6^th Global Ophthalmologists Annual Meeting May 16-18, 2016 Osaka, Japan

Biography:

Bonnie Nga Kwan Choy graduated from the Faculty of Medicine, the University of Hong Kong. She subsequently underwent ophthalmology training at a public hospital in Hong Kong. She joined the University of Hong Kong as Clinical Assistant Professor in 2013 to further her academic pursuit, where she can devote more time in researches. She has delivered more than 10 presentations in various regional and international conferences, including invited speeches, since she joined the University. Her research interest is in the field of Glaucoma.

Abstract:

Synopsis: The course will discuss how residents and general ophthalmologists can determine if there is progression of glaucoma, which is essential to aid further management. Assessments including slit lamp biomicroscopy, fundus photo, optical coherence tomography (retinal nerve fibre layer and ganglion cell complex; trend and event analysis) and visual field. Also, situations which make analysis difficult, such as in high myopia will be discussed. Objective: At the conclusion of the course, audience can get an overview of how they can use various techniques to assess glaucoma progression, the advantages and short-coming of each technique, and how they can integrate anatomical and functional assessment to help them derive a decision on when to step up the treatment.

Biography:

Michael Banitt is an Associate Professor of Ophthalmology at the University of Washington and practices clinical ophthalmology in the area of Cornea and external diseases. He has published over 35 articles in peer reviewed journals.

Abstract:

We describe and demonstrate a novel device for insertion of donor tissue during Descemet’s Membrane Endothelial Keratoplasty (DMEK). The device is a double cylinder with air outlet openings on the inner cylinder. Human corneas not suitable for transplantation were prepared using standard “SCUBA” technique for Descemet’s Membrane Endothelial Keratoplasty. While still submerged and the tissue is completely free from the donor stroma, it is gently placed over the inner cylinder of the device and allowed to wrap around it. The device with the donor endothelium is lifted into the air and allowed to coil around the central cylinder completely with the endothelium side out. The protective outer cylinder is slid with respect to the inner cylinder and donor endothelium to cover and protect it while inserting it through the corneal incision. The device has markings to maintain sidedness and location of the tissue. When inside the anterior chamber the outer cylinder is retracted and air is injected through the inner cylinder and through holes which unfolds the graft towards the iris, so the endothelium orients posteriorly. The device is removed from the eye. The last step is commonly performed with DMEK surgery where air is removed from between the graft and the host cornea and then reinjected under the tissue specifically between the iris and the graft. In conclusion, we demonstrate a novel device capable of inserting DMEK donor tissue into an eye atraumatically, maintain the orientation and unfold the tissue, simplifying the major challenging steps of DMEK surgery.

Biography:

Lamberto A. Ilagan Jr MD is an Ophthalmologist from the Philippines. He has completed his Medical Education at the University of Santo Tomas Faculty of Medicine and Surgery. He had his residency training in Ophthalmology at the University of Santo Tomas Hospital. He received his Diplomate Status in Ophthalmology from the Philippine Board of Ophthalmology in 2009. He is a member of the Philippine Academy of Ophthalmology. Currently he is the Head of Division of Ophthalmology in Healthway Medical Greenbelt 5 and is the Current Chairman of the Department of Ophthalmology of Our Lady of Caysasay Medical Center.

Abstract:

This is a case report of an 80 year old female presented with a bleeding hyperpigmented mass over the left upper eyelid. Gradual increase in the size has been observed over 4 years. Prior consult at a tertiary hospital and incision biopsy revealed carcinoma. She was advised surgery but refused and was lost to follow-up. On examination a 5 x 4mm hyperpigmented ulcerated mass was seen on the lateral aspect of the left upper lid. Upon removal of the superficial crust, multiple live maggots were seen swarming within the ulcerated lesion. Impression was Orbital Myasis, left t/c Basal Cell Carcinoma. Intravenous Ampicillin- Sulbactam 250mg/IV every 8 hours and IV Ketorolac 30mg/IV every 8 hours and a single dose of Mebendazole 500mg/tab were given. Orbital MRI was advised however patient refused due to lack of funding. She underwent debridement and biopsy of the lesion with manual extraction of the maggots. Xylocaine spray was observed to immobilize the larvae. Vaselinized (Petroleum Jelly) gauze was placed over the lesion in order for the larvae in deeper tissues to come out. Histopathology confirmed Basal Cell Carcinoma. Orbital Myasis is a rare condition that causes massive tissue destruction and orbital inflammation. Management options consist of mechanical removal of the larvae, antihelminthic therapy, surgical debridement and orbital exentration for extensive lesions

Biography:

Abstract:

Aim: To reduce astigmatism, increase corneal volume and improve visual acuity. Methods: A retrospective, single-surgeon, single centre, clinic-based study of a surgical procedure on twenty-four eyes of fourteen patients diagnosed with stage-III or stage IV keratoconus. Paired arcuate keratotomy coupled with modified circular keratotomy was performed at a single center by a single surgeon as an outpatient procedure with local anesthetic in a minor surgery room. Modified circular keratotomy was performed 7 mm from the papillary centre with depth of incision ranging between 70% and 90% of corneal thickness. Arcuate keratotomy was performed 2.5mm from the papillary centre with the depth of incision at 90% of corneal thickness. Angular length of the arcs ranged between 60° and 120° depending on the astigmatic power of the cornea. Results: Astigmatism decreased in 87.5% of the 24 treated eyes, increased in 8.33% and did not change in 4.17%. Corneal volume increased in 91.66% of the 24 eyes and decreased in 8.34%. Visual acuity improved in 100% of the eyes; there was a mean improvement of 59% from preoperative visual acuity, 8.34% of the treated eyes reaching a visual acuity of 1.0 (20/20) with correction. No complications occurred during or after surgery. No suturing was performed and there was no rupturing at incision sites. There was statistical significance difference between pre-sph against post-sph (P=0.001). Also between pre.cyl against post.cyl (P=0.005), there was no significance difference between pre-axis against post-axis (P=0.05). Conclusion: Paired arcuate keratotomy coupled with modified circular keratotomy should be considered as an intervention before performing keratoplasty.

Biography:

Jennifer Shum Wei Huen obtained her MBBS degree at the University of Hong Kong and is currently a Clinical Assistant Professor at her Alma Mater. Her subspecialty interest lies in glaucoma and had co-authored a book chapter in the field.

Abstract:

Consensual ophthalmotonic reaction (COR) was first described in 1924. Studies following monocular application of glaucoma drops showed a drop in fellow eye intraocular pressure (IOP). However, studies following trabeculoplasty & monocular surgery showed heterogeneous results. The purpose of this study is to 1) investigate COR in Chinese patients who have received monocular filtration surgery. 2) investigate COR in rabbits underoing monocular selective laser trabeculoplasty (SLT) Methods: A retrospective review of filtration surgeries performed in Queen Mary Hospital from 2014-2015 was conducted. IOP in both eyes was documented preoperatively and postoperatively up to 2 weeks. 12 rabbits underwent monocular SLT. IOP was measured over both eyes up to 1week after SLT. Results: COR was observed in Chinese patients undergoing monocular filtration surgery and rabbits receiving monocular SLT.

Biography:

Nidan Qiao has completed his MD at the age of 25 years from Fudan University. He is the neurosurgeon of Huashan Hospital, the largest neurosrugical center in China. He has published 5 papers in reputed journals.

Abstract:

Purpose: Retinal nerve fiber layer (RNFL) will show retrograde degeneration following damage to the optic nerve or the optic tract in patients with pituitary adenoma. RNFL changes after surgery have not been studied thor- oughly in patients with the transsphenoidal surgery and patients with the transcranial surgery. Methods: Thirty-seven patients with pituitary adenoma were recruited from Huashan hospital between September 2010 and July 2014. Patients were divided into two groups: the transsphenoidal group and the transcranial group. Before surgery, 3 and 9 months after surgery, follow-up optic coherence tomography were conducted. Results: Twenty-one patients underwent transsphenoidal surgery and 16 patients underwent transcranial surgery. No obvious difference were observed between these two groups before surgery. The mean RNFL thickness did not change significantly in patients who underwent transsphe- noidal surgery: 91.1 before surgery, 92.7 at 3 months after surgery (p = 0.392) and 92.8 at 9 months after surgery (p = 0.395). The mean RNFL thickness decreased in patients who underwent transcranial surgery: 93.6 before surgery, 86.1 at 3 months after surgery (p = 0.000) and 88.1 at 9 months after surgery (p = 0.005).
Conclusions: In the short time follow-up, there was no change of RNFL thickness in pituitary adenoma patients underwent transsphenoidal surgery, but a decrease in patients underwent transcranial surgery.

Biography:

Sinumol Thulaseedharan has completed her MBBS in 1995, DO in 1998, MS in 1999 from Kerala University, India and DNB in 2000 from National Board. She is presently the Assistant Professor in Govt. Medical College, Thrissur, Kerala. She had won the Best Paper Award in Anterior Segment from Kerala State, Runner up prize in ASCRS Video Film Festival, SFO, 2013 and one among the top 8 scientific video film producers in All India Ophthalmic Conference 2014.

Abstract:

This is a 1-point scleral fixation of IOL in tunnel bed when there is inadequate capsular bag support for the IOL. This technique can be used as a primary procedure when there is a large posterior capsular rent or a bag subluxation. It can be used as a secondary procedure of IOL implantation in aphakias with some capsular support in the opposite sulcus for the other haptic. This is a better option for managing subluxated or dislocated IOLs as we can fixate the same IOL without explanting it. The technique uses the available capsular remnant to support the leading haptic and an easy single scleral fixation suture to support the trailing haptic. Scleral fixation of the trailing haptic with 9-0 prolene is done in the sclera-corneal tunnel bed 0.75mm behind the limbus. There is no need for preparation of separate scleral beds for fixation. This saves time and provides adequate stability for the IOL without much manipulations or complications. This procedure can be done with routine PC IOLs –rigid/ foldable and single piece / three piece IOLs.

Biography:

Debasmita P Alone has completed her PhD from Cytogenetics Laboratory, Banaras Hindu University and Post-doctoral studies at Laboratory of Molecular Biology, National Institute of Mental Health, Bethesda, USA. She is leading the Molecular Genetics Laboratory, School of Biological Sciences, NISER, a premier institute for research and teaching in India. Research focus of her newly found laboratory is on molecular genetics of FECD and Psuedo-exfoliation in India. She has published in reputed Opthalmology journals of Investigative Opthalmology and Visual Science as well as Experimental Eye Research.

Abstract:

Fuchs’ endothelial corneal dystrophy (FECD) is a progressive deteriorative condition of corneal endothelial cells that predominantly affects women and onsets in the fourth to fifth decade of life. As an autosomal dominant and heterogeneous disease, FECD displays a peculiar trait of corneal guttata formation and excrescences from the Descemet membrane (DM) which are clinically detected using specular microscopy. So far, many genes have been attributed to cause this disease, thereby revealing its genetic complexity. With respect to Asian ethnicity, not many studies have been done to elucidate demographic specific genetic contributors for the disease. Transcription factor 4 (TCF4), that encodes for E2-2 protein, a group of E protein transcription factors known for cellular growth and differentiation, is one such gene that has been associated with this disease. Our recent study substantiates the fact that the intronic tri-nucleotide repeat expansion in this gene is a major contributing factor for the disease pathogenesis. In search of other genetic signatures for this disease, our recent findings suggest that intronic polymorphisms in TCF8 and FEN1 genes have strong associations with the disease in Indian population. Ours is the first report to identify a polymorphic marker for TCF8 gene in association with FECD, thereby rendering a stronger genetic load upon TCF8 for being a causative agent for the disease. Association of FEN1 vouches for the role of oxidative stress as one of the contributing aspect for the pathogenesis of FECD.

Biography:

Dr. Praveen Kumar has completed his MBBS from Grant Medical College and Sir J.J. group of Hospitals, Mumbai and MS (Ophthalmology) from Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, India. He is senior resident at JIPMER, an institute of national importance, India. He has published various papers in reputed national and international journals.

Abstract:

Objective: To identify the effects of chronic alcohol and/or tobacco use on retinal nerve fiber layer (RNFL) thickness and to find the association between severity of addiction with RNFL thinning. Design: Case control study at tertiary care centre in southern India. Methodology: Cases included alcohol and/or tobacco users for at least 5 years. Severity of alcohol and tobacco dependence was graded by Alcohol Use Disorders Identification Test (AUDIT) and Fagerstorm Nicotine Dependence (FTND) scale respectively. Age and gender matched individuals without addictions were taken as controls. RNFL thickness was measured using Stratus Optical Coherence Tomography (OCT). Outcome measures: RNFL thinning by OCT. Statistical analysis: Differences in RNFL thickness between cases and controls were analysed using Mann-Whitney test. Statistical significance was considered with p ≤ 0.05. Effect of alcohol and tobacco consumption on RNFL thickness was analysed using STATA 11 (Statacorp, Texas) and SPSS version 20. Results: A total of 200 eyes of cases and controls respectively were included. Statistically significant RNFL thinning was noted in all quadrants except nasally. Significant RNFL thinning was seen with increased FTND Scale. RNFL thinning was seen with higher AUDIT scale, but this was not statistically significant. Conclusion: People who are addicted to tobacco use are likely to have RNFL thinning. Authors recommend that OCT can be used as feasible preclinical tool to screen RNFL thinning among chronic tobacco and alcohol users.

Biography:

She has completed her graduation in medicine (M.B.B.S) from Mahatma Gandhi Missions Medical College, Mumbai, India at the age of 23 years from Maharashtra University of Health Sciences, Nasik, India. I am specializing in Ophthalmology from Smt.Kashibai Navale Medical College and General Hospital, Pune, India. She started her specialization in August 2013. She has published 3 papers, presented 10 papers and 12 posters at both National and International Conferences.

Abstract:

A hospital based study was conducted on 100 eyes at a tertiary care centre, that underwent clear corneal phacoemulcification with temporal incision and implantation of intraocular lens implantation. 50 eyes had rigid and 50 had foldable intraocular lens implantation irrespective of the type of astigmatism. The length of incision in patients with foldable was 2.8mm and was extended to 5.5mm in patients with rigid intraocular lens. Keratometric and Surgically induced astigmatism was assessed on day 1, 7 and 42. We found that there was no statistically significant difference in visual outcome and surgically induced astigmatism in two groups on day 1, 7 and 42. There was no significant difference in Keratometric Astigmatism in two groups on day1 and 7. The Keratometric Astigmatism was significantly different in two groups on day 42 (P value-0.007), the patients with rigid intraocular lens implant had significantly more astigmatism on day 42 than those with foldable intraocular lens implant. Pre-operatively majority of the patients had against the rule type of astigmatism. It was observed that there was a shift from against the rule type to with the rule type of astigmatism in both the groups. The shift in the type of astigmatism was found to be more in patients with rigid intraocular lens implantation than those with foldable intraocular lens implantation (4%). We found that rigid intraocular lens implants which are cost effective can be beneficial in low socioeconomic set up with no potential disadvantages and side effects.

Biography:

Abstract:

200 patients selected from January 2015 to July 2015, were randomly allocated to two groups of 100 : Group A underwent polishing of the posterior capsule and retro-IOL irrigation-aspiration after IOL insertion while Group B underwent smooth uneventful phacoemulsification and in-the-bag IOL insertion but without polishing of the bag after IOL insertion. Post-operative assessment by slit-lamp and anterior segment OCT was done at 1 week, 1 month , 3 months and 6 months. Slit-lamp examination was done for any anterior chamber reaction. Early post-operative capsular block syndrome was diagnosed by postoperative myopia or refractive surprises when a shallow anterior chamber and a distended capsular bag with IOL separation are found. Post-cataract opacification was seen on slit-lamp examination. RESULTS: Group A did not have any cases of early post-operative CBS and 4 cases of PCO at 6 months. Group B had 6 cases of early post-operative CBS and 13 cases of PCO at 6 months. The difference was statistically significant both for early post-operative CBS (p=0.0289) and PCO at 6 months (p=0.0398). CONCLUSIONS: Polishing of the posterior capsule and retro-IOL irrigation-aspiration after IOL insertion significantly decreases the incidence of of early post-operative capsular block syndrome (CBS) and post-cataract opacification (PCO).

Biography:

Zeyad A Alzaben received his Bachelor degree in Optometry (2013) at the Jordan University of Science & Technology (JUST), and the first MSc degree in Science of Vision and Optometry (2014) at the Universitat Politècnica de Catalunya (UPC), and the second MSc degree in Visual Rehabilitation (2014) at Universida de Valladolid (UVa) / Medicine Faculty. He is a PhD candidate in Optical Engineering doctoral program (2014-2016) at Universitat Politècnica de Catalunya (UPC). He is currently employed as full-time optometrist at the Department of Low Vision of Optipunt Eye Clinic (www.optipunt.com). He has conducted two new researches about normal patients and patients affected by pathological myopia using OCT and MAIA microperimeter, waiting the acceptance letters to be published. He is a student of Corporate Program for Management Development / Advanced Program for Optics Management in ESADE Bussines School in Barcelona (2014-2017). His aim is to utilise his skills to improve his experiences and keep learning more with respect to the challenges about using his valuable assessments.

Abstract:

Optical coherence tomography (OCT) is a useful non-invasive technique to assess the retina without the need for pupil dilation. In particular, the macular and optic disc areas may be explored in detail and with a high level of spatial resolution. A transversal study was designed in which a spectral-domain 3D-OCT-2000 was employed to evaluate several retinal parameters in a sample of 37 young Caucasian adults aged between 12 and 23 years (spherical equivalent from -3.00 to +4.00 D). Normal inter-ocular asymmetry values were determined and 95% inter-ocular difference tolerance values were obtained. Inter-ocular statistically significant differences were uncovered in mean and superior RNFL thickness, as well as in central macular thickness, with larger values in the left eye in all instances, and with tolerance limits of inter-ocular asymmetry (2.5th and 97.5th percentiles) of -9.00 µm to 6.00 µm, -28.00 µm to 9 µm and -39.00 µm to 29.00 µm, respectively. In addition, statically significant differences were found between males and females in mean thickness of the retinal nerve fiber layer (RNFL) in the right eye. These findings give support to the exploration of the normal asymmetries of the retina as an effective approach for an early detection of pathologies such as glaucoma. Differences in instrumentation and sample characteristics compromise direct comparison with published research and warrant the need for further studies.

Biography:

Raghad Alrasheed, a 5th year medical student from King Saud University, Saudi Arabia.

Abstract:

Objectives: To evaluate the current knowledge, awareness, and to assess practices among primary care physicians working in primary care centers in Riyadh, regarding Diabetic Retinopathy (DR).
 Methods: We conducted a cross-sectional study covering 46 randomly selected primary care centers in Riyadh during October 2015. A Self-administered questionnaire was distributed to primary care physicians containing 3 main sections. The first section focused on participants’ demographics and professional background. The second section contained multiple-choice questions on knowledge related to diabetes and DR. A Score of one was given for each correct answer and zero for the wrong or did not know answers. The last section was to assess physicians’ practices. Data was analyzed using SPSS.
 Results: A total of 216 general physicians completed the questionnaire. The mean overall knowledge score for all the respondents was 57±14 out of 100. Knowledge was significantly higher for physicians with >15 years of practice (59±13 vs. 54±15, P=0.04). Male physicians scored better than females, 13% vs. 6.7% respectively scored >75. A defect was noticed in area of screening and follow-up of type 1 diabetes, only 24% of physicians correctly referred patients with type 1 diabetes to an ophthalmologist, whereas 71% referred patients with type 2 diabetes as recommended by the guidelines. Another defect area was detected in treatment options. Majority agreed on the use of laser photocoagulation as treatment. However, only 1/5 of participants were aware of the use of steroids and anti-VEGF as possible options. 65% of physicians claimed the capability of using an ophthalmoscope, 74% of them have examined their patients with it. Conclusion: Our study uncovered areas of defects in knowledge among general practitioners regarding diabetes and DR. Therefore; future seminars on diabetes emphasizing the proper ophthalmological screening and management of patients are necessary.

Biography:

I have completed my MBBS at the age of 24 years from Gujarat University and am currently pursuing post graduate study from M & J Western Regional Institute of Ophthalmology.

Abstract:

We present a case of an 8 year old male who had severe vision loss in his right eye 2 months prior to examination. Best corrected visual acuities were no perception of light in right eye and 6/9 (without correction) in left eye. Pupil evaluation revealed a dilated pupil in right eye and a normal reactive pupil in left eye. Exotropia was visible on gross clinical observation. Biomicroscopy showed moth eaten iris with anterior capsular changes and posterior sub-capsular opacity in right eye. Dilated fundus examination showed serous retinal detachments in the right eye with dilated veins, telangiectatic vessels, hemorrhages and sub-retinal exudates. The retina of the left eye was normal. Retinoblastoma was ruled out with further diagnostic testing. Coats’ disease is definitively identified based on clinical assessment, ultrasonography and laboratory tests. Because of its preponderance to mimic retinoblastoma, application of these tests can differentiate long standing Coats’ disease from neoplastic growths. Treatment of this disorder is based on the extent of disease at presentation.

Biography:

Mohd Radzi Hilmi is currently pursuing his PhD in Health Science (Optometry) at International Islamic University Malaysia (IIUM). He has completed his Master of Optometry (MOptom) from University of New South Wales (UNSW) Australia in 2011. He has obtained his first degree in Optometry in 2010 from IIUM. His research interests are in anterior segment imaging and corneal and external eye diseases.

Abstract:

Pterygium is an abnormal growth on the eye which may cause to severe visual disturbance and is highly prevalent in countries close to equator. However, there is lack of research which addresses the severity and properties of the tissue. Mimicking human color perception has commonly adopted using RGB color space; however, it is still inadequate. In this research work, we propose CIELab color space and vesselness filter to objectively quantify redness of 68 pterygium fibrovascular images and compare the results with other 12 color spaces. Experimental results show that CIELab color space shows better representation of human color perception (correlation coefficient=0.68) compared to using vesselness filter (correlation coefficient=0.43). CIELab can serve as a basis for future work on to automate pterygium clinical grading based on tissue redness.