A review of our most important content from throughout the year
As 2023 nears its end, the reporters and editors from the Eye Care Network would like to thank you–our readers–for engaging with our print magazine, eNewsletters and video interviews. Throughout the year, we have had the privilege of working alongside industry opinion leaders to showcase what’s new and what’s upcoming in the ophthalmology space. If 2023 has shown us anything, it is how much we have to look forward to in 2024 and beyond. From groundbreaking research to cutting-edge tech, there is plenty of reason for eye care professionals and their patients to be excited.
This week, you will see a series of posts featuring the best content from Eye Care Network brands. We’ll showcase our colleagues at Opthalmology Times, Optometry Times and Modern Retina, so keep your eyes peeled (and pardon the pun!).
Jod Mehta, PhD, FRCOphth, who is the Distinguished Professor in Clinical Innovation in Ophthalmology at Singapore National Eye Centre, contributed this cover story for our September issue. The article was based on his 2023 British Society of Refractive Surgery Charles McGhee Lecture. Our editorial team was immediately captivated by the lecture title, “Lenticule Extraction: Will LASIK Cease to Exist?”
Prof Mehta explores that provocative question at length in this article, which charts the potential benefits of lenticule extraction for patients–and the shortcomings that providers must be aware of. While LASIK might not disappear anytime soon, it’s clear the laser refractive surgery landscape is very different now than just one year ago.
Much of our most fascinating content this year came from in-depth conversations with industry leaders at conferences. AnnMarie Hipsley, DPT, PhD, Founder and CEO of Ace Vision Group, met with Ophthalmology Times Europe at the 2023 European Society of Cataract and Refractive Surgeons (ESCRS) meeting to discuss Ace Vision Group's microporation therapeutic technology, used to treat presbyopia. Novel treatments are quickly expanding the range of treatments available for patients with presbyopia, and Dr Hipsley indicated the condition will become a focal point for the eye care space in the days to come.
She used microporation therapeutic technology as an example of the accessible, effective treatments that are newly available to patients. “It's a true biomechanical treatment that's attacking this ocular rigidity from cross-linking in the sclera,” she explained. “It restores the natural dynamic range of focus function in the eye that moves the lens. It's so simple that it seems hard to wrap your brain around. But, it's been a really long journey to get here.”
Cell therapies are among the most fascinating–and complex–treatment modalities gaining popularity in eye care. In our May issue, Thomas V. Johnson III, MD, PhD, of Wilmer Eye Institute at Johns Hopkins Univeristy School of Medicine in Baltimore, Maryland, dove into the topic of retinal ganglion cell (RGC) repopulation.
Ophthalmology is pioneering the field with clinical trials of stem cell-derived retinal pigment epithelium and photoreceptor transplantation, which could potentially restore vision in diseases such as age-related macular degeneration and macular dystrophies. There are staggering implications to consider when researching potential treatments for optic neuropathies. Optic nerve diseases are both prevalent and irreversible; glaucoma alone affects more than 80 million individuals worldwide.
“The list of challenges in making functional RGC replacement a reality is daunting and will require therapeutic manipulation of cellular pathways involving neuronal survival, migration, dendritogenesis and axogenesis, pathfinding, synaptogenesis and myelination,” Dr Johnson wrote. But, there is reason to be hopeful. “Although the concept of optic nerve regeneration has long been the subject of fantasy, recent advances in neuroscience have converged to a point where functional RGC replacement may now be feasible,” he said.
Advances in imaging technology have been one of the biggest instigators of broad-scale change in the field of ophthalmology. Physicians are now able to answer questions that have challenged ophthalmologists for years. During the European Society of Ophthalmology (SOE) Congress, held in Prague, Czech Republic, Nicholas Volpe, MD, spoke on one such benefit of optical coherence tomography (OCT).
In his presentation, “Optic Neuropathy Versus Maculopathy,” Dr Volpe addressed recent developments in this area. “This has for ages been a very hot topic for ophthalmologists, because there are a group of patients that have unexplained vision loss and relatively normal appearing fundi, that is both the macula and the optic nerve,” he said. “At first glance [they] appear to be healthy. And for decades, we would go back and forth–is this an optic nerve problem? Is it a macular problem?”
But the conversation has been “revolutionised” by the advent of OCT, he said, as the imaging technique has provided “a much finer anatomic view of what's happening in the retina.” Especially when combined with other forms of testing, Dr Volpe said, physicians have more certainty than ever about the best treatment protocol for their patients.
Marco Zarbin, MD, PhD, FACS, delivered his talk, “An Assessment of the Impact of Disease Activity Criteria on Dosing Interval Assignment in Clinical Trial Patients with Neovascular AMD,” at this year’s American Society of Retina Specialists (ASRS) meeting. Following the event in Seattle, Washington, we recapped the highlights of his presentation for the November print edition of Ophthalmology Times Europe. In a testament to the relevance of his chosen topic, this article, published in the last few weeks of 2023, quickly became one of our most-read stories of the year.
“The take-home message of this talk is that the definition of active disease in clinical trials affects the estimates of the durability of the agents that are tested in those trials,” Dr Zarbin explained early in his presentation. Referencing a set of clinical studies for neovascular age-related macular degeneration (nAMD), the CANDELA and PULSAR trials, Dr Zarbin noted that differences in active disease criteria were reflected in the study outcomes.
“It may not be surprising that the durability estimates were not the same,” Dr Zarbin said. “In CANDELA, where either a change in vision or a change in anatomy mandated an injection, about 53% of the patients could be maintained with injections every 12 weeks, whereas in the PULSAR trial, where both a change in vision and a change in anatomy were required to mandate an injection, durability increased such that 83% of the patients could be maintained with injections every 12 weeks or longer.”