Article Date: 3/1/2009

Retina Fellows Mentored at Annual Forum
SUBSPECIALTY NEWS

Retina Fellows Mentored at Annual Forum

Dr. Haller Gives Guest Lecture to 80 Attendees.

■ Eighty vitreoretinal fellows from around the country braved frigid Chicago weather to meet and learn at the 9th Annual Retina Fellows Forum on Jan. 30 and 31. The meeting has evolved into a much-anticipated fixture of the final year of training for North American vitreoretinal fellows. As in past years, the fellows spent hours in the lecture hall and were provided ample opportunities to socialize with their "graduating class," the faculty, and representatives from industry.

The faculty, all members of the American Society of Retina Specialists, led the fellows in a discussion-driven intensive review of state-of-the art imaging and surgical devices, sutureless vitrectomy, and dilemmas in the management of AMD, diabetic retinopathy, retinal vein occlusion, and complications of cataract and refractive surgery. A session on "real-world" issues devoted to office and lifestyle management concluded the formal session. Carl Awh, MD, of Tennessee Retina, Nashville, served as course director of the meeting. Codirectors were David R. Chow, MD, and Tarek Hassan, MD. Brandon Busbee, MD, Tom Chang, MD, Diana Do, MD, Peter Kaiser, MD, and John Pollack, MD, completed the faculty.

Dr. Awh with guest lecturer Dr. Julia Haller.

The Distinguished Guest Speaker was Julia Haller, MD, ophthalmologist-in-chief of the Wills Eye Hospital and the immediate past president of the ASRS. Dr. Haller gave an inspiring and entertaining presentation, offering career and life lessons in a captivating lecture titled, "Survival in the Retina World: Life Lessons From the Cartoon Pages."

Bausch & Lomb provided essential support as the major corporate sponsor of the Retina Fellows Forum, while Genentech provided an educational grant to support the opening AMD symposium. In addition, 14 companies representing a cross-section of devices and services important to vitreoretinal practice sent representatives to interact with the fellows and to provide updates to the group about their businesses.

The prestigious Bausch & Lomb Fellows Forum Research Award went to Pouya Dayani, MD, of the Duke University Eye Center for his paper on "Intraoperative Use of Hand-held Spectral Domain Optical Coherence Tomography Imaging in Macular Surgery." Dr. Dayani will present his paper as a specially recognized lecture during the next annual meeting of the ASRS.

Winners of the Fellows Forum bowling tournament exult.

The meeting concluded with dinner, an informal awards ceremony, and the Fourth Annual Fellows Forum Bowling Tournament, in which Dr. Awh's team emerged victorious among teams captained by the faculty.

The 10th Annual Retina Fellows' Forum will be held in Chicago on Friday, Jan. 29 through Saturday, Jan. 30, 2010.

Other sponsors of Fellows Forum included Akorn, Alcon Laboratories, Alimera Sciences, Allergan, Carl Zeiss Meditec, Dutch Ophthalmic USA, Insight Instruments, Iridex Corp, Neovista, Optimedica, OLT Inc, Quantel Medical, Synergetics, and Volk Optical.

Yasuo Tano, MD, Dies

An International Leader in Retina.

■ Yasuo Tano, MD, chair of the Department of Ophthalmology at Osaka University Medical School, Japan, and a major figure in the international retina community, died suddenly on Jan. 31. He was 60.

Dr. Tano was a tireless researcher, an innovator, a prolific writer, and an editor who served on the editorial boards of numerous ophthalmology publications around the globe, including the American Journal of Ophthalmology and Retinal Physician. Dr. Tano was executive editor of the Japanese Journal of Ophthalmology from 1997 until 2006.

"In addition to his considerable professional accomplishments, he was a splendid, refined, charming man with a rapier-like sense of humor," commented Morton Goldberg, MD, of the Wilmer Eye Institute at Johns Hopkins University. "He had a wonderful wife and family."

Yasuo Tano, MD, (1948-2009).

Dr. Tano also served as president of the Asia-Pacific Academy of Ophthalmology and was past president, Japanese Ophthalmological Society. He authored or co-authored at least 700 peer-reviewed English-and Japanese-language publications in ophthalmology and visual sciences, and wrote or edited more than 70 books and chapters on related topics.

His research interests focused on pathophysiology of vitreoretinal disorders. Clinically he was one of the first to perform pars plana vitrectomy in Japan. He also invented many vitreoretinal instruments, which have contributed to advances in vitreoretinal surgery. In addition, he dedicated much of his time to the training of aspiring surgeons, thus paving the way for ensuring excellence in the next generation of retinal specialists.

Dr. Tano was a 1968 graduate of Osaka University and a 1972 graduate of the University of Osaka Medical School. In the late 1970s, he completed vitreoretinal research fellow-ships at both Bascom Palmer Eye Institute in Miami and at the Duke Eye Center in Durham, NC.

In recent years, one of Dr. Tano's major efforts was serving as principal investigator for the Japanese Project for Artificial Vision, whose goal was to develop an artificial retina that could produce at least some level of vision through the development of retina-stimulating electrodes.

The first stage of the project investigated the effects of implanting the stimulating electrodes epiretinally and subretinally. In the second stage, the researchers developed an original method of Suprachoroidal-Transretinal Stimulation (STS) for stimulating the retina, including studying the safety and effectiveness of this approach for clinical application. By 2008, Dr. Tano and his team had developed and written a paper on an artificial vision system with 100 electrodes that is powered and controlled wirelessly.

"He will be missed by the world ophthalmic community as both a colleague and a friend," concluded Jason Slakter, MD, editor-in-chief of Retinal Physician. RP

IN BRIEF
Electronic records mandated. A "carrot-and-stick" approach of incentives and penalties will be used by the federal government to drive medical practices toward the adoption of electronic health records.
As part of the new economic stimulus legislation, practices with Medicare and Medicaid patients can earn bonuses of $15,000 in 2011 if they can demonstrate "meaningful use" of electronic records. Smaller bonuses will be offered to practices that adopt electronic records over the next 3 years, with penalties for nonadoption kicking in after 2014.
The legislation provides financial and technical support for smaller practices of up to 10 physicians that require help in implementing electronic records.
Posurdex trial is encouraging. Allergan has completed the initial analysis of data from its phase 3 studies of Posurdex for macular edema associated with retinal vein occlusion. The data demonstrated that patients receiving either the 350 μg or the 700 μg dose of Posurdex had a statistically significant increase in vision based on a 3-line or better improvement in visual acuity compared to a sham treatment.
In addition, both doses of Posurdex were well tolerated in the studies. Less than 7% of patients receiving 700 or 350 μg of Posurdex experienced an IOP elevation greater than 35 mm Hg at any time during the 6-month study, and at 6 months less than 1% of patients had an IOP above 25 mm Hg.
Posurdex is a novel formulation of dexamethasone in Allergan's proprietary, sustained-release drug-delivery system that can be used to locally administer medications to the retina. This drug-delivery system is also currently being investigated in phase 2 clinical trials to deliver brimonidine as a treatment for retinal disease.
OPKO has new siRNA data. OPKO Health, Inc said it will present initial data on the characterization of its next generation anti-VEGF siRNA molecules at the upcoming ARVO meeting. These new proprietary siRNAs are designed to inhibit the angiogenic VEGFA165 isoform but spare the antiangiogenic VEGFA165b isoform.
VEGFA165 is known to play a critical role in diseases of the eye where the underlying cause of the problem is abnormal growth of blood vessels, such as in wet AMD. Data show that VEGFA165b is an inhibitor of abnormal vessel growth.
Lucentis sales jump. Sales of Genentech's wet AMD treatment ranibizumab (Lucentis) recorded a 20% year-over-year gain with world-wide sales of $235 million in the 3 months ended Dec. 31, 2008. Sales in the comparable 2007 quarter were $197 million. For all of 2008, Lucentis sales increased 7%, totaling $875 million vs $815 million for 2007.
In related news, Roche is still seeking to purchase the 44.2% of Genentech shares that it does not already own. Roche recently dropped its offer from $89 a share to $86.50 a share and said it is taking its offer directly to shareholders instead of continuing to negotiate with Genentech management.
OPKO Spectral OCT SLO. OPKO Health Inc. said it has received 510(k) clearance from the FDA to begin US marketing of its Spectral OCT SLO Combination Imaging System. OPKO says the Spectral OCT SLO is the product of more than a decade of innovation in the field of combination imaging. High-resolution images are produced with inner retinal choroid and vitreous detail that allow for improved monitoring of ophthalmic disease progression or regression. The Spectral OCT SLO is a noncontact, high-resolution noninvasive tomographic and confocal imaging device indicated for in vivo viewing, axial cross-sectional and 3-dimensional imaging, and measurement of posterior ocular structures
Lucentis approved in Japan. Japanese health authorities have approved the use of Lucentis as a treatment for subfoveal wet AMD. It is estimated that approximately 20,000 people sought treatment for wet AMD in Japan in 2007, the latest year for which there are official estimates. Lucentis is marketed by Novartis in Japan.
Iluvien implant shows efficacy. Alimera Sciences Inc. reported positive interim 6-month safety and efficacy results from the first human pharmacokinetic (PK) study of Iluvien (formerly Medidur FA), an implanted sustained-release drug for the treatment of diabetic macular edema.
A total of 37 subjects were enrolled in this trial, 20 patients on the low dose (an approximate 0.23 μg per day dose) of Iluvien and 17 on the high dose (an approximate 0.45 μg per day dose). The 6-month interim readout from the PK study indicated 10% of the low-dose patients and 18% of the high-dose patients showed an improvement in best-corrected visual acuity (BCVA) of 15 letters or greater from baseline.
In addition, the 6-month readout showed 25% of low-dose patients and 41% of high-dose patients had an improvement in BCVA of 10 letters or greater from baseline.
Reactivating retina receptors. Two separate teams of researchers report that they are each making slow but steady progress in efforts to either reactivate or bypass the malfunctioning retina receptors that are responsible for vision loss caused by diseases such as diabetic retinopathy and retinitis pigmentosa.
At the Dean McGee Eye Institute at the University of Oklahoma, researchers from McGee and Harvard Medical School are working on long-range strategies to reactivate or extend the life of the insulin receptors that, when functioning properly, work to reduce vision loss in diabetic retinopathy. The researchers are looking at such potential treatments as drugs and gene therapy.
Another team, supported by the National Eye Institute (NEI), is focusing on developing hardware that transmits electrical signals to the brain, thus replacing the malfunctioning photoreceptors. An "artificial retina" developed by NEI grantees consists of surgically implanted electrodes, special glasses, and microcomputers. The artificial retina, which receives signals through remaining viable retina cells, is being tested on patients with retinitis pigmentosa.
Ophthalmic technicians recognized. The Joint Commission on Allied Health Personnel in Ophthalmology (JCAHPO) said that the ophthalmic allied health profession has received official notification of approval for a separate occupational classification, Ophthalmic Medical Technician, from the US Bureau of Labor's 2010 Standard Occupational Classification (SOC) Committee.
The SOC system is used by federal statistical agencies to classify workers into occupational categories for the purpose of collecting, calculating and disseminating data. For an occupation to be accepted for inclusion in the SOC, it requires a set of uniquely identifiable skills based on knowledge, experience, and the type of work performed.

CORRECTION
In the January/February 2009 issue of Retinal Physician, there was an incorrect mathematical notation in the article "Do alternative treatments for CNV have a place in the era of VEGF inhibition?" by Kartik Kumar, MD, and R.C. Andrew Symons, MD, BS, PhD, FRANZCO. In the first paragraph, the results of the ANCHOR study should have been described as showing that 95% of patients receiving ranibizumab lost <15 letters at 12 months, as compared with 64% of patients in the PDT group losing <15 letters. The editorial board at Retinal Physician regrets the error.


Retinal Physician, Issue: March 2009