APVRSSHOWDAILY December 8-10, 2016
Bangkok, Thailand
The Official Conference News of APVRS 2016
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Highlights
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Clinical pearls abound at the rapid fire session on surgical retina. Be sure not to miss it!
10th APVRS Congress Welcomes Prof. Xiaoxin Li is delivering the APVRS
Yasuo Tano Lecture
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at today’s opening ceremony While at APVRS, start your amazing Thailand adventure...
Published by:
Editorial Team Creative Content Director
Matt Young
Chief Editor
Gloria D. Gamat Project Manager
Ruchi Mahajan Ranga Writers
John McMahon Kaylen Moore Designer
Vitreoretinal Specialists in Bangkok by Ruchi Mahajan Ranga
W
ith the accelerated progress in the field of vitreoretinal treatments, the 10th Asia Pacific Vitreo-Retina Society Congress (APVRS 2016) at the Bangkok Convention Center at CentralWorld, Thailand, is all set to provide interesting opportunities for scientific exchange and advancement. Held in conjunction with the 38th Annual Meeting of Royal College of Ophthalmologists of Thailand (RCOPT), APVRS continues to reach new heights by enabling the ophthalmologists from across the globe to meet and network. Since its inception in 2006, APVRS continues to nurture its mission to assist in the development of the vitreoretinal subspeciality in the Asia Pacific region. The congress offers a perfect platform for integration of skills and knowledge of vitreoretinal specialists and to promote eye care information about vitreoretinal diseases and related issues to the general public. This year the event brings together over 200 invited regional and international speakers sourced from more than 20 countries, addressing a range of current challenges and leading practices.
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Grants and Awards As year 2016 marks the completion of first decade for APVRS, Congress President, Dr. Paisan Ruamviboonsuk welcomes the delegates on behalf of the organizing committee.
“The 10th Congress in 2016 is destined to begin our next decade with further opportunities for scientific exchange and scientific advancement,” Dr. Ruamviboonsuk said. “I appreciate your kind contribution that ensures the success of the Congress.” In an effort to lend a helping hand to young ophthalmologists, APVRS offers partial travel support to deserving candidates under APVRS Tano Travel Grant. The Grant is targeted to help the young ophthalmologists in the Asia-Pacific region by offering them with an initiative to further advance their training and education. The Special Lectures at the APVRS 2016 Congress include the APVRS Tano Lecture by Prof. Xiaoxin Li, the APVRS Ian Constable Lecture by Dr. Jay Chhablani, and the Rutnin Lecture by Dr. R.V. Paul Chan. Cont. on Page 4 >>
PhotooftheDay Matt Young, publisher of the APVRS Show Daily, demonstrates the refractive capability of the AT LISA tri toric 939MP lens at the Zeiss booth.
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Abbreviation of Eylea Product Information: Presentation; 1 ml. solution for intravitreal injection contains 40 mg aflibercept Indication: for treatment of neovascular (wet) age-related macular degeneration (wet AMD), macular edema secondary to central retinal vein occlusion (CRVO), diabetic macular edema (DME), macular edema secondary to branch retinal vein occlusion (BRVO), myopic choroidal neovascularization (myopic CNV). Dosage and method of administration: For Neovascular (wet) age-related macular degeneration (wet AMD), the recommended dose for Eylea is 2 mg (equivalent to 50 microliters) intravitreal injection. EYLEA treatment is initiated with one injection per month for three consecutive doses, followed by one injection every 2 months. For Macular edema secondary to central retinal vein occlusion (CRVO), the recommended dose for EYLEA is 2 mg. After the initial injection, treatment is given monthly until visual and anatomic outcomes are stable for three monthly assessments. For Diabetic macular edema (DME), the recommended dose for EYLEA is 2 mg administered by intravitreal injection monthly for the first 5 consecutive doses, followed by one injection every 2 months. Macular edema secondary to branch retinal vein occlusion (BRVO), the recommended dose for Eylea is 2 mg. After the initial injection, treatment is given monthly. For Myopic choroidal neovascularization (myopic CNV), the recommended dose for EYLEA is a single intravitreal injection of 2 mg. Additional doses should be administered only if visual and anatomic outcomes indicate that the disease persists. Contraindications: Ocular or periocular infection, Active severe intraocular inflammation, Known hypersensitivity to aflibercept or to any of the excipients. Special warnings and precautions for use; Intravitreal injections including those with EYLEA, have been associated with endophthalmitis, Increase in intraocular pressurehave been seen within 60 minutes of an intravitreal injection, Women of childbearing potential should use effective contraception during treatment. Adverse reactions: Very common (≥1/10 patients) Conjunctival hemorrhage, Eye pain Selected adverse reactions: Arterial thromboembolic events (ATEs) are adverse events potentially related to systemic VEGF inhibition. There is a theoretical risk of ATEs following intravitreal use of VEGF inhibitors. Immunogenicity-as with all therapeutic proteins, there is a potential for immunogenicity with EYLEA. Incompatibilities: EYLEA must not be mixed with other medicinal products
โปรดอานรายละเอียดเพิ่มเติมในเอกสารกำกับยา ใบอนุญาตโฆษณาเลขที่ ฆศ. 726/2559
APVRSSHOWDAILY | December 8-10, 2016 | Bangkok, Thailand
Highlights from APVRS 2016 Posters Poster No.: EX1–004
Poster No.: EX1–019
A New Controlled Drug Release System Using Hollow-Core Devices First Author: Dr. Noriaki TAKASE Co-Author(s): Aki Kato, Yuichiro Ogura, Hideaki Usui, Tsutomu Yasukawa
Stem Cell Therapy for Retinal Disorders First Author: Dr. Lucian Del Priore
As anti-VEGF drugs become more commonly used these days, the need for repeated injections may increase the risk of local and systemic adverse events. A team of Japanese specialists has developed a new controlled drug release system, a strategy they suggested that might overcome this problem. The team implanted an intraocular lens-type hollow-core device filled with solid sodium fluorescein and C3F8 gas into rabbit eyes. Preliminary findings suggest that intraocular sustained release of anti-VEGF agents might be feasible.
Poster No.: EX1–024 Novel Red-Free Angiography Findings in Age-Related Macular Degeneration and Polypoidal Choroidal Vasculopathy First Author: Dr. Rui Hua Using confocal scanning laser ophthalmoscope, Dr. Rui Hua investigated red-free angiography (RFA) findings in wet age-related macular degeneration (wAMD) and polypoidal choroidal vasculopathy (PCV). Following the venous phase of fundus fluorescein angiography (FFA), the detection mode was switched to red-free reflectance quickly (within 2–3 seconds), and red-free angiography images were acquired under the same parameters as FFA. Results indicated that RFA can provide more diagnostic imaging information due to the differences in the mechanism of angiography modes, the absorption coefficients of hemoglobins, and retinal chromophores. Thus, RFA may be a promising approach to supplement traditional FFA in wAMD and PCV patients.
The utilization of stem cells in ophthalmology is becoming more promising. Investigating stem cell therapy for retinal disorders, Dr. Lucian Del Priore has transplanted retinal pigment epithelium (RPE) in a small number of patients using either adult human RPE or RPE derived from embryonic stem cells (ESC). The results were compared to evaluate safety and efficacy and to determine factors that may be responsible for limiting successful engraftment in patients with advanced age-related macular degeneration (AMD) or Stargardt disease.
Poster No.: EX1–042 A New Procedure to Prepare a Monolayer Sheet of Cultured Retinal Pigment Epithelial Cells with Bruch Membrane First Author: Dr. Hideaki Usui Co-Author(s): Aki Kato, Soichiro Kuwayama, Yuichiro Ogura, Noriaki Takase, Tsutomu Yasukawa The retinal pigment epithelium (RPE) plays a key role in physiological retinal functions. When the RPE becomes damaged or defective, it becomes a serious pathological finding in age-related macular degeneration, thereby causing inevitable vision loss. While the transplantation of a sheet of cultured RPE cells has been clinically tested, the RPE cell sheets used had no native Bruch membrane but rather substitutes such as sheets made of artificial polymer or collagen, potentially causing graft contraction and fibrosis. Through high-density seeding of RPE cells, Japanese researchers prepared a monolayer sheet of cultured RPE cells with Bruch membrane. Upon investigation, they found that RPE sheet may be used as higher quality biomaterial for RPE transplantation and is also useful to elucidate the morphogenesis of the Bruch membrane.
Poster No.: EX1–023 Macular Abnormalities on Spectral Domain OCT and Fundus Photography in HIV/AIDS Patients with Cytomegalovirus Retinitis First Author: Dr. Kamontip Jantarakairojn Co-Author(s): Somsanguan Ausayakhun, Direk Patikulsila Macular abnormalities in HIV/AIDS patients with cytomegalovirus retinitis (CMVR) were identified by Thai experts using spectral domain optical coherence tomography (OCT) and fundus photography. In these high risk patients, OCT and fundus photography can detect even the minor changes of the macula (i.e. epiretinal membrane, macular scar with foveal center involvement, active macular CVMR, zone 1 active CMVR, and zone 1 CMVR scar) which may actually explain the cause of visual loss. New Eye Co., Ltd. brings creativity to the booth in featuring their New Eye Menus. But you can expect fundus cameras instead of caffè lattes.
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APVRSSHOWDAILY | December 8-10, 2016 | Bangkok, Thailand
by Gloria D. Gamat
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he 10th APVRS Congress kicks off with a rapid fire session on surgical retina updates. Retinal surgeons from across Asia Pacific are presenting various topics – from complicated retinal detachments and ruptured ocular injuries to intravitreal steroid injections – to share clinical pearls. Here are a few excerpts: First up on surgical retina updates, Dr. Durgesh Kumar M.D., vitreoretinal surgeon from Sri Ram Janki Netralaya, Betiahata, Gorakhpur, India, presenting on “Circumferential and Arcuate Long Radial Retinotomies with Wedge Retinectomies in Management of Complicated Retinal Detachments” will discuss the need for techniques to preserve and attach functional macula by circumferencial/long arcuate radial retinotomies and wedge/ anterior flap retinectomies of stiff retina in otherwise unoperable complicated retinal detachments. Presenting about “Morphologic Changes in the Retina After Selective Retina Therapy”, Dr. Eung-Suk Kim, M.D.,
vitreoretinal disease specialist from the Department of Ophthalmology, Kyung Hee University Medical Center, South Korea, will discuss findings on the structural changes in the retina by histologic evaluation and in vivo spectral domain optical coherence tomography (SD-OCT) following selective retina therapy (SRT) controlled by optical feedback techniques (OFT). According to Dr. Kim and colleagues, SRT with OFT could selectively target the retinal pigment epithelium (RPE) without damaging the neurosensory retina. Hence, the technique opens the door to the possibility of clinical trials of well-defined invisible and nondestructive retina therapy, especially for macular disease. From Japan, Dr. Hideyuki Shimizu, M.D., will discuss “Current Trend of Ruptured Ocular Injuries and the Involvement of Crystalline/ Intraocular Lens Ejection”. Dr. Shimizu and team evaluated the clinical features of open-globe ocular injuries to determine the factors that are correlated with poor visual outcome. Based on their findings,
certain trends of ocular injuries are arising and common in elderly patients. Dr. Gaurav Mathur, M.D., from Eye Q Hospital in India, will talk about the “Role of Topical Difluprednate Provocative Test Before Intravitreal Steroid Injections”. Dr. Mathur and team investigated the role of a topical difluprednate 0.05% provocative test before intravitreal steroid use in diabetic macular edema for steroid response, and found that it has good sensitivity and specificity. Difluprednate responders demonstrated high IOP response after IVTA/Ozurdex implants and the IOP increase after the provocative test correlated well with the IOP increase after injections. According to the investigators, if the provocative test is positive, then the risks and benefits of steroid injections should be well understood and weighed before use. For more surgical retina updates, be sure to catch the free paper session today at Lotus 11, from 9.00 a.m. to 10:30 a.m.
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Comprehensive Scientific Agenda The organizing committee of the 10th APVRS Congress, composed of Thai, Asia-Pacific, and international scientific coordinators, have put together a comprehensive and stimulating scientific program. The symposia are designed to cover a broad range of subjects in medical and surgical vitreoretinal pathology including macular degeneration, uveitis, oncology, diabetic eye disease, macular surgery, and pediatric retinal disorders. The scientific program on day 1 will focus on intraocular inflammation, uveitis and scleritis, and ocular oncology and pathology. Day 1 will also showcase scientific sessions on challenging topics related to medical and surgical retina. Day
2 will encompass topics in comprehensive ophthalmology, medical retina, as well as miscellaneous topics including challenges in pediatric retina and strabismus, with the latest advances in age-related macular degeneration (AMD) and polypoidal choroidal vasculopathy (PCV). Surgical retina topics will shed some light on retinal tumors and pediatric retinal surgery. Furthermore, the scientific program on day 3 will include rapid fire mystery oncology case presentation, management of retinal urgency, variety of topics in the management of vitreoretinal diseases, challenges in pediatric retina cases, and much more. Through these scientific sessions, experts from different parts of the world will discuss and share their experiences to promote effective management of these ocular conditions worldwide.
Conference Add-ons To enhance the congress experience for delegates, APVRS 2016 Mobile app provides easy-to-use interactive features. The app features all the scientific sessions and instruction courses, e-posters, posters, video abstracts, floor plan, city map, other general instructions, as well as the APVRS Show Daily. For help on downloading the app and navigation of functions, staff at the registration desk are available to provide assistance. The registration and information desk is located at the main entrance on the 22nd floor of Centara Grand & Bangkok Convention Center. On-site payment with cash and credit cards can be made at the registration Desk during opening hours. Paper posters can be found in the
APVRSSHOWDAILY | December 8-10, 2016 | Bangkok, Thailand
New Gene Associated with East Asian nAMD
Takes Center Stage at the APVRS Tano Lecture by Gloria D. Gamat
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very year the Asia Pacific VitreoRetina Society (APVRS) invites notable ophthalmologists to deliver the APVRS Tano Lecture. The APVRS Tano Lecture was established in 2009 in memory of Prof. Yasuo Tano, APVRS’s founding President. Since then, through the Tano Lecture, the APVRS honors an individual who has made significant contributions to the improvement and advancement of the understanding, diagnosis and treatment of vitreoretinal diseases. On its 10th year, in conjunction with the 38th Annual Academic Meeting of the Royal College of Ophthalmologists of Thailand, the APVRS 2016 Tano Lecture recipient is Prof. Xiaoxin Li. Prof. Xiaoxin Li, chair and professor at the People Eye Center of People’s Hospital Peking University, China, is delivering the APVRS 2016 Tano Lecture. Prof. Li is the honorable president of the Chinese Ophthalmology Society and past president of both the Chinese Ocular Fundus Diseases Society and the APVRS.
exhibition hall where the e-posters and video platform are also located. The exhibition area is located at Convention B1, 22nd Floor in Centara Grand & Bangkok Convention Centre. Delegates and visitors can take a look at the latest products and services showcased by exhibitors from different parts of the world. Known for ornate shrines, best meeting facilities, and countless attractions for visitors, Bangkok is a city that rewards urban explorers with a cornucopia of sights and sounds. The diverse city with amalgamation of old and new will offer the delegates with wide range of activities to amuse themselves, from the religious to the historical to great shopping.
She is an academic committee member of Peking University Health Science Center and dean of Peking University Eye Center. Prof. Li has published 121 papers in international journals, as well as more than 200 papers in Chinese journals. She edited the Chinese book Surgery on Vitreous and Retina and served as chapter editor for Vitreous Diseases, Retina Diseases, Retinal Detachment, among other ophthalmology books in China.
At the APVRS 2016 Tano lecture, Prof. Li will report the function of UBE3D in nAMD and its role in determining therapeutic applications. Using knockdown of zebrafish UBE3D and UBE3D heterozygous mice models, Prof. Li and her team explored possible intervention strategies. Their findings demonstrated that UBE3D plays a role in the pathogenesis of nAMD and it could be a potential target for therapy.
A well published and respected vitreoretinal specialist in China, Prof. Li has been contributing breakthroughs in this ophthalmic field since the early 90s when she first separated all oscillatory potentials from b-waves of the electroretinogram by using Fourier transform. Today, this technique is being used in all electrophysiology equipment as a routine setting.
For further details, be sure not to miss Prof. Li’s Yasuo Tano Lecture immediately following the APVRS 2016 Opening Ceremony on Day 1 (December 8) at Convention A1 from 16:30 to 17:30.
In 2014,Prof. Li reported a new gene, called UBE3D, associated with neovascular AMD (nAMD) in East Asian population. This year, genetics in ophthalmology will be on spotlight at APVRS.
Opening Ceremony and Social Program The Opening Ceremony, open to all delegates will take place on 8th December, 2016 (Thursday) at 16:30 to 17:30 hrs at Convention A1 Centara Grand & Bangkok Convention Centre. It will be followed by a welcome reception at the exhibition hall in Centara Grand & Bangkok Convention Centre at 17:45 to 18:45 hrs. The dress code for the welcome reception is smart casual. The welcome reception offers an excellent platform for networking and re-connecting with peers and colleagues. Day 1 at the APVRS Congress will conclude with a presidential dinner at the Siam Society Under Royal Patronage at 19:30 to 21:00 hrs.
Yasuo Tano Lecture Prof. Xiaoxin Li The Function of AMD Susceptible Gene UBE3D and Potential Therapeutic Applications December 8, 2016, 17:00 – 17:30 Convention A1
Located just about 10-minute walk from the conference venue is the SEA LIFE Bangkok Ocean World, the largest aquarium in Southeast Asia. You can catch a glimpse of tropical ocean environment in an 8 meter-tall aquarium and stroll through a 270-degree ocean tunnel. After the cocktail hour, delegates can also enjoy a special performance and a taste of local Thai cuisine in this spectacular aquatic setting. APVRS 2016 will be an enlightening adventure for general ophthalmologists and retina specialists from across the globe. Aside from providing vitreoretinal specialists with a wonderful platform for sharing latest discoveries and innovation, the congress also creates collaborative opportunities, which are imperative in the continuous development of this burgeoning ophthalmic subspecialty.
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APVRSSHOWDAILY | December 8-10, 2016 | Bangkok, Thailand
Excerpts from
Klebs and Clots
RANZCO 2016 Posters At the recently held RANZCO 2016 in Melbourne, Australia, we found a few stand-out posters with sassy, eye-catching titles. Who said poster titles have to be bland and boring? Ophthalmic experts from down under know better...
The Molecular Biography of John Dalton Mostly known for his physics theories (i.e. atomic theory, Dalton’s law of partial pressures), John Dalton’s contribution to science includes ophthalmology as well. In their poster presented at RANZCO 2016, Dr. Enis D. Kocak and colleagues from The Alfred Hospital in Melbourne, Australia, reviewed Dalton’s original theories and recent developments. In 1794, he described his own color blindness at a lecture he delivered to the Manchester Literary and Philosophical Society and theorized that the distortion of color was caused by blue-tinted vitreous. His foresight to have his own eyes preserved actually ended up disproving his theory. Post-morten analysis of his eyes revealed that his vitreous was perfectly clear. Further, DNA analysis of preserved samples in 1995 showed that he lacked the cone opsin gene, corresponding to deuteranopia (or color blindness), matching his historical descriptions of color defect.
The Bung Eye
An unusual case of Klebsiella endophthalmitis complicated by superior ophthalmic vein thrombosis A retrospective case and literature review reported the presentation, management and pathogenesis of a rare case of endophthalmitis caused by Klebsiella pneumoniae, a gram negative, non-motile, encapsulated, facultative anaerobic bacillus. This case, presented by a team from Royal Perth Hospital in Western Australia, highlights the unusual presentation of two serious eye conditions not often seen in combination: conjuctival congestion and/or chemosis and reduced ocular mobility in combination with any intraocular infection. When this happens, superior ophthalmic vein occlusion should be suspected.
Who Killed the Retinas?
Normally your ophthalmologist will just say 'bad eye'. However, in some communities in Australia, it is more proper to refer to the condition as 'bung eye'. A team from Western Australia presented cases of 'bung eye' to describe clinical findings and to propose the most likely etiology of cases presented.
Trouble, with an unlikely assistant... South Africa suffers from an epidemic of HIV and many other infectious diseases. In fact, HIV may have a role to play in some eye conditions, such as this RANZCO poster presenting a couple of interesting cases of bilateral vision loss in young adults. The condition, Takayasu arteritis, commonly presents with visual symptoms. According to the investigators, Takayasu should be considered in patients with unexplained hypertension or ischemic retinopathy.
APVRSSHOWDAILY | December 8-10, 2016 | Bangkok, Thailand
Thailand
Bangkok: Gateway To Amazing by Ruchi Mahajan Ranga
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angkok, also known as Krung Thep in Thai, is one of the world’s top tourist destinations. The city welcomes more visitors than any other city in the world. Whether you are looking for palatable doses of culture, history or back-to-back nature attractions, Bangkok has a lot to offer for everyone.
If you are visiting Bangkok for the first time, it can be an overwhelming experience. The city’s multi-faceted sights, city life, and glittering attractions appeal to diverse group of tourists. Here are some of the must-see places in this wonderful city:
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The Grand Palace: No visit to Bangkok is complete without a visit to the spectacular and dazzling Grand Palace, the city’s most famous landmark. Built in 1782, the Grand Palace always awes visitors with its intricate detail and beautiful architecture. This awesome complex still remains the spiritual heart of Thai Kingdom and is a proud salute to the creativity and craftsmanship of Thai people. Bangkok Floating Markets: Floating markets throughout Bangkok have now turned into more of a novelty form of entertainment. These markets are extremely popular to visit on weekends by both foreigners and locals. You can catch a glimpse of Thai food cooked and served directly from boats floating on the canal. You can also do trinket shopping and even navigate the market on a personal boat tour. Chinatown: Whether you wish to explore the vibrant street-side cuisine, trade gold, or pay a visit to one of Chinese temples, Chinatown is a haven for every generation. With its dense concentration of gold shops, innumerable market stalls, variety of street side restaurants, a visit to Chinatown in Bangkok will keep you wanting to come back for more.
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The Ancient City: Located in Samut Prakan and set in 320 acres of beautifully landscaped gardens in the outskirts of Bangkok, the city offers an insight to the Thai art and culture. The city houses a total of 116 monuments including bell towers, palaces, pavilions, halls, temples, floating markets, shrines, chedis, and Buddha images.
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Safari World: One of the greatest open zoo and leisure parks in Thailand, Safari World is all set to rewards its visitors with an ultimate experience. You can visit with family to enjoy the best of Jungle Cruise, Eggs World, Bollywood Cowboy Stunt Show, CDV War, and Orangutan Boxing Show. It also houses a Marine Park that has a rich variety of marine animals. If you have kids visiting Bangkok with you, Safari World is going to be hit!
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Madame Tussauds Museum: This is one of the must-visit places when you are in Bangkok. With more than 90 wax figures of various celebrities, Madame Tussauds will send you on an emotionally charged journey proving that it is much more than just a wax museum.
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Bangkok Art & Culture Centre: For all those who love to explore art and culture can spend hours in this contemporary museum browsing through the extensive range of art, design, theatre, music, and film. The Center also hosts a multitude of exhibitions from Thai and international artists.
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Baiyoke Sky Tower: With an iconic height of 309 meters, Baiyoke Sky Tower is Thailand’s tallest building and a very popular shopping, eating, and entertainment hub. The tower also houses one of the tallest hotels in Bangkok - Baiyoke Sky Hotel. This 84-storeyed tower has a skywalk with huge windows for viewing that enables visitors to have uninterrupted views of Bangkok’s skyline. If you want to capture a bird’s eye view of the city, you can enjoy it from the observation deck on the 84th Floor.
Modern and olden times walk hand in hand in the city of Bangkok. The array of delightful must-visit places are beyond the list mentioned above. Start your amazing Thailand experience while at APVRS 2016. The overwhelming spirit of Bangkok awaits!
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