Title:: Proliferative vitreoretinopathy, surgical management and improved techniques
Audience Level: Intermediate/advanced
Proliferative vitreoretinopathy (PVR) is the clinical syndrome associated with
retinal traction and detachment in which proliferative cells multiply and
contract on retinal surfaces and in the vitreous.
PVR is the most common cause of failure in retinal detachment surgery. Therefore,prevention through early recognition of risk factors and subtle signs of PVR and appropriate modification of standard surgical techniques for retinal detachment
remain all important.
In this course we will describe the pathophysiology, main risk factors, and the vitreoretinal surgery of PVR, with the need or not of scleral buckling, lensectomy associated to vitrectomy in PVR, the surgical steps, the dissection of the proliferative tissue using PFCL and different stainings to improve the identification, and dissection of the membranes, the indications and technique of relaxing retinotomy and the endotamponade.
Following attendance of this course the attendee will be able to understand the process of PVR, the surgical techniques employed and the prognostic factors of success.
Title:: Laser Therapy in Retinal Disease: Indications & Procedures
Audience Level: Retina specialists
Background: Laser therapy has been a gold standard in the history of treating retinal diseases such as age-related macular degeneration, retinal vein occlusion, and diabetic retinopathy. Through the years, developments of new drugs and technologies have changed the role of laser therapy. Recent innovations to laser have continued to refine its precision, reducing risks, and increasing its importance as a key treatment.
Course Objective This course aims to discuss the current role of laser therapy in retina practice today. At the conclusion of this course, attendees will be able to distinguish among indications and procedures of laser therapy.
The increasing improvements in OCT devices allow obtainingdetailed OCT images according to various modalities (B scan, en face OCT, OCT Angio).The analysis of OCT images should integrate all recent advancesin the interpretation of the main pathological changes characterizing macular diseases.
Understanding the main functions of the most popular SD-OCT devices, including segmentation and en-face images. Being able to detect all the retinal and choroidal layers on OCT. Knowing the OCT characteristics related to the main signs of macular diseases such as drusen, choroidal newvessels, pigment epithelium detachment, polypoidalchoroidal vasculopathy, sub-retinal fluid, cystoid macular edema, retinal ischemia, vitreo-macular traction… At the end of this course, the attendeesshould have improved their ability to diagnose the main macular diseases on OCT.
A. Differences between the main SD-OCT devices, including OCT Angio and impact on the examination strategy
B. Normal OCT B-scan of the Macula: new nomenclature. Normal OCT Angio.
D. Signs of macular diseases on OCT
- Vitreo-macular adhesion/vitreo-macular traction, early PVD,new OCT classification.
- Epiretinal membranes and macular pseudo-holes
- Macular holes, measurement of the hole diameter
- Macular edema, andmacular cystic cavities of various etiologies
- Drusen, Geographic atrophy
- Choroidal new vessels
- Pigment epithelium detachment
- Polypoidal choroidal vasculopathy
- Retinal angiomatous proliferation
- Central serous chorioretinopathy, subretinal fluid and deposits
Targeted audience and level:
Retina specialists / Intermediate/ Advanced Level
Alain Gaudric (Paris)
Sarah Mrejen (Paris)
Pearse Keane (London)
Giovanni Staurenghi (Milano)
Not for website:
Title:: Submacular haemorrhages in AMD: a practical guide to management
Course Leader: David Steel
Audience Level: Retinal specialists
A proposal for a didactic course at Euretina Nice 2015 - with scheduled questions and answers managed by the course organiser.
Course Description:Submacular haemorrhage (SMH) presenting in patients with neovascular age-related macular degeneration (nAMD), when left untreated, is associated with a poor visual prognosis. Risk factors for its occurrence are ill defined and the exact incidence of SMH in patients with AMD is uncertain. Patients with significant SMH were excluded from all the recent major randomised control trials for nAMD and the optimum management is uncertain. The location, size, thickness and duration of SMH have an important bearing on treatment and outcomes. Thin or extrafoveal SMH may be best treated with anti VEGF agents alone. Thicker subfoveal blood can be displaced away from the foveal centre either by means of an expansile gas injection combined with intravitreal TPA or with vitrectomy, subretinal TPA injection and air or gas exchange. Anti VEGF agents can be used concomitantly either intravitreally or subretinally. Both approaches have their pros and cons which will be discussed. More invasive techniques may have a role in selected severe cases.
This course will summarise what is known about SMH in nAMD and discuss a variety of therapeutic interventions including practical skills and techniques.
Hillenkamp J, Surguch V, Framme C, Gabel VP, Sachs HG. Management of submacularhemorrhage with intravitreal versus subretinal injection of recombinant tissue plasminogen activator.Graefes Arch ClinExpOphthalmol.2010 ;248(1):5-11.
vanZeeburg EJ, van Meurs JC. Literature review of recombinant tissue plasminogen activator used for recent-onset submacularhemorrhage displacement in age-related macular degeneration.Ophthalmologica. 2013;229(1):1-14.
Steel DH, Sandhu SS. Submacular haemorrhages associated with neovascular
age-related macular degeneration. Br J Ophthalmol. 2011 Aug;95(8):1051-7.
At the end of the course it is expected that the attendees will be able to:
1) Understand the epidemiology and characteristics of SMH in AMD including mechanisms of visual loss if untreated , risk factors for occurrence , classification, and clinical assessment
2) Define which patients benefits from anti VEGF treatment alone
3) Describe the range of SMH displacement techniques available for SMH- including which technique to choose in which situation and optimising visual results.
4) Discuss the surgical techniques themselves so that they have a clear knowledge of the surgical steps involved
5) Discuss what options are available for massive haemorrhages
Conclusion: A comprehensive knowledge of the causes, pathophysiology and management of submacular haemorrhages associated with AMD
The vitreoretinal interface – physiology, pathology and treatment
This course gives an overview over the physiology of the vireoretinal interface and it's pathophysiological role in the pathogenesis of various conditions such as tractive maculopathies (macular hole, epimacular membranes, macular pseudoholes and lamellar holes etc) and other macular dieseases. We aim to establish a clinical correlation with modern high resolution imaging modalities such as OCT and other macular functional diagnostic tools such as microperimetry. We will discuss several disease entities with regard to (differential) diagnostic and predictive aspects of therapeutic strategies and will present relevant clinico-morphologic correlations. Also, the role and potential impact of new therapeutic measures such as enzymatic vitreolysis on the vitreoretinal interface will be discussed.
Jan Keunen NETHERLANDS
Camiel Boon NETHERLANDS
V. Chong UK
E. Midena ITALY
Jeff Luttrull USA
Title:: Subthreshold Laser Surgery
Advantages and disadvantages of micropulse and other subthreshold laser techniques
Course Leader and Organisers :
J. Keunen NETHERLANDS (course leader)
Audience Level: Beginners, Intermediate & Advanced level Retina Specialists (including Residents with posterior segment laser experience).
5 Didactic presentations with scheduled questions and answers, managed by the course leader;
Followed by case presentations and active discussions between the audience and panelists.
Abstract and outline
ABSTRACT. Subthreshold tissue-sparing laser therapy is worldwide a subject of growing interest for retina specialists. Micropulse diode laser therapy is currently the most frequent used subthreshold laser technique, producing a therapeutic treatment effect without detectable intraretinal damage on clinical examination during or after treatment (even on autofluorescence and SD-OCT). The controlled delivery of laser micropulses affords excellent treatment options for diabetic macular edema (DME), central serous chorioretinopathy (CSR), macular edema secondary to branch retinal vein occlusion (BRVO), and glaucoma.
This course will explain the micropulse technology and focus on the benefits and challenges in the treatment of retinal disorders using a micropulse diode laser. It has been shown to be as effective as conventional argon laser for DME (see the suggested readings) without reported complications or collateral effects so far.
However, treating below the ophthalmoscopically visible endpoint raises the question of the optimum laser dose. The most serious disadvantage seems undertreatment. Therefore, the development of optimal laser settings will be discussed in order to minimize the clinical concern of nonresponders. Retreatment is easily feasible, as micropulse treatment does not produce chorioretinal scars or carry an increased risk of CNV.
OUTLINE. Different subthreshold techniques will be discussed, and their tissue effects. Micropulse diode laser settings and safety issues will be presented, the optimum indications, doubts after treatment (how long wait for a treatment response?) and retreatment indications discussed. A possible future for combined micropulse and anti-VEGF treatment strategies resulting in lesser injections for DME will be discussed, followed by clinical cases with an interactive discussion of the panel with the audience.
1. Figueira J, Khan J, Nunes S, Sivaprasad S, Rosa A, de Abreu JF, Cunha-Vaz JG, Chong NV.
Prospective randomized controlled trial comparing sub-threshold micropulse diode laser photocoagulation and conventional green laser for clinically significant diabetic macular oedema. Br J Ophthalmol. 2009;93(10):1341-1344.
2. Vujosevic S, Bottega E, Casciano M,Pilotto E, Convento E, Midena E. Microperimetry and fundus auto fluorescence in diabetic macular edema: subthreshold micropulse diode laser versus modified early treatment diabetic retinopathy study laser photocoagulation. Retina. 2010;30(6):908-916.
3. Luttrull JK, Sramek C, Palanker D, Spink CJ, Musch DC. Long-term safety, high-resolution imaging, and tissue temperature modeling of subvisible diode micropulse photocoagulation for retinovascular macular edema. Retina. 2012 Feb;32(2):375-86.
4. Luttrull JK, Sinclair SH. Safety of transfoveal subthreshold diode micropulse laser for fovea-involving diabetic macular edema in eyes with good visual acuity. Retina. 2014 Oct;34(10):2010-20.
Course Objectives: The aim of the course is to provide retinal specialists with an up-to-date overview of the clinical significance of subthreshold laser surgery, with a focus on micropulse diode laser treatment.
The expected outcome for participants is that they will better understand the basics of tissue-sparing laser surgery, recognise the optimum treatment indications and will be able to perform micropulse laser surgery safely in their own practice.
Conclusion: Participants will gain from the course a full understanding of the key differences between conventional and subthreshold laser surgery techniques and will recognize the advantages and disadvantages of tissue sparing laser treatment.
Title:: ABC in effective ophthalmic publishing
Course Leader: A. Grzybowski, Professor of Ophthalmology, Poznan, Olsztyn, Poland
Audience Level: Comprehensive ophthalmologists/ Basic
Format Options: Didactic presentations with scheduled questions and answers managed by the course director
Abstract and outline
Fast development of computer technology and internet changed the publication practice over last decade. The need for speed and global availability of publication has become now at least equally important as the prestige of a journal. In this course we emphasize the basics of modern scientific publishing looking more closely on the manuscript traffic within the editorial office and
the manuscript selection. In this light we indicate good authors habits which dramatically speeds up the publication process. We also take a look at two other major problems, such as ethical problems, and understanding the role of citations and journals impact factor in building up scientific career.
At the conclusion of this course the attendee will be able to describe the essentials of a good article, how to deal with reviewers comments and how to prepare the revision, how to prepare the good case report article, and characterize some aspects of multicentre trials and ethics in publishing.
1. Stefánsson E, Kivelä T. The ingredients of a good paper. Acta Ophthalmol. 2010;88:619-21.
2. Grzybowski A. The journal impact factor: how to interpret its true value and importance. Med Sci Monit. 2009;15(2):SR1-4.
3. Grzybowski A. Impact factor – benefits and limitations. Acta Ophthalmologica 2015
5. Liesegang TJ, Bartley GB. Toward Transparency of Financial Disclosure. American Journal
of Ophthalmology 2014; 158: 855–857.
5. Bartley GB, Albert DM, Liesegang TJ. Choosing Our Words Carefully: Plagiarism in the Internet Age. Ophthalmology 2014; 121: 807–808.
Course Description: In this course we emphasize the basics of modern scientific publishing, including the structure of an original and review article, case report and letter to the editor. We will instruct how to prepare a good revision. .
To discuss basics of a good article
To discuss differences among different sort of articles, original, review, case reports and letter to the editor;
To discuss basic of ethical issues in publishing
Conclusion: Participants will be able to describe the essentials of a good article, how to deal with reviewers comments and how to prepare the revision, how to prepare the good case report article, and characterize some aspects of multicentre trials and ethics in publishing.
Management of recurrent retinal detachment course outline
Didactic presentations with scheduled questions and answers managed by the course director.
Target audience and level:
Abstract and outline :
Background: Despite the evolving technical advances in retinal detachment (RD) surgery, the recurrence rate still ranges between 10% to 20%, making it the most common complication of retinal detachment surgery.
This course will provide an overview of the different causes, preventative strategies, and management options of recurrent RD.
At the conclusion of this course the attendee will be: (1) able to describe the possible causes and risk factors for recurrent RD, (2) Be familiar with the principles and technical details of pneumatic retinopexy, scleral buckling and vitrectomy procedures that would reduce the risk of recurrence of RD, and (3) Be able to understand the different surgical techniques for the management of recurrent RD including revision of the scleral buckles, combining scleral buckling and vitrectomy, performing retinectomy and the use of different tamponading agents.
Course Leader Mr DAH Laidlaw/Mr Moin Mohamed
Audience Level: Retina specialists/Comprehensive ophthalmologists/ Beginner / Intermediate /
Didactic presentations with scheduled questions and answers managed by the course director
Abstract and outline
Course Objectives and Conclusion: This course will provide participants with a practical pragmatic understanding of the basis and management of Proliferative Diabetic Retinopathy.
We will cover the biochemical basis of the condition, description of the treated and untreated natural history of the condition, the importance of general medical management of diabetes , hypertension and lipids and screening for retinopathy; a description of treatment thresholds and a guide to how to do a PRP and anti VEGF treatment , and a discussion of the role of vitrectomy in the management .
Stem cell-based therapies in retinal disease - Fundamentals and Application
Comprehensive ophthalmologists/ Retina specialists / Beginner/Intermediate
Didactic presentations with scheduled questions and answers managed by the course director
This course aims to provide the clinician with a basic introduction to stem cells, as well as profound background information on ways of isolation and application of retinal stem cells through didactic presentations.
Topics that will be discussed in depth include a general introduction to stem cells, approaches of how to isolate stem cells, results from clinical studies and perspectives for future use in the field of retinal therapy.
At the conclusion of this educational session, the attendee will be able to understand fundamental basics and be up-to date with latest clinical study results of stem cell-based retinal treatment modalities.