Retinal Disease Highlights From the 2010 AAO Meeting

October 28, 2010

Many of us just returned from the largest ophthalmic “trade show” in the world.  The American Academy of Ophthalmology convened in Chicago last week.  This meeting was combined with the Middle East Africa Council of Ophthalmology (MEACO).  Perhaps 40 K attended the meeting.

I also attended the 2 day retinal subspecialty meeting which preceded the larger AAO meeting.  Thus, I had 5 days to expand my knowledge.

Most of the congress was focused on technology, especially electronic medical records.  Few discoveries were revealed.  This may be for two reasons:  there is nothing really new going on right now, and/or, the Internet allows such rapid sharing of information, that it is impossible to “wow” anyone at this meeting.  Probably both are true.

With regard to retinal disease, my particular specialty, there is little new, but lots to be excited about.

Avastin and Lucentis continue to be the mainstays of treatment for wet macular degeneration.  There is evidence that the two drugs are similar in clinical efficacy…a notion I support.  It is likely that these types of drugs will be delivered with a sustained release system, thus, obviating the need for repeated intraocular injections.

Ozurdex is now indicated for the treatment of uveitis.  It was originally FDA approved for the treatment of RVO only.  By itself, not earth-shattering, but does make sense clinically.  Sustained release steroids for chronic intraocular inflammation.  Sounds much better.

The highlight of the meeting is the potential for Iluvien to be FDA approved soon.  Iluvien is similar to Ozurdex in that both are injectable intraocular sustained release systems.  Iluvien will be a sustained release system that delivers intraocular steroids for the treatment of diabetic macular edema.   While this is a particularly promising development for patients with diabetic retinopathy, this has larger implications for eye treatment overall.

What Does This Mean?  Illuvien is likely to be the second FDA approved intraocular drug delivery system.  This will be a significant endorsement of drug delivery to the eye.  We are entering a new era of pharmaceutical therapeutics;  sustained release inside the eye.  For now, we are focused on retinal disease.  But soon, very soon, devices will emerge promising better therapeutics for almost any eye condition.

Just think, glaucoma may be treated by such a device.

Randall V. Wong, M.D.
Retina Specialist, Fairfax, Virginia

 

 



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2 Responses to “Retinal Disease Highlights From the 2010 AAO Meeting”

  1. Lolly on December 1st, 2010 12:25 pm

    Hello, I appreciate your blog and find it useful. I have a question and a comment.

    I have Leber’s congenital amaurosis (LCA). I recently had cataract surgery on both eyes. The surgeon also removed scar tissue from both retinas and performed vitrectomies on both eyes. The purpose of the surgery was to improve the vision in my stronger eye, and make both eyes healthier.

    He could not implant the IOL in the stronger eye, because the retina was loose. He put silicone oil in the eye to help hold the retina in place. This means I do not have a lens in that eye.

    In the short term, I realized that using dilation drops helped improve the light getting through to the stronger eye and asked for a prescription, which I got. It is for Atropine.

    Having done some research on this drug, I’m concerned about how long it stays in the body, and any other undesirable side effects of atropine. What would you recommend to help increase the light and clarity of vision until we can decide on a course of action?

    We are in discussion about future options for a permanent solution to increase clarity of vision in this eye.

    I am primarily interested in improving my navigational vision.

  2. ari weitzner on December 1st, 2010 9:57 pm

    absorption of atropine drops in the body of an adult is negligible and clinically insignificant. rare to see side effects in an adult. until the oil is removed- if it can be removed-not much can be done at this time to help this eye.

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