Emily Y. Chew, M.D
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THE MEDICARE APPEALS PROCESS P. 16 • RESEARCH BRIEFS P. 60 OCTA AND GLAUCOMA P. 62 • THE LATEST TECHNOLOGY AND DRUGS P. 70 WILLS EYE RESIDENT CASE SERIES P. 77 Review of Ophthalmology Vol. XXV, No. 5 • May 2019 • Charting Your Own Course • The Questionable Cataract • EHR Glaucoma Own Course • The Issues • Uveitic 2019 • Charting Your No. 5 • May Review of Ophthalmology Vol. XXV, MAMAYY 22019019 reviewofophthalmology.comreviewofophthalmology.com CHARTING YOUR OWN COURSE Experts share tips on how to go solo, but note that there are many challenges to overcome as well. P. 20 ALSO INSIDE: • EHR: Room for Improvement? P. 32 • The Questionable Cataract: Who Decides? P. 40 • How to Manage Uveitic Glaucoma P. 48 • Strong Moves for Weak Zonules P. 54 001_rp0519_fc.indd 1 4/16/19 10:03 AM +3.25 D RP0519_J & J Surgical.indd 1 4/5/19 9:57 AM REVIEW NEWS Volume XXV • No. 5 • May 2019 Calcium Intake and Age- Related Macular Degeneration In a recently published study, a secondary the association between calcium in- analysis of patients enrolled in the take and AMD have produced mixed Age-Related Eye Disease Study was results. Findings from the Blue conducted to determine whether an Mountains Eye Study show that Emily Chew, MD Emily Chew, association exists between dietary and calcium may be an important factor supplementary calcium intake and in limiting AMD development/pro- age-related macular degeneration. gression.1 Conversely, fi ndings from Emily Chew, MD, director of the di- the Nutrition Examination Survey vision of epidemiology and clinical ap- suggest that increased calcium in- plications at the National Eye Institute take is harmful in terms of macular at the National Institutes of Health, degeneration.2 However, Dr. -
CURRICULUM VITAE Morton Falk Goldberg, MD, FACS, FAOSFRACO
CURRICULUM VITAE Morton Falk Goldberg, M.D., F.A.C.S., F.A.O.S. F.R.A.C.O. (Hon), M.D. (Hon., University Coimbra) PERSONAL DATA: Born, June 8, 1937 Lawrence, MA, USA Married, Myrna Davidov 5/6/1968 Children: Matthew Falk Michael Falk EDUCATION: A.B., Biology – Magna cum laude, 1958 Harvard College, Cambridge MA Detur Prize, 1954-1955 Phi Beta Kappa, Senior Sixteen 1958 M.D., Medicine – Cum Laude 1962 Lehman Fellowship 1958-1962 Alpha Omega Alpha, Senior Ten 1962 INTERNSHIP: Department of Medicine, 1962-1963 Peter Bent Brigham Hospital, Boston, MA RESIDENCY: Assistant Resident in Ophthalmology 1963-1966 Wilmer Ophthalmological Institute, Johns Hopkins Hospital, Baltimore, MD CHIEF RESIDENT: Chief Resident in Ophthalmology Mar. 1966-Jun. 1966 Yale-New Haven Hospital Chief Resident in Ophthalmology, Jul. 1966-Jun. 1967 Wilmer Ophthalmological Institute Johns Hopkins Hospital BOARD CERTIFICATION: American Board of Ophthalmology 1968 Page 1 CURRICULUM VITAE Morton Falk Goldberg, M.D., F.A.C.S., F.A.O.S. F.R.A.C.O. (Hon), M.D. (Hon., University Coimbra) HONORARY DEGREES: F.R.A.C.O., Honorary Fellow of the Royal Australian 1962 College of Ophthalmology Doctoris Honoris Causa, University of Coimbra, 1995 Portugal MEDALS: Inaugural Ida Mann Medal, Oxford University 1980 Arnall Patz Medal, Macula Society 1999 Prof. Isaac Michaelson Medal, Israel Academy Of 2000 Sciences and Humanities and the Hebrew University- Hadassah Medical Organization David Paton Medal, Cullen Eye Institute and Baylor 2002 College of Medicine Lucien Howe Medal, American Ophthalmological -
Copyright and Use of This Thesis This Thesis Must Be Used in Accordance with the Provisions of the Copyright Act 1968
COPYRIGHT AND USE OF THIS THESIS This thesis must be used in accordance with the provisions of the Copyright Act 1968. Reproduction of material protected by copyright may be an infringement of copyright and copyright owners may be entitled to take legal action against persons who infringe their copyright. Section 51 (2) of the Copyright Act permits an authorized officer of a university library or archives to provide a copy (by communication or otherwise) of an unpublished thesis kept in the library or archives, to a person who satisfies the authorized officer that he or she requires the reproduction for the purposes of research or study. The Copyright Act grants the creator of a work a number of moral rights, specifically the right of attribution, the right against false attribution and the right of integrity. You may infringe the author’s moral rights if you: - fail to acknowledge the author of this thesis if you quote sections from the work - attribute this thesis to another author - subject this thesis to derogatory treatment which may prejudice the author’s reputation For further information contact the University’s Copyright Service. sydney.edu.au/copyright Clinical Studies into the Causes of Idiopathic Macular Telangiectasia Type 2: Sleep Apnoea and Macular Telangiectasia: The SAMTel Project Martin Lee Submitted to the Faculty of Medicine in fulfillment of the requirements of the degree Masters of Philosophy (Medicine) Department of Clinical Ophthalmology & Eye Health University of Sydney January 2015 Acknowledgements: To my family, especially parents, Anne and Russell, and siblings Alison and Frances, thank you for your unbridled support and endless encouragement to enable me to continue to pursue my educational interests. -
Contributing Lecturers
2019 CONTINUING EDUCATION PROGRAM June 14, 15 & 16 CONTRIBUTING LECTURERS Emily Chew, MD Emily Chew is the Director of the Division of Epidemiology and Clinical Applications (DECA), at the National Eye Institute, the National Institutes of Health in Bethesda, Maryland. She is also the Chief of the Clinical Trials Branch. Emily received her medical degree and her ophthalmology training at the U. of Toronto, School of Medicine, in Toronto, Canada. She completed her fellowship in Medical Retina at the Wilmer Eye Institute, the Johns Hopkins Medical Institutes and the U. of Nijmegen, the Netherlands Her research interest includes designing and conducting phase I/II clinical trials and epidemiologic studies in chronic retinovascular diseases such as age-related macular degeneration, diabetic retinopathy, the leading causes of blindness in the US. She also studies rare diseases such as ocular manifestation of von Hippel-Lindau Disease and others. She works extensively in large multi-centered trials headed by the staff of DECA including the diabetic studies, the Age-Related Eye Disease Study and the Age-Related Eye Disease Study 2, which she chairs. She also chairs the Actions to Control Cardiovascular Risk in Diabetes (ACCORD) Eye Study in participants with type 2 diabetes, working in collaboration with NHLBI and NIDDK colleagues. Emily Chew is the director of the clinical program in the Macular Telangiectasia Project (Mac Tel Project) which is an international study conducted in 22 clinics in 7 countries along with four basic science laboratories. She chairs the current international study, known as the AMD Ryan Initiative Study (ARIS), which evaluates the natural course of early AMD. -
Macular Telangiectasia Type 2: Quantitative Analysis of a Novel
View metadata, citation and similar papers at core.ac.uk brought to you by CORE provided by UCL Discovery Macular telangiectasia type 2: quantitative analysis of a novel phenotype and implications for the pathobiology of the disease Mali Okada, MBBS, MMed*; Catherine A Egan, FRANZCO*†; Tjebo FC Heeren, MD*‡; Adnan Tufail, MD, FRCOphth*; Marcus Fruttiger, PhD‡; Peter M Maloca, MD*§ * Moorfields Eye Hospital NHS Foundation Trust, London, UK † Department of Ophthalmology, University of Bonn, Bonn, Germany ‡ UCL Institute of Ophthalmology, London, United Kingdom § Department of Ophthalmology, University of Basel, Basel, Switzerland Short Title: Retinal microcystoid spaces in MacTel 2 Funding: Supported by the Lowy Medical Research Institute, Sydney, Australia as part of The Macular Telangiectasia Project (MO, CE). AT receives a proportion of funding from the National Institute for Health Research (NIHR) and Biomedical Research Centre at Moorfields Eye Hospital and the University College London Institute of Ophthalmology. The views expressed in the publication are those of the authors and not necessarily those of the Department of Health. Financial Disclosures: AT is on the advisory board for Heidelberg engineering (Heidelberg, Germany) and Optovue (Optovue Inc, USA). PM receives fees for lectures from Heidelberg engineering (Heidelberg, Germany) 1 Address for correspondence: Peter M Maloca, MD Moorfields Eye Hospital 162 City Road, London EC1V 2PD London, United Kingdom Tel: +44 20 72533411 Fax: +44 20 72534696 [email protected] Key words Macular telangiectasia type 2; spectral domain optical coherence tomography; volume rendering; microcystoid spaces; cystoid macular oedema; microcystic macular oedema; inner nuclear layer cysts; microcysts; microcavitations Summary Statement Retinal microcystoid spaces are a novel phenotype of Macular Telangiectasia (MacTel) type 2 on optical coherence tomography. -
The Evolving Management of Diabetic Retinopathy: Lessons from Wisconsin and Beyond
The Evolving Management of Diabetic Retinopathy: Lessons from Wisconsin and Beyond AuthorBlock: Lloyd P. Aiello1,2 1Joslin Diabetes Center, Boston, Massachusetts, United States; 2Ophthalmology, Harvard Medical School, Boston, Massachusetts, United States; DisclosureBlock: Lloyd P. Aiello, KalVista Code C (Consultant), KalVista Code I (Personal Financial Interest), Novo Nordisk Code C (Consultant), Optos Code R (Recipient) Presentation Description Less than 50 years ago, diabetic retinopathy was a severe blindng disease with few therapeutic options and often poor outcomes. The advent of laser photocoagulation ushered in a new era where severe visual loss from proliferative diabetic retinopathy (PDR) and diabetic macular edema (DME) could be averted in the majority of patients. However, some degree of visual loss was still frequent and laser photocoagulation destroyed areas of retina leading to side effects and complications. The discovery that VEGF played a central role in both PDR and DME led to development of VEGF inhibitors and a revolution in the care of diabetic eye disease. As a result, visual loss was further reduced, previously unseen magnitudes of visual improvement were realized, and amelioration nonproliferative diabetic retinopathy severity was also observed. The clinical benefit in various patient cohorts and therapeutic differences between VEGF inhibitors have also been evaluated. These and numerous other developing therapies contiunue to make the clinical care of diabetic eye disease one of the longest and most rapidly evolving areas in ophthalmology. Throughout these many remarkable advancements, the fundamental robust understanding of the natural history and epidemiology of diabetic retinopathy provided by the Klein's and others have supported and guided the many clinical trial evaluations of these therapies. -
Print This Issue
January 2011 National Institutes of Health • Department of Health and Human Services • newsinhealth.nih.gov Inside News: 3 Protein Shapes... 4 Dialysis and Kidney Patients... College Drinking... Dietary Supplements Your Aging Eyes “You might find you’re holding your book farther away to read it. You How You See as Time Goes By might even start thinking your arms You may barely notice the changes just aren’t long enough,” says Dr. at first. Maybe you’ve found Emily Chew, a clinical researcher at yourself reaching more NIH’s National Eye Institute. “A good often for your glasses to and simple treatment for presbyopia see up close. You might is reading glasses.” have trouble adjusting to Cloudy areas in the lens, called glaring lights or reading cataracts, are another common eye when the light is dim. You problem that comes with age. may even have put on blue More than 22 million Ameri- socks thinking they were cans have cataracts. By age black. These are some of 80, more than half of us the normal changes to will have had them. Some your eyes and vision as cataracts stay small and have you age. little effect on eyesight, but As more Americans others become large and head toward retirement interfere with vision. Symp- and beyond, scientists toms include blurriness, expect the number of people with of disability in older adults,” says Dr. difficulty seeing well at night, lights age-related eye problems to rise Cynthia Owsley, an eye researcher at that seem too bright and faded color dramatically. You can’t prevent all the University of Alabama at Birming- vision. -
Genetic Disruption of Serine Biosynthesis Is a Key Driver Of
bioRxiv preprint doi: https://doi.org/10.1101/2020.02.04.934356; this version posted February 5, 2020. The copyright holder for this preprint (which was not certified by peer review) is the author/funder, who has granted bioRxiv a license to display the preprint in perpetuity. It is made available under aCC-BY-NC-ND 4.0 International license. 1 Genetic Disruption of Serine Biosynthesis is a Key 2 Driver of Macular Telangiectasia Type 2 Etiology and 3 Progression 4 5 RoBerto Bonelli,1,2 Brendan R E Ansell,1,2 Luca Lotta,3 Thomas Scerri,1,2 Traci E Clemons,4 Irene Leung,5 The 6 MacTel Consortium,6 Tunde Peto,7 Alan C Bird,8 Ferenc Sallo,9 Claudia LangenBerg,3 and Melanie Bahlo*1,2. 7 8 9 1 Department of Medical Biology, The University of Melbourne, 3052, Parkville, Victoria, Australia. 10 2 Population Health and Immunity Division, Walter and Eliza Hall Institute of Medical Research, 3052, Parkville, Victoria, 11 Australia. 12 3 MRC Epidemiology Unit, University of Cambridge, CB2 0SL, Cambridge, UK. 13 4 The EMMES Corporation, Rockville, 20850, Maryland, United States. 14 5 Department of Research and Development, Moorfields Eye Hospital NHS Foundation Trust, EC1V 2PD, London, United 15 Kingdom. 16 6 A list of members and affiliations is provided in Table S8. 17 7 Department of Ophthalmology, Queen’s University, Belfast, BT7 1NN, United Kingdom. 18 8 Inherited Eye Disease, Moorfields Eye Hospital NHS Foundation Trust, EC1V 2PD, London, United Kingdom. 19 9 Department of Ophthalmology, University of Lausanne, Hôpital Ophtalmique Jules-Gonin, Fondation Asile des aveugles, 20 Switzerland. -
ARMD from Spinach to Injection
1/19/17 Risk Factors determined by the Mayo Clinic • Age. Your risk of macular degeneraon increases as you age, especially aer age 50. Macular ARMD degeneraon is most common in people older than 65. • Family history of macular degenera6on. If someone in your family had macular degeneraon, you're more likely to develop macular degeneraon. From Spinach to Injec9on • Race. Macular degeneraon is more common in whites (Caucasians) than it is in other races. • Smoking. Smoking cigareTes increases your risk of macular degeneraon. • Obesity. Being severely overweight increases the chance that early or intermediate macular degeneraon will progress to the more severe form of the disease. • Diet. A diet that includes few fruits and vegetables may increase the risk of macular degeneraon. • High blood pressure. Diseases that affect the circulatory system, such as high blood pressure or high cholesterol, may increase the risk of macular degeneraon. Steven M. Newman, O.D., C.N.S. • Inflammaon. Your immune system can cause swelling of your body 9ssues, which may Board Cer9fied Optometric Physician increase the risk of macular degeneraon. Florida Board of Optometry • Cardiovascular disease. If you have had diseases that affected your heart and blood vessels (cardiovascular disease), you may be at higher risk of macular degeneraon Board Cer9fied Nutri9on Specialist American College of Nutri8on ARMD gene9cs Hippocrates – Alternate complement pathway – ARMS2/HTRA1 – HDL cholesterol pathway “He who does not know – Extracellular matrix – Angiogenesis pathway food, how can he – Vitamin D pathway understand the diseases of man?” 1 1/19/17 Our body was designed to absorb nutrients the old fashioned way…by eang natural foods rich in an9oxidants. -
Rotational Three-Dimensional OCTA
www.nature.com/scientificreports OPEN Rotational Three-dimensional OCTA: a Notable New Imaging Tool to Characterize Type 3 Macular Neovascularization Enrico Borrelli 1, Riccardo Sacconi 1, Gerd Klose2, Luis de Sisternes3, Francesco Bandello1 & Giuseppe Querques 1* This study explored whether rotational three-dimensional (3D) visualization of optical coherence tomography angiography (OCTA) volume data may yield valuable information regarding type 3 macular neovascularization (MNV). In this retrospective, cross-sectional study, we collected data from 15 eyes (13 patients) with treatment-naïve type 3 MNV in their post-nascent stage and age-related macular degeneration (AMD). Subjects were imaged with the SS-OCT system (PLEX Elite 9000, Carl Zeiss Meditec Inc., Dublin, CA, USA). The OCTA volume data were processed with a prototype volume projection removal algorithm and then analyzed using volumetric visualization techniques in order to obtain a 3D visualization of the region occupied by type 3 MNV. The two-dimensional and three-dimensional OCTA images were investigated. Mean ± SD age was 75.1 ± 7.4 years. BCVA was 0.42 ± 0.21 LogMAR in the study eyes. Considering the cohort of analyzed eyes, on rotational 3D OCTA images, a total of 35 neovascular lesions (vs 22 lesions detected on 2D OCTA images) rising from the deep vascular complex and variably spanning the outer retinal layers and eventually reaching the RPE/sub-RPE space were detected. Nine of 35 lesions had a saccular shape, while the remaining cases had a fliform shape. On rotational 3D OCTA images, these lesions were inclined on the three planes, instead of perpendicular to the RPE/Bruch’s membrane. -
Improving Anti-VEGF Drugs in the Vitreous by Eda Isil Altiok A
Improving Anti-VEGF Drugs in the Vitreous By Eda Isil Altiok A dissertation submitted in partial satisfaction of the Requirement for the degree of Joint Doctor of Philosophy with UC San Francisco In Bioengineering In the graduate division Of the University of California, Berkeley Committee in charge: Professor Kevin E. Healy, Chair Professor David Schaffer Professor Tejal Desai Professor Anthony Adams Fall 2015 Improving Anti-VEGF Drugs in the Vitreous © 2015 by Eda Isil Altiok University of California, Berkeley Abstract Improving Anti-VEGF Drugs in the Vitreous By Eda Isil Altiok Doctor of Philosophy in Bioengineering University of California, Berkeley Professor Kevin Healy, Chair The work described in this dissertation present a novel technique utilizing multivalent hyaluronic acid bioconjugates with an anti-VEGF protein for improving the action of drugs in the vitreous. This technology, which has shown efficacy both in vitro and in vivo has the potential to enhance the bioactivity of drugs used for treating patients with diseases including diabetic retinopathy, wet AMD and other neovascular diseases of the retina. Chapter 2 described our initial efforts in creating multivalent conjugates of the anti-VEGF protein, sFlt. Before beginning in vivo studies, we wanted to determine what parameters would maximize the bioactivity of mvsFlt. We investigated the use of several HyA molecular weights and valencies of sFlt molecules to HyA chains. The characterization and in vitro experiments were carried out with 6 mvsFlt conjugates of 300 kDa, 650 kDa and 1 MDa molecular weights with feed ratios of 10 sFlt per 1 HyA chain (termed low conjugation ratio (LCR)) and 30 sFlt per 1 HyA chain (termed high conjugation ratio (HCR)). -
American Academy of Pediatrics Proceedings
Pediatrics VOLUME 19 MARCH 1957 Nuxtnui 3 AMERICAN ACADEMY OF PEDIATRICS PROCEEDINGS THE ROLE OF OXYGEN IN RETROLENTAL FIBROPLASIA E. Mead Johnson Award Address By Arnall Patz, M.D. Departments of Ophthalmology and Pediatrics, District of Columbia General Hospital and the Hofiberger Research Laboratories, Sinai Hospital, Baltimore, Maryland [ In presenting an E. Mead Johnson award problem of retrolental fibroplasia than I)i. Patz. to Dr. Patz, Dr. Bakwin, President of the Acad- His contributions are considered to be a beauti- cmv, made the following remarks: “Dr. Arnall fiil exercise in experimental medicine, the more Patz, Recipient of the Second E. NIead Johnson noteworthy 1)ecause he made them while en- Award, was born in Elberton, Georgia, in 1920. gaging in the private practice of ophthalmol- He attended Emory University at Atlanta and ogy. graduated from the Medical School at that Uni- [“It is for these works that the Academy’s versitv in 1945. Dr. Patz interned at Sinai Committee on Awards has selected 1)r. Patz as Hospital in Baltimore; served in the Medical the recipient of an E. \lead Johnson Award Corps of the Army for 2 years; following which for 1956. This award consists of a handsome he became resident in Ophthalmology at the scroll amid a check for $1000 which we take District of Columbia General Hospital. In 1950 pleasure in iio\v presenting to Dr. Patz. and 1951 Dr. Patz was Research Fellow in [“Dr. Patz will honor us by giving a r-suni’ Ophthalmology at the Armed Forces Institute of his work which has contributed SO miiticli to of Pathology.