On Sunday morning, Drs. Lee Jampol and John Wells discussed persistent macular thickening in DRCR.net during the first NPDR session. In Protocol I, 6 monthly injections of ranibizumab was provided unless vision improved to 20/20 or OCT normalized. Why the magic number 6? Data showed that the percentage of eyes with resolution of DME increases up to month 6. However after 6 injections, 40% of patients still had persistent macular thickening. In this subgroup of patients, continuous injection of ranibizumab was beneficial with good outcomes with 14-15 additional injections at 2 years. Among the 3 anti-VEGF medications compared in Protocol T, aflibercept and ranibizumab showed better anatomic results compared to bevacizumab. It seems like we will be continuing our injection journey with our DME patients. In the near future, we look forward to more data regarding how to incorporate other treatment modalities such as steroids, focal laser, and micro-pulse laser.
Also, while catching up with old friends and making new ones, you can head over to the poster session, located at the left end of the Exhibition Hall, to learn about the investigative efforts of other ASRS colleagues. There is a great selection of posters this year.
And if you go further down the Exhibition Hall, you will see the 2017 Membership Survey Preferences and Trends (PAT Survey). Overall, the mainstream treatment preferences are similar among US and international retinal specialists. Some difference that I noted:
In treating giant retinal tears there are differences in usage of silicone oil (more by our international colleagues) or gas (more by US surgeons), and using a scleral buckle (more in the US) or not (international). Staining adjuvant for internal limiting membrane peeling between ICG (US) and brilliant blue (international). The majority of our international colleagues also take care of cataracts while performing vitreoretinal surgery.
Congratulations to the award recipients, Drs. Paul A. Sieving, John T. Thompon, James Folk, and Lawrence Yannuzzi. Our profession and countless patients throughout the world have benefited immensely from your dedication and remarkable insights throughout the years!
Miin (Irene) Roh, MD PhD
Vitreoretinal Surgery Fellow
Mass Eye and Ear, Harvard Medical School, Boston MA