RETINA TIMESThe Official Publication of the American Society of Retina Specialists Fall 2012 Issue 46 46 RETINA TIMES <Wbb(&'(?iik[*, Organizational Staff Jeffrey S. Heier, MD Clinical Trials: Future Pathways Section Editor Lebkc[)&"DkcX[h* J. Michael Jumper, MD Boston, MA Retina Times (ISSN 2164-4411) is published 5 times a year Editor-in-Chief Suber S. Huang, MD, MBA by the American Society of Retina Specialists (ASRS) San Francisco, CA [email protected] President, Foundation of the ASRS as a service to its membership. Cleveland, OH Susan Raef, MSMC Managing Editor G. Baker Hubbard, III, MD The mission of the publication is to strive to be the definitive Chicago, IL Pediatric Retina Section Co-Editor information source for ASRS members on Society news, [email protected] Atlanta, GA meeting plans, socioeconomic topics, international news, and Ana Schedler J. Michael Jumper, MD other relevant information on issues, instruments, and study Graphic Designer PAT Survey Section Editor San Francisco, CA updates for the practicing retinal specialist. Toby Zallman Production Artist Peter K. Kaiser, MD Schedler Brennan Design + Consulting ASRS-AAO Councilor Representative Articles published herein are reviewed by the editor-in-chief Chicago, IL Cleveland, OH and managing editor for editorial content only. The accuracy Oonagh Petrizzi Stacy Kiff of information contained is the responsibility of the individual Proofreader Annual Meeting Section Editor author. Letters and other unsolicited material are assumed to be Stamford, CT Chicago, IL intended for publication and are subject to rejection or editing. John T. Thompson, MD William T. Koch, COA, COE, CPC ASRS President Coding Pitfalls Section Editor Baltimore, MD St. Louis, MO All articles which appear in Retina Times are intended for Gaurav K. Shah, MD informational purposes only and should not be relied on by Mathew W. MacCumber, MD, PhD ASRS Communications Committee Chair ASRS-AAO Councilor Representative any reader for any other purpose. The opinions and positions St. Louis, MO Chicago, IL expressed in Retina Times articles are solely those of Jill F. Blim, MS Charles W. Mango, MD the authors and do not represent the opinions or positions ASRS Executive Vice President E-Retina Section Editor of the American Society of Retina Specialists Board of Chicago, IL New York, NY Directors, members, employees, or Retina Times editorial John R. Minarcik Jr, MD, CDR, MC, USN Section Editors staff and volunteers. Retina in the Military Section Co-Editor Michael M. Altaweel, MD Fairfax, VA Literature Roundup Section Co-Editor Funding for Retina Times is provided by advertisements Robert A. Mittra, MD Madison, WI PAT Survey Section Co-Editor contained within. Carl C. Awh, MD Minneapolis, MN Fellows’ Forum Section Editor Prithvi Mruthyunjaya, MD Nashville, TN Retina Education Section Co-Editor Jerald A. Bovino, MD Durham, NC Jerry’s Wisdom Section Editor Joel Pearlman, MD, PhD Aspen, CO Retina Genetics Section Co-Editor Marcus H. Colyer, MD, MAJ, MC, USA Sacramento, CA Retina in the Military Section Co-Editor Dante J. Pieramici, MD Bethesda, MD What’s News Section Editor Zélia M. Corrêa, MD, PhD Santa Barbara, CA Ocular Oncology Section Co-Editor P. Kumar Rao, MD 20 North Wacker Drive, Suite 2030 Cincinnati, OH Uveitis Section Editor Chicago, IL 60606 Pravin U. Dugel, MD St. Louis, MO Research & Development Section Editor phone: 312-578-8760 Carl D. Regillo, MD Phoenix, AZ KOL Corner Section Editor www.asrs.org Nicholas E. Engelbrecht, MD Philadelphia, PA Pediatric Retina Section Co-Editor © 2012 American Society of Retina Specialists. David Rhee, MD St. Louis, MO Road Test Section Editor Philadelphia, PA All rights reserved. No part of this publication may be reproduced or Philip J. Ferrone, MD Site Selection Section Editor transmitted, in any form, without the prior written permission of the William L. Rich III, MD Great Neck, NY American Society of Retina Specialists. AAO Medical Director of Health Policy Mitchell S. Fineman, MD Falls Church, VA Block Time Section Co-Editor <_dWdY_Wb:_iYbeikh[iEh]Wd_pWj_edWbIjW\\ SriniVas R. Sadda, MD Philadelphia, PA Ocular Imaging Section Editor Dr. Jumper – COVALENT MEDICAL, INC: Equity Owner, Stock; Dutch Brett T. Foxman, MD Los Angeles, CA Ophthalmics USA: Speaker, Honoraria. Film Festival Section Editor Ms. Blim – None. Ms. Raef – None. Ms. Schedler – None. Ms. Zallman – None. Michael A. Samuel, MD Northfield, NJ In the Spotlight Section Editor Ms. Petrizzi – None. K. Bailey Freund, MD Pasadena, CA X-Files Section Editor Dr. Thompson – GENENTECH: Investigator, Grants; REGENERON Reginald J. Sanders, MD New York, NY PHARMACEUTICALS, INC: Investigator, Grants; PFIZER, INC: Practice Management Meeting Section Editor Chevy Chase, MD Investigator, Grants. Sunir J. Garg, MD Block Time Section Co-Editor Chirag P. Shah, MD, MPH Philadelphia, PA Dr. Shah – ALCON LABORATORIES, INC: Consultant, Equipment Clinical Trials: Future Pathways Section Co-Editor Boston, MA (department or practice); ALLERGAN, INC: Consultant, Equjpment Omesh Gupta, MD, MBA Retina Education Section Co-Editor (department or practice); QLT, INC: Consultant, Equipment (department Marc J. Spirn, MD Philadelphia, PA or practice); DORC: Consultant, Equipment (department or practice). KOL Corner Section Co-Editor Larry Halperin, MD Philadelphia, PA Retinomics Section Editor Asheesh Tewari, MD Ft. Lauderdale, FL Literature Roundup Section Co-Editor On the Cover J. William Harbour, MD Detroit, MI Intraretinal neovascularization associated with Ocular Oncology Section Co-Editor Trexler M. Topping, MD Miami, FL Tea Leaves Section Editor macular fibrosis in Coats disease, courtesy Tarek S. Hassan, MD Boston, MA J. Michael Jumper, MD. Road Test Section Editor Kang Zhang, MD, PhD Royal Oak, MI Retina Genetics Section Co-Editor San Diego, CA CONTENTS >> Photo courtesy J. Michael Jumper, MD Michael Jumper, J. courtesy Photo Color photograph corresponding to the angiographic image on the cover. The macular fibrosis is associated with an intraretinal vascular anastamosis and neovascularization. 7 FROM THE PRESIDENT 20 INTERNATIONAL CORNER 42 THE KOL CORNER ASRS Version 3.0: Moving the Bringing the International Retina Wet AMD: The Changing Landscape Vision Forward Community Together 44 RETINA PRACTICE PEARLS 22 RETINOMICS 8 FOUNDATION UPDATE Foundation Seeks Volunteers in 4 Key Areas The Patient Protection and 46 BLOCK TIME Affordable Care Act: 2010-2012— How Has the Retina Subspecialty Changed 9 FROM THE EDITOR’S DESK a Curmudgeon’s Report Card Since Vitrectomy? A Special Thanks to Our Active-Duty Military Retina Specialists The ACA Opens the Door to Health 50 JERRY’S WISDOM Coverage for Millions Everybody Is Sellin’ Somethin’ 10 FILM FESTIVAL 26 ASRS SYMPOSIUM Film Festival Honors Winners from Clinical Trials ‘Unplugged’— 51 TEA LEAVES 5 Countries Part 1: Applying AMD Trial Results Concierge Retina—That’s What We to Clinical Practice Already Provide! ASRS 30TH Anniversary 33 RETINA IN THE MILITARY 52 THE ASRS X-FILES Serving in Afghanistan: 3 Deployed Retina Specialists Share Their Stories 53 LITERATURE ROUNDUP 12 ASRS 30th ANNUAL MEETING HIGHLIGHTS NEW 38 POINT/COUNTERPOINT 56 X-FILES SOLUTION ASRS Celebrates 30th Anniversary at Annual Meeting Point: Scleral Buckling Has a Continuing 57 ADVERTISER INDEX Role in Repairing Retinal Detachment 16 CLINICAL TRIALS: Counterpoint: Most Primary Retinal FUTURE PATHWAYS Detachments Can Be Repaired With Understanding Time-to-Event Analysis a Vitrectomy 4 | retina times | Fall 2012 | Volume )&, Number * | Issue *, | FROM THE PRESIDENT >> John T. Thompson, MD President, ASRS ASRS Version 3.0: Moving the Vision Forward I am honored to serve you as I begin my term as the 18th president of the ASRS, and I look forward to helping the Society advocate on behalf of retina specialists. As you know, we just celebrated our 30th annual meeting in Las Vegas—an outstanding event with record attendance of nearly 1000 retina specialists. (For a recap of the meeting, including photos, please see page 12.) This year’s gala dinner and Umbo Lounge Our Society’s first 2 administrators, Dee addition to a much larger annual meeting at the Haze Nightclub were as memorable Smith (Roy’s secretary) and Jerry Lewis (Allen’s and ancillary conferences such as the practice as the 1999 Rome meeting gala, which office manager), were focused primarily management and masters meetings. featured chariots, Roman centurians, and on admitting new members, processing dues, attendees wearing togas. (The togas were and organizing the annual meetings. The 7IHI)$&0?cfb[c[dj_d]j^[ Kirk Packo’s idea.) 2 accomplished much, even though Jerry ijhWj[]_Y]hemj^fbWd worked out of her home and the membership The field of retina has changed substantially David Williams, president from 2008 to 2010, records were kept on file cards. The Vitreous since the first ASRS meeting in 1983. Being a recognized that the ASRS infrastructure Society was granted ACCME accreditation retina specialist 30 years ago meant spending was limiting the Society and needed to during Jerry Lewis’ tenure, and it was under about half of your time in the OR and seeing change if we wished to implement many of her leadership that a club became a society some patients in the office for preop/postop our members’ great ideas. He assembled a with 1400 members. visits and laser treatments. Vitreous surgery committee of leaders and future leaders early was relatively new, and the early Vitreous The first Vitreous Society meeting I attended in his presidency.