ESCRS/EURETINA symposium on cataract and beyond looks at cutting-edge of knowledge and techniques

[caption id="attachment_5442" align="alignnone" width="1024"] EURETINA President Ursula Schmidt Erfurth and ESCRS President David J Spalton chairing yesterday's joint ESCRS/EURETINA Symposium[/caption] The joint ESCRS/EURETINA Symposium, ‘Cataract, AMD and Beyond’, drew a big number of delegates to the Bella Center’s largest auditorium yesterday afternoon. It was a report on the cutting-edge of knowledge and technique regarding topics, treatments and techniques that affect millions of patients in Europe and the rest of the world. “Optical coherence tomography (OCT) angiography rapidly generates simultaneous structural OCT images and depth-encoded angiography of high quality,” said Dr Andreas Pollreisz in the opening presentation. “The result is that three-dimensionality allows localisation of flow within specific tissue layers independently, a feature not available in traditional fluorescein angiography,” said Dr Pollreisz. “Because it is non-invasive and as risk-free as standard OCT, extensive follow-up imaging can be conducted of patients under treatment,” added Dr Pollreisz. Dr Eberhart Zrenner spoke next, updating delegates on the current status of electronic retinal implants for visual rehabilitation. “There are three anatomical approaches. Epiretinal, subretinal and suprachoroidal implant locations each have their relative advantages and disadvantages,” he said. Currently, six major projects are ongoing worldwide. Most have an external camera, an external, battery-powered image-processing device and a stimulating retinal implant with an array of electrodes. “The goals of these implants are light perception and improved mobility,” he said. Continuing on the topic for advanced, high-tech intraocular implants, Dr Giuliana Silvestri presented the latest on intraocular telescopes and magnifiers. “Is there a need for intraocular magnifying aids?” asked Dr Silvestri. “Many patients with macular degeneration have little or no hope of useful central vision, either due to atrophy or non-response to anti-VEGF treatment.” The implants, which look like technologically advanced, complicated intraocular lenses, magnify the incoming image by approximately three times. “Although the central scotoma does not go away, it becomes smaller relative to the image projected on the posterior pole,” said Dr Silvestri. “The trade-off is a constricted visual field.” Dr Lyndon da Cruz is not satisfied with optical solutions. He presented delegates with his technique of inducing stem cells to develop into retinal pigment epithelium (RPE) tissue on a stiff, 10-micron-thick membrane, which can then be preloaded into an injector and inserted under the retina in patients with macular degeneration. “Previous RPE transplantation or macular translocation techniques have always used ‘old’ RPE. Here, we’re placing the overlying retina on brand-new RPE. This is what we mean when we talk about regenerative medicine,” said Dr da Cruz. Dr Ronald Yeoh, Singapore put to rest fears that cataract extraction will frequently exacerbate the progression of macular degeneration. “Cataracts often co-exist with AMD, as they are both age-related and share common risk factors,” said Dr Yeoh. “Fortunately, epidemiological data does not definitively show that cataract surgery is associated with AMD progression.” However, Dr Yeoh did emphasize the importance of close follow-up of at-risk patients in the postoperative period. Focusing on another potential complication after cataract surgery, Professor Jose Garcia-Arumi, Spain, presented “Retinal Detachment After Cataract Surgery: Is It Preventable?” “Although it is relatively rare, rhegmatogenous retinal detachment has a four-fold increased incidence in the years after cataract surgery, as compared to the normal population,” said Dr Garcia-Arumi. As such, he recommended treating retinal pathologies that could lead to retinal detachment prior to surgery, particularly in younger patients who have not yet had a posterior vitreous detachment.