December 14-16, 2018 Seoul, South Korea Day 1 APVRSSHOWDAILY The Official Conference News of APVRS 2018 by

Highlights

E-poster Sneak Peek Strike Gold Online at 4 APVRS 2018

See More of Seoul APVRS 2018 Delegate 9 Tour Guide

Do not miss the Opening Ceremony and the APVRS Tano Lecture (Submacular Hemorrhage; Where Are We Now? by Dr. Masahito Ohji) in the Auditorium at 15:30 - 16:00H today.

Published by: APVRS ‘Goes for the ’ Gold by Brooke Herron CEO & Publisher in Seoul Matt Young he team at PIE Magazine has one thing on imaging modalities or operation procedures, Production & Circulation Manager Tits collective mind: Gold. And not ‘make- which no doubt will lead to extensive discussion Hannah Nguyen you-rich’ gold (although we like that too), we’re among colleagues in the vitreo-retinal field.” Chief Editor talking about the ‘gold standard’ . . . meaning In addition to discussing the current gold Gloria D. Gamat the best current standards for posterior segment standard, APVRS also looks toward raising that Associate Editor conditions and treatments. bar in the future. In fact, this year’s congress Brooke Herron With that said, the 12th meeting of the Asia- also includes a symposium on “big data,” which Pacific Vitreo-retina Society (APVRS), held in Project Manager according to Dr. Paisan Ruamviboonsuk, has Ruchi Mahajan Ranga conjunction with the 34th meeting of the Korean recently sparked tremendous interest in both the Retina Society (KRS), is bound to be a ‘golden’ medical and non-medical fields. Publications & Digital Manager congress. So, in the spirit of ‘going for the gold’, Alex Young Cont. on Page 3 >> we’ve uncovered a ‘goldmine’ of informative Graphic Designers sessions and symposiums, free papers and Winson Chua PhotooftheDay Edison Tan posters/e-posters from the region’s leading retina experts. Photographer Dwayne Foong “The 12th APVRS Congress has invited renowned speakers and moderators, not just Writers from the Asia-Pacific region, but also from Hazlin Hassan Joanna Lee around the world, in various subspecialties John Butcher ranging from age-related macular degeneration (AMD) and polypoidal choroidal vasculopathy Media MICE Pte. Ltd. 6001 Beach Road, #19-06 (PCV), diabetic macular edema (DME), Golden Mile Tower, pathological myopia, retinal dystrophy, Singapore 199589 intraocular tumors, uveitis, to ocular trauma,” Tel: +65 8186 7677 Fax: +65 6298 6316 said Dr. Won Ki Lee, president of the 12th APVRS Email: [email protected] Congress and president of the Korean Retina www.mediaMICE.com Seoul snowfall can’t keep us away! Society. “The distinguished speakers will deliver We look forward to reporting on gold www.piemagazine.org their presentations on diagnoses, therapeutics, standard treatments at APVRS, Day 1. 1 1-4

EEA is approed for patients wit

Wet AMD(Wet Age-related Macular Degenration) DME(Diabetic Macular Edema) RVO(Retinal Vein Occlusion) mCNV(Myopic Choroidal Neovascularization)

5-7

5 6 PP-EYL-KR-0105-1 7 3 APVRSSHOWDAILY | December 14-16, 2018 | Seoul, Korea

Cont. from Page 1 >> Harnessing big data “Harnessing big data through analytics “ with combination of artificial intelligence through analytics with (AI) and machine learning may yield combination of artificial invaluable answers to epidemiologic, intelligence (AI) and machine basic research, clinical practice questions, etc., and hence drive improvements in learning may yield invaluable patient care. These innovative approaches answers to epidemiologic, will be an enlightening adventure for both comprehensive ophthalmologists basic research, clinical 1-4 and retinal specialists,” said Dr. practice questions, etc.. Ruamviboonsuk, who serves as the chair ” – Dr. Paisan Ruamviboonsuk EEA is approed for patients wit of the scientific program committee. Invited Symposiums Strike Gold Institutes of Health, the DRCR Network affect the posterior and surgical Wet AMD(Wet Age-related Macular Degenration) is dedicated to multi-center clinical management options. DME(Diabetic Macular Edema) This year, more than 500 abstracts were research of diabetic retinopathy, 2018-12-16 | 10:30-12:00 submitted for free paper and poster macular edema, as well as other retinal Ballroom 202-203 RVO(Retinal Vein Occlusion) consideration. These – along with the diseases. During this symposium, mCNV(Myopic Choroidal Neovascularization) invited symposiums and award lectures – recent findings for the management of “Since our meeting last year, the field create a truly golden scientific program. diabetic macular edema and PDR will of vitreoretinal diseases has continued Here’s a sneak peek of some of the be highlighted, with specific relevance to evolve with medical and surgical symposia. to Asian populations. treatment options and exciting research,” 2018-12-15 | 10:30-12:00 said Dr. Ruamviboonsuk. “With that in Retinal Vascular Disease. Delve deep Auditorium mind, the Scientific Program Committee into the management of retinal comprising Asia-Pacific, international, and vascular diseases with this symposium. Latest Advancement in Macular local Korean coordinators, has worked Topics include the role of diagnostic Intervention. This session explores diligently to provide a remarkable range imaging tools (like wide-field imaging, innovations in surgical retina, with of topics that cover many key issues and optical coherence tomography insights into stem cell implantation, major challenges in vitreoretinal practice angiography); the impact of AI; and new surgical technologies and in the world today.” advances in imaging and treatment of the Argus II retinal prosthesis – all In addition to the congress’s macular telangiectasias. In addition, potential armamentarium additions to noteworthy symposiums, free paper trial-based and real-world treatment enhance patient care. sessions and posters, attendees should strategies (including anti-VEGF 2018-12-15 | 10:30-12:00 also plan to attend the prestigious award injections, steroid implants and lasers) Ballroom 104 - 105 lectures – and this year, another has been will be presented. added: the Hyung-Woo Kwak Lecture. 2018-12-14 | 10:30-12:00 Big Data and Epidemiology. As This is in remembrance of Prof. Kwak, a Ballroom 202-203 mentioned by Dr. Ruamviboonsuk, this pioneer and inspiration in retinal research. symposium will focus on combining This, along with the Tano, Constable and Controversies in Retina. Explore big data with AI and machine International Award-named lectures, are challenging and controversial issues learning to allow rapid analysis of certain to be gold. faced by posterior segment surgeons large amounts of data. This has With all of these incredible oppor- 5-7 in this symposium. Covering a range potential applications in traditional tunities for professional development, of topics, expect to hear about the epidemiology, including use of “real delegates should balance the scientific latest diagnostic and surgical imaging world” surveys, cohort studies, genetic sessions with social engagements and instrumentation; micropulse lasers; epidemiology and statistical modeling. entertainment – and thankfully, extra- curricular activities abound at APVRS treatment options for proliferative 2018-12-16 | 08:30-10:00 2018. The congress’s social program diabetic retinopathy (PDR); pros and Ballroom 202-203 cons of surgical techniques for floaters provides ample prospects for networking and celebration, while the dynamic city and myopic traction maculopathy; and Management of Anterior Segment of Seoul tempts visitors with a modern the impact of AI in ophthalmology. Surgery Complications. Suitable skyline, ancient temples and pagodas, 2018-12-14 | 13:40-15:10 for all ophthalmologists, especially delicious street food, and shopping. Auditorium trainees, vitreoretinal surgery fellows Indeed, APVRS 2018 offers a goldmine and general ophthalmologists, this 5 6 of ophthalmic wisdom and skill sharing. PP-EYL-KR-0105-1 7 Diabetic Retinopathy Symposium: symposium covers common anterior Surely you will find each session truly DRCR.net. Sponsored by the National segment surgery complications that valuable to your practice! 4 APVRSSHOWDAILY | December 14-16, 2018 | Seoul, Korea

E-poster Sneak Peek: Strike Gold Online at APVRS 2018 Do I see e-poster highlights?!

Fundus Images and Machine Learning for conditions and uncommon complications. three to six additional months (with ocular PDR Diagnosis Such is the case from Drs. Amelya Sari, ultrasonography). Mutmainah Mayuuddin and Anggun While this case is rare, the authors We are just beginning to understand Yudantha. believe that all ophthalmologists should the capabilities of machine learning In an e-poster called An Unusual be aware that a large choroidal mass and artificial intelligence in ophthalmic Appearance of Large Choroidal Mass with can lead to retinoschisis. In addition, applications. Coupled with widefield Retinoschisis, the authors present the case they noted that the pathophysiology of fundus imaging, this technology has the of a 62-year-old male. He had painless, retinoschisis caused by choroidal mass has potential to aid in diagnosis and improve blurry vision in his right eye and worsened never been reported, so it’s important to patient care as a result. visual acuity (hand movement), with no use ancillary tests and clinical diagnosis to In an e-poster titled Accuracy of history of trauma or known malignancy. determine the cause. Ultra-WideField Fundus Ophthalmoscopy- Multiple screenings and tests were Assisted Deep Learning, a Machine-Learning performed to assess the patient, including Exploring Treat-and-Extend Regimens Technology, for Detecting Treatment-Naive a funduscopic examination, which Proliferative Diabetic Retinopathy, Dr. Yuki showed a clear vitreous and choroidal Whether it’s due to lack or access or Yoshizumi and colleagues investigated the mass in superotemporal site, with orange- prohibitive cost, compliance can be an detection of treatment-naïve proliferative colored pigmentation and subretinal issue for patients needing anti-VEGF diabetic retinopathy (PDR) using ultra- fluid surrounding the mass. Ocular therapy. Now, new treat-and-extend (T&E) widefield fundus images with a deep ultrasonography showed high internal regimens are showing promise to improve convolutional neural network (DCNN), reflectivity, positive sound attenuation visual acuity, while reducing the number which is a machine learning technology. and acoustic solidity mass (size 9.7 x of injections needed – which may not only The authors amplified 378 images (132 10.9 x 5.0 mm), while optical coherence benefit patients, but physicians as well. PDR and 246 non-PDR) and examined the tomography on the macula demonstrated In this vein, Dr. Shih Jen Chen and area under the curve (AUC), sensitivity and an elevated dome shape and splitting of colleagues shared results from the specificity. They conducted a training with the neurosensory retina. In addition, to PLANET STUDY, in an e-poster titled: DCNN using the images and constructed a rule out systemic cancer, an abdomen Treat-and-Extend Intravitreal Aflibercept deep learning model which demonstrated ultrasonography, chest x-ray and Use in Patients with Polypoidal Choroidal high sensitivity (94.7%); high specificity laboratory examination were performed. Vasculopathy (PCV) at 2 Years. (97.2%) and an AUC of 0.969. This led the The patient also had an enlargement Patients were randomized at week 12 investigators to conclude that PDR could of the prostate, but laboratory markers to receive either intravitreal aflibercept be diagnosed using this approach. showed a normal result and no (IVT-AFL) plus sham photodynamic malignancy was found by a urologist. therapy (PDT) or IVT-AFL plus rescue An Unusual Case of a Large Choroidal The authors suspected a benign PDT. From weeks 52 to 96, patients Mass with Retinoschisis choroidal mass with retinoschisis, along not requiring rescue PDT could have with hemangioma and nevus. The patient their treatment intervals extended by The eye is both a delicate and underwent ocular ultrasonography on a one to two weeks at each visit (at the intricate structure, which can lead to rare monthly interval and will be observed for investigator’s discretion.

6 APVRSSHOWDAILY | December 14-16, 2018 | Seoul, Korea

10 out of 10 patients agree, less is more when it comes to injections

Investigators found that in the IVT- and +9.1 letters, respectively. VR Surgery: Assessing Visual Outcomes AFL monotherapy and IVT-AFL plus The most frequent ocular adverse from BRVO Complications rescue PDT groups, 57.9% and 51.9% events were conjunctival hemorrhage reached treatment intervals extending to (6.4%) in IVT-AFL monotherapy group and Branch retinal vein occlusion (BRVO) is ≥10 weeks respectively; and 41.2% and dry eye (6.8%) in IVT-AFL plus rescue PDT a sight-threatening condition that can 37.0% reached intervals of ≥12 weeks group. result in serious complications. Generally, respectively. The mean best-corrected These results led the authors to neovascularization in BRVO develops six visual acuity (BCVA) change from baseline conclude that at two years, patients to 12 months after the disease’s onset, and to week 96 was +11.1 and +11.0 ETDRS receiving IVT-AFL monotherapy in a vitreous hemorrhage (VH) occurs two to letters (≥10-week group) and +10.5 and treat-and-extend (T&E) regimen had three years later. +11.5 ETDRS letters (≥12-week group). considerable improvements in visual and In an e-poster called Vitreoretinal The mean number of injections from anatomical outcomes – similar to those Surgery for Late Complications of Branch week 52 to 96 was 4.1 and 4.4 (≥10-week with fixed dosing in year one – but with Retinal Vein Occlusion, Drs. Faika Deddy group) and 3.9 and 4.2 (≥12-week group), fewer injections. They concluded that and Ramzi Amin presented a case of a respectively. Over 96 weeks, 15.9% “furthermore, IVT-AFL was noninferior to 59-year-old woman with VH secondary to patients in IVT-AFL monotherapy and IVT-AFL plus rescue PDT in patients with BRVO with neovascularization elsewhere. 18.0% in IVT-AFL plus rescue PDT groups PCV.” They noted that vitrectomy is indicated met the rescue criteria and gained +10.7 when VH fails to resolve spontaneously

XL_ABSOLU_PUB_AN-1218 7 APVRSSHOWDAILY | December 14-16, 2018 | Seoul, Korea

and laser treatment is considered for on SD-OCT; 21 eyes (87.5%) had normal However, five days later during his regression of the neovascularization. foveal contour; and 1 eye (4.2%) had outpatient department follow-up, a The authors explained that once an epiretinal membrane with lamellar dilated fundus examination showed scleral the blood cleared following vitrectomy, macular hole. indentation, superotemporal retinal sectoral photocoagulation was used on The authors concluded “when used dialysis with vitreous base avulsion, and the areas of neovascularization. Here, as a tamponade agent, silicone oil causes localized retinal detachment without vitrectomy involves the removal of VH and greater damage to the photoreceptors, macula involvement (OS). The patient was releases the hyaloid from the fronds of foveal atrophy and poorer recovery of scheduled for scleral buckling the following retinal neovascularization ingrowth, while vision as compared to gas. Its use should day. the goal of photocoagulation is to destroy be reserved for repair of complex retinal On admission for surgery, indirect ischemic retina and increase oxygen detachments.” ophthalmoscopy then revealed a giant tension in the eye. retinal tear (GRT) from 10 to 2 o’clock The patient’s visual outcome was Traumatic Retinal Detachment: A Rare with bullous retinal detachment (OS). measured seven days after surgery. Visual and Interesting Case Dr. Tseng changed the surgical plan to acuity improved from hand movement encircling scleral buckling with pars plana to 0.3 logMAR, which led Drs. Deddy In this case report, Dr. Po-Chen Tseng vitrectomy and gas tamponade. He said and Amin to conclude that vitrectomy illustrates why careful preoperative that during the surgery, “we observed combined with laser photocoagulation assessment is critical to saving sight. In his a GRT with avulsion of the pars plana is safe and effective for intravascular e-poster Traumatic Retinal Detachment epithelium from the vitreous base, which reperfusion and produces significantly — Combined Retinal Dialysis and Giant was seen as an irregular ribbon within the better visual acuity results. Retinal Tear: A Case Report, Dr. Tseng vitreous cavity.” To prevent the GRT from shares a case involving a 25-year-old, slipping, perfluorocarbon liquid was used Vitrectomy: Gas versus Silicone Oil highly myopic (-11.75D) male who was intraoperatively. Tamponade struck in the left eye while playing Following the surgery, Dr. Tseng said basketball. that “the visual acuity in his left eye Dr. Mohit Dogra and colleagues At presentation, the patient’s best- returned to 20/20 after cataract extraction recently presented their findings from a corrected visual acuity (BCVA) was 20/20 six months later and the retina remained retrospective interventional case series in (OD), 20/25 (OS) with normal intraocular attached with break in bed one year after an e-poster titled: Comparison of Spectral- pressure. A dilated fundus examination surgery.” Domain Optical Coherence Tomography revealed draped vitreous opacity with In conclusion, the author pointed out Findings between Eyes Undergoing Pars clumps of pigment in upper quadrant, but how important preoperative assessment Plana Vitrectomy with Gas Versus Vitrectomy without an obvious retinal break in the left is – and that recognizing these conditions with Silicone Oil Tamponade for Primary eye. is crucial to providing the patient with Non-Complex Rhegmatogenous Retinal optimal management and treatment. Detachment. In this series, patients with a history of trauma, previous retinal surgery/laser, giant retinal tears, choroidal detachment, choroidal colobomas, proliferative vitreoretinopathy greater than C2, or with follow-up of less than three months were excluded. In total, 40 eyes of 40 patients (14 females and 26 males) with a mean age of 54.69 were included. The patients were split into two groups: 24 underwent pars plana vitrectomy (PPV) with gas and 16 had PPV with silicone oil. High-definition spectral- domain optical coherence tomography (SD-OCT) was performed at months one and three. Of the 16 who had PPV with silicone oil, 8 eyes (50%) had foveal atrophy on SD- OCT at 3 months; 2 eyes (12.5%) had an

epiretinal membrane; and the remaining Dramatic 6 eyes (37.5%) had normal foveal contour. reenactment of Of the 24 patients who had PPV with gas, blunt trauma only 2 eyes (8.3%) had foveal atrophy causing retinal detachment.

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1 As ranked in a recent report by U.S. News and World Report. © 2018 IRIDEX. All rights reserved. IRIDEX, the IRIDEX logo, Cyclo G6, MicroPulse, and G-Probe are trademarks or registered trademarks of IRIDEX. AD0190.C 11.2018 9 APVRSSHOWDAILY | December 14-16, 2018 | Seoul, Korea

® CYCLO G6 GLAUCOMA LASER SYSTEM See More of Non-incisional, repeatable, and for a wide range of glaucoma cases. Over 100,000 probes and 1,100 systems shipped to more than 50 countries. Used in 37 of the 39 best U.S. hospitals for ophthalmology1 SeoulSeoulAPVRS 2018 Delegate Tour Guide by Brooke Herron

elcome to Seoul: The capital AND For pop culture aficionados, the Explore More of Seoul Wlargest city in South Korea. Here, Gangnam district owes some of its modern skyscrapers and traditional popularity to Korean Pop (K-pop) artist Psy Delegates with some free time will have palaces and temples find common- and his song “Gangnam Style,” which has ample options to explore in Seoul. For ground in this fashionable metropolis of garnered more than 2 billion online views those seeking a bit of history, the Seoul pop-culture, history, shopping, dining and worldwide. [And if you’re not familiar capital area balances its modernity more. with this song, or with K-pop in general, with an astounding five UNESCO World With a sprawling metropolitan area, head over to YouTube.com for a quick Heritage Sites: Changdeokgung Palace, delegates at the Asia-Pacific Vitreo-retina education on Korean pop culture.] Hwaseong Fortress, Jongmyo Shrine, Society (APVRS) will undoubtedly find Attendees needing a dose of retail Namhansanseong and the Royal Tombs of numerous attractions, delights and sights therapy have easy access to Coex Starfield the Joseon Dynasty. to entertain in between the congress’s Mall, an underground shopping mecca One of these sites, Changdeokgung impressive scientific program. with a large movie theater complex and (also known as Changdeok Palace), is numerous fine dining restaurants. Also the most preserved of the remaining Quick Sights in Seoul located near Coex, is Bongeunsa Temple, royal palaces and is considered by some constructed in 794, and home to 3,479 to be the most beautiful. It was initially Busy delegates may not have too much Buddhist scriptures. Admission is free, completed in 1412, but subsequently time to explore – fortunately, the area and the temple is open year-round. burned down during a Japanese surrounding the conference venue has The Gangnam district is also home to invasion in 1592. King Seonjo and King multiple attractions nearby. Located in several recreation areas including tourist Gwanghaegun reconstructed the palace the popular Gangnam district, the event destination Olympic Park, as well as in 1609. Tourists must book a one-hour venue – Coex Convention and Exhibition Seonjeongneung Park, which is home to tour to look around, so check online or call MicroPulse P3™ Device G-Probe® Device G-Probe Illuminate™ Device Center – is not only well-recognized as royal tombs. ahead for more information. events center, but a tourist attraction as Continuing on the palace theme, the For earlier to advanced For advanced glaucoma therapies in well. Gyeongbokgung Palace (also known as glaucoma therapies in continuous wave mode. Gyeongbok Palace) is said to be Seoul’s MicroPulse mode. most popular attraction. Constructed in 1395 by King Taejo, the founder of the Joseon Dynasty, it now houses 300 buildings including the National Folk Museum and National Palace Museum. Those in the know say to spend at least a half day inside the compound for the full Learn more at APVRS booth 26 or iridex.com/cyclog6 experience. Free audio tours are available, check online for time slots. 1 As ranked in a recent report by U.S. News and World Report. Between these two palaces lies © 2018 IRIDEX. All rights reserved. IRIDEX, the IRIDEX logo, Cyclo G6, MicroPulse, and G-Probe are trademarks or registered trademarks of IRIDEX. AD0190.C 11.2018 another must-see: Bukchon Hanok Village. Hanoks are traditional Korean homes 10 APVRSSHOWDAILY | December 14-16, 2018 | Seoul, Korea

with tiled roofs and stone floors – and this deck renown for the panoramic views visit this major recreation complex, which neighborhood has 900, dating all the way of the cityscape below. There are two includes: the world’s largest indoor theme back to the Joseon Dynasty. Traditional ways to reach the top: walking (which my park; and outdoor amusement park; an meets contemporary here as well – some Internet sources say isn’t difficult) or cable artificial island, inside a lake, linked by of these hanoks have been transformed car (which allows you to see more along monorail; shopping malls; a luxury hotel; a into tea houses, cafes, art galleries and the way). At the top of the 236.7-meter Korean folk museum; sports facilities; and museums, making it an ideal respite from tower, there are two dining options: one movie theaters. a busy conference schedule. upmarket, one casual. Markets and street food are also a big Nature lovers can also rejoice in draw in Seoul. The Dongdaemun Market Seoul, as the city is surrounded by eight A Dose of Retail and Culinary Therapy is Korea’s largest retail shopping district, mountains and boasts numerous parks. with more than 30,000 fashion shops Head to the city’s guardian mountain For those seeking fun indoors (and out and 50,000 manufacturers opened for Namsan and visit the N Seoul Tower, an of the chilly weather!) head to Lotte World. 24-hours a day. Visitors will find all types iconic city landmark with an observation Each year, more than 7.3 million people of goods and services here, with a range varying from leather goods to fortune tellers and cuisine. For a more traditional street market, check out Gwangjang Market – Seoul’s largest food alley (or meokja golmok) with more than 200 food stalls. Foodies flock to this market to sample traditional Korean delights like mandu (Korean dumplings) and bibimbap and boribap (mixed rice and barley topped with a selection of veggies). Certainly, between the congress and the dynamic city of Seoul, delegates will find numerous activities to fill their free time. The city’s high-tech backdrop steeped in traditional roots creates an ideal backdrop for APVRS, one of Asia’s most important ophthalmic conventions.

This is

High Magnification Performance 1

Extended Depth of Field1

Integration with the CONSTELLATION® Vision System

Reference: 1. Alcon Data on File. Yin L, Sarangapani R. Assessment of visual attributes for NGENUITY® 3D Visualization System 1.0 for digitally assisted vitreoretinal surgery. Alcon Modeling and Simulation. January 2016.

© 2018 Novartis 5/18 K71810912161