European VitreoRetinal Society a certain philosophy

ABSTRACT   CONTACT DETAILS   Ron Adelman New Haven, CT USA Email:...

ABSTRACT   CONTACT DETAILS   Ron Adelman New Haven, CT USA Email:...

ABSTRACT Instructors: Ron Adelman, USA & Hassan Mortada, Egypt The course is a comprehensive update of the medical & surgical management of diabetic retinopathy. The dilemma of dealing with diabetic macula edema will be intensively explained. The role of different drugs, laser techniques and surgical approaches in dealing with both tractional and non-tractional DME will be elaborated. Using many high quality videos, the surgical...

TASS and Endophthalmitis ABSTRACT CONTACT DETAILS   Ron Adelman New Haven, CT, USA Email:...

DRCR Trials CONTACT DETAILS   Ron Adelman New Haven, CT, USA Email:...

An Introduction to RPE Transplantation CONTACT DETAILS   Ron Adelman New Haven, CT, USA Email:...

Contact Details: Email: ron.adelman@yale.edu  

Review of Literature and State of Knowledge

Media not available due to technical recording problems. EVRS is very sorry for the inconvenience.   A new mechanism for clearance of an embolus from retinal artery is angiophagy. Angiphagy is a robust mechanism for extravasation of embolus in retina, brain and kidney.

Media not available due to technical recording problems. EVRS is very sorry for the inconvenience.   The safety, efficacy and technique of intravitreal injection in the office will be discussed. Based on published data use of topical antibiotics are not necessary, but use of sterile technique is essential.

Media not available due to technical recording problems. EVRS is very sorry for the inconvenience.   Pneumatic retinopexy is highly successful in managing a selected group of retinal detachments. Good case selection and meticulous technique increase the success rate.

Media not available due to technical recording problems. EVRS is very sorry for the inconvenience.   Advantages: The aim of this study is to evaluate the choroidal thickness and the outer choroidoscleral boundary before and after vitrectomy for idiopathic epiretinal membrane in one eye and in the unaffected fellow eye and in healthy volunteers. Methods: A prospective, cross-sectional study will be presented. Twenty-one patients with...

Introduction: Diabetes mellitus is the most common cause of proliferative vascular retinopathy, which also includes retinal venous occlusive disease, Sickle cell retinopathy and retinopathy of prematurity. The underlying abnormality in these disorders is retinal ischemia, which may ultimately lead to the formation and contraction of proliferative fibrovascular membranes with subsequent vitreous hemorrhage and/or retinal detachment. In...

Advantages: Aflibercept (VEGF Trap Eye, Eylea) has a longer duration of action compared to ranibizumab (Lucentis). Methods: Randomized clinical trials. Effectiveness / Safety: In a phase II trial patients with diabetic macular edema gained 9.7 letters with aflibercept every 8 weeks and 13.1 letters with aflibercept every 4 weeks.  Phase III trials, VISTA and VIVID, are underway. Take home message: Aflibercept may be an effective...

Advantages: Intravitreal ranibizumab improves vision of patients with diabetic macular edema. Methods: Review of recent clinical trials such as DRCR.net. Effectiveness / Safety: DRCR trials showed that in patients with diabetic macular edema, intravitreal ranibizumab with prompt or deferred focal/grid laser had superior Visual Acuity outcome compared with focal/grid laser treatment alone. Take home message: Intravitreal ranibizumab is...

Advantages: Anti-VEGF agents such as ranibizumab and bevacizumab have revolutionized treatment of wet macular degeneration and diabetic macular edema. Methods: Retrospective study and review of literature. Effectiveness / Safety: Four out of 116 patients (3.45%) developed persistent ocular hypertension following intravitreal injection of ranibizumab (Lucentis) or bevacizumab (Avastin).  The range of preinjection IOP was 8–15 mmHg (mean,...

Advantages: Anti-VEGF medications such as ranibizumab and bevacizumab have revolutionized treatment of macular degeneration, retinal vein occlusions and diabetic macular edema. Methods: This presentation discusses development of ranibizumab and bevacizumab from bench (1990s) to bedside (2006).  The process of laboratory studies, randomized clinical trials and FDA approval will be discussed. Effectiveness / Safety: A number of seminal...

Ron Adelman (New Haven, CT, USA) Age-related macular degeneration (AMD) is the most common cause of legal blindness in the Western countries.  About 1/3 of senior citizens are affected by this condition.  We will discuss diagnostic challenges and state of the art management of macular degeneration.  New advances in the management of AMD such as AREDS II, CATT trial, aflibercept (VEGF trap, Eylea) and their clinical applications will be...

Ron Adelman (New Haven, CT, USA) Advantages: Pneumatic retinopexy is an office procedure with high success rate in a selected group of patients with retinal detachment. Methods: Retinal break is treated with cryotherapy followed by intravitreal injection of 0.3 to 0.5 ml SF6 or C3F8 gas. Patient needs to position accordingly in order to place gas on the break (bubble on the trouble). Alternatively gas can be injected first, and then laser...

Ron A Adelman, Adarsh V Arya, Curtis L Hagedorn (New Haven, CT, USA) Purpose: To study the success rate of pars plana vitrectomy (PPV) versus scleral buckle (SB) in the management of pseudophakic retinal detachments (RDs). Design: Meta-analysis of published studies from 1966 to 2004 regarding surgical treatment of pseudophakic RDs. Two thousand two hundred thirty eyes: 1579 operated by SB, 457 by PPV, and 194 by the combined method of PPV...

http://www.evrs.eu/medias/2010/congress/Central-Serous-Chorioretinopathy.flv Ron A. Adelman, Shelly T. Lee (New Haven, FL, USA) Advantages: Intravitreal injection of bevacizumab may be effective in patients with recurrent central serous chorioretinopathy (CSC). Methods: A retrospective study of patients with a diagnosis of recurrent CSC who were treated with intravitreal bevacizumab from January 2007 – January 2009. 1.5 mg...

Ron A. Adelman (New Haven, CT, USA) Advantages: To develop a culture model of human fetal retinal pigment epithelium (hfRPE) to examine the effects of serum and proinflammatory cytokines on the tight junctions of the outer blood retinal barrier.  In the wet form of age-related macular degeneration (AMD), leaky capillaries grow in the subretinal space, exposing the apical side of the RPE to serum. Further, proinflammatory cytokines are...

http://www.evrs.eu/medias/2010/congress/Age-Related-Macular-Degeneration.flv Ron A. Adelman, X Chen, Rajeev Seth (New Haven, CT, USA) Advantages: Music therapy might help to reduce patients’ anxiety during intravitreal injections. Methods: A prospective, randomized controlled study. 51 patients underwent intravitreal injection in an outpatient clinical setting were recruited and randomized to one of two groups – a group...

http://www.evrs.eu/medias/2009/congress/Retinal-Vein-Occlusions.flv Authors: Ron A. Adelman, M.K. George, New Haven, CT, USA Advantages: Improvement in visual acuity and macular edema in patients with retinal vein occlusions. Methods: 19 patients with retinal vein occlusions were included in the study. Patients received monthly injections of bevacizumab for 3 months. During follw up, additional injection was performed if edema was detected...

http://www.evrs.eu/medias/2009/congress/Systematic-Primary-Pars-Plana-Vitrectomy-vs-Only-in-Selected-Cases.flv Author: Ron A. Adelman, New Haven, CT, USA Advantages: Each specific type of retinal detachment needs its own specific treatment. Methods: Pneumatic retinopexy for superior phakic detachments. For other phakic detachments without PVR, scleral buckle is utilized. For Pseudophakic detachments vitrectomy is the preferred...

http://www.evrs.eu/medias/2009/congress/Systematic-Primary-Pars-Plana-Vitrectomy-vs-Only-in-Selected-Cases.flv Author: Ron A. Adelman, New Haven, CT, USA Advantages: Easy to use, supports vitreous base 360 degree. Methods: #41encircling band to support retinal break. Effectiveness / Safety: Over 90% success rate with one surgery. Take home message: Scleral buckle with a small size encircling band is an effective treatment for retinal...

http://www.evrs.eu/medias/2009/congress/Systematic-Primary-Pneumatic-Retinopexy-vs-Only-in-Selected-Cases.flv Author: Ron A. Adelman, New-Haven, CT, USA Advantages: Less invasive, effective if good case selection, office procedure. Methods: Pneumatic retinopexy (cryotherapy, intravitreal gas, positioning) for phakic retinal detachments with a superior break and without PVR. Effectiveness / Safety: Over 90% anatomic success with good visual...

http://www.evrs.eu/medias/2009/congress/Anti-VEGF-Alone.flv Author: Ron A. Adelman, New Haven, CT, USA Advantages: Reduction of number of injection, improving compliance Methods: Injection of anti VEGF monthly for 3 months. After three months decision for treatment is based on OCT. Effectiveness / Safety: Improved patient satisfaction.

Ron A. Adelman, MD, MPH (New Haven, CT), James E Kempton, MD (New Haven, CT), Natalie A Afshari, MD (Durham, NC), M Bruce Shields, MD (New Haven, CT) PURPOSE: To determine which criteria are important and used by retina fellowship directors in their selection of fellows. METHODS: A survey was sent to 85 retina, 60 cornea and external disease, and 50 glaucoma fellowships in the United States and Canada listed in the San Francisco Matching...

Vicente A. Diaz, MD (New Haven, CT), Robert B. Schonberger, MA (New Haven, CT), Kwang Suh, MA, PhD (Cleveland, OH), Rafat Ansari, PhD (Cleveland, OH), David G. Silverman, MD (New Haven, CT), Ron A. Adelman, MD, MPH (New Haven, CT) PURPOSE: Do choroidal vascular beds exhibit the surge in parasympathetic activity previously seen in forehead vascular beds in response to intravenous phenylephrine? How does this effect choroidal blood...

Ron A. Adelman, MD, MPH (New Haven, CT), Adarsh Arya, MD (New Haven, CT), John Emerson, PhD (New Haven, CT) PURPOSE: To study predictive factors that determine visual improvement following intravitreal triamcinolone acetonide for macular edema in diabetes and retinal vein occlusions. METHODS: A meta-analysis was performed on the articles reporting functional outcome following intravitreal triamcinolone in macular edema associated with...

S. R. Vora, C. L. Hagedorn, N. Khan, M. Aslan, J. P. Concato, R. A. Adelman Purpose: To evaluate functional and fundoscopic outcomes among patients receiving multiple treatments with macular laser photocoagulation for clinically significant diabetic macular edema. Methods: A retrospective record review was conducted of all patients who had multiple macular laser treatments for diabetic macular edema from September, 1988 to May, 2004 at the...