Dec 2017

SPECIAL FEATURE: RANZCO 2017
CONTINUED FROM PAGE 15
holding force. It’s a massive improvement. It’s
brand new here, but the feedback we’ve had from
Europe is that this is fantastic.”
DORC also launched a new SF6 gas, used in
retinal surgery, at RANZCO 2017.
Designs for Vision – Oculus Corvis ST
New on DFV’s stand was the updated Oculus
Corvis ST, the first instrument to enable
ophthalmologists to perform fast and
comprehensive screenings for biomechanically
weak corneas, said the company, recording the
cornea’s reaction to a defined air pulse with a
high-speed Scheimpflug-camera that takes over
300 images a second, to measure IOP and corneal
thickness with far greater precision.
The Corvis ST is particularly useful for
comprehensive biomechanical screening and
keratoconus detection, said Ignatios Koukouras,
DFV’s national product manager, diagnostic, at
RANZCO 2017. “Nothing else in the world can
measure corneal biomechanics like the Corvis. It is
the only instrument that can actually determine
the stiffening effect of corneal cross-linking.”
The Corvis also integrates with the Oculus
Pentacam to provide an even more detailed
corneal analysis, he added.
Battling DHB
bureaucracy
“An ophthalmologist
without
images is like
a radiologist
without x-rays.”
Read how a Kiwi
doctor is trying
to change one
backward
practice in
our DHBs. See
‘Chalkeyes
presents…’
on p26
360˚
Pachymetry
Tonometry
Refraction
Keratometry
From little things, big things grow
BY HEATHER MACHIN*
Versatility and collegiality were celebrated
at this year’s Australian Ophthalmic Nurses
Association – Western Australia (AONAWA)
meeting, held adjunct and just prior to the main
RANZCO meeting in Perth.
With more than 100 delegates from across
Australia and further afield, the programme,
led by AONAWA president Gina Storey, focused
on the connectivity between service providers,
ophthalmologist and nurse sub-specialty experts,
and independent nurse-led project and research
presentations.
Perth-based ophthalmologist, Associate
Professor Geoffrey Lam, presented alongside
neonatal clinical nurse specialist, Karen Shearer, an
early career nurse responsible for implementing
a dynamic nurse-led digital imaging programme
for the screening of retinopathy of prematurity.
Associate Professor Angus Turner and nurseparamedic
Sharon Brown, both from Lions Outback
Vision, further demonstrated the unique nature
of their collaboration while managing eye care for
rural and remote communities where teamwork is
essential and demand on services remains high.
The collaborative approach continued, with
Professor Steven Wiffen, from Lions Eye Bank of
Western Australia, and myself exploring the many
facets of eye tissue bioethics, corneal recipient
needs and surgical techniques, challenging
delegates to consider the possibilities and
limitations we would go to, as a society, to
provide human tissue to those waiting for ocular
transplant surgery.
An impressive line-up of nurse-led initiatives
continued, with key note international nurse
speaker, Dr Elissa McDonald, a microbial keratitis
researcher from the University of Auckland,
setting the pace. Elissa was joined on the
platform by Associate Professor Vicki Drury
from the Singapore Eye Institute; clinical nurse
specialist Joanna McCulloch from the Sydney Eye
Hospital; outgoing AONA-National Council chair
and educator Amanda Wylie from Queensland
University of Technology; and nurse practitioner
TRK-2P
Four in one
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Operate from any position
Your complete automated refraction solution
For further information regarding these leading-edge
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EMR
patient
record
Anne Lentakis from Kingswood Eye Centre in
Adelaide. Their collective take home message was
loud and clear: ophthalmic nurses are in a unique
position to contribute further to the needs of the
vision impaired, be that through self-reflection
and improvement of their own practice; by
supporting other eye care providers; or through
nurse-led research initiatives, all creating a lot of
enthusiastic discussion among delegates.
On the eve of the conference, during an exclusive
cocktail hour and tour of the Perth Eye Hospital,
AONAWA launched their new logo – a crisp
inspirational design that retains its symbolic, yet
reimagined, WA Swan.
The lasting appeal of the ophthalmic nurse
programme was the positive anticipation built
up amongst delegates and the expectation and
opportunities to rejuvenation and reimagine
ophthalmic nursing in Australia, with hopeful
symbiotic opportunities with the ophthalmic
nursing community in New Zealand and beyond.
With a successful close to the 2017 nursing
calendar, and a commendable event for AONAWA,
the ophthalmic nursing community turn their
attention to RANZCO Adelaide 2018, hosted by
AONAVIC and their South Australian sub-branch.
International key note speaker, Dr Elethia Dean
MBA PhD from Chicago will lead the event, with
promise of further names to be announced in the
coming months.
The 2018 hosts warmly welcome participation
from ophthalmic nurses in New Zealand and
beyond and will be calling for abstracts shortly.
* Heather Machin RN MBA, is an ophthalmic operating theatreregistered
nurse, project officer to the Lions Eye Donation Service
and to the Eye Bank Association of Australia and New Zealand, a
consultant to the Fred Hollows Foundation NZ and the incoming
AONA-National Council chair.
Ozurdex approved
Ozurdex, a long-acting
intravitreal steroid,
delivered via a sustainedrelease
ocular implant is now
available and funded for New
Zealand adult diabetic macular
oedema (DMO) patients, which
is welcome news, say Kiwi retina
specialists.
“It’s great news because Pharmac
has been very reticent to fund new
medications for use in the eye,
and we’ve found ourselves behind
our international colleagues a lot
of the time in what we can use
to treat our patients, without
them getting a big out-of-pocket
expense. So, we’re really very
excited about this,” said Retina
Specialists’ Dr Rachel Barnes at
RANZCO 2017.
Eye Doctors’ Andrew Riley was
involved with the clinical studies
on Ozurdex (previously Posurdex)
with his colleague, principal
investigator, Dr Mark Donaldson,
so he knows first-hand the benefits
the Ozurdex slow-release system
can bring to patients, he said. “It gives you
another option, a good option. We haven’t had a
second or third line (treatment) as good as this.
The treatment load won’t be as bad for patients,
and we now have something to better maintain
their vision.”
Ozurdex is a biodegradable, intravitreal,
rod-shaped implant containing 700mcg
dexamethasone, which targets inflammatory
mediators involved in the generation and
regulation of the inflammatory response in
DMO. Specially-designed to provide sustained
delivery, the implant results in less frequent
injections compared to anti-VEGFs.
“Diabetes is an ever-increasing problem in
New Zealand, and is particularly prevalent in
the Maori and Pacific Islander populations.
Many of these patients already inject insulin,
so the additional burden of frequent injections
for DMO can severely affect independence and
quality of life,” said Auckland Eye’s Dr Philip
Polkinghorne. “For some patients, anti-VEGF
treatments are less effective than we would
like, so it is important that New Zealanders with
diabetes and DMO have access to alternative
treatments in order to avoid preventable sight
loss.”
A recent study showed that more than 35%
of patients with DMO fail to achieve ≥10-letter
improvement in best-corrected visual acuity
(BCVA) after two years of first-line anti-VEGFs.
While in clinical trials, Ozurdex delivered a rapid
and significant vision improvement of 15 or
AONA keynote, Dr Elissa McDonald from the University of Auckland
Dr Rachel Barnes and Allergan’s Mellissa Isa
more letters compared with sham treatment
in the whole population of DMO patients;
provided sustained, long-term improvements
in vision in DMO patients with a mean of four
injections over three years, compared with
sham treatment: and was found to promote
rapid central retinal thickness reduction, with
significant and sustained visual gains.
The efficacy and tolerability profile of
Ozurdex is supported by two, three-year,
multicentre, double-masked, randomised,
sham-controlled phase III studies involving
more than 1,000 patients as part of the MEAD
(macular (o)edema: assessment of implantable
dexamethasone in diabetes) trials. Only a small
percentage of patients in the trial are reported
to have experienced adverse ocular events,
including: 1.4% with retinal tears and 0.6% for
each of retinal detachment, endophthalmitis
and hypotony of the eye. Less than one in three
patients experienced an IOP increase from
baseline of ≥10 mmHg. Elevations in IOP did not
have a cumulative effect and were manageable
with topical IOP-lowering treatment, reported
Allergan.
Ozurdex has been approved for the treatment
of macular oedema due to retinal vein occlusion;
adult patients with visual impairment due
to DMO who are pseudophakic or who are
considered insufficiently responsive to, or
unsuitable for non-corticosteroid therapy; and
non-infectious uveitis affecting the posterior
segment of the eye.
16 NEW ZEALAND OPTICS December 2017