Eyeworld

Reporting from the 2015 AAO annual meeting, November 14–17, Las Vegas EW MEETING REPORTER 72 December 2015 Blumenkranz said. The expecta- tion for the number of Americans at least 65 years old reaching 72 million within 15 years will place a "significant stress" on ophthal- mology because the number of ophthalmologists is not expected to increase proportionately. That growing elder population is expect- ed to fuel an increase in overall healthcare expenditures from 17% to 20% of gross domestic prod- uct. However, the surging use of smartphone technology, medical applications, cloud-based storage, and data analysis are providing a growing number of opportunities to reduce diagnostic costs while improving the accuracy and depth of data collected. For instance, the use of low-cost mobile technology can provide similar capabilities as a fixed office-based auto refractometer, at one-twentieth of the cost. Mobile phone-based diagnostic equipment is "capable of performing a wide variety of functions across health- care," Dr. Blumenkranz said. "This equipment can bend the cost curve." Such technology may see some of its biggest benefits in home monitor- ing, which can provide vastly more real-world measurements to identify and track the development of many conditions. Despite so-called big data providing much more informa- tion, ophthalmologists will still need effective. "Is it occasionally helpful? Yes," Dr. Han said. "Do we need it routinely? No." Justis P. Ehlers, MD, Cleveland, was unable to overcome attendees' skepticism, despite under- scoring the technology's potential to transform the surgical approach to macular surgery through the visualization of residual membranes, confirmation of surgical objectives, and identification of architectural alterations resulting from surgical manipulations. Editors' note: Dr. Ehlers has financial interests with Alcon, Bioptigen (Durham, N.C.), Carl Zeiss Meditec, Genentech, Leica (Buffalo Grove, Ill.), Synergetics—purchased by Valeant (Bridgewater, N.J.), and ThromboGenics (Heverlee, Belgium). Dr. Han has financial interests with Alcon and Allergan. Digital technology key to better health, reduced costs The promise of emerging digital technology to improve patient out- comes and bend the healthcare cost curve was the focus of the Charles L. Schepens, MD, Lecture by Mark S. Blumenkranz, MD, Menlo Park, Calif. The convergence of a quickly growing older population and the new digital age will bring major benefits to ophthalmology, Dr. Three anti-VEGF injections determine long-term response The best corrected visual acuity response after 3 anti-VEGF injec- tions—at 12 weeks—is a strong pre- dictor of long-term BCVA response among diabetic macular edema patients, according to an analysis of 3-year protocol 1 data from the Dia- betic Retinopathy Clinical Research Network, presented by Pravin U. Dugel, MD, Phoenix, Ariz. Among the 375 patients studied, the stable outcomes continued regardless of how well or poorly they responded to the treatment. "The eyes that were categorized by early BCVA re- sponse did differ in several baseline characteristics, for instance they tended to be older, the vision tended to be better, and the retina tended to be thinner, and we wanted to know if that impacted the study conclu- sion," Dr. Dugel said. "After con- trolling for potential confounders, a strong association remained between BCVA improvement at 12 weeks and 52 weeks, and there was no evidence of a ceiling effect." The findings mean that early response remains a significant predictor of long-term behavior, even after adjusting for baseline characteristics, according to Dr. Dugel. Editors' note: Dr. Dugel has financial interests with Abbott Medical Optics (Abbott Park, Ill.), Acucela (Seattle), Alcon, Alimera Sciences (Alpharetta, Ga.), Allergan, DigiSight (Portola Val- ley, Calif.), Genentech (San Francisco), Ophthotech (New York), Ora (Andover, Mass.), and Regeneron (Tarrytown, N.Y.). Little support for routine intraop OCT in macular surgery Attendees overwhelmingly rejected the routine use of intraop OCT for macular surgery after a presentation of cases alternately defending and criticizing the practice. Seventy- nine percent of voting audience members rejected the practice after Dennis P. Han, MD, Milwaukee, Wis., questioned the significance of OCT's ability to identify visually significant membranes and whether it improves surgical safety or is cost View videos from AAO 2015: EWrePlay.org Bonnie An Henderson, MD, discusses uses for low add multifocal IOLs. Sponsored by

• Cover