Day one at the ASRS Annual Meeting was off to a running start, literally for me. Since the meeting started in the afternoon I started the day with a beautiful run along the Charles River. The Boston weather seems to be right on target for the upcoming weekend’s events and meeting.
Sumit Sharma led an excellent uveitis instructional course with Phoebe Lin, Sunil Srivastava, Dilraj Grewal, and Glenn Jaffe who all shared their pearls for the workup and management of uveitis patients. Dr. Srivastava shared his clinical exam pearl with the audience: he asks all his patients about their tattoos as an inflamed tattoo may be an indicator of granulomatous disease such as sarcoidosis. Phoebe Lin discussed use of steroid implants in patients who are refractory or intolerant to systemic therapy and the use of periocular versus intravitreal steroids in uveitis patients. One interesting tip I learned was that you could decant Kenalog to give a more concentrated intravitreal dose, particularly in vitrectomized eyes. The panel was joined by one of their mutual mentors Glenn Jaffe who added his pearls to the discussion related to the removal and replacement of Retisert implants. Dr. Grewal reviewed immunosuppressive therapies, noting the MUST trial showed those on immunosuppression may have long-term visual outcome benefits.
Lejla Vajzovic led an interactive session on Pediatric Vitreoretinal Surgical Techniques with an all-star panel of pediatric surgical experts including Caroline Baumal, Sengul Ozdek, Michael Trese, and Emmanuel Chang. Dr. Ozdek presented an interesting case of likely FEVR in a patient with buphthalmos. The panel discussed their differing approaches to a patient with Coats’ disease and an exudative retinal detachment which included use of anterior chamber infusion, external drainage, and cryotherapy versus when to use an internal approach with vitrectomy with or without lensectomy. The panel ended with a lively discussion on the controversies associated with the use of anti-VEGF in retinopathy of prematurity and the pros and cons of treatment with anti-VEGF versus laser.
A panel of experts “Duked” it out at the Vitreoretinal Surgical Rounds which rounded out my day. Cases included optic disc pic maculopathy presented by Dr. Thomas Stone, a giant retinal tear and total retinal detachment in a child presented by Dr. Lejla Vajzovic, a combined rhegmatogenous and tractional retinal detachment in a patient with FEVR by Dr. Dean Eliott, refractory macular hole closure with lens capsule by Dr. David Chow, possible hemorrhagic occlusive retinal vasculitis after cataract surgery by Dr. Tarek Hassan, vitreoretinal biopsy techniques for uveal melanoma by Dr. Amy Schefler, and a challenging combined tractional/rhegmatogenous retinal detachment repair by Dr. Dilraj Grewal.
All then toasted to the start of a great meeting at the Boston Public Library!
Avni Finn, MD MBA
Vitreoretinal Surgery Fellow
Duke Eye Center, Durham NC