Review of Ophthalmology

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Review of Ophthalmology

News, information & other items of interest from the editors of Review of Ophthalmology.

Review of Ophthalmology highlights current, clinically relevant information on surgical techniques, disease diagnosis and management and new technologies. Its physician and staff editors present timely reports in a format that stresses accessible editorial information and graphics, including news, regulatory issues, ophthalmic sub-specialties such as glaucoma, retina, refractive surgery, cornea an

d external disease, pediatric ophthalmology and oculoplastics, as well as coverage of practice management, contact lenses and optical.

10/01/2024

Join Drs. Amr Kouchouk and Casey Claypool for an Educational Webinar on Dry Eye Disease. https://na.eventscloud.com/website/72729/

09/30/2024

New Technis Odyssey IOL for Better Distance Vision
Johnson & Johnson says the next-generation intraocular lens offers higher tolerance to residual refractive errors and a continuous full range of vision. In the company-led study, 93% of patients became free from glasses at all distances and reported no or mild halos, glare or starbursts one month after surgery.

Compared to J&J’s PanOptix IOL, the Technis Odyssey offers a 14% smaller readable print size.

For more information, go to https://www.prnewswire.com/news-releases/johnson--johnson-rolls-out-new-tecnis-odyssey-next-generation-intraocular-lens-offering-cataract-patients-precise-vision-at-every-distance-in-any-lighting-302261636.html

09/30/2024

An Update on Dead Bag Syndrome
The cause of this rare presentation is still a mystery, but many are dedicated to its continued research.

Intraocular lens dislocation may be rare, but it’s a scenario every cataract surgeon prepares for. Late in-the-bag dislocation has been linked to pseudoexfoliation syndrome, uveitis, myopia and other diseases, and surgeons are trained in management strategies that include IOL exchange or suturing techniques.1 Not all cases are so easily explained, however. What if a patient presents with a late dislocated IOL and none of the typical conditions appear to be a contributing factor?

This could be “dead bag syndrome.” Read more in the latest Refractive/Cataract Rundown: https://www.reviewofophthalmology.com/article/an-update-on-dead-bag-syndrome

09/27/2024

A Review of Tyrosine Kinase Inhibitors
A look at the mechanism of action and results for a new kind of VEGF inhibitor in the pipeline.

So, what are Tyrosine Kinase Inhibitors? The VEGF family includes VEGF A, B, C, D and E, as well as placental growth factor (P1GF), which bind to different forms of VEGF receptors (VEGFR) that have been identified. These include VEGFR 1, 2 and 3. The most important players in angiogenesis are VEGF-A and its receptors VEGFR-1 (fms-like tyrosine kinase-1 or Flt-1) and 2 (kinase insert domain-containing receptor or KDR), both receptor tyrosine kinases (RTK). This family of receptors has been implicated in angiogenesis, tumorigenesis and metastasis. P1GF can also play a role through synergism with VEGF in pathological conditions, thus increasing angiogenesis and plasma extravasation.

Read more on TKIs: https://www.reviewofophthalmology.com/article/a-review-of-tyrosine-kinase-inhibitors

09/25/2024

Diabetes May Lessen the Effect Of Anti-VEGF Therapy in AMD

Researchers of a recent study report that during anti-VEGF therapy, macular neovascularization lesion size continued to decrease in the non-diabetic group over the course of 12 months, but had a smaller decrease in the diabetic group, suggesting the disease may be a risk factor to consider during anti-angiogenic treatment.

Read more: https://www.reviewofophthalmology.com/article/diabetes-may-lessen-the-effect-of-antivegf-therapy-in-amd

09/23/2024

September 2024 Wills Eye Resident Case Series
A 78-year-old man presents to the Wills Eye ER after seeing “strobe lights” followed by progressively blurred vision in both eyes over a one-week period.

The patient’s past ocular history was pertinent for a remote history of cataract surgery in both eyes. His medical history was notable for hyperlipidemia, hypothyroidism, gastroesophageal reflux disease, hypertension, spinal stenosis relieved after a lumbar laminectomy, chronic urinary tract infections and bladder incontinence. Previous investigation of his urinary symptoms revealed a high-grade urothelial carcinoma with lymph node involvement diagnosed one year before ophthalmic presentation. His urothelial cancer was treated with a right nephroureterectomy and three cycles of adjuvant chemotherapy with dose-dense methotrexate, vinblastine, doxorubicin and cisplatin (ddMVAC). He was most recently treated with a single dose of maintenance pembrolizumab therapy, just one month prior to presentation.

Read the full work-up for this case: https://www.reviewofophthalmology.com/article/september-2024-wills-eye-resident-case-series

Wills Eye Hospital

09/20/2024

Navigating Challenging Cataract Cases
Get a review of cataract surgery challenges that range from the immediately obvious to the seemingly imperceptible. From trauma-induced issues decades in the making to a failure to achieve what seemed like easily attainable postop goals. Plus, a capsule tear in a shallow anterior chamber at the worst possible time. All of these dilemmas were eventually resolved. Here’s how.

Read here: https://www.reviewofophthalmology.com/article/navigating-challenging-cataract-cases

09/19/2024

Join Drs. .brimer.7 and Gregg Berdy for an Educational Webinar on Dry Eye Disease. https://na.eventscloud.com/website/72729/

09/18/2024

EHR: Is It Time to Make the Switch?
Transitioning to a new EHR system can be a time-consuming and challenging process. In this recent feature, those with experience offer advice on how to make it go as smoothly as possible.

Read here: https://www.reviewofophthalmology.com/article/ehr-is-it-time-to-make-the-switch

09/16/2024

Cobalt blue light excites the fluorescein in order to view dry eye signs and symptoms. Anat Galor, MD (University of Miami Health System in Florida) uses this form of staining to locate and characterize corneal epithelial staining, highlight tear stability, assess for anatomic abnormalities and highlight the tear lake.

Get more tips on dry eye examination + diagnosis in this feature from our latest issue, “More Than Meets the Dry Eye.” Read now at www.reviewofophthalmology.com 📖

09/16/2024

More Than Meets the Dry Eye
Experts share their examination methods and tools when diagnosing patients with dry-eye disease.

“We actually do a quick, but comprehensive exam to try to look at contributors of patient symptoms that fall under the umbrella of dry eye,” says Anat Galor, MD, an ophthalmologist from the University of Miami Health System in Florida. “We start with an external exam because conditions of the periocular skin can contribute to dry-eye symptoms, such as rosacea and other types of dermatitis. Then, we look at the eyelids and eyelashes because things like anterior and posterior blepharitis can impact symptoms. Then, we look at tear stability, tear production and epithelial disruption. And at the same time, we’re looking for any lumps or bumps, whether it’s on the conjunctiva, such as a pinguecula or pterygium on the cornea, like Salzmann’s nodular degeneration, because any anatomical issue can lead to symptoms of dryness.

Keep reading: https://www.reviewofophthalmology.com/article/more-than-meets-the-dry-eye

09/14/2024

Spruce Up Your DED Algorithm
Several new treatments are available now. Here’s how experts are integrating them into their dry-eye management.

Innovation in the dry-eye space has taken off over the last few decades, and now ophthalmologists have more options than ever before for treating patients’ dry-eye disease. “It’s an amazing time to be a specialist in this area because there are so many different therapeutic options available to handle the complexity and variety of the ocular surface issues we encounter on a day-to-day basis in the clinic,” says Christopher Starr, MD, FACS, a cornea and cataract/refractive specialist at Weill Cornell Medicine in New York. “As new treatments get FDA approved and become available, I try to incorporate them into my personal algorithm.”

Read this September feature here: https://www.reviewofophthalmology.com/article/spruce-up-your-ded-algorithm

09/12/2024

The annual Review of Cornea & External Disease supplement is now live on our website! The 2024 edition features these four articles from our experts:

🔹A Review of Photorefractive Keratectomy
🔹What is New in Artificial Corneas
🔹Corneal Neovascularization and Lipid Keratopathy
🔹Succeeding with DALK

Read now at https://www.reviewofophthalmology.com/publications/review-of-cornea-and-external-disease-2024.

09/10/2024

This just in: The September issue of Review of Ophthalmology is live on our website! 🗞️ Look through the table of contents for an overview of the topics covered by our experts this month.

Read at www.reviewofophthalmology.com. Print subscribers will receive their issues soon in the mail!

09/06/2024

Find out what's new in the ophthalmology marketplace in the Product News column appearing in the August issue. Read about the latest innovations at https://www.reviewofophthalmology.com/article/fda-oks-kahook-dual-blade-for-poag

09/04/2024

Register for an Educational Webinar on Dry Eye Disease with Drs. .brimer.7 and Gregg Berdy! https://na.eventscloud.com/website/72729/

09/02/2024

Managing IOP After Keratoplasty
Tips for how to avoid and reduce high pressures and glaucomatous damage after corneal transplant procedures.

Causes of high IOP and glaucoma after penetrating keratoplasty include angle distortion and collapse of the trabecular meshwork due to tight, long, superficial sutures; large-diameter trephine use; same-sized or undersized grafts; retained viscoelastic; inflammation; steroid response; PAS formation; and exacerbation of pre-existing glaucoma. The last two of these are among the leading causes of increased intraocular pressure or glaucoma following a PKP procedure.

Read more: https://www.reviewofophthalmology.com/article/managing-iop-after-keratoplasty

08/30/2024

Oculoplastics and Cataract Involvement
A discussion of the diseases to address prior to cataract surgery, and the ones that may be able to wait.

There’s a joke that the eyelids get in the way of cataract surgeons operating on the eyeball, but for us as oculoplastic surgeons, the globe gets in the way of operating in the orbit. It’s important for cataract surgeons to be aware of the status of the eyelids when discussing surgery with their patients. If the eyelids aren’t in optimal position or shape, or if the patient has complaints of tearing, it’s important to consider an evaluation to see if there’s an obstruction of the nasolacrimal drainage system, which should be addressed before cataract surgery.

Read more: https://www.reviewofophthalmology.com/article/oculoplastics-and-cataract-involvement

08/28/2024

Let’s talk treatment resistance in wet AMD. While anti-VEGF injections are highly successful at stabilizing visual acuity and slowing progression in patients with wet AMD, there remains a subset of patients who experience inadequate treatment response.

In this August issue feature, experts discuss treatment resistance, how they monitor and treat patients who aren’t responding to the initial therapy & exciting wet AMD therapies on the horizon. Read at www.reviewofophthalmology.com 📖

08/28/2024

Best Practices for Managing RAO
When time is of the essence in a case of RAO, here’s how to best respond with the proper treatment.

Retinal artery occlusions occur due to partial or complete cessation of blood flow through the central or branch retinal arteries. Once the initial vascular event has occurred, the compromised blood supply to the inner retinal layers leads to near immediate ischemia. Cytotoxic edema develops with resultant retinal whitening on fundoscopic examination (image). Subsequently, a period of inflammation occurs in response to the damage. Thereafter, retinal atrophy and thinning develop around six weeks from the initial occlusion.

Continue reading: https://www.reviewofophthalmology.com/article/best-practices-for-managing-rao

$A New Way to Track Refractive OutcomesUse this application to graph outcomes for your refractive surgery procedures.Math...$

08/26/2024

A New Way to Track Refractive Outcomes
Use this application to graph outcomes for your refractive surgery procedures.

Mathieu Gauvin, MD, and Avi Wallerstein, MD, principal investigators from the McGill University Refractive Surgery Research Unit in Quebec, Canada, have developed a free software program called mEYEstro that automatically graphs refractive surgery outcomes.

Read more about mEYEstro and its potential use for refractive surgeons: https://www.reviewofophthalmology.com/article/a-new-way-to-track-refractive-outcomes

08/23/2024

Susvimo Implant to Return to Market Following Recall

After voluntarily recalling Susvimo (ranibizumab injection) in October 2022, Genentech announced last month the reintroduction of the ocular implant for the treatment of wet age-related macular degeneration.

Susvimo is implanted surgically and refilled once every six months with a needle designed specifically for the implant. It was initially approved by the FDA in 2021 for the treatment of wet AMD in eyes with at least two prior anti-VEGF injections.

Read this story and more in the News section of the August issue: https://www.reviewofophthalmology.com/article/susvimo-implant-to-return-to-market-following-recall

08/21/2024

Retinal artery occlusions are a well-known cause of significant visual morbidity. When it comes to retinal artery occlusions, “time is retina,” much like “time is brain” for ischemic stroke.

In the latest Retinal Insider, experts discuss the most recent guidelines regarding workup and evaluation of suspected RAOs and review the current evidence for proposed treatments.

Read now at www.reviewofophthalmology.com or in the August issue of Review of Ophthalmology 📖

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08/21/2024

The Presbyopia Drop Pipeline
For physicians and patients open to pharmaceutical treatments for presbyopia, new options may be arriving soon. Here’s a breakdown of what’s available and what’s to come: https://www.reviewofophthalmology.com/article/the-presbyopia-drop-pipeline

08/19/2024

Treating Wet AMD Patients Who Also Have GA
GA can be treated after wet AMD treatment, concurrently with wet AMD treatment, or not at all.

“Wet AMD is a greater risk to vision, not so much in terms of quantitative impact, but in terms of timeline, meaning that you lose vision more quickly from wet AMD than dry AMD,” explains J. Sebag, MD, who is in practice at the Doheny Eye Institute at UCLA and president of VMR Consulting, in Huntington Beach, California. “Additionally, the evidence supporting the efficacy of treatment for wet AMD is far superior to the evidence supporting the efficacy of geographic atrophy treatment. Yes, treatment slows the rate of GA progression, but there’s no proof that slowing the rate of progression translates to better vision."

Continue reading: https://www.reviewofophthalmology.com/article/treating-wet-amd-patients-who-also-have-ga

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