EURETINA 2024: David Yorston, FRCS, FRCOphth, says data can unify us

At this year's EURETINA meeting, David Yorston, FRCS, FRCOphth, delivered the Gisbert Richard Lecture, titled "Ten Years on: What Have We Learned From the Euretina/BEAVRS Database so far." Here, he speaks about his lecture, the database and what lessons he hopes retina specialists took home with them.

The below transcript has been lightly edited for clarity.

David Yorston, FRCS, FRCOphth: Hi, I'm David Yorston, and I'm a consultant retinal surgeon in Glasgow and the West of Scotland. I delivered the Gisbert Richard Lecture; that is awarded to a vitreoretinal surgeon every year. It's a huge and very unexpected honor to be asked to give it, and I was talking about the EURETINA database.

This is an online database that was established a little over 10 years ago with funding from EURETINA, and now contains data from over 15,000 retinal detachments and over 5,000 macular holes, and we produced over 10 original research papers based on this data. We've learned a number of different things. We've learned things about the phenotype of macular holes in retinal detachment, for example, that macular holes are larger in women than they are in men, and hence more likely to fail. We've learned that older patients tend to have more complex retinal detachments, and we've learned things about the management of these things. We've learned that in macular hole, the conventional definition of a large hole was 400 microns, but we've shown that the prognosis only changes when the hole is over 500 microns. So we've changed the definition of a large hole. In retinal detachment, we've shown that early surgery, particularly surgery within the first 72 hours, gives much better visual outcomes than delayed or later surgery. So that's changed the conventional wisdom. Again, it that was that macular off holes or detachments are not urgent, we've shown that they probably are. And then, we've used innovative methods, such as propensity score matching, to do almost like randomized trials of interventions, and that's shown that denser on is better than light oil in eyes with inferior pathology, and we've shown that ILM flaps is superior to an ILM peel for large holes, of what 500 microns are over. I hope that the thing that they really remember is the most important lesson, which is the one at the end, which is that in a world that's increasingly divided and polarized, the EURETINA database reminds us of how much we can achieve when we work together collaboratively, and I hope that's the message that everybody takes away with them.

I've really enjoyed presentations by David Steel, who's one of my colleagues in the UK and has a very good team around him that been able to do some very sophisticated analysis of individual patient data in, for example, macular hole, and also was responsible for the propensity score matching analysis that shown that heavy oil is superior to light oil. So anytime he's speaking, it's always worth going to hear him, and I've always learned a lot from that.