Sheryl brings a wealth of editorial experience to MJH Life Sciences’ Eye Care Network, having engaged with the readers and the greater ophthalmic community of 

for more than 20 years. As Group Editorial Director, Sheryl’s purview extends across the print and digital network of 

Ophthalmology Times, Ophthalmology Times Europe, Modern Retina 

 Prior to ophthalmology, Sheryl previously covered the fields of audiology and confectionery science/technology/manufacturing.

Sheryl is also passionate about the mission, vision and values of Ophthalmic World Leaders (OWL) and recently completed her term on its Board of Directors. She continues to volunteer as Editor-in-Chief of the organization’s 

Magazine. In 2013, she was honored with the group’s inaugural Rising Star Award.

In addition, she has served as a judge for 

 Health Care Heroes Awards program as well as the Jesse H. Neal National Business Journalism Awards.

Sheryl Stevenson

home

authors

sheryl-stevenson

Rishi P. Singh, MD, FASRS, highlights the two-year results of the YOSEMITE and RHINE trials, in which patients were randomized to receive either faricimab or aflibercept, in a presentation at the 2022 Retina World Congress.

My presentation was on the two-year results of the YOSEMITE and RHINE trials. This trial enrolled patients and randomized them to receiving either faricimab or Eylea within the course of the trial. The patients in the faricimab arm were actually given either a personalized treatment approach after four loading doses or given the drug every eight weeks after loading period.

And what the study found was really quite interesting. The faricimab molecule, which is both a combined anti-Ang2 and an anti-VEGF, performed better than the aflibercept drug in the trial in many different ways.

First and foremost, the durability of the drug was significantly better in the faricimab study, with almost 79% of patients achieving acute 12 week of dosing and the personalized treatment approach during the end of the two-year study.

In addition, 60% of patients who received the drug every 16 weeks at the end of the two-year trial, and we found greater reductions in retinal fluid, especially intraretinal fluid, within the faricimab arm compared to aflibercept. As well as we saw better resolution of diabetic macular edema in a faster fashion within the faricimab arms compared to aflibercept during the two-year trial.

Videos

In the study, the faricimab molecule, which is a combined anti-Ang2 and anti-VEGF, performed better than the aflibercept drug in many different ways. Rishi P. Singh, MD, FASRS, summarizes some of these key findings.

Significance of the YOSEMITE and RHINE 2-year DMO clinical trial results

Dara Conlon, Executive Vice President of EURETINA, and Prof. Anat Loewenstein, General Secretary of EURETINA, discuss some key features of this year's Congress.

EURETINA leadership discusses what to expect at the 2022 Congress, outlines Women in Retina programme

A novel non-invasive ocular imaging method may be able to detect an early indicator of glaucoma in time to prevent disease progression and vision loss, according to research from the New York Eye and Ear Infirmary of Mount Sinai (NYEE). The study was published in 

The study focused on measuring flavoprotein fluorescence (FPF) in the eye. Mitochondria—which are responsible for generating energy in cells—produce FPF when they are stressed, and levels of FPF are elevated in people with glaucoma compared to those with normal eyes.

Mitochondrial dysfunction in the optic nerve, which sends light signals to the brain and is critical for vision, can eventually lead to loss of cells and tissue damage, causing multiple eye diseases such as glaucoma, and macular degeneration, as well as other retinal damage. This is the first comprehensive study to look at FPF changes in the optic nerves in patients with different stages of glaucoma compared to healthy eyes.

“Glaucoma is difficult to diagnose in early stages, and often physicians agonize to confirm subtle signs of progression in advanced stages. Once structural damage to the optic nerve has occurred, it is currently not possible to reverse. The better we become at identifying early or ongoing degeneration, the more proactive we can be at implementing protective therapy,” says principal investigator Dr Richard B. Rosen, Vice Chair and Director of Ophthalmology Research at NYEE and Chief of the Retina Service for the Mount Sinai Health System. “Our study shows FPF may be useful as an objective measure for predicting glaucoma progression earlier than measuring structural damage, with similar sensitivity to visual field changes but easier and potentially more consistently.”

A team of researchers used the OcuMet Beacon—a fundus camera with special filters that specifically isolates the fluorescence, developed by OcuSciences—to analyse 86 eyes. Fifty of the eyes had glaucoma, based upon thinning of the retinal fibre layer, and 36 had no disease. They found FPF, an indicator of mitochondrial oxidative stress, was significantly higher in glaucoma eyes compared with normal eyes, especially in early-stage glaucoma cases where damage is difficult to detect. Levels of FPF correlated with other means of detecting glaucoma including visual field mean deviation, visual field pattern deviation, and retinal nerve fibre layer thickness.

These results suggest that FPF could be used clinically to reliably and objectively detect metabolic evidence of injury due to glaucoma, limiting the need for frequent visual field testing, the gold standard for measuring visual function. In fact, the researchers say, FPF may be a more accurate measurement, as visual fields have a number of downsides—they are subjective, fluctuate with a patient’s attention, and patients can lose concentration during this assessment.

“Previous studies have demonstrated that when the mitochondrial oxidative stress is relieved by medication or surgery, the flavoprotein fluorescence levels go down. This makes the technique very attractive as a sensitive way of monitoring response to therapy,” explains Dr Rosen. “This measurement could potentially be used as a first-line indicator to monitor of glaucoma progression for the patient and the physician.”

Researchers say their next step is to see if FPF can reliably monitor the effect of therapy for glaucoma patients, to see when treatment has flattened the risk curve of progression in advanced cases, as well as identifying patients who require early glaucoma intervention.

Articles

Flavoprotein fluorescence could serve as a new biomarker, according to a Mount Sinai study. This measurement could potentially be used as a first-line indicator to monitor of glaucoma progression for the patient and the physician.

High-tech, noninvasive imaging identifies early glaucoma

Dr Sunir J. Garg discusses the benefits of hypersonic vitrectomy as a novel technologic advancement for retinal surgeons in a presentation at the 2022 Retina World Congress.

Yeah, so hypersonic vitrectomy is one of the really most novel ways we have of removing vitreous, and our traditional guillotine cutters are really amazing. And as they've gotten faster and faster, they take smaller bites of the vitreous gel. And as you take smaller bites of the vitreous gel, you reduce viscosity. When you have less viscosity, you're able to remove the gel a lot more efficiently.

And over the past 10 to 15 years, our cutters went from 2500 cuts a minute to 15,000 cuts a minute to getting closer to 30,000 cuts a minute. But there's certain inherent limitations. Smaller bites are still small bites, but they're not tiny particles.

One of the other limitations of our standard guillotine cutters is they're a needle and needle design. And as you may remember from high school physics, the smaller you make a lumen, the exponentially more resistance you have. Hypersonic vitrectomy not only takes small little particles of the vitreous gel, but it doesn't have a needle and needle design. So the single lumen gives you an effectively larger internal radius, enabling you to remove the vitreous gel a lot more efficiently.

So we looked at a bunch of different cases using this technology. And we found that we could do pretty much a whole host of retinal surgeries with it: retinal detachments, retain lens material, silicone oil cases. And for a lot of cases, it was really great. And surgeons found that was particularly advantageous for removing vitreous gel in mobile retina. So in retinal detachment cases it was terrific. We could use that same port to remove retain lens materials, we didn't have to open up a frag in these cases. And some of my colleagues actually used it to remove silicone oil.

And it was kind of neat to be able to do basically the entire surgery with one instrument. There was a couple of cases in which I don't think anything's going to be better than a guillotine cutter, particularly in really thick, dense diabetic membranes. Using scissors or guillotine cutters are really fabulous. And there's a couple of cases that had a really kind of glassy, thick vitreous gel, that this didn't work that great, but honestly, neither did my guillotine cutter so I think that was just those cases.

One of the other potential advantages of this is you don't need gas, so you don't need big gas tanks and you don't need to be tethered to an operating room. So whether you're in places around the world that don't have easy access to those things, or whether you're looking at doing vitrectomy outside of the traditional or this might be really advantageous.

There are some limitations about it, you know, we're still refining the different port technologies. So one of the great things about this is you can change the port. So you can make it into a teardrop shape; you can make it into a sigmoid shape, and some of our new iterations seem to be a lot more efficient than our old ones.

We're also adjusting some of the parameters of the handpiece. One of the things that we found is by increasing the frequency, we can dramatically increase the force or the ability of the instrument to cut the vitreous gel. And we're currently working on a new sigmoid shape, which seems to be a major improvement over what we had before.

But considering that the technology is really new, and there's only been hundreds or maybe 1,000 cases done, I'm really impressed with how dramatically better the technology continues to get. And as we use it more often, I think we'll continue to refine it.

Though the speed of traditional guillotine cutters has increased significantly in recent years, there are certain limitations. With the advent of hypersonic vitrectomy, Dr Sunir J. Garg explains how retinal surgeons can remove the vitreous gel with more efficiency.

Author | Sheryl Stevenson

Articles

EURETINA leadership discusses what to expect at the 2022 Congress, outlines Women in Retina programme

High-tech, noninvasive imaging identifies early glaucoma

Hypersonic vitrectomy a novel technology for removing vitreous

Significance of the YOSEMITE and RHINE 2-year DMO clinical trial results