment for NAION. We investigated the suitability of blood inflammatory proteins as biomarkers and therapeutic targets of NAION.Methods: We conducted an exploratory, cross-sectional case-control study including 18 patients with NAION (n = 5 acute, and n = 13 chronic) and 9 controls. NAION was confirmed by clinical examination and optical coherence tomography. Subjects underwent peripheral blood collection; plasma was isolated within 2 hours and analyzed using a 76-plex array of cytokines, chemokines, and growth factors.Results: In acute NAION, there was increased peripapillary retinal thickness on optical coherence tomography consistent with optic disc edema. Plasma profiling revealed dramatic changes in inflammatory proteins in NAION. Statistical analysis generated a list of 20 top-ranked molecules in NAION, with 15% overlap in acute and chronic NAION. Principal component analysis, hierarchical clustering, and Spearman correlation generally segregated controls, acute and chronic NAION, with some overlap. Longitudinal data from one patient demonstrated an evolving inflammatory pattern from acute to chronic NAION. In acute NAION, Eotaxin-3, MCP-2, TPO, and TRAIL were the top biomarker candidates. In chronic NAION, IL-1alpha and CXCL10 emerged as the strongest therapeutic targets.Conclusions: Post-NAION inflammation occurs in both acute and chronic NAION. Statistical analysis of plasma profile changes generated a list of 20 potential biomarker and therapeutic targets of NAION.Translational Relevance: We identified blood molecular targets to improve NAION diagnosis and treatment.

    View details for DOI 10.1167/tvst.10.8.17

    View details for PubMedID 34264294

  • Immunoprofiling of Nonarteritic Anterior Ischemic Optic Neuropathy Mesentier-Louro, L., Stell, L., Yan, Y., Montague, A., Perez, V., Liao, Y. ASSOC RESEARCH VISION OPHTHALMOLOGY INC. 2021
  • Multimodal Imaging of Posterior Dislocation of Crystalline Lens Nucleus following Vitrectomy. Journal of ophthalmic & vision research Karth, P. A., Swinney, C. C., Montague, A. A., Moshfeghi, D. M. 2015; 10 (2): 197-199

    View details for DOI 10.4103/2008-322X.163785

    View details for PubMedID 26425326

  • Comparison of One-Day Versus One-Hour Application of Topical Gatifloxacin in Eliminating Conjunctival Bacterial Flora 111th Annual Meeting of the American-Academy-of-Ophthalmology Moss, J. M., Nguyen, D., Liu, Y. I., Singh, K., Montague, A., Egbert, P. R., de Kaspar, H. M., Ta, C. N. ELSEVIER SCIENCE INC. 2008: 2013–16

    Abstract

    To compare efficacies of 1-day, 1-hour, and combined 1-day/1-hour preoperative topical gatifloxacin in eliminating conjunctival bacterial flora.Prospective, comparative case series.Sixty patients (120 eyes) scheduled to undergo anterior segment intraocular surgery at Stanford University Medical Center.Cultures were collected from the palpebral conjunctival sac at baseline and after 1 day (4 doses), 1 hour (3 doses), and 1 day/1 hour (7 doses) of gatifloxacin use.Incidence of positive bacterial samples collected pre- and post-antibiotic treatment and number of colony forming units (CFUs).SeptiChek (Becton Dickinson, Franklin Lakes, NJ) positive cultures significantly decreased from 67% growth at baseline to 28% (P<0.0001) after 1 day and from 60% at baseline to 37% (P = 0.018) after 1 hour of gatifloxacin use. Reductions of 44% growth at baseline to 12% (P = 0.0001) after 1 day and 32% at baseline to 13% (P = 0.029) after 1 hour of gatifloxacin use were observed on blood agar. Surgical eyes that received both 1-day and 1-hour preoperative gatifloxacin had reductions from 67% growth at baseline to 18% posttreatment (P<0.0001) and 45% at baseline to 7% posttreatment (P<0.0001) on SeptiChek and blood agar media, respectively. In addition to a lower frequency of positive cultures, a significantly lower CFU count was found after 1-day (P = 0.004) and 1-hour (P = 0.049) gatifloxacin use compared with pretreatment levels. Combined 1-day/1-hour doses of gatifloxacin were associated with a greater reduction in CFUs (P = 0.001) when compared with 1-hour treatment alone.Both 1-hour and 1-day topical gatifloxacin use are effective in reducing the frequency of conjunctival bacterial growth and the overall bacterial load as measured by CFUs, relative to baseline. Although a 1-hour pretreatment is associated with a reduction in bacterial growth, the combination of 1-day and 1-hour preoperative gatifloxacin dosing results in an even lower overall bacterial load, suggesting that the latter might be the preferred preoperative regimen for eyes undergoing anterior segment surgery.

    View details for DOI 10.1016/j.ophtha.2008.06.024

    View details for PubMedID 18708260

  • Prospective comparison of topical moxifloxacin in eliminating conjunctival bacterial flora following a one-day or one-hour application Annual Meeting of the Association-for-Research-in-Vision-and-Ophthalmology Ta, C. N., Chan, I., Dhatt, H. S., Paterno, J., Fisher, E., Singh, K., Montague, A., Egbert, P. R., Cockerham, G., de Kaspar, H. M. MARY ANN LIEBERT INC. 2008: 427–31

    Abstract

    The aim of this study was to compare the efficacy of a 1-hour(h) versus 1-day application of topical moxifloxacin in eliminating conjunctival bacterial flora.In this prospective, nonrandomized, controlled trial, the surgical eyes of 60 patients scheduled for intraocular surgery received topical moxifloxacin four times a day, starting 1 day prior to surgery and three additional applications at 5-minute intervals 1 h before surgery. The nonsurgical eye of each patient only received three applications of the same antibiotic at 5-minute intervals 1 h before surgery. Conjunctival cultures were obtained at baseline and after antibiotic application.Prior to antibiotic application, 80% of surgical eyes and 70% of nonsurgical eyes had positive cultures. Following the 1-day application, significantly fewer eyes (40%) had positive cultures (P < 0.0001), with a further reduction to 32% with three additional doses 1 h prior to surgery. In the nonsurgical eye, the decrease in the percentage of positive cultures, from 55% to 53% following the three applications 1 h prior to surgery, was not significant (P > 0.9999). The 1-day application was associated with significantly fewer positive cultures, compared to the 1-h group (P = 0.0267).The one-day application of moxifloxacin resulted in significantly fewer positive conjunctival cultures, compared with a 1-h application.

    View details for DOI 10.1089/jop.2008.0018

    View details for PubMedID 18665815

  • CustomVue laser in situ keratomileusis treatment after previous keratorefractive surgery JOURNAL OF CATARACT AND REFRACTIVE SURGERY Montague, A. A., Manche, E. E. 2006; 32 (5): 795-798

    Abstract

    To evaluate the efficacy, predictability, and safety of Visx CustomVue wavefront-guided enhancement after previous keratorefractive surgery.Stanford University Eye Laser Center, Stanford, California, USA.A retrospective analysis was used to evaluate wavefront-guided enhancement in a preliminary set of 120 eyes of 102 patients. All eyes had previous keratorefractive surgery (photorefractive keratoplasty [PRK] in 1 eye, laser in situ keratomileusis [LASIK] in 119 eyes); the prekeratorefractive surgery spherical equivalent (SE) refraction ranged from -1.25 diopters (D) to -7.00 D. Primary outcome variables including uncorrected visual acuity (UCVA), manifest refraction, and complications were evaluated at 1 and 3 months.At 1 month, the mean pre-enhancement SE was reduced from -0.91 D +/- 0.40 (SD) (range -2.375 to -0.125 D) to -0.13 +/- 0.33 D (range -1.25 to 0.75 D) with 91% of eyes within +/-0.5 D of emmetropia and 100% within +/-1.0 D. All eyes showed equal or improved UCVA (range 20/15 to 20/30) with 20/20 or better in 84 of 91 eyes. At 3 months, the mean was -0.20 +/- 0.32 D (range -0.75 to 0.75 D) with 100% of eyes within +/-0.75 D of emmetropia. All eyes showed equal or improved UCVA (range 20/15 to 20/30) with 20/20 or better in 74 of 84 eyes. Higher-order wavefront aberration analysis showed that the mean root-mean-square error was reduced from 0.39 +/- 0.14 microm (range 0.16 to 0.86 microm) to 0.34 +/- 0.12 microm (range 0.12 to 0.78 microm). Coma was reduced from 0.22 +/- 0.13 microm (range 0.02 to 0.71 microm) to 0.16 +/- 0.11 microm (range 0.01 to 0.62 microm), and trefoil was reduced from 0.16 +/- 0.09 microm (range 0.01 to 0.62 microm) to 0.11 +/- 0.07 microm (range 0.01 to 0.27 microm). Spherical aberration was unchanged from 0.14 +/- 0.14 microm (range -0.18 to 0.59 microm) to 0.14 +/- 0.14 microm (range -0.16 to 0.5 microm).Preliminary data show that Visx CustomVue wavefront-guided enhancement after keratorefractive surgery is an effective, predictable, and safe procedure.

    View details for DOI 10.1016/j.jcrs.2006.01.081

    View details for PubMedID 16765797

  • Differential distribution of ionotropic glutamate receptor subunits in the rat olfactory bulb JOURNAL OF COMPARATIVE NEUROLOGY Montague, A. A., Greer, C. A. 1999; 405 (2): 233-246

    Abstract

    The subcellular localization of ionotropic glutamate receptor (GluR) subunits was examined with light and electron microscopy in the rat olfactory bulb by using antibodies to alpha-amino-3-hydroxy-5-methylisoxazole-4-propionic acid (AMPA) receptor subunits: GluR1, GluR2/3, and GluR4; and kainate (KA) receptor subunits: GluR5/6/7. Immunoreactivity to GluR1 was heavy in the glomerular layer, moderate in the external plexiform layer, and localized to periglomerular somata and dendrites, short axon somata and dendrites, mitral cell somata, and mitral/tufted dendrites. GluR2/3 immunoreactivity was heavy in the external plexiform and glomerular layers and localized to periglomerular somata and dendrites, mitral cell somata, mitral/tufted dendrites, granule cell somata, and olfactory nerve-associated glia. GluR4 immunoreactivity showed heavy staining in the external plexiform and olfactory nerve layers with localization to mitral cells, mitral/tufted dendritic processes, and olfactory nerve glial processes. GluR5/6/7 immunoreactivity was heavy in the external plexiform layer, moderate in the olfactory nerve and glomerular layers, and localized to granule cells, mitral cells, and mitral/tufted dendritic processes. Ultrastructural immunolabeling for all antibodies examined showed immunoreactivity in the postsynaptic membrane and densities, adjacent dendritic cytoplasm, and somatic cytoplasm. These data demonstrate a highly specific laminar, cellular, and subcellular distribution of ionotropic GluR subunits within the primary afferent and local synaptic circuits of the olfactory bulb. The results are consistent with the notion that the different roles subserved by glutamate in the olfactory bulb are actuated, in part, by a differential distribution of GluR subunits.

    View details for Web of Science ID 000078411900007

    View details for PubMedID 10023812