Program BofR 2013 · vitreomacular traction and macular hol e. With the advent of ocriplasmin, cthe era of pharmacologic vitreolysis has dawned. Although ocriplasmin is effective

COURSE DIRECTOR

CARL C. AWH, MD

COURSE CO-DIRECTORS

DAVID R. CHOW, MD

TAREK S. HASSAN, MD

DECEMBER 5-7, 2013

NEW YORK, NY

A FELLOWS’ FORUM, INC. PRODUCTION

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Mark S. Blumenkranz, MDPalo Alto, CAJackson Memorial Lecture,2013 AAO Annual Meeting

Trexler Topping, MDBoston, MAFounders Award Lecture, 2013 ASRS Annual Meeting

Michael T. Trese, MDRoyal Oak, MIJ. Donald M. Gass AwardLecture, 2013 Retina SocietyAnnual Meeting

George A. Williams, MDRoyal Oak, MIGertrude D. Pyron AwardLecture, 2013 ASRS Annual Meeting

Lawrence A. Yannuzzi, MDNew York, NYSchepens Lecture, 2013 AAORetina Subspecialty Day

Michael S. Ip, MDMadison, WIAssociate Editor, JAMAOphthalmology

Timothy W. Olsen, MDAtlanta, GAExecutive Editor, AmericanJournal of Ophthalmology

Jonathan L. Prenner, MDNew Brunswick, NJAssistant Editor, RETINA

Andrew P. Schachat,MDCleveland, OHDistinguished Senior Editor, Ophthalmology

Emily Y. Chew, MDBethesda, MD

Donald J. D’Amico, MDNew York, NY

Mark S. Humayun, MD, PhDLos Angeles, CA

Pravin U. Dugel, MDPhoenix, AZ

Philip J. Ferrone, MDGreat Neck, NY

Jeffrey S. Heier, MDBoston, MA

Baruch D. Kuppermann, MD, PhDIrvine, CA

Carl C. Awh, MDCourse DirectorNashville, TN

David R. Chow, MDCourse Co-DirectorToronto, Canada

Tarek S. Hassan, MDCourse Co-DirectorRoyal Oak, MI

NAMED LECTURER AWARD WINNERS

JOURNAL EDITORS

PANELISTS

SPECIAL GUEST FACULTY DIRECTORS

BEST OF RETINA 2013 GUEST FACULTY

2013 SCIENTIFICPROGRAM

Thursday, DECEMBER 5

5:30–8:00PM

RegistrationWestin New York at Times Square

6:00–8:00PM

Welcome ReceptionWestin New York at Times SquareBar 10 – Mezzanine

8:00–10:00PM

Dinner on own

Friday, DECEMBER 6

6:30–11:15AM

RegistrationWestin New York at Times SquareMajestic Ballroom Foyer – 5th floor

6:30–7:30AM

Breakfast Westin New York at Times SquareGershwin Ballroom – 4th floor

6:30–11:15AM

Exhibit Hall Westin New York at Times SquareGershwin Ballroom – 4th floor

7:30–10:05AM

Session 1 7:30–7:45AM

Opening Remarks

Carl C. Awh, MDCourse Director

7:45–8:15AM

Best of Retina from JAMA Ophthalmology

Michael S. Ip, MDFormer Associate Editor,JAMA Ophthalmology

8:15–8:20AM

Audience and PanelDiscussion

8:20–8:50AM

Best of Retina from AJO

Timothy W. Olsen, MDExecutive Editor, AJO

8:50–8:55AM

Audience and Panel Discussion

8:55–9:25AM

Best of Retina from RETINA

Jonathan L. Prenner, MDAssistant Editor, RETINA

9:25–9:30AM


9:30–10:00AM

Best of Retina from Ophthalmology

Andrew P. Schachat, MDDistinguished Senior Editor,Ophthalmology

10:00–10:05AM


10:05–10:35AM

Break

10:35–11:25AM

Session 2 10:35–10:50AMSPONSOR PRESENTATION

Regeneron Pharmaceuticals, Inc.

10:50–11:20AM

Journal Panel Discussion

Donald J. D’Amico, MD (Moderator)Michael S. Ip, MD, Timothy W. Olsen, MD, Jonathan L. Prenner, MD, Andrew P. Schachat, MD (Panelists)

11:20–11:25PM

AnnouncementsCarl C. Awh, MD

4 BEST OF R E T INA 2013 NY

BEST OF R E T INA 2013 NY 5

11:25–11:35AM

Board Bus for Regeneron Meet at Westin New York at Times Square, 43rd Street entrance

11:35AM–12:45PM

Transfer to Regeneron

12:45–4:45PM

Lunch and Tour at Regeneron

4:45–6:00PM

Transfer to Westin

6:45PM

Walk to Celsius at Bryant ParkMeet in Westin New York at Times Square Lobby to walk to Celsius at Bryant Park

7:00–10:00PM

Dinner at Celsius at Bryant Park

Saturday, DECEMBER 7

6:30AM–6:00PM

Registration

6:30AM–7:30AM

Breakfast

6:30AM–4:25PM

Exhibit Hall

7:30–10:05AM

Session 37:30–7:45AM

AnnouncementsCarl C. Awh, MD

7:45–8:15AM

Results from the Age-Related Eye Disease Study 2:Lutein/Zeaxanthin andOmega-3 Fatty Acids for Age-related Macular Degeneration

Emily Y. Chew, MD

8:15–8:30AM


8:30 –9:00AMJACKSON MEMORIAL LECTURE 2013 AAO ANNUAL MEETING:

Therapeutic Lasers inOphthalmology: Interactions of Photons,Patients and Physicians

Mark S. Blumenkranz, MD

PURPOSE: To present the evolution of lasertherapy in modern ophthalmic practice

DESIGN: Review of published experimentaland clinical studies

METHODS: A review of the work of multipleinvestigators leading to the invention of thelaser, its biophysical effects on ophthalmictissue, and the development of various laserbased devices and methods to treatcommon ophthalmologic disorders withparticular emphasis on new and emergingretinal and anterior segment applications.

RESULTS: Because the eye, more than anyother organ or tissue in the body isoptimized for the transmission of light andits transduction into neural signals, lasers areparticularly well suited for ophthalmictherapy. The high quality of the ocular opticsand delicate structure of the neural retinaand other ocular tissues require exceedinglyhigh precision and selectivity for any thera-peutic intervention. These high demandshave inspired continuous development ofhighly sophisticated laser systems that havedramatically impacted the treatment ofcommon diseases including diabeticretinopathy, age related macular degener-ation, retinal venous occlusive disease,retinopathy of prematurity, optical aberra-tions, cataract and glaucoma amongstothers.

Recent developments in scanning lasersystems, real time OCT and other imageguided systems with eye tracking, real-timefeedback, as well as ultra-short pulsedurations have enabled unprecedentedselectivity, precision and safety in oculartherapy. However, improved outcomes comewith increased cost of medical care, andoptimization of their cost effectiveness willcontinue to be required in the future.

CONCLUSIONS: The invention and evolution of modern ophthalmic lasers have revolu-tionized the practice of ophthalmology andcan serve as a model for understanding theprocess of innovation, including the societalbenefits and also unintended consequencesof advances in medical technology.

9:00–9:15AM


9:15–9:20AMSPONSOR PRESENTATION

Alcon Laboratories, Inc.

9:20–9:25AMSPONSOR PRESENTATION

Arctic Group of Companies

9:25–9:45AMSCHEPENS LECTURE2013 AAO RETINA SUBSPECIALTY DAY:

Acute Zonal Occult Outer Retinopathy

Lawrence A. Yannuzzi, MD

Acute Zonal Occult Outer Retinopathy has been a perplexing clinical problem,encompassing a variety of chorioretinalinflammatory and degenerative diseases.Based on multimodal imaging, two centers,one in New York and one in Chicago havereclassified the disease, starting from theoriginal description by J. Donald Gass andincorporating multimodal imaging toestablish a definitive diagnosis.

9:45AM–9:55AM


9:55 -10:00AMSPONSOR PRESENTATION

Bausch + Lomb

10:00 -10:05AMSPONSOR PRESENTATION

Genentech, Inc.

10:05–10:35AM

Break

10:35AM–12:45PM

Session 410:35–11:05AMTHE FOUNDERS AWARD LECTURE2013 ASRS ANNUAL MEETING:

The Practice of Medicine –Now a Data Driven Process

Trexler M. Topping, MD

The backbone of medicine has been toprovide excellent patient care, teachyounger physicians, and conduct research toimprove quality of care for all. However intoday’s world you need the numbers game. I chronicle the medical process includingpractice administration, coding andreimbursement, public policy and advocacy,in addition to the backbone of care,teaching and research.

In practice management one needs tocalculate the cost of doing business i.e.practice expense. This can be done for allaspects including facilities, testing, staff.Then by allocating costs to the individualphysician, you encourage a more efficientand cost effective practice. With internalaccounting, encourage better cost controland data management possible.

Diagnostic codes (now ICD-9CM) are usedto identify our patient problems. MDs desireultra-simple bare bones codes, and the CPTcodes for defining services they want asremunerative as possible. Payment isthrough RBRVS, through RVU – work,practice expense and liability. Relative valuesof codes determined by RUC and CMS.More emphasis is placed today on the timeaspect of work.

In your practice m=need data for your MDs.Try to improve efficiency. Assess qualityoutcome on basis of data.

New payment models will be used, to payfor total care of a diagnosis for a year. Thisdepends upon knowing stage of disease,number of eyes involved. New codes arebeing introduced to do this. You will needmedical informatics to survive. Know yourcosts, patient mix, and cost of care delivery.

Will need practice metrics to compete-patient type and numbers, referral sources,procedure mix, payer mix, financial, andcomparisons with past, present andprojected future. You will benefit of practicedashboards with KPIs (key performanceindicators). Patient time in office from arrivalto departure (cycle time) monitored toimprove patient satisfaction.

Dashboard can be valuable for MDcompliance comparison with peers for levelof coding, utilization of diagnostic testingand imaging, and intra-vitreal drug use.

Practice informatics will be needed in thenew world of care delivery to enable you to do what you love to do – give optimalpatient care, teach and do research toimprove the fate of our patients.

11:05–11:20AM


11:20-11:45AM

Update on the Argus II Retinal Prosthesis System

Mark S. Humayun, MD, PhD

11:45AM–12:00PM


12:00–12:05PMSPONSOR PRESENTATION

OCULUS Surgical, Inc.

12:05–12:45PM

Late Breaking News:Genetics of AMD and AREDS Supplements

Emily Y. Chew, MD

Carl C. Awh, MD


12:45–1:50PM

Lunch

6 BEST OF R E T INA 2013 NY

BEST OF R E T INA 2013 NY 7

1:50–3:55PM

Session 51:50–2:00PM

The Physician PaymentsSunshine ActTina Webb

2:00–2:10PM

Industry Perspective: The Affordable Care Act Jeff LeMay

2:10–2:20PM


2:20–2:50PMTHE GERTRUDE D. PYRON AWARD LECTURE, 2013 ASRS ANNUAL MEETING:

Pharmacologic Vitreolysis: Past, Present and Future

George A. Williams, MD

Although the term pharmacologic vitreolysisis relatively recent, the concept of pharma-cologic manipulation of the molecularbiology of the vitreous is not new. In 1947,Ludwig von Sallmann presented the conceptof using hyaluronidase as a vitreolytic agentfor the treatment of vitreous hemorrhage.Subsequently, collagenase, chondroitinase,hyaluronidase, dispase, plasmin and ocri -plasmin were evaluated in animal studiesand clinical trials. As the understanding ofthe molecular dynamics of the vitreousexpanded, it became apparent that thevitreous plays a pathogenic role in a varietyof retinal diseases beyond tractionalphenomenon. The concept of vitreodynamicswas introduced by Trese to describe themolecular sequelae of vitreolysis such aschanges in oxygen flux, cytokine andgrowth factor expression and ocularpharmacokinetics. In 2013, ocriplasmin, arecombinant plasmin-based enzyme, becameavailable for the treatment of symptomaticvitreomacular traction and macular hole.With the advent of ocriplasmin, the era of

pharmacologic vitreolysis has dawned.Although ocriplasmin is effective in manypatients, there remains a significant oppor-tunity to further improve the efficacy ofocriplasmin and expand its indications.Potential techniques for improved efficacyinclude combination therapy with othervitreolytic agents and mechanical adjunctssuch as gas bubbles or small gaugevitrectomy. The full therapeutic potential ofpharmacologic vitreolysis remains promising.

2:50–3:05PM


3:05–3:35PMTHE J. DONALD M. GASS AWARDLECTURE, 2013 RETINA SOCIETY ANNUAL MEETING:

Telemedicine for InfantRetinal Screening

Michael T. Trese, MD

For many years, infant retinal examinationshave been done in a similar fashion forretinopathy of prematurity or other suspi-cious retinal problems around the time ofbirth. This technique included indirectophthalmoscopy and retinal drawings.Currently, telemedicine for retinopathy ofprematurity is evolving as an excellent wayto perform screening for retinopathy ofprematurity due to better documentation inevery NICU and supplies the potential forROP screening in more remote areas. Thistalk with discuss the use of current andfuture telemedicine techniques to screen notonly prematurely born children, but perhapsall newborn infants for retinal-vascular, foroncologic, and for assembly problems, suchas persistent fetal vasculature syndrome,coloboma, and retinal dysplasia. Evidencewill be presented that shows that suchinfant screening may have a yield higherthan the current infant screening for hearingexaminations. Certainly telemedicinescreening for retinopathy of prematurity isnearly here, but perhaps screening of allnewborns would be advantageous in termsof discovery of disease and planning thechild’s visual and educational future.

3:35–3:45PM



Insight Instruments, Inc.


Notal Vision

3:55–4:25PM

Break

4:25–6:00PM

Session 64:25–4:30PMSPONSOR PRESENTATION

Synergetics, Inc.


ThromboGenics, Inc.

4:35–5:05PM

New Drugs in the Pipeline for AMD

Pravin U. Dugel, MD

5:05–5:20PM


5:20–6:00PM

The Best of Retina Wrap-upCarl C. Awh, MD

6:00–7:00PM

Closing Reception

7:00PM

Dinner on own

GRATEFULLY ACKNOWLEDGES GENEROUS

CONTRIBUTIONS FROM THE FOLLOWING COMPANIES:

DiamondRegeneron

Pharmaceuticals, Inc.

P latinumAllergan, Inc.

GoldAlcon Laboratories, Inc.

Arctic Group of Companies

Bausch + Lomb

Genentech, Inc.

Insight Instruments, Inc.

Notal Vision

OCULUS Surgical, Inc.

Synergetics, Inc.

ThromboGenics, Inc.

Best ofRETINA

2013

Documents

Program BofR 2013 · vitreomacular traction and macular hol e. With the advent of ocriplasmin, cthe era of pharmacologic vitreolysis has dawned. Although ocriplasmin is effective