Table of Contents - WOC 2012

WOC2012 Abstract Book
PO-RET-66
Triple Combination for Anti-VEGF Non-Responders: A Retrospective
Case Series
Lee Jacob (1,2) , Lam Wai-Ching (1,2)
1. University of Toronto
2. Toronto Western Hospital
Purpose: To report the effects of triple combination therapy with verteporfin
photodynamic therapy (PDT), anti-vascular endothelial growth factor (anti-
VEGF), and dexamethasone on a series of patients with neovascular
age-related macular degeneration (AMD) non-responsive to anti-VEGF
monotherapy.
Methods: This is a retrospective, observational, single center case series. Nine
patients with neovascular AMD who demonstrated poor anatomical response
[central foveal thickness (CFT)> 250 microns, or change of CFT< 50 microns
to three or more intravitreal anti-VEGF injections] were offered triple therapy
with verteporfin half-fluence PDT, anti-VEGF, and intravitreal dexamethasone
from October 2008 to October 2010 at the Toronto Western Hospital. Outcome
measures were visual acuity stability and change in central foveal thickness
(CFT) as measured by optical coherence tomography (OCT).
Results: The average number of anti-VEGF injections prior to initiation of
combination therapy was 10.0. At the three months follow up visit, 88.9%
of patients had stable vision. The mean change in CFT was 194.8 microns.
77.8% of patients had decreased CFT.
Conclusion: Our case series shows that patients who fail to demonstrate an
appropriate response to anti-VEGF monotherapy may benefit with an anatomic
response and visual stability from triple combination therapy.
PO-RET-67
Diagnosis and Management of Age-Related Macular Degeneration
Abdelghani Wael (1,2,3,4,5)
1. The Woodlands Retina Center
2. The Methodist Hospital
3. Memorial Hermann Hospital
4. St. Joseph Medical Center
5. Tomball Regional Hospital
Objective: This course is designed to give ophthalmologists an update on
modalities used in diagnosis and treatment of Age-Related Macular
Degeneration (AMD).
Summary Of Content: The course will cover prevalence, risk factors,
physiological basis, pathogenesis and clinical presentation of AMD. Tests and
investigations useful in the diagnosis of AMD will be reviewed. An overview
of treatment options as well as recent advancements in management will be
discussed. Special attention will be given to treatments used in neovascular
AMD including the role of anti VEGF therapy. Illustrations and case studies
will be used throughout the course to clarify the material and give practicing
doctors an opportunity to test their understanding of the material. Target
Audience: This course is beneficial to both general ophthalmologists and
Vitreo-Retinal specialists. General ophthalmologists completing this course
should be able to: i)Describe characteristics of neovascular versus dry AMD
(ii)Explain physiological basis and anatomical changes of AMD(iii)Describe
clinical manifestations of AMD(iv)Describe eye examinations recommended
for patients with AMD. Ophthalmologists will have the opportunity to compare
and discuss the newer modalities used in the treatment of neovascular AMD
including the different types of anti VEGF therapy used in USA. Educational
Level: Intermediate
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PO-RET-68
Predicting the response to intravitreal anti-VEGF based on the
response in the fellow eye in the setting of clinically significant
diabetic macular edema
Karth Peter (1) , Wirostko William (1)
1. Medical College of Wisconsin
PURPOSE: To study the predictability of response to intravitreal bevacizumab
in eyes based on the response to intravitreal bevacizumab in the fellow eye in
clinically significant diabetic macular edema (CSDME).
Methods: Retrospective chart review was conducted on 28 patients (56 eyes)
with bilateral CSDME who underwent bilateral bevacizumab therapy.
Responses in both eyes were measured by change in central foveal thickness
(CFT) via optic coherence tomography (OCT), and change in visual acuity.
Age, lens status, and starting macular thickness were recorded.
Results: In CSDME, 21% of the response to bevacizumab on OCT in the fellow
eye may be explained by the percentage change in CFT in the first eye [CI:
0.092 - 0.716; P value is 0.0141]. The pre-injection CFT is a predictor of
response to bevacizumab [R2=14%, P-value = 0.0041]. Lens status, change in
visual acuity, and age were not statistically significant predictors of response.
Conclusions: In CSDME, the response to bevacizumab in the fellow eye is
partially explained by the response in the first eye to bevacizumab and by
the pre-injection CFT. Lens status, change in visual acuity, and age were not
statistically significant predictors of response.
PO-RET-69
Diabetic Retinopathy: Diagnosis and Management
Abdelghani Wael (1,2,3,4,5)
1. The Woodlands Retina Centre
2. Memorial Hermann Hospital
3. The Methodist Hospital
4. ST. Joseph Medical Centre
5. Tomball Regional Centre
Objective: This course is designed to give ophthalmologists an overview of
Diabetic Retinopathy
Summary Of Content: The course will briefly cover prevalence, risk factors,
physiological basis, pathogenesis and clinical presentations of Diabetic
Retinopathy. Clinical diagnosis and investigations that are recommended in
Diabetic Retinopathy will be reviewed. Treatment and management including
the use of anti-VEGF will also be discussed. Illustrations and case studies will
be used throughout the course to clarify the material and give practicing doctors
an opportunity to test their understanding of the material. Target Audience: This
course is meant to benefit general ophthalmologists Participants completing
this course should be able to.-
Explain the physiological basis and anatomical changes associated with
Diabetic Retinopay .-Describe the clinical manifestations and stages of
Diabetic Retinopathy.-
Describe the eye examinations recommended for patients with Diabetic
Retinopat.-Describe the treatment of the various stages of Diabetic Retinopathy.
Educational Level: Intermediate