Richard Rivers, MD, PhD, MBA, Associate Professor, Division Chief, Ophthalmological Anesthesia

Dr. Richard J. Rivers is an associate professor of anesthesiology and critical care medicine and ophthalmology at the Johns Hopkins University School of Medicine. His area of clinical expertise is ophthalmological anesthesia. He serves as chief of anesthesia at the Wilmer Eye Institute at Johns Hopkins.

Dr. Rivers received his bachelor’s degree in chemical engineering from Clarkson University and his medical degree from the University of Toledo College of Medicine. He was a transitional resident at the University of Toledo Hospital before performing an anesthesiology research fellowship and a residency in anesthesiology at the University of Virginia Health Sciences Center. Dr. Rivers then completed a Ph.D. in physiology at the University of Virginia Health Sciences Center.

Prior to joining Johns Hopkins, Dr. Rivers was on faculty at the University of Rochester and then became chief of anesthesia at Lattimore Surgical Center in Rochester. He joined the Johns Hopkins faculty as chief of Anesthesia in 2002 and completed an M.B.A. at Johns Hopkins Carey Business School in 2009.

Dr. Rivers is past president of the Ophthalmic Anesthesia Society and is a member of many professional organizations including the Maryland Society of Anesthesiologists, the International Anesthesia Research Society and the American Society of Anesthesiologists.

Dr. Richard Rivers’ primary interest is vascular communication. He is actively studying microcirculation physiology to determine how metabolic demands are signaled between the tissue and the vascular network and along the vascular network itself. To conduct his work, Dr. Rivers uses a technique called intravital fluorescence microscopy, which enables him to measure the blood flow within a single artery, vein, or capillary. Further, with micropipettes, specific agonists and antagonists can be applied directly to the blood vessel to determine the effect on blood flow in real time.

Currently, Dr. Rivers is working to determine the role for inwardly rectifying potassium channels (Kir) 2.1 and 6.1 in signaling along the vessel wall, as well as the role of gap junctions. One of his initiatives is to develop viral vectors to use as tools to study the promoters that are specific for cell types in the vessel wall. The vectors are used to downregulate proteins such as the potassium channels and gap junctions to determine the effect on vascular function. Dr. Rivers is excited to have discovered that using hyaluronidase to break down the extracellular matrix enhances viral expression. In the future, Dr. Rivers may use RNA interference (RNAi) as another method for downregulating the proteins. He is also just beginning to test mice with specific gene deletions in his experimental models.

Ultimately, Dr. Rivers hopes that a better basic understanding of the microcirculation will lead to a better comprehension of disease processes, such as the angiogenesis that occurs in cancer and circulatory dysfunction associated with diabetes. This knowledge at the molecular level could enable the development of specific drugs that can target these processes and limit disease progression.

Professional Activities

  • Association of University Anesthesiologists
  • American Society of Anesthesiologists
  • International Anesthesia Research Society
  • Microcirculation Society – Member, Executive Council, 2006-present
  • American Physiological Society
  • American Association for the Advancement of Science
  • Maryland Society of Anesthesiologists
  • Phi Kappa Phi Honor Society
  • Tau Beta Pi Honor Society
  • Fellow, Cardiovascular Section, American Physiological Society
  • Ophthalmic Anesthesia Society, Executive Board 2003-present;
  • President 2005-2006, Vice president 2004-2005

Selected Publications

  1. Chen Y, Rivers RJ. Arteriolar occlusion causes independent cellular responses in endothelium and smooth muscle. Microcirculation 9:353 – 62, 2002.
  2. Rivers RJ, Thengchaisri N. Remote arteriolar dilations caused by methacholine: A role for CGRP sensory nerves? Am J Physiol Heart Circ Physiol 289:H608 – 13, 2005.
  3. Frame MD, Rivers RJ, Altland O, Cameron S. Mechanisms initiating integrin-stimulated flow recruitment in arteriolar networks. J Appl Physiol 102 (6):2279 – 87, 2007.
  4. Blumberg D, Congdon N, Jampel H, Gilbert D, Elliott R, Rivers R, Munoz B, Quigley H. The effects of sevoflurane and ketamine on intraocular pressure in children during examination under anesthesia. Am J Ophthalmol 143(3):494 – 9, 2007.
  5. Santhanam L, Lim HK, Lim HK, Miriel V, Brown T, Patel M, Balanson S, Ryoo S, Anderson M, Irani K, Khanday F, Di Costanzo L, Nyhan D, Hare JM, Christianson DW, Rivers R, Shoukas A, Berkowitz DE. Inducible NO synthase-dependent s-nitrosylation and activation of arginase1 contribute to age-related endothelial dysfunction. Circ Res 101(7):692 – 702, 2007.

Honors

  • Ophthalmic Anesthesia Society, Executive Board
  • American Association for the Advancement of Science