This episode is a recording of the retina-focused EyeNovation webinar episode which was a collaboration between Canadian Ophthalmological Society and the Canadian Retina Society. Dr. Chakravarthy will provide a background to the double layer sign, its definition and how it is detected.  Data to support the presentation will be from the EDNA trial . This study possesses an imaging dataset that was captured  longitudinally in over 500 high risk eyes and obtained robust rates of progression to neovascularization as well as  time to the event.  The presence of  the DLS and or other features of intermediate AMD were assessed at baseline and included measurements of length of separation of the RPE from its basement membrane, height of separation and the number of B scans involved.    Rates of progression in eyes without and with DLS were computed and models built to assess risk of progression to neovascularization.   In addition the DLS and SIRE signs were compared for their contributions to risk of progression.   The findings from these analyses and their clinical significance will be discussed .

Make sure to register for the Canadian Retina Society (CRS) annual meeting which will take place in Vancouver, BC from April 25-27, 2025. Go to https://www.crsscr.ca to register.

In this episode, Dr. Muni discusses two of his recent publications on repair of retinal detachment. In the first article, he discusses long-term reattachment rates of patients that were studied in the PIVOT trial, showing that both groups of patients who underwent either pneumatic retinopexy or vitrectomy had excellent long-term attachment rates. In the second article, he discusses Suprachoroidal Viscopexy, which is a novel in-office method of repairing retinal attachment, using viscoelastic agents injected in the suprachoroidal space to create a temporary buckling effect. 

Discussed Articles:

• Chen TS, Motekalem Y, Melo IM, Hillier RJ, Berger AR, Giavedoni LR, Wong DT, Altomare F, Muni RH. Long-Term Redetachment Rates of Pneumatic Retinopexy versus Pars Plana Vitrectomy in Retinal Detachment: A PIVOT Post Hoc Analysis. Ophthalmol Retina. 2024 Aug 23:S2468-6530(24)00397-X. doi: 10.1016/j.oret.2024.08.011. Epub ahead of print. PMID: 39182651.

• Muni RH, Melo IM, Demian S, Minelli T, Batawi H, Park J, Pecaku A. In-Office Suprachoroidal Viscopexy for Acute Rhegmatogenous Retinal Detachment. JAMA Ophthalmol. 2024 Dec 12. doi: 10.1001/jamaophthalmol.2024.5202. Epub ahead of print. PMID: 39666366.

Dr. Cindy Chen describes her group’s work on a retrospective review of association of systemic methotrexate therapy and a lower rate of proliferative vitreoretinopathy (PVR) after retinal detachment repair in large cohort of 2674 eligible patients. 

Professor Maher Saleh discusses his group’s findings for the use of perfluorocarbon in the treatment of macula-off retinal detachment. The study results suggest that perfluorocarbon liquid use during vitrectomy for macula-Off Retinal detachment has no impact on Macular folds and Metamorphopsia.

Discussed article: 

Wurtz M, Dormegny L, Muller C, Bourcier T, Ballonzoli L, Gaucher D, Saleh M. PERFLUOROCARBON LIQUID USE DURING VITRECTOMY FOR MACULA-OFF RETINAL DETACHMENT HAS NO IMPACT ON MACULAR FOLDS AND METAMORPHOPSIA. Retina. 2024 Nov 1;44(11):1891-1898. doi: 10.1097/IAE.0000000000004220. PMID: 39102743.

Dr. Marc Spirn from Wills Eye Hospital discusses the results of a retrospective study of performing lattice degeneration on a series of patients who had lattice degeneration with high risk features.

The discussed article:

Kazan AS, Mahmoudzadeh R, Salabati M, Sharpe J, Fineman MS, Hsu J, Yonekawa Y, Spirn MJ. Indications and Outcomes of Laser Retinopexy in Eyes With High-Risk Lattice Degeneration. J Vitreoretin Dis. 2024 Apr 25;8(4):381-387. doi: 10.1177/24741264241248253. PMID: 39148566; PMCID: PMC11323511.

Dr. Witkin from the American Society of Retina Specialists talks about our current knowledge of the incidence of retinal vasculitis following intravitreal injection of Pegcetacoplan for treatment of geographic atrophy.

Discussed article:

Witkin AJ, Jaffe GJ, Srivastava SK, Davis JL, Kim JE. Retinal Vasculitis After Intravitreal Pegcetacoplan: Report From the ASRS Research and Safety in Therapeutics (ReST) Committee. J Vitreoretin Dis. 2023 Dec 21;8(1):9-20. doi: 10.1177/24741264231220224. Erratum in: J Vitreoretin Dis. 2024 Feb 29;8(3):363. doi: 10.1177/24741264241238212. PMID: 38223782; PMCID: PMC10786078.

A panel of guests optometrists share their feedback about communication issues between optometry and the speciality of retina. Guests panelists: Dr. George Papadakis, Dr. Brian Feinstein, Dr. Lena Moiseiykina and Dr. Nagar Sohbati. 

Dr. Arthur sit describes his surprising research results on the effect of scleral buckle on ocular fluid dynamics.

The discussed article: Lyons LJ, Kazemi A, Bakri SJ, Barkmeier AJ, Iezzi R, Olsen TW, Hodge DO, Sit AJ. The Effect of Scleral Buckle Surgery on Tonographic Outflow Facility, Positional Intraocular Pressure, and Ocular Biomechanics. Ophthalmol Glaucoma. 2024 Jan-Feb;7(1):1-7. doi: 10.1016/j.ogla.2023.07.007. Epub 2023 Jul 22. PMID: 37482122.

Dr. Paul Micevych from the UC San Francisco discusses his group's work on systemic and individual risk factors leading to complicated diabetic retinopathy requiring vitrectomy. 

Discussed article: Micevych PS, Taha AM, Poddar A, Stewart JM. Individual and Systems-Based Risk Factors for Diabetic Vitrectomy in an Urban Safety-Net Hospital. Ophthalmol Retina. 2023 Dec;7(12):1027-1034. doi: 10.1016/j.oret.2023.05.014. Epub 2023 May 24. PMID: 37236319.

Dr. Nina Ahuja and Dr. Nupura Bakshi elaborate on the concept of Equity, Diversity and Inclusion in medicine and discuss their recent publication about the EDI landscape in the Canadian ophthalmology post-secondary programs. The discussed article:

Lee EY, Farrokhyar F, Bakshi N, Levin LA, Ahuja N. Equity, diversity, and inclusion landscape in Canadian postgraduate medical education for ophthalmology. Can J Ophthalmol. 2024 Feb;59(1):31-39. doi: 10.1016/j.jcjo.2022.08.015. Epub 2022 Sep 24. PMID: 36162441.