Day 2 of APAO-AIOC 2025 in New Delhi spotlighted the APAO Women in Ophthalmology Symposium—a standout session packed with real-world insights into retinal diseases.
We’re bringing you exactly what you need to hear from the retina frontlines at the 40th Congress of the Asia-Pacific Academy of Ophthalmology (APAO 2025), held in conjunction with the 83rd Annual Conference of the All India Ophthalmological Society (AIOC 2025) in New Delhi.
Day 2 featured the powerhouse APAO Women in Ophthalmology (WIO) Symposium: Real-World Experiences in Combating Retinal Diseases.
And who better to guide us through it than a stellar lineup of women retina leaders: Dr. Choi Mun Chan (Singapore), Dr. Lia Zaini (Indonesia), Prof. Dr. Kyoko Ohno-Matsui (Japan), Dr. Eli Pradhan (Nepal), Dr. Parveen Sen (India) and Dr. Suganeswari Ganesan (India).
From inherited dystrophies to anti-VEGF advances and retinal surgeries, each speaker brought insights you’ll want to take straight to the clinic.
New perspectives in IRDs
“Retinitis pigmentosa isn’t as simple as we once thought,” said Dr. Choi Mun Chan, opening her talk on New Perspectives in Inherited Retinal Dystrophies (IRDs). She explained how evolving genetics are shifting how IRDs are diagnosed and treated.
While once viewed as monogenic, “there is a thinking about polygenic contributions in IRDs,” she explained, pointing to the role of modifier genes like RPGRIP1L, which can intensify disease severity in patients with RPGR gene mutations.
She emphasized the impact of non-coding variants—intronic, promoter and enhancer mutations—that don’t alter proteins directly but still disrupt gene regulation. “This can help us solve cases where we don’t find a causative mutation,” she said, advocating for whole genome and RNA sequencing over limited gene panels.
Dr. Chan also explored therapeutic frontiers, including CRISPR-based gene editing, antisense oligonucleotides and gene-agnostic strategies like Ocugen’s OCU400, targeting retinal transcription factors.
READ MORE: One Day, Three IRD Gene Therapy Triumphs
Management of infectious endophthalmitis
With her talk on Management of Infectious Endophthalmitis, Dr. Lia Zaini brought clinical reality to the stage. While the Endophthalmitis Vitrectomy Study (EVS) remains the gold standard, Dr. Zaini questioned its ongoing relevance, especially in low-resource settings.
“Surgery can reduce bacterial load, toxins and inflammatory mediators,” she emphasized, adding that early vitrectomy should be considered even in patients with better than light perception—contrary to traditional EVS guidelines.
Drawing from her experience in Aceh, Indonesia, Dr. Zaini outlined the real-life challenges of managing infections in regions with limited access to retinal care, surgical equipment and follow-up. “Most of our patients come in with severe vision loss—no light perception or hand movements—and can’t return for regular care,” she said.
Her team’s novel protocol includes intravitreal antibiotics, systemic fluoroquinolones and corticosteroids for inflammation. In severe cases, they opt for vitrectomy, IOL extraction, and, when needed, silicone oil tamponade—though follow-up for oil removal remains a barrier. Her data showed improved outcomes, reducing severe vision loss from 88% to 50%.
“Infectious endophthalmitis is not one-size-fits-all,” Dr. Zaini concluded. “We need updated evidence that reflects the real-world conditions we treat every day.”
READ MORE: A Zesty Solution to Reduce the Risk of Endophthalmitis
Complications of pathologic myopia
“Pathologic myopia remains a major cause of blindness,” began Prof. Dr. Kyoko Ohno-Matsui at APAO-AIOC 2025. Ranked as the leading cause of blindness in several Asian populations, its complications often go unnoticed—until it’s too late.
Prof. Ohno-Matsui focused on three major culprits: myopic maculopathy (especially neovascularization), myopic traction maculopathy and glaucoma. Central to these issues is posterior staphyloma, a structural deformation of the eye.
She explained that myopic neovascularization, while initially treatable with anti-VEGF therapy, often leaves behind a more insidious issue: “Macular atrophy develops even after successful treatment, leading to long-term vision decline.”
Another red flag? Myopic retinoschisis, which may progress to macular holes or retinal detachment. She emphasized newer surgical techniques like fovea-sparing ILM peeling to reduce damage to already fragile tissue.
Most alarming, though, was the silent role of glaucoma: “It’s underdiagnosed, often until vision is already lost,” she warned. With distorted optic discs and misleading IOP readings, it hides in plain sight.
Her message was clear: don’t just manage pathologic myopia—monitor it aggressively. The risk of permanent, preventable vision loss is too high to ignore.
Anti-VEGF in DME: New options and real-world realities
“Diabetic macular edema is one of the most difficult challenges we face—especially when it doesn’t respond to treatment,” said Dr. Eli Pradhan during her session on the latest trends in anti-VEGF therapy for DME. Drawing from both international studies and local realities, she mapped out a rapidly shifting therapeutic landscape.
While anti-VEGF agents like bevacizumab, ranibizumab and aflibercept remain first-line treatments, Dr. Pradhan highlighted the role of newer agents like brolucizumab and faricimab. “Brolucizumab showed promising results over 100 weeks—but we must be cautious due to risks of retinal vasculitis and inflammation,” she noted.
For refractory DME, she emphasized the need to consider inflammatory pathways and shift toward corticosteroids or combination regimens. “When monthly anti-VEGF doesn’t work after six months, we need to think beyond VEGF inhibition,” she explained. Cost and accessibility also play a role—“In Nepal, bevacizumab remains our go-to option due to affordability.”
As biosimilars enter the market, Dr. Pradhan called for more region-specific evidence and strategies that reflect real-world settings.
READ MORE: Three New Potential Alternatives to Anti-VEGF
How multimodal imaging is transforming AMD management
“Imaging in AMD isn’t just diagnostic—it’s your best friend throughout the treatment journey,” said Dr. Parveen Sen in her dynamic talk on how multimodal imaging (MMI) has reshaped the way we understand and manage age-related macular degeneration (AMD).
Gone are the days of a simple dry vs. wet AMD framework. Dr. Sen explained how we now recognize over 38 types of drusen, including subretinal drusenoid deposits (SDDs), which are linked to thinner choroids, type 3 neovascularization and a higher risk of geographic atrophy. “The terminology has evolved—what we once called CNV, we now call macular neovascularization (MNV),” she noted.
Using OCT and OCT-A, clinicians can now pinpoint lesion types, fluid compartments and disease activity with far more precision. “Type 3 MNV responds beautifully to anti-VEGF therapy,” she explained, “but Type 1 may need multiple injections.”
MMI also allows clinicians to safely observe non-exudative CNVs, assess treatment response and even determine when to pause therapy. “We’ve shifted from invasive to noninvasive tools—and OCT has become the new gold standard,” Dr. Sen emphasized. Still, she reminded the audience, “Technology is powerful, but clinical acumen remains irreplaceable.”
READ MORE: OCT and OCTA Innovations
Unmasking masquerade syndromes
Dr. Suganeswari Ganesan took the audience on a diagnostic rollercoaster with her talk on Masquerade Syndromes—those tricky cases where dangerous pathology hides behind deceptively benign symptoms. “Not all pigmented lesions are melanomas, but a melanoma must never be missed,” she warned.
Dr. Ganesan shared a series of real-life cases that challenged even experienced clinicians. From a 17-year-old girl with fever and vitritis, later diagnosed with adolescent-onset retinoblastoma, to a supposed choroidal melanoma that turned out to be a leiomyoma, she showed how histopathology and immunohistochemistry can completely change the course of diagnosis and treatment.
One memorable case involved a melanocytoma misdiagnosed as melanoma, nearly leading to unnecessary enucleation. Another? A plasmacytoma that mimicked uveal melanoma but required a systemic workup for multiple myeloma. Even a history of renal cell carcinoma can mislead—what looked like a metastasis was just a benign lesion.
“The key message is this: MRI is not diagnostic in pigmented uveal lesions—tissue biopsy is mandatory,” she said. Through storytelling, science, and sharp clinical acumen, Dr. Ganesan reminded us why careful evaluation and a broad differential can make all the difference.
WIO Symposium delivers clinical clarity
If Day 2 of APAO-AIOC 2025 had a theme, it was this: the details matter—and so do the people who see them.
From genetics to imaging, infection control to masquerade syndromes, the APAO Women in Ophthalmology Symposium didn’t just deliver academic insights—it brought real-world clarity to some of retina’s most challenging questions.
Whether it was Dr. Choi Mun Chan reframing inherited retinal dystrophies through the lens of modifier genes, or Dr. Lia Zaini questioning long-held guidelines in endophthalmitis based on the lived realities of low-resource care, each speaker pushed the conversation forward.
These were more than lectures—they were clinical masterclasses, each one grounded in practical wisdom and delivered with clarity, courage and care. If this is what Day 2 looks like, we can’t wait to see what’s next!
Stay tuned to our conference coverage page for more!
Editor’s Note: Reporting for this story took place during the 40th Congress of the Asia-Pacific Academy of Ophthalmology (APAO 2025), being held in conjunction with the 83rd Annual Conference of the All India Ophthalmological Society (AIOC 2025) from 3-6 April in New Delhi, India.
