2014 ny · 2016-12-18 · 2014 ny course director carl c. aw h, md course co-directors david r. cho...

2014 NY

COURSE DIRECTOR CARL C. AWH, MD

COURSE CO-DIRECTORS DAVID R. CHOW, MDTAREK S. HASSAN, MD

DECEMBER 4-6, 2014 • NEW YORK, NY

A FELLOWS’ FORUM, INC. PRODUCTION

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CME ACCREDITATION AND CREDIT DESIGNATION

This activity has been planned and implemented in accordance with the accreditation requirements andpolicies of the Accreditation Council for Continuing Medical Education through the joint providership of

William Beaumont Hospital and Medical Conference Planners, Inc. William Beaumont Hospital isaccredited by the ACCME to provide continuing medical education for physicians. William Beaumont

Hospital designates this live activity for a maximum of 14.25 AMA PRA Category 1 Credit(s).™

Physicians should claim only the credit commensurate with the extent of their participation in the activity. Credit breakdown: Fri = 7.25, Sat = 7.00

Carl Awh,MDCourse Director

Jean Bennett, MD, PhD, FARVOKeynote SpeakerARVO 2014 Meeting

Neil Bressler,MDEditor-in-Chief, JAMA Ophthalmology

Alexander Brucker,MDJ. Donald M. Gass Award LectureRetina Society 2014 Annual MeetingEditor-in-Chief, RETINA

Peter Campochiaro,MDThe RRF Award of MeritRetina Society 2014 Annual Meeting

David Chow,MDCourse Co-Director

Donald D’Amico,MDModerator, Journal Editor Panel

Pravin Dugel,MD Dean Eliott,MD Philip Ferrone,MD Hans Grossniklaus,MD, MBAJackson Memorial LectureAAO 2014 Annual Meeting

J. William Harbour,MDThe Paul Henkind MemorialLecture and Award, MaculaSociety 2014 Annual Meeting

Tarek Hassan,MDCourse Co-Director

Peter Kaiser,MD Szilárd Kiss,MD Timothy Olsen,MDExecutive Editor, AJO

Carl Regillo,MDFounders Award LectureARDS 2014 Annual Meeting

Kourous Rezaei,MDModerator, Best of RETINAWS

Andrew Schachat,MDGertrude Pyron Award LectureASRS 2014 Annual MeetingEditor-in-Chief, Ophthalmology

Hendrik Scholl,MD, MAW. Richard Green LectureMacula Society 2014 Annual Meeting

Jerry Shields,MDSchepens LectureAAO 2014 Annual Meeting

Faculty

BEST OF R E T INA 2014 NY 3

PROGRAM

ThursdayDECEMBER 4

5:30PM-8:30PM

RegistrationWestin New York Times Square, Bar 10

6:00PM-8:00PM

Welcome ReceptionWestin New York Times Square, Bar 10

8:00PM

Dinner on own

FridayDECEMBER 5

6:45AM-5:30PM

RegistrationWestin New York at Times SquareMajestic Ballroom Foyer, 5th Floor

6:45AM – 7:25AM

BreakfastWestin New York at Times SquareGershwin Ballroom, 4th Floor

6:45AM-3:50PM

ExhibitsWestin New York at Times SquareGershwin Ballroom, 4th Floor

7:30AM-9:45AM

SESSION 1Majestic Ballroom, 5th Floor

7:30AM-7:45AM

Opening Remarks

Carl C. Awh, MDCourse Director

7:45AM-8:15AM

Best of Retina from JAMA Ophthalmology

Neil M. Bressler, MDEditor-in-Chief, JAMA Ophthalmology

8:15AM-8:25AM

Audience and Panel Discussion

8:25AM-8:55AM

Best of Retina from AJO

Timothy W. Olsen, MDExecutive Editor, AJO

8:55AM-9:05AM


9:05AM-9:35AM

Best of Retina from RETINA

Alexander J. Brucker, MDEditor-in-Chief, RETINA

9:35AM-9:45AM


9:45AM-10:15AM

Break

10:15AM-12:25PM

SESSION 210:15AM-10:55AM

ASRS 2014 GERTRUDE D. PYRONAWARD LECTURE

Fourteen-ThousandDecisions and Counting –Tales from an Editorand Best of Retina from Ophthalmology

Andrew P. Schachat, MDEditor-in-Chief, Ophthalmology

Dr. Schachat was Editor of Ophthalmologyfor ten years and prior to that, AssociateEditor of the Archives of Ophthalmology,now JAMA Ophthalmology, for many years.He is and remains an Editor of Ryan’s Retina.During his tenure, Dr. Schachat made over14,000 accept/revise/reject decisions atOphthalmology. The presentation reviewscharacteristics of good and less goodmanuscripts with a focus on improvedreporting of clinical manuscripts.

10:55AM-11:05AM


11:05AM-11:50AM

Journal Panel Discussion

Donald J. D’Amico, MD (Moderator)Neil M. Bressler, MD, Timothy W. Olsen,MD, Alexander J. Brucker, MD, Andrew P. Schachat, MD (Panelists)

4 BEST OF R E T INA 2014 NY

11:50AM-12:20PM

Update on Genetics andAREDS Supplements

Carl C. Awh, MD

This presentation will review recent publica-tions and research relevant to the use ofgenetic testing to guide selection of nutri-tional supplements for patients with AMD.Evidence exists that patients followed inAREDS with the combination of highcomplement factor H (CFH) and low age-related maculopathy susceptibility 2 (ARMS2)genetic risk had a deleterious response tothe AREDS formulation. Analysis of AREDSdata suggests that this relationship is dueprimarily to the zinc component of theAREDS formulation, a hypothesis supportedby independent research regarding the roleof zinc in the pathogenesis of AMD.

12:20PM-12:30PM


12:30PM-2:00PM

Lunch and Industry Presentations

2:00PM-3:20PM

SESSION 32:00PM-2:30PM

AAO 2014 RETINA SUBSPECIALTY DAY CHARLES L. SCHEPENS LECTURE

Management of PosteriorUveal Melanoma: Past, Present and Future

Jerry A. Shields, MD

PURPOSE: To review management of ciliarybody and choroidal melanoma (posterioruveal melanoma; PUM) over the last centurywith emphasis on changing concepts.

DESIGN: Retrospective review

PARTICIPANTS: Review of personalexperience over 40 years and pertinent literature on management of PUM.

INTERVENTION: Diagnosis and therapy forposterior uveal melanoma.

MAIN OUTCOME MEASURES: Patient survival.

RESULTS: In the early 1900s, most patientspresented with a large symptomaticmelanoma,that necessitated enucleation,and the systemic prognosis was poor. In the1970s, controversy erupted regarding therole of enucleation for PUM. Some author-ities advocated prompt enucleation whileothers proposed that enucleation promotedmetastasis, known as the Zimmermanhypothesis. Others recommended obser-vation, withholding treatment until tumorgrowth was documented.

During the 1970s there was a trend towardeye-saving procedures, including laser photo -coagulation, surgical removal of tumor, andtechniques of radiotherapy. Despite localtreatment success, systemic prognosisremained guarded with approximately 40% mortality overall. However, there wasconvincing evidence that smaller tumorsoffered a significantly better prognosis.

Currently, there is a movement towardearlier identification and treatment of smallmelanomas using clinical factors predictiveof malignant potential, in keeping withsimilar philosophy regarding other cancers.Further understanding of melanoma cyto -genetics and molecular pathways havehelped to recognize patients at risk formetastasis. At-risk patients are offeredsystemic therapeutic trials to prevent metastasis. We anticipate that the futuremanagement of PUM will focus ondetection of clinical and imaging clues forearliest diagnosis, prompt local tumortreatment, and systemic targeted therapiesfor microscopic metastasis or prevention of metastasis. Personalized evaluation ofpatient-specific melanoma molecular path -way signature could potentially allow fortherapeutic intervention at a site specific tothe pathway abnormality that leads to thedevelopment of melanoma.

CONCLUSION: Management of PUM hasmade major strides over the past centuryfrom the days of enucleation for massive,fatal tumor to early detection of smallesttumors with a more favorable prognosis.Current and future targeted specific tumorpathway interruption using systemic agentscould improve survival.

2:30PM-2:40PM


2:40PM-3:10PM

RETINA SOCIETY 2014 RRF AWARD OF MERIT IN RETINA RESEARCH

Development of Treatmentsfor Retinal/ChoroidalVascular Diseases

Peter A. Campochiaro, MD

PURPOSE: The pathway for development ofnew treatments for retinal/choroidal vasculardiseases is well-established and validated.The purpose is to present the pathway andillustrate how it is used.

METHODS: The first step is development ofan animal model that mimics key aspects of the disease process and is feasible andpractical to use. It is then necessary todevelop candidate targets, a process thatoften involves piecing together bits ofcircumstantial evidence often from patientswith the disease process. It is then necessaryto develop a specific antagonist to thecandidate target and if possible, a knockoutof the gene that codes for the target. Thenext step is to use the specific antagonistand/or knockout in the animal model to determine if the candidate target iscritical for development of the diseasephenotype.

After choosing a route of administration andformulation, safety and biodistribution mustbe established. The design of early phaseclinical trials is an art, because while themajor goal is to test safety, it is advantageousto test for an efficacy signal. Mid-phaseproof-of-concept clinical trials are critical tomake a go/no go decision and to informdesign of registration trials. Successful registration trials validate the target andvalidate the animal model that was used inpreclinical trials.

RESULTS: Once a target is validated, newstrategies to neutralize the target morecompletely and for longer periods are testedin the validated model bringing the processfull circle. The circle is repeated many timesto optimize neutralization of the validatedtarget and to try to identify new targets.


When good animal models are not available,it is sometimes necessary to truncate thecircle and use patients with the disease asthe model provided there is good safetydata for the specific antagonist and thereare good efficacy outcome measures.

CONCLUSIONS: Many examples to illustratethese points will be provided.

3:10PM-3:20PM


3:20PM-3:50PM

Break

3:50PM-5:40PM


ARVO 2014 KEYNOTE LECTURE

Seeing the Light with Retinal Gene Therapy:Behind-the-Scenes Perspectives

Jean Bennett, MD, PhD, FARVO

Gene therapy has restored sight in patientswith a form of Leber’s Congenital Amaurosis(LCA), an inherited blindness that begins atbirth. This presentation will describe thesafety and efficacy results after gene therapyin 12 subjects, born with LCA. The subjectswere treated at The Children’s Hospital ofPhiladelphia in one eye and all eligiblesubjects have had re-administration to thecontralateral eye.

The presentation will also describe how thisdata has been used to initiate a Phase 3study aimed at obtaining US Food and DrugAdministration approval of this intervention.Finally, the presentation will share a behind-the-scenes perspective on the prospects andchallenges of develop ing gene therapy forother forms of inherited blindness. WhileLCA is a rare blinding disease, the resultsfrom these studies could pave the way fordevelopment of other gene-based treat-ments for more common forms of blindnessand for other inherited diseases.

4:20PM-4:30PM


4:30PM-5:00PM

Future Management of Wet AMD: Update on Clinical Trials 2014

Peter K. Kaiser, MD

This talk is an update on the latest clinicaltrials in exudative age-related maculardegeneration. From promising drugsentering the pipeline, to drugs in or finishing phase 3, the top prospects will be discussed.

5:00PM-5:10PM


5:10PM-5:30PM

Stem Cell Therapy for Atrophic AMD: Phase 1 Results

Dean Eliott, MD

A phase 1 study was conducted to assessthe safety of subretinal injection of stemcells for dry macular degeneration withgeographic atrophy and for Stargardt’sdisease. There were no ocular or systemicadverse events related to the stem cells.Patient characteristics, surgical procedureand results will be presented.

5:30PM-5:40PM


5:40PM-6:45PM

Reception

6:45PM

Dinner on own

SaturdayDECEMBER 6

6:45AM-5:30PM

Registration

6:45AM-7:25AM

Breakfast

6:45AM-3:50PM

Exhibits

7:30AM-9:40AM


AnnouncementsCarl C. Awh, MD

7:40AM-8:10AM

MACULA SOCIETY 2014 GREEN LECTURE AND AWARD

Macular Degeneration: From Mechanism to Therapy

Hendrik P.N. Scholl, MD, MA

Until recently, slow neurodegeneration ofthe retina and macula secondary to geneticmutations have been considered incurable.Molecular genetic studies in the last twodecades have revealed the underlyingmolecular cause in a substantial fraction ofpatients. The mammalian eye has been atthe forefront of therapeutic trials based ongene replacement, stem cell and pharma-cotherapy in humans with retinaldegenerations. This is at least partly due tothe accessibility of the human eye and theopportunity to study this part of the brain ingreat detail with non-invasive methods.

Spectral-domain optical coherence tomog-raphy (sd-OCT) and adaptive optics (AO)reflectance imaging allow to visualize retinalstructure at the cellular and even sub-cellular level while functional tests such asfundus-controlled (or micro-) perimetryallow to map the sensitivity of the retinawith high resolution. It has thus becomepossible to correlate structure and functionof the central retina with high precision andto obtain multi-modal imaging of the retina.

6 BEST OF R E T INA 2014 NY

8:10AM-8:20AM


8:20AM-8:50AM

ARDS 2014 FOUNDERS AWARD LECTURE

Anti-VEGF MaintenanceTherapy for Neovascular AMD

Carl D. Regillo, MD

The functional and anatomic outcomesachieved in the pivotal ranibizumab phase IIItrials with monthly injections set the standardfor comparison for the treatment of neovas-cular age-related macular degeneration(nAMD) with intravitreal, pan-VEGF inhibitors.There is now level I evidence from the CATTand IVAN studies that demonstrated non-inferiority of bevacizumab compared toranibizumab in this setting.

Aflibercept has demonstrated equivalency to ranibizumab in its phase III VIEW studieswhen dosed monthly and bimonthly in themaintenance phase of therapy. Although allthree agents have been shown to performwell to treat nAMD when dosed in afrequent and fixed fashion, the drugs aretypically administered in a more individual izedmanner in clinical practice worldwide.

Individualizing anti-VEGF therapy for nAMDincludes the as needed (PRN) and the treat-and-extend (TAE) approaches. The formerhas been tested in several large scale,comparative trials and the results over twoyears of using pan-VEGF blockers PRN havenot shown to be non-inferior to continuous,frequent dosing.

The TAE style of therapy has evolved into the most frequently used treatment approachin the US and is gaining in popularity else -where. Although there are no studiesavailable that directly compare TAE to eitherPRN or fixed regimens, there is mountingevidence from retrospective and prospectivestudies to support its use. Evidence to dateusing the various treatment strategies innAMD will be reviewed.

8:50AM-9:00AM


9:00AM-9:40AM

Late Breaking News

9:40AM-10:10AM

Break

10:10AM-12:45PM


Best of RETINAWS

Kourous A. Rezaei, MD

RETINAWS at the Best of Retina 2014 showcases the most interesting surgical videosand experiences that were presented byretina surgeons around the world during theRETINAWS courses in 2014. A panel ofexperts will discuss the presented surgeriesand also share their own most educationalsurgical experience from the year of 2014.

11:25AM-11:55AM

RETINA SOCIETY 2014 J. DONALD M. GASS AWARD LECTURE

In Memoriam of the Art of Scleral Buckling

Alexander J. Brucker, MD

PURPOSE: In memoriam of the art of scleral buckling.

METHODS: An historic review of retinaldetachment surgery.

RESULTS: From the initial description of theHelmholtz ophthalmoscope, the repair ofretinal detachments has been based uponthe principle of: Find the hole, treat the holeand close the hole. The skill set of finding

the retinal defect, documenting the locationof retinal breaks, planning the type of scleralbuckle procedure necessary for the closingof the defects, and then flattening of thedetachment often with external drainage ofsubretinal fluid was learned over many yearsof training and experience. The technique of indirect ophthalmoscopy with scleraldepression, drainage of subretinal fluid andthe placement of just the right bucklebecame an art form rather that a rotesurgical procedure. Today that skill set isbeing lost. The repair of retinal detachmentsis now an intraocular procedure whichrequires a new set of skills.

CONCLUSIONS: While the end result ofretinal detachment surgery is the flatteningof the retina with restoration of vision, thereis less and less controversy con cerning theuse of vitreous surgery as a primary methodfor the repair of most retinal detachments.The result is the loss of the experiencenecessary to learn when and how toperform scleral buckling surgery. For that we now pay tribute.

11:55AM-12:05PM


12:05PM-12:35PM

Retinal Imaging –From the Posterior Pole to the Far Periphery

Szilárd Kiss, MD

The revolution and evolution in retinalimaging – of both the posterior pole and thefar periphery – included the expansion ofultra wide field imaging into the realm ofindocyanine green angiography and thecommercial availability of OCT angiography.With the greater understanding of theimportant contribution of the peripheralretina, ultra wide field imaging is becomingthe standard of care in many retinal disorders,especially retinal vein occlusion and diabeticretinopathy, and even in many ocular inflam-matory conditions. With the expandedavailability of OCT angiography, we have


already begun to unearth interesting (andpreviously unknown) details about theretinal vasculature in the posterior pole –this will undoubtedly only continue toexpand in the coming year.

12:35PM-12:45PM


12:45PM-2:00PM

Lunch and Industry Presentations

2:00PM-3:20PM


MACULA SOCIETY 2014 PAUL HENKIND MEMORIAL LECTURE AND AWARD

Uveal Melanoma – The Present and the Future

J. William Harbour, MD

Uveal melanoma is the most commonprimary intraocular malignancy and has astrong propensity for fatal metastasis. Recentadvances in the molecular genetics of uvealmelanoma are revolutionizing our understand -ing of this cancer and the care of patients.

The development of a new molecular classi -fication of uveal melanoma based on a widelyavailable 15-gene expression profile nowallows patients at high risk of metastasis tobe identified early so that individualizedmanagement can be offered. The recentdiscovery of major driver mutations in uveal melanoma provide a rational basis fordevelopment of new targeted therapies.Taken together, these advances are trans-forming our understanding and managementof uveal melanoma with the ultimate goal of improving patient outcomes.

2:30PM-2:40PM


2:40PM-3:10PM

AAO 2014 JACKSON MEMORIAL LECTURE

Retinoblastoma: 50 Years of Progress

Hans E. Grossniklaus, MD, MBA

Progress made in understanding the geneticbasis, molecular pathology, and treatment of retinoblastoma was reviewed since theprevious Jackson lecture on the topic waspublished 50 years ago. The literature regard -ing retinoblastoma was reviewed since 1963.Advances in understanding the biology and treatment of retinoblastoma providedcontext through the author’s clinical, patho-logical and research experiences.

Retinoblastoma was first identified in the1500s and defined as a unique clinico -pathologic entity in 1809. Until the mid-1900s,knowledge advanced sporadically, with tech -nological developments of ophthalmoscopyand light microscopy, and with the introduc-tions of surgical enucleation, chemotherapyand radiation therapy. During the last 50 years, research and treatment haveprogressed at an unprecedented rate due to innovations in molecular biology and thedevelopment of targeted therapies.

Nearly all patients with retinoblastoma indeveloped countries can now be cured oftheir primary cancer – a remarkable achieve -ment for a childhood cancer that once was uniformly fatal. Much of this success isowed to deciphering the role of the Rbgene, and the benefits of targeted therapies,such as chemoreduction with consolidationas well as intra-arterial and intravitrealchemotherapies. Going forward, the mainchallenge will be ensuring that access tocare is available for all children, particularlythose in developing countries.

3:10PM-3:20PM


3:20PM-3:50PM

Break

3:50PM-5:30PM


Latest and Greatest inPharmacologic Treatment of Diabetic Retinopathy andDiabetic Macular Edema

Pravin U. Dugel, MD

I will be showing Medicare based data previously not presented regarding the “curerate” for DME with our current treatmentstrategies. I will then discuss the positioningof newly approved steroid delivery devices.Finally, I will present new data on a new Tie 2 activator with a unique delivery formulation.

4:20PM-4:30PM


4:30PM-5:30PM

Late Breaking News

5:30PM

Adjourn

5:30PM-6:30PM

Closing Reception

6:30PM

Dinner on own

THIS CME ACTIVITY IS SUPPORTED BY AN EDUCATIONAL GRANT FROM:

Regeneron Pharmaceuticals, Inc.

ExhibitorsBEST OF RETINA 2014 GRATEFULLY

ACKNOWLEDGES GENEROUS CONTRIBUTIONS FROM THE FOLLOWING COMPANIES:

DIAMOND

Allergan, Inc.

PLATINUM

Genentech, Inc.

GOLD

Regeneron Pharmaceuticals, Inc.

SILVER

Alcon Laboratories, Inc.

Arctic Group of Companies

Bausch + Lomb

Dutch Ophthalmic, USA

Insight Instruments, Inc.

OCULUS Surgical, Inc.

Optos, Inc.

Synergetics, Inc.

ThromboGenics, Inc.

2014 ny · 2016-12-18 · 2014 ny course director carl c. aw h, md course co-directors david r. cho...

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