Dr. Silva's primary expertise lies in the fields of ocular telehealth for diabetic retinopathy, ultrawide field (UWF) retinal imaging and electronic medical record review. Dr. Silva has contributed 63 scientific publications with 24 original articles (16 as either first or last author), 10 study group publications, 20 review articles, 2 clinical guidelines and 9 book chapters. His work and efforts have been recognized with 10 national and international awards that include Young Clinician Award from the Center for Integration of Medicine and Innovative Technology and Eleanor and Miles Shore 50th Anniversary Fellowship Program for Scholars in Medicine, Harvard Medical School. He has been recognized by Philippine President Benigno S. Aquino III as one of The Outstanding Young Men Awardee for Medicine in 2013 and the Presidential Award for Filipinos Overseas in 2014. Dr. Silva directs telemedicine and retinal imaging research programs that has led to collaborative efforts in Philippines with Joslin and the Diabetic Retinopathy Research Network (DRCR.net). Presently, the Philippine reading center is prospectively evaluating UWF angiograms and retrospectively evaluating optical coherence tomography scans from clinical trials conducted by DRCR.net.
As assistant chief of telemedicine, Dr. Silva directs efforts of the Joslin Vision Network (JVN) in Boston, provides support to over 90 clinical sites through the Indian Health Service and develops collaborative efforts with both industry and clinical programs internationally. Outcomes data derived from the JVN have led to key publications describing novel approaches to telemedicine and better understanding of telemedicine outcomes. These contributions include elucidating the role of imager evaluation at the time of telemedicine imaging and the evaluation of various automated and low light imagine systems.
Dr. Silva's publications on UWF imaging has described its ability to detect posterior and peripheral diabetic retinopathy, its potential to improve efficiency of telemedicine programs and determine patients at exceptional risk for retinopathy progression. These papers have been recognized as one of the top practice changing publications in September 2012 by the American Academy of Ophthalmology and again in April 2015. His work has allowed the adoption of the UWF imaging technology with a reduction in the ungradable rate through undilated pupils by 75% with a present ungradable rate of less than 3%. This approach has reduced image evaluation time by 25%, increased the identification of retinopathy by 20% and increased the identification of sight-threatening retinopathy by 40%. Furthermore, the presence and predominance of these peripheral changes is predictive of retinopathy progression and the development of advanced sight-threatening retinopathy by nearly 4 and 5 fold respectively.
His administrative emphasis has been on fostering greater clinical innovation and the development of infrastructure that will facilitate and nurture such innovation. Dr. Silva is actively involved in the Electronic Medical Record Development at Joslin and at The Medical City in the Philippines. The program at The Medical City was awarded recognition for Innovations in Healthcare IT during the Asian Hospital Management Awards 2014.