The Retina Channel Podcast (Keyvan Koushan, MD, FRCSC)

Dr. Noemi Lois from Queens University in Belfast, UK discusses results of the DIAMONDS study, which was a prospective trial that looked into the effectiveness, safety, and cost-effectiveness of subthreshold micropulse laser (SML), compared with standard laser (SL), for diabetic macular edema (DME) with central retinal thickness (CRT) < 400 um.

Referenced article:

Lois N, Campbell C, Waugh N, Azuara-Blanco A, Maredza M, Mistry H, McAuley D, Acharya N, Aslam TM, Bailey C, Chong V, Downey L, Eleftheriadis H, Fatum S, George S, Ghanchi F, Groppe M, Hamilton R, Menon G, Saad A, Sivaprasad S, Shiew M, Steel DH, Talks JS, Doherty P, McDowell C, Clarke M; DIAMONDS Study Group. Diabetic Macular Edema and Diode Subthreshold Micropulse Laser: A Randomized Double-Masked Noninferiority Clinical Trial. Ophthalmology. 2023 Jan;130(1):14-27. doi: 10.1016/j.ophtha.2022.08.012. Epub 2022 Aug 13. PMID: 35973593.

Dr. Camiel Boon from Leiden University Medical Center (LUMC) and Amsterdam University Medical Centers in Amsterdam discusses the results of his research work on the comparison of half-dose PDT vs micropulse laser to treat central serous chorioretinopathy.

Full reference of the discussed article:

van Dijk, E. H. C., Fauser, S., Breukink, M. B., Blanco-Garavito, R., Groenewoud, J. M. M., Keunen, J. E. E., . . . Boon, C. J. F. (2018). Half-Dose Photodynamic Therapy versus High-Density Subthreshold Micropulse Laser Treatment in Patients with Chronic Central Serous Chorioretinopathy: The PLACE Trial. Ophthalmology. doi:10.1016/j.ophtha.2018.04.021

Dr. SriniVas Sadda discusses development of macular atrophy in an analysis of HARBOR Study which investigated treatment of wet AMD using 0.5 mg and 2.0 mg of Ranibizumab dosing. 

Full reference of the discussed article:

Sadda, S. R., Tuomi, L. L., Ding, B., Fung, A. E., & Hopkins, J. J. (2018). Macular Atrophy in the HARBOR Study for Neovascular Age-Related Macular Degeneration. Ophthalmology. doi:10.1016/j.ophtha.2017.12.026

Dr. David Brown discusses his recent article in Ophthalmology about the role of targeted peripheral retinal laser photocoagulation to lower the treatment burden for diabetic macular edema.

Full reference of the article: 

Brown, D. M., Ou, W. C., Wong, T. P., Kim, R. Y., Croft, D. E., Wykoff, C. C., & Group, D. S. (2018). Targeted Retinal Photocoagulation for Diabetic Macular Edema with Peripheral Retinal Nonperfusion: Three-Year Randomized DAVE Trial. Ophthalmology. doi:10.1016/j.ophtha.2017.11.026

Dr. Paul Micevych from the UC San Francisco discusses his group's work on systemic and individual risk factors leading to complicated diabetic retinopathy requiring vitrectomy. 

Discussed article: Micevych PS, Taha AM, Poddar A, Stewart JM. Individual and Systems-Based Risk Factors for Diabetic Vitrectomy in an Urban Safety-Net Hospital. Ophthalmol Retina. 2023 Dec;7(12):1027-1034. doi: 10.1016/j.oret.2023.05.014. Epub 2023 May 24. PMID: 37236319.

Dr. Guymer discusses the results of the FLUID study which investigated whether some residual sub retinal fluid can be tolerated in neovascular macular degeneration. 

Full reference:

Tolerating Subretinal Fluid in Neovascular Age-Related Macular Degeneration Treated with Ranibizumab Using a Treat-and-Extend Regimen. Guymer, Robyn H.Chang, Andrew et al. Ophthalmology, Volume 126, Issue 5, 723 - 734

Dr. Brian Ballios uses his expertise to talk about the article titled "Autologous Induced Stem-Cell–Derived Retinal Cells for Macular Degeneration" by Mandai et al. The article reports use of induced pluripotent stems to culture and transplant Retinal Pigment Epithelial Cells in a patient with advanced Age-Related Macular Degeneration. 

The full reference to the article:

Autologous Induced Stem-Cell–Derived Retinal Cells for Macular Degeneration, Mandai M, Watanabe A, Kurimoto Y, Hirami Y, Morinaga C, Daimon T, Fujihara M, Akimaru H, Sakai N, Shibata Y, Terada M, Nomiya Y, Tanishima S, Nakamura M, Kamao H, Sugita S, Onishi A, Ito T, Fujita K, Kawamata S, Go MJ, Shinohara C, Hata KI, Sawada M, Yamamoto M, Ohta S, Ohara Y, Yoshida K, Kuwahara J, Kitano Y, Amano N, Umekage M, Kitaoka F, Tanaka A, Okada C, Takasu N, Ogawa S, Yamanaka S, Takahashi M., N Engl J Med. 2017 Mar 16;376(11):1038-1046.

doi: 10.1056/NEJMoa1608368.

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Dr. Rajeev Muni describes the results of his research on the correlation of cytokine levels (VEGF, ICAM, etc) and the anatomical response to intravitreal ranibizumab for the treatment of diabetic macular edema.

Full reference of the article:

Hillier, R. J., Ojaimi, E., Wong, D. T., Mak, M. Y. K., Berger, A. R., Kohly, R. P., . . . Muni, R. H. (2018). Aqueous Humor Cytokine Levels and Anatomic Response to Intravitreal Ranibizumab in Diabetic Macular Edema. JAMA Ophthalmol. doi:10.1001/jamaophthalmol.2018.0179

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Dr. Soliman discusses his team's analysis of clinical predictors of low histopathology in eyes that were enucleated because of retinoblastoma. The goal of the study is to find clinical indicators in retinoblastoma that could be used to salvage eyes via eye-preserving treatment methods instead of enucleation. 

Dr. Leffler discusses his team's analysis of the country-wide mortality from COVID-19 pandemic and its correlation with mask usage by the public.

Full reference:

Leffler CT, Ing E, McKeown CA, Pratt D, Grzybowski A. Final Country-wide Mortality from the Novel Coronavirus (COVID-19) Pandemic and Notes Regarding Mask Usage by the Public. April 4, 2020. Available from: researchgate.net. 

Dr. Almeida presents a mathematical model based on Newtonian mechanics to discuss vision recovery of different anti-VEGF medications. 

The discussed article:

Almeida DRP, Ruzicki J, Xu K, Chin EK. Vision Recovery Velocity, Momentum and Acceleration: Advanced Vitreoretinal Analytics as Measure of Treatment Efficacy for Neovascular Age-Related Macular Degeneration. Clin Ophthalmol. 2021 Jan 18;15:189-194. doi: 10.2147/OPTH.S288621. PMID: 33500611; PMCID: PMC7822233.

Dr. Jong Park discusses surgical mananement of full-thickness macular holes associated with macular telangiectasia. 

Referenced article:

Park JG, Adrean SD, Begaj T, Capone A Jr, Charles S, Chen SN, Chou HD, Cohen MN, Corona ST, Faia LJ, Garg SJ, Garretson BR, Gregori NZ, Haller JA, Houghton OM, Hsu J, Jo J, Kaiser RS, Lai CC, Mahgoub MM, Mansoor M, Matoba R, Morizane Y, Nehemy MB, Raphaelian PV, Regillo CD, Ruby AJ, Runner MM, Sneed SR, Sohn EH, Spirn MJ, Vander JF, Wakabayashi T, Wolfe JD, Wykoff CC, Yonekawa Y, Yoon YH, Mahmoud TH. Surgical Management of Full-Thickness Macular Holes in Macular Telangiectasia Type 2: A Global Multicenter Study. Ophthalmology. 2024 Jan;131(1):66-77. doi: 10.1016/j.ophtha.2023.08.025. Epub 2023 Sep 3. PMID: 37661066.

Dr. Antoszyk from the DRCR Retina Network discusses Protocol AB, which compared anti-VEGF injections vs immediate pars plana vitrectomy for the treatment of vitreous hemorrhage due to proliferative diabetic retinopathy.

The discussed article:

Antoszyk AN, Glassman AR, Beaulieu WT, Jampol LM, Jhaveri CD, Punjabi OS, Salehi-Had H, Wells JA 3rd, Maguire MG, Stockdale CR, Martin DF, Sun JK; DRCR Retina Network. Effect of Intravitreous Aflibercept vs Vitrectomy With Panretinal Photocoagulation on Visual Acuity in Patients With Vitreous Hemorrhage From Proliferative Diabetic Retinopathy: A Randomized Clinical Trial. JAMA. 2020 Dec 15;324(23):2383-2395. doi: 10.1001/jama.2020.23027. PMID: 33320223; PMCID: PMC7739132.

In a panel discussion with Dr. Koushan, Drs. Daniel Ting, Olivia Li and Steven Yeh discuss the preparedness of ophthalmologists in the COVID-19 crisis. The discussion is based on the most recent Ophthalmology editorial:

Preparedness among Ophthalmologists: During and Beyond the COVID-19 Pandemic. Olivia Li, Ji-PengWong, Tien Y.Wong, Edmund Y.Mehta, JodLin, HaotianLin, XiaofengStrouthidis, Nicholas G.Park, Ki HoFung, Adrian T.McLeod, Stephen D.Busin, MassimoParke, David W.Holland, Gary N.Chodosh, JamesYeh, StevenTing, Daniel S.W. et al.
Ophthalmology, Volume 127, Issue 5, 569 - 572 

Dr. Kumar discussed his group's prospective study on the comparative outcomes of two different drainage techniques (posterior retinotomy vs PFCL) for repair of rhegmatogenous retina detachment. 

Dr. Gupta discusses findings of this large retrospective study on the risk and associations of rhegmatogenous retinal detachment after intravitreal anti-VEGF injections.

Discussed article: 

Dr. Sean Adrean discusses his retrospective analysis of patients with wet AMD who had over 50 anti-VEGF injections.

Full reference of the discussed article:

Adrean, S. D., S. Chaili, H. Ramkumar, A. Pirouz, and S. Grant. "Consistent Long-Term Therapy of Neovascular Age-Related Macular Degeneration Managed by 50 or More Anti-Vegf Injections Using a Treat-Extend-Stop Protocol." Ophthalmology  (Feb 10 2018).

Dr. Chirag Shah discusses his pilot randomized clinical trial on the application of YAG Vitreolysis to reduce symptoms of floaters associated with Weiss ring. The full reference of the discussed article is:

Shah, C. P., & Heier, J. S. (2017). YAG Laser Vitreolysis vs Sham YAG Vitreolysis for Symptomatic Vitreous Floaters: A Randomized Clinical Trial. JAMA Ophthalmol, 135(9), 918-923. doi:10.1001/jamaophthalmol.2017.2388

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Dr. Pereira speaks about his group’s report on retinal findings in patients with severe COVID-19 infections who were admitted in the ICU.

Discussed article:

Pereira LA, Soares LCM, Nascimento PA, et al. Br J Ophthalmol Epub ahead of print: [please include Day Month Year]. doi:10.1136/bjophthalmol- 2020-317576

Dr. Baumal discusses features and outcomes of eyes with retinal vasculitis and intraocular inflammation after intravitreal injection of brolucizumab for treatment of neovascular age-related macular degeneration.

Discussed article: 

Baumal CR, Spaide RF, Vajzovic L, et al. Retinal Vasculitis and Intraocular Inflammation after Intravitreal Injection of Brolucizumab [published online ahead of print, 2020 Apr 25]. Ophthalmology. 2020;S0161-6420(20)30371-7. doi:10.1016/j.ophtha.2020.04.017

Dr. Niffenegger discusses a case series of secondary macular hole treatment with topical therapy.

Discussed article:

Drs. Muni and Juncal discuss their case series on the level of anti-VEGF drugs and VEGF-A levels on lactating mothers who had received intravitreal anti-VEGF injections.

Reference for the article:

Ranibizumab and Aflibercept Levels in Breast Milk after Intravitreal Injection; Verena R. Juncal,Quratulain Paracha,Motaz Bamakrid,
,Carolina L.M. Francisconi, Julia Farah, Amin Kherani
,Rajeev H. Muni;  Ophthalmology, published on line Sep.11, 2019

https://doi.org/10.1016/j.ophtha.2019.08.022

Dr. Vander from Wills Eye Hospital discusses the effect of vitreous tap on the management of 60 cases of endophthalmitis post intravitreal anti-VEGF injections.

The discussed article: 

Changes in Management Based on Vitreous Culture in Endophthalmitis After Intravitreal Anti-vascular Endothelial Growth Factor Injection. Patel SN, Storey PP, Pancholy M, Obeid A, Wibbelsman TD, Levin H, Hsu J, Garg SJ, Dunn JP, Vander JF. Am J Ophthalmol. 2019 Nov;207:224-231. doi: 10.1016/j.ajo.2019.06.008. Epub 2019 Jun 13

Dr. Nina Ahuja (@docsleadership) discusses her newly published booked titled "Stress in Medicine, Lessons Learned Through my Years as a Surgeon, from Med School to Residency, and Beyond". In an intimate account of her journey through her medical career, Dr. Ahuja discusses some of hardships and difficulties that she has gone through with the goal of bringing more transparency to the medical education and breaking the culture of silence. 

The book is available through Amazon and Apple Books.

Dr. Efrem Mandelcorn from the University of Toronto talks about 3 different surgical techniques that he's published in 3 different articles:

1. Macular hydodissection for challenging macular holes:

2. Scleral needling for closure of sclerotomies:

Dr. Mark Humayun discusses the results of his team's work on implantation of RPE stems cells placed on a bioengineered surface for dry AMD. 

Full reference of the article:

Kashani, A. H., Lebkowski, J. S., Rahhal, F. M., Avery, R. L., Salehi-Had, H., Dang, W., . . . Humayun, M. S. (2018). A bioengineered retinal pigment epithelial monolayer for advanced, dry age-related macular degeneration. Sci Transl Med, 10(435). doi:10.1126/scitranslmed.aao4097

Dr. Chakravarthy from Belfast, UK discusses a secondary analysis of the IVAN Trial to compare effects of intravitreal anti-VEGF therapy on serum VEGF levels with possible trends in system adverse events in the context of wet AMD.

Full reference:

Chris A.Rogers, Lauren J.Scott, Barnaby C.Reeves, Susan Downes, Andrew J.Lotery, Andrew D.Dick, Usha Chakravarthy for IVAN trial investigators, Serum Vascular Endothelial Growth Factor Levels in the IVAN Trial; Relationships with Drug, Dosing, and Systemic Serious Adverse Events, Ophthalmology Retina, Feb. 2018

http://dx.doi.org/10.1016/j.oret.2017.05.015

Dr. Nina Ahuja and Dr. Nupura Bakshi elaborate on the concept of Equity, Diversity and Inclusion in medicine and discuss their recent publication about the EDI landscape in the Canadian ophthalmology post-secondary programs. The discussed article:

Lee EY, Farrokhyar F, Bakshi N, Levin LA, Ahuja N. Equity, diversity, and inclusion landscape in Canadian postgraduate medical education for ophthalmology. Can J Ophthalmol. 2024 Feb;59(1):31-39. doi: 10.1016/j.jcjo.2022.08.015. Epub 2022 Sep 24. PMID: 36162441.

Dr. Amin Kherani discusses the Clarity study which compares use of intravitreal aflibercept injections versus PRP laser for proliferative diabetic retinopathy. We also briefly discuss DRCR.net protocol S results that compare intravitreal ranibizumab versus PRP laser for the same indication.

Full reference of the Clarity article:

Clinical efficacy of intravitreal aflibercept versus panretinal photocoagulation for best corrected visual acuity in patients with proliferative diabetic retinopathy at 52 weeks (CLARITY): a multicentre, single-blinded, randomised, controlled, phase 2b, non-inferiority trial. Sivaprasad, SobhaBhatnagar, A et al. The Lancet , Volume 389 , Issue 10085 , 2193 - 2203

DOI:10.1016/S0140-6736(17)31193-5

Dr. J. Fernando Arevalo discusses results of an international multicenter study that compared surgical success rates of vitrectomy vs vitrectomy + scleral buckle to repair retinal detachments due to giant retinal tears. The study collected 200 patients data over a 12 year period.

Referenced article:

Ong SS, Ahmed I, Gonzales A, Al-Fakhri AS, Al-Subaie HF, Al-Qhatani FS, Alsulaiman SM, Mura M, Maia M, Kondo Kuroiwa DA, Maia NT, Berrocal MH, Wu L, Zas M, Francos JP, Cubero-Parra JM, Arsiwala LT, Handa JT, Arevalo JF. Vitrectomy versus Vitrectomy with Scleral Buckling in the Treatment of Giant Retinal Tear Related Retinal Detachments: An International Multicenter Study. Ophthalmol Retina. 2022 Jul;6(7):595-606. doi: 10.1016/j.oret.2022.03.004. Epub 2022 Mar 15. PMID: 35304304. 

A panel of guests optometrists share their feedback about communication issues between optometry and the speciality of retina. Guests panelists: Dr. George Papadakis, Dr. Brian Feinstein, Dr. Lena Moiseiykina and Dr. Nagar Sohbati. 

Dr. Sabri discusses his group's analysis of various screening criteria to detect visually significant Retinopathy of Prematurity while minimizing unnecessary retinal exams.

Discussed article:

Sabri K, Shivananda S, Farrokhyar F, Selvitella A, Easterbrook B Kin B, Seidlitz W, Lee SK; Canadian Neonatal Network and the Canadian Association of Pediatric Ophthalmology and Strabismus. Refining evidence-based retinopathy of prematurity screening guidelines: The SCREENROP study. Paediatr Child Health. 2019 Aug 12;25(7):455-466. doi: 10.1093/pch/pxz085. PMID: 33173557; PMCID: PMC7606175.

Dr. Sun discusses Protocol V results that investigated efficacy of 3 treatment approaches for DME in eyes with vision of 20/25 or better: aflibercept injections, focal laser, or observation.

Reference to the publication: 

Baker CW, Glassman AR, Beaulieu WT, Antoszyk AN, Browning DJ, Chalam KV, Grover S, Jampol LM, Jhaveri CD8, Melia M, Stockdale CR, Martin DF, Sun JK; DRCR Retina Network. Effect of Initial Management With Aflibercept vs Laser Photocoagulation vs Observation on Vision Loss Among Patients With Diabetic Macular Edema Involving the Center of the Macula and Good Visual Acuity: A Randomized Clinical Trial. JAMA. 2019 Apr 29. doi: 10.1001/jama.2019.5790.

Dr. Daniel Lavinsky describes the results of a small randomized controlled clinical trial investigating functional and anatomical outcomes of using nondamaging retinal laser for the treatment of macular telangiectasia type II.

The discussed article:

Lavinsky D, Silva MOD, Chaves AE, Schneider WFM, Lavinsky F, Palanker D. FUNCTIONAL AND STRUCTURAL EFFECTS OF NONDAMAGING RETINAL LASER THERAPY FOR MACULAR TELANGIECTASIA TYPE 2: A Randomized Sham-Controlled Clinical Trial. Retina. 2021 Mar 1;41(3):487-494. doi: 10.1097/IAE.0000000000002882. PMID: 33370517.

Dr. Landon Rohowetz discusses his group's findings of a retrospective analysis of the characteristics of Retinal Detachment cases that were associated with Retinal Dialysis. 

Discussed article:

Rohowetz LJ, Jabbehdari S, Smiddy WE, Berrocal AM, Townsend JH, Chang JS, Yannuzzi N, Sridhar J, Haddock LJ, Fortun JA, Flynn HW Jr; Retinal Dialysis Study Group. Retinal Detachment Associated with Retinal Dialysis: Clinical Features and Outcomes of Surgery in a 10-Year Study. Ophthalmol Retina. 2023 Oct;7(10):857-861. doi: 10.1016/j.oret.2023.06.013. Epub 2023 Jun 26. PMID: 37379884; PMCID: PMC10592222.

Dr. Sarraf talks about his group's work on the correlation of PED size and variablity and the visual improvement during the treatment of neovascular AMD as analyzed using data from HAWK and HARRIER studies.

Referenced article:  Sarraf D, Khanani AM, Sadda SR, Chang A, Wong DT, Kempf AS, Saffar I, Tang S, Tadayoni R. PIGMENT EPITHELIAL DETACHMENT THICKNESS AND VARIABILITY AFFECTS VISUAL OUTCOMES IN PATIENTS WITH NEOVASCULAR AGE-RELATED MACULAR DEGENERATION. Retina. 2024 Jan 1;44(1):10-19. doi: 10.1097/IAE.0000000000003935. PMID: 37824807.

Dr. M. Ali Khan describes his article on the long term outcomes of 27-gauge vitrectomy for 390 eyes.

Full reference of the articles is:

Khan, M. A., Kuley, A., Riemann, C. D., Berrocal, M. H., Lakhanpal, R. R., Hsu, J., . . . Regillo, C. D. (2017). Long-Term Visual Outcomes and Safety Profile of 27-Gauge Pars Plana Vitrectomy for Posterior Segment Disease. Ophthalmology. doi:10.1016/j.ophtha.2017.09.013

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Dr. Mark Gillies from Sydney, Australia discusses 2-year results of the RIVAL Study which investigated rates of geographic atrophy and visual acuity changes in patients with wet AMD.

Full reference: 

Gillies, M. C., Hunyor, A. P., Arnold, J. J., Guymer, R. H., Wolf, S., Ng, P., . . . McAllister, I. L. (2019). Effect of Ranibizumab and Aflibercept on Best-Corrected Visual Acuity in Treat-and-Extend for Neovascular Age-Related Macular Degeneration: A Randomized Clinical Trial. JAMA Ophthalmol. doi:10.1001/jamaophthalmol.2018.6776

Dr. Xuejing Chen discusses her group's retrospective analysis of the incidence and risk factors of delayed retinal breaks following a symptomatic posterior vitreous detachment.

Discussed article:

Jindachomthong KK, Cabral H, Subramanian ML, Ness S, Siegel NH, Chhablani J, Hsu SX, Chen X. Incidence and risk factors for delayed retinal tears following an acute, symptomatic posterior vitreous detachment. Ophthalmol Retina. 2022 Oct 25:S2468-6530(22)00514-0. doi: 10.1016/j.oret.2022.10.012. Epub ahead of print. PMID: 36307014.

Dr. Richard Rosen discusses a review of perfusion density changes (measured by OCT-Angiography) as measured before and immediately after intravitreal injections. 

Full reference of the article:

Barash, A., Chui, T. Y. P., Garcia, P., & Rosen, R. B. (2019). Acute Macular and Peripapillary Angiographic Changes with Intravitreal Injections. Retina. doi:10.1097/IAE.0000000000002433

Prof. Gemmy Cheung from the National University of Singapore and Singapore National Eye Center discusses her research results on progression of Geographic Atrophy on Asian vs non-Asian Eyes.

References Article:

Teo KYC, Fujimoto S, Sadda SR, Kokame G, Gomi F, Kim JE, Cheng MFS, Corradetti G, Amornpetchsathaporn A, Chainakul M, Lee WK, Lai TYY, Ruamviboonsuk P, Cheung CMG. Geographic Atrophy Phenotypes in Subjects of Different Ethnicity: Asia-Pacific Ocular Imaging Society Work Group Report 3. Ophthalmol Retina. 2023 Jul;7(7):593-604. doi: 10.1016/j.oret.2022.12.013. Epub 2022 Dec 28. PMID: 36586466.

Dr. Smiddy presents a cost analysis of the step therapy for treatment of diabetic macular edema based on DRCR protocol AC results.

Discussed article:

Patel NA, Al-Khersan H, Yannuzzi NA, Lin J, Smiddy WE. Aflibercept Monotherapy versus Bevacizumab-First for Diabetic Macular Edema: A Cost Analysis Based on Diabetic Retinopathy Clinical Research Network Protocol AC Results. Ophthalmol Retina. 2023 May;7(5):413-419. doi: 10.1016/j.oret.2022.11.010. Epub 2022 Nov 22. PMID: 36423893.

Dr. Jay Duker speaks about the results of the DAVIO trial which was a phase 1 trial investigating an intravitreal implant (EYP-1901) containg vorolanib (a VEGF and receptor blocker) in a bioerodible Durasert implant for the treatment of wet AMD. 

Dr. Sridhar (host of the Straight from the Cutter's Mouth podcast) discusses his recent article on the trends of women's representation in VR meetings in the US between 2015 and 2019.

The discusses article: 

Sridhar J, Kuriyan AE, Yonekawa Y, Berrocal A, Khan MA, Chan RVP, Haller JA. Representation of Women in Vitreoretinal Meeting Faculty Roles from 2015 through 2019. Am J Ophthalmol. 2021 Jan;221:131-136. doi: 10.1016/j.ajo.2020.09.001. Epub 2020 Sep 9. PMID: 32918901; PMCID: PMC7736466.

Dr. Jason Hsu from Wills Eye Hospital returns to The Retina Channel to discuss his groups' retrospective study of eyes with advanced retinal detachement (PVR grade C or worse) that underwent retinectomy without lensectomy. Their study showed that 75% of these eyes at 3 months (and 68% at 6 months) had single surgery anatomic success. The study is suggestive that lensectomy and even peripheral vitreous base sheving may not be necessary when doing retinectomy for advanced RD cases. 

Full reference to the article:

Mahmoudzadeh R, Mokhashi N, Anderson H, Patel S, Salabati M, Chiang A, Kuriyan AE, Gupta OP, Mehta S, Garg SJ, Hsu J. Outcomes of Retinectomy without Lensectomy in Rhegmatogenous Retinal Detachments with Proliferative Vitreoretinopathy. Ophthalmol Retina. 2023 Jan;7(1):52-58. doi: 10.1016/j.oret.2022.07.008. Epub 2022 Aug 5. PMID: 35940476.

Dr. Raj Maturi from DRCR.net discusses final results of the DRCR.net protocol U, which investigated addition of Dexamethasone implant to ranibizumab for the treatment of persistent diabetic macular edema. The full reference of the article is:

Maturi, R. K., Glassman, A. R., Liu, D., Beck, R. W., Bhavsar, A. R., Bressler, N. M., . . . Diabetic Retinopathy Clinical Research, N. (2017). Effect of Adding Dexamethasone to Continued Ranibizumab Treatment in Patients With Persistent Diabetic Macular Edema: A DRCR Network Phase 2 Randomized Clinical Trial. JAMA Ophthalmol. doi:10.1001/jamaophthalmol.2017.4914

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Dr. Charlie Wykoff describes the treat-and-extend (TREX) approach for the treatment of wet AMD. He then explains the study design and the 3-year results of the TREX-AMD trial. The full reference of the article is:

Wykoff, C. C., Ou, W. C., Croft, D. E., Payne, J. F., Brown, D. M., Clark, W. L., . . . Group, T.-A. S. (2017). Neovascular age-related macular degeneration management in the third year: final results from the TREX-AMD randomised trial. Br J Ophthalmol. doi:10.1136/bjophthalmol-2017-310822

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Professors Sahel and Roska describe partial visual recovery of a patient with advanced RP using optogenetic technology. 

Discussed article:

Sahel JA, Boulanger-Scemama E, Pagot C, Arleo A, Galluppi F, Martel JN, Esposti SD, Delaux A, de Saint Aubert JB, de Montleau C, Gutman E, Audo I, Duebel J, Picaud S, Dalkara D, Blouin L, Taiel M, Roska B. Partial recovery of visual function in a blind patient after optogenetic therapy. Nat Med. 2021 Jul;27(7):1223-1229. doi: 10.1038/s41591-021-01351-4. Epub 2021 May 24. PMID: 34031601.

Dr. Marc Spirn from Wills Eye Hospital discusses the results of a retrospective study of performing lattice degeneration on a series of patients who had lattice degeneration with high risk features.

The discussed article:

Kazan AS, Mahmoudzadeh R, Salabati M, Sharpe J, Fineman MS, Hsu J, Yonekawa Y, Spirn MJ. Indications and Outcomes of Laser Retinopexy in Eyes With High-Risk Lattice Degeneration. J Vitreoretin Dis. 2024 Apr 25;8(4):381-387. doi: 10.1177/24741264241248253. PMID: 39148566; PMCID: PMC11323511.

Dr. David Sarraf from UCLA discusses Paracentral Acute Middle Maculopathy (PAMM) and its the ischemic implications. 

Discussed article:

Wang D, Au A, Duker JS, Sarraf D. PAMM and the ischemic cascade associated with radiation retinopathy. Am J Ophthalmol Case Rep. 2020 Sep 8;20:100918. doi: 10.1016/j.ajoc.2020.100918. PMID: 32984654; PMCID: PMC7495006.

Dr. Jhavery discusses results of DRCR Retina Protocol AC study which compared DME response to anti-VEGF injections in patients who received Aflibercept monotherapy vs those who started with Bevacizumab first and then switched to Aflibercept if needed. 

Discussed article:

Jhaveri CD, Glassman AR, Ferris FL 3rd, Liu D, Maguire MG, Allen JB, Baker CW, Browning D, Cunningham MA, Friedman SM, Jampol LM, Marcus DM, Martin DF, Preston CM, Stockdale CR, Sun JK; DRCR Retina Network. Aflibercept Monotherapy or Bevacizumab First for Diabetic Macular Edema. N Engl J Med. 2022 Aug 25;387(8):692-703. doi: 10.1056/NEJMoa2204225. Epub 2022 Jul 14. PMID: 35833805.

Dr. Finn discusses her groups' case series on temporal associattion CRVO and HRVO in young healthy patients after COVID-19 infection.

Discussed article:

Ashkenazy N, Patel NA, Sridhar J, Yannuzzi NA, Belin PJ, Kaplan R, Kothari N, Benitez Bajandas GA, Kohly RP, Roizenblatt R, Pinhas A, Mundae R, Rosen RB, Ryan EH Jr, Chiang A, Chang LK, Khurana RN, Finn AP. Hemi- and Central Retinal Vein Occlusion Associated with COVID-19 Infection in Young Patients without Known Risk Factors. Ophthalmol Retina. 2022 Jun;6(6):520-530. doi: 10.1016/j.oret.2022.02.004. Epub 2022 Mar 10. PMID: 35278727; PMCID: PMC8907133.

Dr. Philip Hykin discusses the LEAVO trial which was a large prospective trial comparing the efficacy of three main anti-VEGF intravitreal injections (bevacizumab, ranibizumab and aflibercept) for treating macular edema secondary to Central Retinal Vein Occlusion.

The discussed article:

Clinical Effectiveness of Intravitreal Therapy With Ranibizumab vs Aflibercept vs Bevacizumab for Macular Edema Secondary to Central Retinal Vein Occlusion: A Randomized Clinical Trial.

Hykin P, Prevost AT, Vasconcelos JC, Murphy C, Kelly J, Ramu J, Hounsome B, Yang Y, Harding SP, Lotery A, Chakravarthy U, Sivaprasad S; LEAVO Study Group. JAMA Ophthalmol. 2019 Aug 29. doi:10.1001/jamaophthalmol.2019.3305.

Dr. Tina Felfeli discusses 3 articles around COVID-19 and ophthalmology: (1) Effect of various concretions and exposure times of common ophthalmology anti-septics on COVID-19 infected cell lines. (2) Effect of the pandemic on the backlog of elective ophthalmic surgical cases in the province of Ontario, Canada (3) Detection of the COVID-19 virus in different ocular tissues of a patient that tested positive for COVID-19. 

Referenced articles:

1. Felfeli T, Kasloff SB, Krishnan J, El-Defrawy SR, Mazzulli T, Cutts TA. In vitro efficacy of topical ophthalmic antiseptics against SARS-CoV-2. BMJ Open Ophthalmol. 2021 Jun 9;6(1):e000765. doi: 10.1136/bmjophth-2021-000765. PMID: 34192157; PMCID: PMC8190983.
2. Predicting the Ophthalmic Surgical Backlog as a Result of the COVID-19 Pandemic: A population-based study and microsimulation model to inform surgical recovery plans
   Tina Felfeli, Raphael Ximenes, David MJ Naimark, Philip L Hooper, Robert J Campbell, Sherif R El-Defrawy, Beate Sander, the COVID-19 Mod Collab
   medRxiv 2021.03.25.21254375; doi:https://doi.org/10.1101/2021.03.25.21254375
3. Felfeli T, Mazzulli T, Clark ST, El-Defrawy SR, Chan CC. SARS-CoV-2 Not Detectable in Ocular Specimens of a Patient with a Past Infection. Ocul Immunol Inflamm. 2021 Apr 7:1-3. doi: 10.1080/09273948.2021.1894458. Epub ahead of print. PMID: 33826479.

Dr. Jennifer Sun discusses 5-year results of DRCR.net Protocol S that investigated outcomes of treatment of proliferative diabetic retinopathy using traditional PRP laser vs intravitreal ranibizumab injections. 

Full reference:

Gross, J. G., Glassman, A. R., Liu, D., Sun, J. K., Antoszyk, A. N., Baker, C. W., . . . Diabetic Retinopathy Clinical Research, N. (2018). Five-Year Outcomes of Panretinal Photocoagulation vs Intravitreous Ranibizumab for Proliferative Diabetic Retinopathy: A Randomized Clinical Trial. JAMA Ophthalmol. doi:10.1001/jamaophthalmol.2018.3255

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Dr. Ozkok describes his publication on the association of Red Blood Cells Distribution Width (RDW) and vision in patients with Central or Branch Retina Vein Occlusion. 

Full Reference of the article:

Ozkok, A., Nesmith, B. L. W., & Schaal, S. (2018). Association of Red Cell Distribution Width Values with Vision Potential in Retinal Vein Occlusion. Ophthalmology Retina, 2(6), 582-586. doi:10.1016/j.oret.2017.09.018

Drs. Muni and Hillier discuss the results of the PIVOT study that prospectively compared results of pneumatic retinopexy vs. pars plana vitrectomy for repair of rhegmatogenous retinal detachment.

This podcast episode is simulcast with the online appearance of the article. 

Full reference:

Hillier, R. J., Felfeli, T., Berger, A. R., Wong, D. T., Altomare, F., Dai, D., . . . Muni, R. H. (2018). The Pneumatic Retinopexy versus Vitrectomy for the Management of Primary Rhegmatogenous Retinal Detachment Outcomes Randomized Trial (PIVOT). Ophthalmology. doi:10.1016/j.ophtha.2018.11.014

Dr. Arthur sit describes his surprising research results on the effect of scleral buckle on ocular fluid dynamics.

The discussed article: Lyons LJ, Kazemi A, Bakri SJ, Barkmeier AJ, Iezzi R, Olsen TW, Hodge DO, Sit AJ. The Effect of Scleral Buckle Surgery on Tonographic Outflow Facility, Positional Intraocular Pressure, and Ocular Biomechanics. Ophthalmol Glaucoma. 2024 Jan-Feb;7(1):1-7. doi: 10.1016/j.ogla.2023.07.007. Epub 2023 Jul 22. PMID: 37482122.

Dr. Robert Devenyi discusses the 5-year safety and performance results of the Argus II retinal prosthesis implant. He also share his own experience with the device including surgical steps and patient outcomes. The episode logo reflects the retinal images of the 11 devices that he has implanted so far.

The full reference of the article is:

da Cruz, L., et al. (2016). "Five-Year Safety and Performance Results from the Argus II Retinal Prosthesis System Clinical Trial." Ophthalmology 123(10): 2248-2254.

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Professor Robyn Guymer from Melbourne, Australia discusses results of the LEAD trial that investigated the use of nanopulase laser for dry AMD.

Full reference of the article:

Guymer, R. H., Wu, Z., Hodgson, L. A. B., Caruso, E., Brassington, K. H., Tindill, N., . . . Laser Intervention in Early Stages of Age-Related Macular Degeneration Study, G. (2018). Subthreshold Nanosecond Laser Intervention in Age-Related Macular Degeneration: The LEAD Randomized Controlled Clinical Trial. Ophthalmology. doi:10.1016/j.ophtha.2018.09.015

Dr. Peter Kertes discusses the publication of the first year results of the CANTREAT study that investigates monthly vs treat-and-extend dosing of ranibizumab for wet AMD. 

Full reference:

Kertes, P. J., Galic, I. J., Greve, M., Williams, R. G., Rampakakis, E., Scarino, A., & Sheidow, T. (2019). Canadian Treat and Extend Analysis Trial with Ranibizumab in Patients with Neovascular Age-related Macular Disease: 1-Year Results of the Randomized CANTREAT Study. Ophthalmology. doi:10.1016/j.ophtha.2019.01.013

Dr. Kourous Rezaei reviews the results of the GATHER1 trial on complement C5 inhibition for slowing down progression of geography atrophy in dry AMD.

References article:

Jaffe GJ, Westby K, Csaky KG, Monés J, Pearlman JA, Patel SS, Joondeph BC, Randolph J, Masonson H, Rezaei KA. C5 Inhibitor Avacincaptad Pegol for Geographic Atrophy Due to Age-Related Macular Degeneration: A Randomized Pivotal Phase 2/3 Trial. Ophthalmology. 2021 Apr;128(4):576-586. doi: 10.1016/j.ophtha.2020.08.027. Epub 2020 Sep 1. PMID: 32882310.

Dr. Seider elaborates on his group's large retrospective study on rates and risk factors for complicated acute posterior vitreous detachment.

Full reference to the discussed article:

Seider MI, Conell C, Melles RB. Complications of Acute Posterior Vitreous Detachment. Ophthalmology. 2021 Jul 27:S0161-6420(21)00552-2. doi: 10.1016/j.ophtha.2021.07.020. Epub ahead of print. PMID: 34324945.

Dr. Jabs and Dr. Acharya discuss the results of the MERIT trial that investigated relative efficacy of intrvitreal injections of Dexamethasone implant vs ranibizumab vs methotrexate for the treatment of macular oedema associated with uveitis. Discussed article:

Multicenter Uveitis Steroid Treatment Trial (MUST) Research Group, Writing Committee:; Acharya NR, Vitale AT, Sugar EA, Holbrook JT, Burke AE, Thorne JE, Altaweel MM, Kempen JH, Jabs DA. Intravitreal Therapy for Uveitic Macular Edema-Ranibizumab versus Methotrexate versus the Dexamethasone Implant: The MERIT Trial Results. Ophthalmology. 2023 Sep;130(9):914-923. doi: 10.1016/j.ophtha.2023.04.011. Epub 2023 Jun 13. PMID: 37318415; PMCID: PMC10524707.

Drs. Lee and Apte discuss their recent paper on our current understanding of using retinal imaging biomarkers to evaluate Alzheimer's disease.

Discussed article:

Lee CS, Apte RS, Retinal Biomarkers of Alzheimer’s Disease, American Journal of Ophthalmology (2020), doi: https://doi.org/10.1016/j.ajo.2020.04.040.

Dr. Jason Hsu discusses the review of patients with PDR who were lost to followup after limited anti-VEGF or PRP treatment and returned for treatment after at least 6 mo.

Full reference:

Obeid, A., Su, D., Patel, S. N., Uhr, J. H., Borkar, D., Gao, X., . . . Hsu, J. (2018). Outcomes of Eyes Lost to Follow-up with Proliferative Diabetic Retinopathy That Received Panretinal Photocoagulation versus Intravitreal Anti-Vascular Endothelial Growth Factor. Ophthalmology. doi:10.1016/j.ophtha.2018.07.027

Dr. Tamer Mahmoud discusses an innovative surgical method for closure of refractory macular holes using autologous retinal transplants. 

Full reference of the discusses article:

Grewal, D. S., Charles, S., Parolini, B., Kadonosono, K., & Mahmoud, T. H. (2019). Autologous Retinal Transplant for Refractory Macular Holes: Multicenter International Collaborative Study Group. Ophthalmology. doi:10.1016/j.ophtha.2019.01.027

Dr. Kokame from the University of Hawaii reports a novel method of repairing certain types of retinal detachment using minimized eye movement followed by laser retinopexy. Referenced article:

Kokame GT, Yee S, Omizo JN, Villanueva L, Liu J. Laser Treatment after Minimized Eye Movement for Repair of Retinal Detachment. Ophthalmol Retina. 2021 Sep;5(9):939-941. doi: 10.1016/j.oret.2021.01.014. Epub 2021 Jan 30. PMID: 33529816.

Dr. Witkin from the American Society of Retina Specialists talks about our current knowledge of the incidence of retinal vasculitis following intravitreal injection of Pegcetacoplan for treatment of geographic atrophy.

Discussed article:

Witkin AJ, Jaffe GJ, Srivastava SK, Davis JL, Kim JE. Retinal Vasculitis After Intravitreal Pegcetacoplan: Report From the ASRS Research and Safety in Therapeutics (ReST) Committee. J Vitreoretin Dis. 2023 Dec 21;8(1):9-20. doi: 10.1177/24741264231220224. Erratum in: J Vitreoretin Dis. 2024 Feb 29;8(3):363. doi: 10.1177/24741264241238212. PMID: 38223782; PMCID: PMC10786078.

Dr. Dugel discusses 1 and 2 year results of HAWK and HARRIER on Brolucizumab for neovascular AMD. 

Full reference: 

Dugel, P. U., Koh, A., Ogura, Y., Jaffe, G. J., Schmidt-Erfurth, U., Brown, D. M., . . . Investigators, H. S. (2019). HAWK and HARRIER: Phase 3, Multicenter, Randomized, Double-Masked Trials of Brolucizumab for Neovascular Age-Related Macular Degeneration. Ophthalmology. doi:10.1016/j.ophtha.2019.04.017

Dr. Regillo describes the results of the phase 3 prospective study of Ranibizumab Port Delivery System (PDS) for the treatment of neovascular AMD. 

Reference Article:

Regillo C, Berger B, Brooks L, Clark WL, Mittra R, Wykoff CC, Callaway NF, DeGraaf S, Ding HT, Fung AE, Gune S, Le Pogam S, Smith R, Willis JR, Barteselli G. Archway Phase 3 Trial of the Port Delivery System with Ranibizumab for Neovascular Age-Related Macular Degeneration 2-Year Results. Ophthalmology. 2023 Jul;130(7):735-747. doi: 10.1016/j.ophtha.2023.02.024. Epub 2023 Mar 2. PMID: 36870451.

Full article:

Catomeris AJ, Ballios BG, Sangermano R, Wagner NE, Comander JI, Pierce EA, Place EM, Bujakowska KM, Huckfeldt RM. Novel RCBTB1 variants causing later-onset non-syndromic retinal dystrophy with macular chorioretinal atrophy. Ophthalmic Genet. 2022 Jan 20:1-8. doi: 10.1080/13816810.2021.2023196. Epub ahead of print. PMID: 35057699.

Dr. Shildkrot discusses progression of glaucomatous changes in 28 eyes that were receiving anti-VEGF injections.

Discussed article:

Effects of Intravitreal Anti-VEGF Therapy on Glaucoma-like Progression in Susceptible Eyes, Du, Jeanette MD; Patrie, James T ; Prum, Bruce E.; Netland, Peter A.; Shildkrot, Yevgeniy (Eugene) MD,  Journal of Glaucoma: December 2019 - Volume 28 - Issue 12 - p 1035-1040

doi: 10.1097/IJG.0000000000001382

Dr. Birger Lindtjørn from Norway discusses his team's prospective trial on comparison of SF6 vs air tamponade in vitrectomy for closure of small-medium macular holes.

Discussed article:

Lindtjørn B, Krohn J, Haugstad M, Stene-Johansen I, Austeng D, Basit S, Fossen K, Varhaug P, Kvaløy JT, Forsaa VA. Air versus Sulfur Hexafluoride Gas Tamponade for Small and Medium-Sized Macular Holes: A Randomized Noninferiority Trial. Ophthalmol Retina. 2022 Apr 7:S2468-6530(22)00179-8. doi: 10.1016/j.oret.2022.04.003. Epub ahead of print. PMID: 35398546.

Dr. Charles Wykoff discusses results of DRCR protocol T ancillary study on plasma free VEGF concentrations after different intravitreal anti-VEGF injections for diabetic macular edema.

Full reference of the discussed article:

Jampol, L. M., A. R. Glassman, D. Liu, L. P. Aiello, N. M. Bressler, E. J. Duh, S. Quaggin, et al. "Plasma Vascular Endothelial Growth Factor Concentrations after Intravitreous Anti-Vascular Endothelial Growth Factor Therapy for Diabetic Macular Edema." Ophthalmology  (Mar 7 2018).

Dr. Koh from Singapore National University Hospital discusses his team's simulation study on aerosol transmission through slit lamp shields and face masks. 

Discussed article: 

Chuan OS, Bin Razali MA, Shaffiee L, Xing YJ, Yin Fei TT, Chee LS, Koh V, Do slit lamp shields and face masks protect ophthalmologists amidst COVID-19?, Ophthalmology (2020), doi: https://doi.org/10.1016/j.ophtha.2020.06.031.

Dr. David Almeida discusses the result of his group's large retrospective analysis of management and outcomes of 40 cases of endophthalmitis from over 258,000 intravitreal anti-VEGF injections. 

Full reference:

Xu, K., Chin, E. K., Bennett, S. R., Williams, D. F., Ryan, E. H., Dev, S., . . . Almeida, D. R. P. (2018). Endophthalmitis after Intravitreal Injection of Vascular Endothelial Growth Factor Inhibitors: Management and Visual Outcomes. Ophthalmology. doi:10.1016/j.ophtha.2018.01.022

Dr. Schrag discusses his publication on the prevalence of cardiovascular risk factors in patients who present with Central Retinal Artery Occlusion.

Discussed article:

Lavin, P., Patrylo, M., Hollar, M., Espaillat, K. B., Kirshner, H., & Schrag, M. (2018). Stroke Risk and Risk Factors in Patients With Central Retinal Artery Occlusion. Am J Ophthalmol, 196, 96-100. doi:10.1016/j.ajo.2018.08.027

Wu Z, Kumar H, Hodgson LAB, Guymer RH. Reticular Pseudodrusen on the Risk of Progression in Intermediate Age-Related Macular Degeneration. Am J Ophthalmol. 2022 Mar 11:S0002-9394(22)00101-5. doi: 10.1016/j.ajo.2022.03.007. Epub ahead of print. PMID: 35288077.

Dr. Raj Maturi from the DRCR Retina Network discusses effect of early anti-VEGF injections in moderate-severe NPDR to prevent vision-threatening complications of diabetic retinopathy. This is the 2-year results of a 4-year study.  

Discussed article:

Maturi RK, Glassman AR, Josic K, Antoszyk AN, Blodi BA, Jampol LM, Marcus DM, Martin DF, Melia M, Salehi-Had H, Stockdale CR, Punjabi OS, Sun JK; DRCR Retina Network. Effect of Intravitreous Anti-Vascular Endothelial Growth Factor vs Sham Treatment for Prevention of Vision-Threatening Complications of Diabetic Retinopathy: The Protocol W Randomized Clinical Trial. JAMA Ophthalmol. 2021 Mar 30:e210606. doi: 10.1001/jamaophthalmol.2021.0606. Epub ahead of print. PMID: 33784735; PMCID: PMC8010644.

Dr. Zicarelli discusses his group's 10-yr retrospective analysis on the prognostic factors associated with Peripheral exudative hemorrhagic chorioretinpathy. 

Discussed article:

Zicarelli F, Preziosa C, Staurenghi G, Pellegrini M. Peripheral exudative haemorrhagic chorioretinopathy: a widefield imaging study. Br J Ophthalmol. 2020 Sep 3:bjophthalmol-2020-317083. doi: 10.1136/bjophthalmol-2020-317083. PMID: 32883656