Parisa E. Naeini, MD
Vitreoretinal Surgery Fellow
University of California, Davis
In the “innovative retinal interventions” session, novel methods of treating retinal conditions were discussed.
Dr. Kazuaki Kadonosono introduced cannulation of central retinal artery as a treatment option for central retinal artery occlusion (CRAO). The procedure consists of cannulating the central retinal artery around the optic disc with a 47-gauge microneedle and injecting tissue plasminogen activator (tPA). He discussed the outcomes in their series of 30 eyes with CRAO and severe non-perfusion at baseline who underwent cannulation. The patients demonstrated improved perfusion on fluorescein angiography and had improved visual fields.
Dr. Claus Eckardt then presented the use of a scleral inlay for the treatment of optic disc pit maculopathy. He reported on 2 eyes of 2 patients with optic pit maculopathy and subretinal fluid. In both of these patients an autologous scleral flap was harvested and inserted into the pit, similar to an inlay. This procedure resulted in resolution of subretinal fluid in both patients.
Dr. Carl Awh discussed hypersonic vitrectomy. This is a new FDA-approved vitrectomy platform that takes advantage of ultrasonic power to drive the vitrectomy tip. The tip creates a localized area of tissue disruption (liquefaction). The emulsified material is then suctioned out of the eye. This cutter has been used safely for induction of PVD, core vitrectomy, shaving, removal of dense vitreous hemorrhage, etc.
Dr. Tamer Mahmoud then presented on his technique of autologous retinal transplantation for complex macular hole repair. In this method, a piece of retina is harvested and inserted onto the macular hole. This procedure resulted not only in successful closure of the hole but also some functional improvement in vision and microperimetry. Technical challenges of the procedure were discussed. A multicenter, prospective study is underway to assess the outcomes.
Finally, Dr. Amir Kashani discussed RPE sheet transplantation as a novel treatment for vision loss secondary to geographic atrophy. In this method, a composite implant consisting of human embryonic stem cell-derived RPE cells on a bioengineered synthetic substrate is surgically inserted under the retina. This is a phase 1/2a clinical trial with the goal of enrolling 20 patients to evaluate safety and tolerability (primary goal) and effectiveness.
We hope you enjoyed our coverage of the 2017 American Academy of Ophthalmology Retina Subspecialty Day.