Darius Moshfeghi, M.D.
Retina EditorThe evening has appeared to taken have a toll on the audience. Whereas yesterday we were standing room only, this morning we are at 60%, and they all appear hangdog to one extent. Good thing we are starting off with OCT.
Spectral Domain/Fourier Domain OCT
The future is now. Go buy one. There are at least 7 to choose from—Zeiss, Heidelberg, Optovue, OTI, Topcon, Copernicus, Bioptigen. If you can figure out which one is going to be the king, particularly with respect to inclusion criteria for clinical trials, call me. But seriously, they are wicked cool.
High Frequency Ultrasound
Have to agree with John Kitchens on this one. I don’t think that I would get rid of my Cirrus to get one of these.
Angiography Update
Not much new going on here. The Optos wide-angle angiography is cool, but limited in application because of the unit and the pay-for-click utilization scheme. Mark Blumenkranz showed some interesting slides from Steve Schwartz and colleagues at Jules Stein. Of particular interest was their use of the wide-angle angiography to perform sector PRP for sector neovascularization in diabetic retinopathy.
Acetozolamide for Macular Edema
Gerald Fishman of University Illinois Chicago gave the most interesting talk of the past two days.
Retinitis Pigmentosa. Trusopt 3 times a day for patient with RP. 13/15 patients demonstrated improved CMT in 1 one eye. 7/15 improved vision. Not all patients respond. 4/15 patients demonstrated bilateral improvement. Rebound noted with continued therapy. 3-4 months holiday and restart improved. Improvement noted in 4 weeks.
Juvenile XLR. 9 patients. 8 showed a positive response. All showed 1 line improvement, 4 demonstrated rebound. Sometimes 3-4 months before therapeutic effect is noted. Sustained improvement for 1-2 years.
Recommendations for RP—start on diamox sequesls 500 mg qd. If response, trusopt tid, monitor monthly.
Recommendations for juvenile XLR—trusopt tid and monitor for 3 months.