Article Date: 1/1/2006

UPFRONT
ASRS Special Edition
Jason S. Slakter, MD

As we begin a new year, it is only natural to reflect on recent changes and contemplate the future. This was really brought home when I discussed the management of a patient with macular degeneration with one of our fellows. He has spent his entire professional career with the ability to choose among various therapies for choroidal neovascularization. For those of us with a decade or more of clinical experience, it is still shocking to see the rapid evolution in this small segment of our field. With these advances, we, as retinal physicians, must also change our thought process. In the past, �reduction in visual loss� was the primary outcome. Patients who presented with stability or even slight degrees of vision improvement were often thought of as having achieved their endpoint, and therapy was often withheld. With newer therapies that may actually improve visual acuity, we must reassess our treatment algorithm. These rapid developments and changes are not restricted only to macular degeneration. I remember well just 15 years ago when Drs. Kelly and Wendell demonstrated that macular holes, a previously untreatable condition, could be surgically repaired with a high degree of success. We now look at macular holes and other maculopathies as not only correctable, but as some of the most successful surgeries that we perform. The introduction of small-incision vitrectomy techniques, which lower operative morbidity, have made these surgeries even more successful.

A careful analysis of therapeutic options and the clinical trial results that are available will help to guide physicians in managing patients in this new era. It behooves all of us to pay close attention to the literature as well as to engage in an open, frank, and honest dialogue with our colleagues, which will ultimately assist in deriving the best approach to managing our patients.

A TIME AND PLACE FOR CHANGE

In the spirit of change and open dialogue, I would like to remind everyone of the upcoming 2nd Annual Retinal Physician Symposium to be held in the Atlantis Resort in the Bahamas from May 31 to June 3, 2006. The lineup of speakers is first rate, but, more importantly, we again expect to have a lively interactive discussion on the issues facing all aspects of our profession.

On behalf of the publishing team and the entire Editorial Board of Retinal Physician, let me wish you all a Happy New Year; I am certain it will be filled with even more exciting new developments and changes in our field.



Retinal Physician, Issue: January 2006