Day 2 :
Keynote Forum
J. T. Lin
New Vision, Inc. Taipei, Taiwan
Keynote: Progress of the 28-year Laser Vision Technology
Time : 9:00
Biography:
Prof. J.T. Lin, PhD (1981), University of Rochester. He served as a Visiting Professor at National Chao-tung University and Associate Professor at the University of Central Florida, Founder & CEO of Nasdaq-listed companies, He is the Chairman & CEO of New Vision Inc. and a Visiting Professor at HE Medical University (China). He holds over 40 patents and is the inventor (US patents, 1992, 2000) of LASIK procedure using flying-spot scanning method and the solid-state UV laser. He has published over 55 book chapters and 70 SCI journal papers. He is WHO's WHO in Leading American Executives, Model of oversea Chinese Young Entrepreneur and Fellow of American Society of Laser Surgery & Medicine.
Abstract:
This presentation consists of the historical review of ophthalmic laser technologies (1987 to 2016) and the recent developments of corneal cross-linking (CXL). The first human trial of PRK conducted in 1987 was based upon the IBM patent (UV laser for organic tissue ablation) and obtained the FDA clearance in 1995 (and LASIK in 2002). The flying-spot scanning technology for customized corneal reshaping was first proposed by Dr. J.T. Lin in 1992 (US patent). During 1995-1999, various laser systems/procedures were developed including: LTK (using Ho:YAG), DTK (using diode laser), RF and CK for hyperopia corrections; solid state lasers YAG-213 nm (for PRK), Mini-Excimer for PRK etc. Technologies developed in the 2000s include: eye-tracking device, microkeratome, Elevation map, topograpy-guided LASIK, wavefront for customized LASIK; presbyopia treatment using accommodative IOL, SEB (Schachar) and laser scleral-ablation (Lin); and femto-second lasers (for cornea flap, cataract, and stroma lens cut). In the recent years, UV-light riboflavin-activated corneal cross-linking (CXL) has beeen explored for various combined procedures including CXL-femto-laser, CXL-IOL, CXL-corneal-ring, CXL-sclera, and CXL-pediatric-myopes. The technical and clinical issues for CXL will be presented including: the optimal dose for new protocols, and riboflavin diffusion methods such as epi-off, epi-on, direct introduction of riboflavin into the stroma (pocket technique, ring technique, needle technique), and enrichment of riboflavin in the stroma by iontophoresis. Optimal CXL based on a dynamic theory will be presented for the first time.
- Symposium Session On Diabetic Retinopathy and Foveal Hypoplasia
Session Introduction
Ayala Pollack
Kaplan Medical Center, Israel
Title: Diabetic retinopathy and foveal hypoplasia
Biography:
Prof. Ayala Pollack is a Professor and Chairperson of the Ophthalmology Department at Kaplan Medical Center. She graduated from the Sackler School of Medicine, Tel Aviv University with the honour of distinction and award for excellent thesis. During Medical school she started basic science research in the Department of Embryology and Teratology, Sackler School of Medicine, Tel Aviv University, She completed training in Ophthalmology Kaplan Medical Center and in the Department of Ophthalmology, Rothschild Hospital, Haifa, Israel affiliated to the Technion-Israel Institute of Technology.
Abstract:
Background: The spectrum of foveal hypoplasia (FH) ranges from a narrow central avascular zone to that of absent foveal pit with continuity of the superficial vascular layers and absent FAZ. In cases of diabetic retinopathy in FH, these features results in a central micro-vascular disease with unique characteristics. Purpose: To present the pathological features of diabetic retinopathy in cases of FH as they are seen in retinal imaging. Methods: Patients with foveal hypoplasia and diabetic retinopathy underwent fundoscopic examination, OCT and FA imaging. The images were analyzed to determine the degree of hypoplasia and to identify the characteristics of the retinopathy. Results: The distribution of retinal capillaries reduced foveal avascular zone (FAZ) was demonstrated. Diabetic retinopathy in these cases was characterized by microaneurysms and hard exudates in extreme proximity to the foveola. Cystoid spaces within the retina were also more likely to occur at the center of the fovea. Conclusions: The natural history and implications for therapy of diabetic maculopathy are related to variations of foveal anatomy as well as to known systemic factors. In FH, micro-angiography presents centrally and early visual loss from edema and exudates may ensue.
- Track 6 Neuro Ophthalmology
Track 7 Lens Disorders and Refractive Surgery
Track 8 Visual Neuroscience
Track 9 Ocular Microbiology and Immunology
Track 10 Research Trends in Surgical and Medical Ophthalmology
Session Introduction
Peirong Lu
Director and Professor Department of Ophthalmology, the First Affiliated Hospital of Soochow University
Title: Secondary Multifocal Intraocular Lens Implantation in Patient with White Cataract
Biography:
Peirong Lu received his Ph.D. degree from Kanazawa University at 2004. He did his postdoctoral training at Soochow University. Currently, he is the professor and director of Department of Ophthalmology, the First Affiliated Hospital of Soochow University. His research focuses on ocular neovascularization and cataract and is well funded. He has published more than 20 papers including Invest Ophthalmol & Vis Sci, Journal of Immunology, Cornea, Molecular Vision, and American Journal of Pathology.
Abstract:
White cataract occupies certain proportion in cataract patients in developing country. Most of the white cataracts have to give up the refractive IOL implantation because of the limited accuracy of the axis length and IOL power measurement. However, the white cataract patients also have the right to choice refractive IOL and obtain satisfied uncorrected distance and near visual acuity and spectacle independence after cataract surgery if we can detect the axis length precisely. To evaluate the outcomes of secondary multifocal intraocular lens (IOL) implantation in white cataract eyes, white cataract patients accepted secondary multifocal IOL implantation between June 2014 and January 2015 were retrospective reviewed. Ocular biometric parameters, surgical and visual outcomes were analyzed. Compared to conventional primary IOLs implantation, for the optimal white cataract patient, the white cataract were firstly extracted, following the optical biometry being precisely measured and also it is easy to identify whether the patient has adequate visual function, then the multifocal intraocular lens was secondary implanted. A total of five appropriate white cataract patients were enrolled in the secondary multifocal IOL implantation and were retrospective reviewed. The novel management strategy of secondary multifocal IOLs implantation were successful and without obvious adverse events. All the patients were achieved satisfied near and distance visual acuity and spectacle freedom. The outcomes suggest our novel management strategy is a safe and effective option for white cataract undergoing cataract surgery.
Li-Ju Lai
Chang Gung Memorial Hospital, Chia-Yi, Taiwan
Title: Pediatric optic Neuritis in Rural Area of Taiwan
Biography:
Li-Ju Lai had completed her PhD from Chang Gung University in Taiwan and postdoctoral studies from Univeristy of Pittsburgh in USA. She is the director of Health Promotion for Children Program in Chang Gung Memorial Hospital, Chia-Yi branch, Taiwan. She has published more than 26 papers in reputed journals and has been serving as an editorial board member of repute.
Abstract:
Pediatric optic neuritis characteristically presents with significant visual loss, which is easily mis-diagnosed with malingering especially in under-served medical area of Taiwan. Recurrent optic neuritis episodes could be a red flag sign of underlined multiple sclerosis and could result in other severe complications . This is a cross-sectional community-based study, 3918 children participated in the program of Health Promotion for Children in Chia-Yi with their informed content during the year of 2015. Six children were diagnosed with pediatric optic neuritis. Careful medical history and drug history were evaluated. Visual acuity, intraocular pressure (IOP), color test, optical coherence tomography (OCT), visual evoke potential (VEP), and magnetic resonance imaging (MRI) were used for diagnosis. Autoimmune survey with serum level of Complement 3 (C3), complement C4 (C4), anti-nuclear antibody (ANA), Anti-ENA, Anti-neutrophil cytoplasmic antibody (ANCA), and Anti-Aquaporin 4 (AQP4) antibody were also done. The incidence of pediatric optic neuritis is different from the data of western countries. The relationship between the influenza vaccine and optic neuritis in children needs further evaluations. Children who claim vision loss or headache with unknown causes should receive further management and treatment. Careful history taking is as important as the color test, visual acuity and visual evoked potential examination to diagnose the optic neuritis and prevent further complications.
Robert Chang
Assistant Professor of Ophthalmology Stanford University School of Medicine, CA 94305, USA
Title: Minimally Invasive Glaucoma Surgery – Tips on Mastering the Istent
Biography:
Dr. Chang received his MD from University of Missouri, Kansas City School of Medicine. He completed his residency at the prestigious Washington University in St. Louis, followed by a research and clinical glaucoma fellowship at the renowned Bascom Palmer Eye Institute in Miami. He has published over 33 peer-reviewed papers, delivered 85 invited national and international lectures, and been awarded 11 grants. He has a full-time clinical practice, teaches, volunteers internationally, and is a Stanford Biodesign Faculty Fellow. He is a consultant for multiple ophthalmic companies as well as a scientific advisor to early stage medical device startups.
Abstract:
This oral presentation will cover tips and pearls on incorporating the Glaukos Istent, a minimally invasive glaucoma surgery (MIGS), into your ophthalmology practice for the treatment of open angle glaucoma. It will encompass an overview of trabecular meshwork-based ab interno surgery, discuss the new devices with a focus on Istent, introduce gonioscopic angle surgery as a new skill, provide surgical videos of optimal and suboptimal Istent placement, discuss patient selection, technique, efficacy, post-op management, and complications, and finally, review the literature on Istent outcomes. The course is presented from a United States perspective, and briefly mentions cataract surgery in conjunction with the Istent.
Dimitris Hatziavramidis
National Technical University of Athens, Greece
Title: A Posterior-Eye Drug Delivery System for Treatment of Age-Related Macular Degeneration
Biography:
Dimitris Hatziavramidis has completed his BSc at NTUA (Greece) and MSc at University of Manchester (UK) and his PhD at University of Illinois (USA). He has spent most part of his career working for academic institutions and large corporations in the USA and is currently a Professor at NTUA. Prior to this, he served as a Professor and Director of the Particle Technology and Crystallization Center for pharmaceutical products, in the Department of Biological and Chemical Engineering at Illinois Institute of Technology in Chicago, IL. He is a Fellow of AIChE. He has published extensively in reputed journals and has several patents.
Abstract:
Age-related macular degeneration (AMD) is a progressive, neurodegenerative, occular disease and a leading cause of irreversible loss of vision in aging adults in developed countries. Its pathogenesis is characterized by uncontrolled proliferation of cells and cell growth in blood vessels, leaking of blood and proteins and aberrant folding, aggregation and accumulation of proteins. Over-expression of the vascular epithelial growth factor (VEGF) causes uncontrolled blood vessel growth resulting in violation of the blood-retina barrier and accumulation of blood and protein debris causes neuro-degeneration of cells in the retinal pigment epithelium (RPE) and tissue dysfunction. The current treatment of AMD is primarily based on anti-VEGF drugs which are administered by intra-vitreal injection. It has been recently proposed to administer exogenous heat shock proteins such as Hsp70 by intra-vitreal injection in order to clear accumulated debris from RPE and inhibit aggregate-based cell neuro-degeneration. An equally effective and less vision-threatening than intra-vitreal injection route of administration of the above macromolecular drugs is trans-scleral delivery from an implant in the posterior eye, made out of a poly (N-isopropyl acrylamide) (NIPAM) thermally sensitive gel. This gel undergoes a phase transition characterized by a lower critical solution temperature (LCST) of 33oC, below which the drug is loaded in the gel and above which the drug is released from the gel.
Ms Shelly-Anne Lalchan
Glaucoma Eye Foundation of Trinidad and Tobago (GiFT)
Title: An Analysis of First Line Treatment in Open Angle Glaucoma in Trinidad and Tobago, Caribbean
Biography:
Ms Lalchan pursued her postgraduate degree in ophthalmology and is fellowship trained in glaucoma. She has worked at Leeds Teaching Hospitals, Moorfield’s Eye Hospitals and The Western Eye Hospital in London. She is a member of the International Society for glaucoma Surgery and was awarded The International Ophthalmology in Education Award by AAO in 2015. She is a scientific advisor for the Diabetes Association of Trinidad and Tobago. Additionally, she is the founder and President of the non-profit GiFT (Glaucoma iFoundation of Trinidad and Tobago and director of Lily-The Eye Specialist Ltd and The Glaucoma Specialist Centre.
Abstract:
AIM: To qualify the epidemiology of patients diagnosed with primary open angle glaucoma; to analyse education pathway and, to determine, within the practical clinical setting, the efficacy of first line treatment within a high risk population . METHOD: A retrospective, consecutive series was analysed. The patient pathway incorporated multiple educational components ie educational videos, booklets, perimetry questionnaire, drop instillation techniques, compliance tips, prognosis and risks to family members. Inclusion criteria: age >35yrs, open angle glaucoma, new diagnosis and treatment initiation (glaucomatous optic neuropathy and/or visual field defect consistent with retinal nerve fibre layer damage), refractive error +3.0 to -5.0DS. RESULTS: Demographics: N 131 eyes ; mean age 60yrs (36-80yrs, SD 8.92); 28% had family history of glaucoma. The pre-treatment IOP mean 24.5mmHg (12-62mmHg SD 8.59;); mean CCT 537um ( 483-619um SD 26.4;); 78.5% of eyes had a CCT <555um. 8.4% had a mean deviation of <-12 db. There was no statistically significant difference ,one way ANOVA p 0.06. CONCLUSION: Education needs to be emphasized within the patient pathway in developing countries. First line therapy demonstrates good efficacy in a practical clinical scenario in a high risk population.
Biography:
Prof. Ayala Pollack is a Professor and Chairperson of the Ophthalmology Department at Kaplan Medical Center. She graduated from the Sackler School of Medicine, Tel Aviv University with the honour of distinction and award for excellent thesis. During Medical school she started basic science research in the Department of Embryology and Teratology, Sackler School of Medicine, Tel Aviv University, She completed training in Ophthalmology Kaplan Medical Center and in the Department of Ophthalmology, Rothschild Hospital, Haifa, Israel affiliated to the Technion-Israel Institute of Technology.
Abstract:
In the era of OCT, we are often asked to make a diagnosis relying on an OCT appearance. The following cases represent two extreme varieties of unusual foveal conditions. The first is foveal hypoplasia which may be isolated or associated with other ocular conditions and characterized by the continuity of the inner retinal layers in the fovea with variable degrees of decreased foveal pit and absence of cone specialization. Decreased visual acuity and nystagmus may be present, dependent on the degree of hypoplasia. The improved resolution of OCT helps to diagnose and differentiate the degree of foveal hypoplasia. The second condition is a “double fovea” configuration on OCT which was first suspected to be an evolutionary remnant of ancient foveal configuration presently found in birds. A careful clinical examination and using a different scanning plane helped to discover the reason of this unusual appearance on OCT. Both examples show that OCT is a very important tool for diagnosing and characterizing different foveal conditions but is an adjunct to a careful clinical examination and that its interpretation is meaningful only in that context.
Anderson Ho Cheung Shum
Department of Mechanical Engineering, University of Hong Kong
Title: The Effect on the Diffusion of Small Aqueous Soluble Molecules Based on the Interactions with Collagen in Vitreous Humor
Biography:
Dr. Shum is an assistant professor in Mechanical Engineering at the University of Hong Kong. He received his undergraduate degree from Princeton University, and Ph.D. i from Harvard University. His research interests include emulsions, microfluidics, emulsion-templated materials and soft matter. He received the Early Career Award by the Research Grants Council of Hong Kong. He is an editorial board member in “Scientific Reports” published by the Nature Publishing Group and in other journals. He has published ~70 articles and is a reviewer for journals, including “Nature Nanotechnology” and “PNAS”, and for funding agencies in the United States, Europe and Asia.
Abstract:
Diffusion of protein-based drugs (e.g. ranibizumab and bevacizumab) in the eye often depends on the viscosity and the mesh size of the vitreous humor. The diffusion speed of molecules within a liquid is inversely proportional to the viscosity, and therefore the molecules diffuse much slower in vitreous humor than in water. The mesh size of the vitreous affects the diffusion of drugs with a large molecular weight due to the role of the network as a physical barrier to the drugs involved. However, little has been studied regarding the interaction (or the binding) between the vitreous components and the drug molecules. The surface charge on the vitreous component that causes the binding with the drug molecules also potentially plays a significant role in the diffusion of the drug molecules. This effect may become very significant particularly in the diffusion of small molecular drugs (e.g. dexamethasone). In this study, the interaction between the small drug molecules and the vitreous components is studied. The interaction being studied is independent of the viscosity (by using homogenized vitreous samples) and the mesh size of the vitreous (small testing molecules). Our results show that the diffusion of the small aqueous soluble molecules is highly interfered by the macromolecules present in the vitreous content when compared with water as the diffusion medium. Our results further suggest that the small molecules probably bind with the collagen, but not the hyaluronate, that are present in the vitreous humor.
Hae Min Kang
Department of Ophthalmology, Catholic Kwandong University College of Medicine, International St. Mary’s Hospital
Title: Treatment of Polypoidal Choroidal Vasculopathy
Biography:
Hae Min Kang earned her MD at the age of 25 from Yonsei University College of Medicine where she also pursued postdoctoral studies. After completion of retinal fellowships, she is now an associate professor at Catholic Kwandong University College of Medicine with position of the head of Retinal department in International St.Mary’s Hospital. She has published more than 20 papers in reputed SCI journals, and she has been serving as an editorial board member and the expert reviewer board of repute. Her research interest lies on age-related macular degeneration, especially on polypoidal choroidal vasculopathy.
Abstract:
Polypoidal choroidal vasculopathy (PCV) is characterized by abnormal branching vascular networks with terminating polypoidal lesions. PCV is known to be prevalent amongst Asian population, accounting up to 50% of presumed exudative age-related macular degeneration (AMD). PCV is now generally considered to be a peculiar subset of exudative AMD, however, recent studies also suggest that PCV is one of pachychoroid diseases. Currently, the mainstay of treatment for PCV includes anti-vascular endothelial growth factor (VEGF) therapy, photodynamic therapy (PDT), or combination therapy (PDT combined with anti-VEGF therapy). PDT is still effective treatment option for PCV, whereas it is not considered as the primary treatment for typical exudative AMD. When we start treatment for PCV, several points should be concerned because of its distinct features. Although the natural course of PCV seems to be more favorable than that of typical exudative AMD, PCV frequently recurs despite of treatments, leading to visual deterioration. Thus, thorough long-term follow-up is necessary for the patients with PCV. In addition, hemorrhagic tendency of PCV also should be taken into account, especially when considering PDT for PCV. PCV can lead to profound subretinal hemorrhage or break-through vitreous hemorrhage which may cause sudden visual loss.
Wencan Wu
The Eye Hospital of Wenzhou Medical University, Wenzhou 325027, China
Title: Image-Guided Endoscopic Transnasal Optic Nerve Decompression for Patients with Compressive Optic Neuropathy Resulted from Fibrous Dysplasia
Biography:
Wencan Wu has completed his PhD at the age of 33 years from Xiangya Medical College of Central Southern University and from Oct 2013 to June 2015 he studied as a clinical ＆ research fellow at Bascom Palmer Eye Institute of University of Miami. He is specialized the endoscopic techniques in the ophthalmology. Now he is the director of the Center of Orbital ＆ Oculoplastic Surgery in the Eye Hospital of Wenzhou Medical University. He has published more than 22 papers in reputed journals and has been serving as an editorial board member of many journals.
Abstract:
BACKGROUND: Visual loss is a dreaded outcome of patients with fibrous dysplasia due to compressive optic neuropathy resulted from excessively abnormal growth of the sphenoidal bone. Even though there are many controversies, to remove the hypertropic bone to release the compression on the optic nerve is the base for vision recovery. Till now many methods have been applied to unroof the nerve therapeutically to recover the visual acuity in the setting of optic nerve dysfunction, however, the reported outcomes are mixed. Here we introduced a novel mini-invasive surgical approach to decompress the optic nerve which was guided by navigation surgical system and its results were reported. METHODS: From 2014.1 to 2015.12, patients who were diagnosed compressive optic neuropathy just resulted from fibrous dysplasia were performed the surgery of endoscopic transnasal optic nerve decompression guided by a magnetic navigation surgical system. Before operation, pupil examination, vision function examinations included Snellen’s visual acuity, 30ºvisual field and pattern VEP, the orbital high-resolution CT scan were conventionally performed. Patients’ age, demographics and the surgical procedures, follow-up time, results of the surgery and complications were recorded. RESULTS: Totally, 8 patients received the surgical treatment of endoscopic transnasal optic nerve decompression. All patients were determined compressive optic neuropathy according to the history and various clinical examinations. All surgeries were uneventfully completed. The patient age ranged from 8 years to 16 years, with male 3 and female 5. The history of obvious visual disorders ranged from 11 months to 3 years. Six patients had bilateral compressive optic neuropathy, and while, only one side was performed the surgery and the other as the control. All patients were followed up for 9 months to 15 months, with an average of 12.1±2.5 months. The surgical time ranged from 2.5 hours to 6.5 hours, with an average of 3.4 ±1.2 hours. The visual acuity ranged from light perception (LP) to 0.4. After surgery, the visual acuity improved significantly in all 8 patients and no changes in the controlled sides. No complications, including visual decent, infection, CSF leakage, and nose disorders, happened. CONCLUSIONS: The therapeutic surgery of endoscopic transnasal optic nerve decompression guided by navigation surgical system would be an advocated treatment of visual recovery for patients with continuous deterioration of vision resulted from fibrous dysplasia, with advantages of reliable outcomes of visual recovery, minimal morbidity, safety, and few complications.
Dr. Kin CHIU
Laboratory of retina-brain research, Department of Ophthalmology, The University of Hong Kong, Hong Kong, P. R. China
Title: Neuroprotective Effects of Papaverine on Retinal Ganglion Cells in Optic Nerve Transection Model
Biography:
Dr. Kin CHIU completed her Master and Bachelor of Clinical Medicine degree in Tianjin Medical University, P.R. China. She focused on neuroscience research and got her Ph.D in the University of Hong Kong. Her long term research goal is to find a way to prevent continous visual loss in neurodegenerative retinal diseases, such as glaucoma and age-related macular degeneration. Her research works focus on investigating the mechanism of neuronal degeneration and finding new approaches to prevent neuronal death and promote neuronal survival and regeneration. Related treatment strategies include immune modulation, electrical stimulation and optogenetic therapies.
Abstract:
Papaverine is an opium alkaloid antispasmodic drug, used primarily in the treatment of visceral spasm and vasospasm. It is also known as a specific inhibitor of phosphodiesterase (PDE) 10A. In striatonigral and striatopallidal neurons, inhibition of PDE 10A by papaverine activated cAMP/PKA signal cascade. This study was aimed to investigate the effects of papaverine on the survival of retinal ganglion cells in rat optic nerve transection model. After intraorbital optic nerve (ON) crush of the right eye, 2 ïl of BSS or 50, 200, 500 ïg/ml papaverine was injected to vitreous cavity in the injured eye. At 2 or 7 days after the insult, retina samples were collected for retinal ganglion cell (RGC) count and immunohistochemistry analysis. At seven days, comparing to the BSS control group, RGC density of the 500 ïg/ml group showed significant increased survival of RGC. Immunoreactivity of phosphorylated-cAMP response element binding protein (p-CREB) was not detectable in the BSS control group. Increased expression of p-CREB was detected in the RGC layer and inner neuclear layer of the papavarine treated groups at both 2 and 7 days groups. Our result showed that papaverine was neuroprotective to RGC when their axons were transected in the crush model. This effect might be through up-regulation of the p-CREB.
Bonnie Nga Kwan Choy
The University of Hong Kong, Hong Kong
Title: What You do From the Morning to Sleep that Affects your Eyes – Life Style in Relation to Glaucoma Management
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:
Glaucoma is a common chronic eye disease that can result in blindness. Apart from intraocular pressure control with medications, laser and surgery, glaucoma patients often ask about how they can achieve better glaucoma control in their daily life, whether any diets or habits they should adopt or avoid. There are literatures showing that calories restriction, low salt diet and green tea (anti-oxidant) intake, and use of food supplements such as wolfberry may help with glaucoma control, while coffee should be avoided as it may cause intraocular pressure elevation. Smoking which induces vasoconstriction also adversely affect glaucoma control. Even during sleep, head posture is shown to affect intraocular pressure, and glaucoma tends to be more severe on the side which patients lay. Physical exercise was found to lower intraocular pressure, so regular exercise should be advised for glaucoma subjects. Apart from controlling intraocular pressure, management of systemic diseases including hypertension, diabetes, obstructive sleep apnea is essential to achieve optimal glaucoma control. The talk will include literature review of how the above life styles may contribute to glaucoma management. Ophthalmologists can then offer suggestions to how patients may help managing the diseases in their daily life, in addition to ensuring compliance to glaucoma medications.
Biography:
Ian Wong is currently Clinical Assistant Professor at the Department of Ophthalmology, LKS Faculty of Medicine, The University of Hong Kong (HKU). Since then, he has devoted his time and effort in academic research, and has to date published 42 international peer-reviewed journal articles. Other than that, he has written 7 book chapters, including one in the book RETINA 5e. He recently took up the role of Editor-in-Chief of the Hong Kong Journal of Ophthalmology.
Abstract:
Viral retinitis is a group of conditions including Cytomegalovirus (CMV) retinitis, Progressive Outer Retinal Necrosis (PORN), and Acute Retinal Necrosis. Despite different aetiologies, there are similarties. Traditionally, CMV retinitis affected Human Immunodeficiency Virus (HIV) infected patients, but is now being increasingly recognised outside of this group. Highly Active Antiretroviral Therapy (HAART) has changed the presentation of CMV retinitis, whilst the advent of intravitreal antivirals has changed the treatment options available. This course aims to highlight these and other trends in viral retinitis via the below talks: 1. Who is at risk? Background & demographics. 2. Situation in Asia vs Western patients. 3. Presenting signs and symptoms 4. Diagnostic challenge - how to make a diagnosis? 5. Therapeutic challenge - Medical treatment & long term prophylaxis 6. Therapeutic challenge - Surgical treatment 7. Summary + case study + small quiz
Dr Gyanendra
University Graduate School of Medicine, Maebashi, Japan, Vitreoretina Department Lumbini Eye Institute Bhairahawa, Nepal
Title: Spectral Domain Optical Coherence Tomography (SD-OCT) Characteristics of Retinal layers in Branch Retinal Vein Occlusion
Biography:
Dr. Gyanendra Lamichhane worked as Ophthalmologist (Phaco surgeon and medical retina specialist) at Shree Rana Ambika Shah Eye Hospital, Lumbini Eye Institute, Bhairahawa, Nepal from 15th June 2009 -19th February 2013. This institute is affiliated with the National Academy of Medical Sciences (NAMS), Nepal. Experience of more than twenty thousands (30,000) cataract and other ocular surgeries. House Officer, Universal College of Medical Sciences Bhairahawa, Nepal (2004-2006).
Abstract:
Aim : To study spectral domain optical coherence tomography (SD-OCT) characteristics of retinal layers in branch retinal vein occlusion .Methods :30 patients with branch retinal vein occlusion attending vitro retina clinic in a tertiary eye hospital were studied with SD-OCT . Integrity of inner segment outer segment junction, External limiting membrane, central retinal thickness and presence or absence of serous macular detachment were analyzed .Results :24 (80%) patients had disrupted photoreceptor Inner Segment Outer Segment(IS/OS) integrity. External Limiting Membrane was disrupted in 66.66% patients ( n=20). Cystoid Macular Edema was present in 53.33% patients (n=16). Average central retinal thickness was 432.9 μm. Conclusions: Spectral domain OCT characteristics can help to detect the changes in various retina layers and thus predict the visual outcome in patients with macular edema due to branch retinal vein occlusion. Keyword: SD-OCT, IS/OS junction, Branch retinal vein occlusion
Jasleen Kaur Jolly
University of Oxford, UK
Title: A Qualitative and Quantitative Assessment of Fundus Auto-Fluorescence Patterns in Patients with Choroideremia
Biography:
Jasleen Kaur Jolly is an optometrist working for the Nuffield Laboratory of Ophthalmology, University of Oxford and Oxford Eye Hospital. She studied at Cardiff University and the University of Manchester, working across the world in various settings to gain a wide range of experience. She is actively involved in clinical research in the fields of retinal gene therapy, cataract surgery outcomes and low vision. Her main interest is improving outcome measures following gene therapy treatments.
Abstract:
Purpose: We set out to characterize the pattern of fundus auto-fluorescence (AF) loss in choroideremia (CHM) patients of varying ages and disease severity in order to determine the average rate of progression of this potential disease biomarker. Methods: Fifty consecutive CHM patients (100 eyes) attending outpatient clinics at Oxford Eye Hospital underwent analysis with the Heidelberg OCT Spectralis with auto-fluorescence capabilities. The area of residual AF was traced using Heidelberg Eye Explorer. Bland-Altman analysis was used to calculate the coefficient of repeatability (CR). The degree of AF loss was correlated to age and the pattern of residual AF constructed into color-coded maps in order to gain insight into the mechanism of disease progression. Results: The CR for measurement of AF area is <1% indicating a small change is likely to be significant. Correlation of patient age and area of residual AF produced a clinically relevant index of expected anatomical disease. Progression is 5-10% of the residual area each year and follows a logarithmic pattern with age (r=0.69, P<0.001). The mean half-life of AF is 9 years. Qualitatively, the pattern of remaining AF was bifocal, with maximal preservation around the fovea (predominantly temporal) with late preservation around the optic disc. Conclusions: The area of residual AF in CHM can be measured reproducibly and shows a distinct pattern of loss. The residual area is inversely correlated to age. The ratio of the two variables may provide useful information regarding the rate of progression for any individual at a point in time.
Abdulelah A. Al-Abdullah
King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.
Title: Retinal Complications After Anterior Versus Posterior Chamber Phakic Intraocular Lens Implantation in a Myopic Cohort
Biography:
Abdulelah A. Al-Abdullah has completed his Vitreoretinal and Uveitis fellowship 2014 at King Khaled Eye Specialist Hospital, He is currently vitreoretinal and uveitis consultant at King Khaled Eye Specialist Hospital.
Abstract:
PURPOSE: To compare the incidence and characteristics of retinal complications following implantation of two types of phakic intraocular lenses (PIOLs) in patients with myopia. METHODS: In this comparative, retrospective study, 603 eyes of 344 patients with myopia underwent implantation of either an Artisan iris-fixated phakic intraocular lens IOL (Artisan; Ophtec, Groningen, Netherlands) (Artisan group) or a Visian implantable collamer lens (ICL; STAAR Surgical Company, Monrovia, CA) (ICL group) between June 2005 and December 2013. Preoperative, operative, and postoperative clinical data were collected on the incidence of retinal complications, including rhegmatogenous retinal detachment (RRD) or choroidal neovascular membrane (CNVM). RESULTS: The Artisan lens was implanted in 185 (30.68%) eyes and 418 (69.32%) eyes underwent ICL implantation. Mean follow-up was 26.78 months (range: 9 days to 98 months). Mean preoperative spherical equivalent (SE) was -12.44 ± 4.43 D (range: -1.13 to -31.00 D). The overall rate of retinal complications was 1%. Postoperatively, 3 (0.7%) eyes developed RRD in the ICL group, and no eyes developed RRD in the Artisan group. Submacular hemorrhage was observed in 1 (0.24%) eye in the ICL group. Two (1%) eyes developed CNVM in the Artisan group. The mean time from PIOL implantation to retinal complications was 15.6 months (range: 0.03 to 43 months). CONCLUSIONS: Implantation of ICL or Artisan phakic IOL demonstrated comparable rates of retinal complications. Anterior chamber PIOL does not increase the risk of retinal detachment or CNVM in patients with myopia.
Jennifer Joy Y Santos-Rayos
University of the Philippines, Philippines
Title: Macular Pigment Optical Density in Filipinos with Age-Related Macular Degeneration After Lutein and Zeaxanthin Supplementation: A Non-Randomized Comparative Study
Biography:
Jennifer Joy Y Santos-Rayos completed her Medicine degree in 2011 and Ophthalmology training in 2014 from the University of the Philippines – Manila, Philippine General Hospital. She is presently working with the Philippine Eye Research Institute as Project Manager and researcher, working for research projects commissioned by UNICEF, Department of Health and the Philippine Health Insurance Corporation. She also has a private practice in Manila. Her study entitled “Macular Pigment Optical Density among Filipinos with Age-related Macular Degeneration after Lutein and Zeaxanthin Supplementation” has won in several research competitions from the Philippine Ophthalmology Association and Philippine College of Surgeons.
Abstract:
Objectives: This study determined the baseline Macular Pigment Optical Density (MPOD) for those without retinal disease (group 1), those with non-exudative Age-related Macular Degeneration (AMD) (group 2), and those with exudative AMD (group 3). The effect of Lutein-Zeaxanthin supplementation was also determined. Method: For this study, 120 participants completed the baseline MPOD measurement and supplementation of Lutein (12 mg/day) and Zeaxanthin (1 mg/day) for 90 days. Factors of MPOD were also obtained through a questionnaire. Results: The mean baseline MPOD for the three groups were as follows: 0.382 DU (+ 0.10) for group 1, 0.333 DU (+0.07) for group 2, and 0.283 DU (+0.07) for group 3. Baseline MPOD of group 1 was statistically higher than baseline MPOD of group 2 (p=0.021) and group 3 (p=0.001). Mean baseline MPOD of group 2 is significantly higher than group 3 (p=0.017). MPOD after supplementation was also statistically significant using one-way repeated measures ANOVA. For Group 1, the MPOD levels increased significantly every month of supplementation, except on the third month when it did not reach statistical significance (p=0.001, p=0.003 and p=1.00 respectively). For Groups 2 and 3, MPOD levels increased significantly every month (group 2 p=0.021, p=0.010, p=0.008; and group 3 p=0.000, p=0.026, and p=0.00). Of the factors tested, weak and non-significant correlation was found. Conclusion: Patients without retinal disease have higher MPOD than patients with Non-neovascular AMD, and an even higher MPOD than patients with neovascular AMD. Supplementation increased the MPOD for three months.
- Instruction Course By Alex
Session Introduction
Alex Ng
University of Hong Kong
Title: Clinical Application of Corneal Collagen Cross-Linking – Keratoconus and Beyond
Biography:
Dr Alex Ng obtained his MBBS degree from the University of Hong Kong in 2008. He received his basic and 2 years of higher surgical ophthalmology training in the United Christian Hospital. In October 2013, he joined the Department of Ophthalmology, the University of Hong Kong as clinical assistant professor, with a research interest in anterior segment disorders including refractive cataract surgeries, corneal disorders and ocular surface diseases.
Abstract:
Synopsis: This course will discuss the clinical use of corneal collagen crosslinking in the treatment of a wide spectrum of diseases including corneal ectasia, infective keratitis, bullous keratopathy and cystic bleb leakage. Various techniques of crosslinking will be discussed, including use of accelerated, pulsed and trans-epithelial crosslinking. Objective: At the conclusion of this course, the attendee will be more confident in selecting the most suitable technique of crosslinking in the treatment of keratoconus. They will also have a better understanding on the use of crosslinking in other anterior segment disorders including leaking cystic bleb, bullous keratopathy and infectious keratitis.