Eyeworld

NOV 2014

EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.

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EW MEETING REPORTER 68 Reporting from the American Academy of Ophthalmology (AAO) 2014 annual meeting, Chicago In a discussion of the genetics of pseudoexfoliation, John Fingert, MD, PhD, Iowa City, Iowa, pointed out that the LOXL1 gene is the only known genetic risk factor, but test- ing for LOXL1 mutations does not reliably predict who will develop the disease. As a result, there is no clin- ical utility for genetic testing today, and Dr. Fingert counsels patients that a clinical ophthalmic exam is the best diagnostic test available. There is evidence that cataract surgery alone can reduce IOP in pseudoexfoliation patients in the short to intermediate term, said Karim F. Damji, MD, Edmonton, Canada. Dr. Damji suggested adding a glaucoma procedure to cataract surgery in those pseudoexfoliation patients with moderate to advanced glaucoma to further control IOP postoperatively. Editors' note: Drs. Pasquale, Fingert, and Damji have no financial interests related to their comments. Opening Session welcomes attendees to AAO 2014 The AAO annual meeting officially kicked off with an Opening Session. Opening remarks were given by Jonathan B. Rubenstein, MD, Chicago. Stefan Seregard, MD, Stockholm, Sweden, gave the SOE President's Address. AAO President Gregory L. Skuta, MD, Oklahoma City, also gave an address, followed by the Academy Awards. This year's Laureate Award was given to Jerry A. Shields, MD, Philadelphia, and was presented to him by his wife, Carol L. Shields, MD, Philadelphia. She expressed her "distinguished pleasure and once-in- a-lifetime honor" to introduce him. Dr. Jerry Shields has spent 40 years practicing full-time ocular oncology with the singular goal of improv- ing outcomes for patients with eye tumors and helping establish the subspecialty of ocular oncology. Opening addresses concluded with comments from David W. Parke II, MD, San Francisco, the executive vice president of AAO, and Russell N. Van Gelder, MD, PhD, Seattle, the president elect of AAO. Editors' note: The physicians have no financial interests related to their comments Jackson Memorial Lecture focuses on advances in retinoblastoma Hans Grossniklaus, MD, MBA, Atlanta, presented the 2014 Jackson Memorial Lecture, "Retinoblastoma: 50 Years of Progress" at the Opening Session. Fifty years ago, Edwin Dunphy, MD, presented the Jackson Memorial Lecture and chronicled the story of retinoblastoma up to that point, but it is time to update the story, Dr. Grossniklaus said. Re- search and treatment have advanced at an unprecedented rate since then due to advances in molecular biolo- gy and targeted therapy, he said. Molecular biology elucidated the genetic basis of retinoblastoma, revealing that there are 2 varieties of the disease—heritable and non- heritable. Patients with heritable retinoblastoma present at an early age, often with multiple bilateral tumors, and those with the non- heritable form present at a later age, usually with single, unilateral tumors, Dr. Grossniklaus said. Genetic analysis of the disease also revealed that the retinoblasto- ma protein, encoded by retinoblas- toma gene 1, is a master regulator of the cell cycle, demonstrating the profound role it has in virtually all cancers. Targeted therapy for retino- blastoma became prominent in the 1990s with the development of 2 intraocular chemotherapy delivery methods. Intra-arterial chemother- apy enables delivery of medication directly into the ophthalmic artery, and intravitreal injections enable drug delivery to the retina, Dr. Grossniklaus said. New intraocular therapy methods are being devel- oped, including suprachoroidal in- jections that will enable medication to reach the retina without penetrat- ing the vitreous. Medicine is now in an era of global health awareness, Dr. Grossniklaus said, and the chal- lenge for treating retinoblastoma on a global scale is surmounting socioeconomic barriers to access to care. In the U.S. and Europe, more than 90% of retinoblastoma patients survive, but that rate drops to as low as 40% in developing countries. Physicians need to work to ensure that children with retinoblastoma in low-income regions have access to adequate medical care, he said. Dr. Grossniklaus concluded by saying that in studying this one disease, physicians have come to understand the basic mechanisms of cancer, and the great remaining November 2014 View it now: AAO 2014 ... EWrePlay.org Zoltan Nagy, MD, PhD, Budapest, Hungary, discusses the results of a study that show a reduction in the rate of PCO in femtosecond cataract surgery. continued on page 70 Supported by

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