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Are You Keeping Up? Know the Latest Developments in Retinal Imaging from APVRS 2022

If you’ve been following the Media MICE team on our recent globe-trotting adventures, you’ll have noticed that we recently visited Taiwan. Don’t worry, the UN didn’t entrust us with a critical mission of peace. Thankfully for global politics, we were there for a more ocular occasion, namely, the 15th Asia-Pacific Vitreo-retina Society (APVRS 2022) Congress held in the country’s capital, Taipei.

APVRS 2022 was full of outstanding ocular content, more than we could possibly distill down into a few articles — but that didn’t stop us from trying.

One of the highlights at the Congress was a seminar called Advanced Retinal Imaging, held on November 20. Here are some of the top extracts for your convenience — with a focus on the latest developments in retinal imaging technology.

Find the ultimate imaging tool for uveitis

One of our top highlights was given by Dr. Shwu-Jiuan Sheu of Kaohsiung Medical University Hospital in Taipei, Taiwan. In her presentation, Imaging in Posterior Uveitis, Dr. Sheu started by emphasizing that spectral domain optical coherence tomography (OCT) imaging was “valuable for all subtypes of uveitis for identifying and monitoring macular edema, and could be used to monitor retinal structural involvement as well as choroidal involvement.”

She went on to recommend the use of B-scan ultrasonography, as it can be used to determine whether a patient is experiencing vitritis, retinal detachment, choroidal thickening, and macular tucking. She said that another variant of ultrasonography, ultrasound biomicroscopy, is particularly useful in uveitis treatment as it can be used to evaluate the ciliary body and the iris for abnormalities.

Finally, Dr. Sheu advised doctors to adopt a broader approach to imaging technology in diagnosing patients with uveitis, as the layers of verification this technique offers can highlight potential complications more efficiently.

Apps for diabetic retinopathy screening

Diabetes has become a primary global concern, and its effect on ophthalmology is becoming particularly noticeable. So it was fascinating to watch the next presenter, Dr. SriniVas R. Sadda of the Stein Eye Institute at the University of California (Los Angeles, USA).

Dr. Sadda’s presentation, entitled The Global Epidemic of Diabetes, highlighted several issues that limit the best possible patient outcomes, including a lack of access to treatment, particularly in struggling or marginalized communities. Additionally, he described how telehealth is increasingly providing improved treatment access, especially thanks to mobile phones.

More apps are being developed to screen for diabetic retinopathy (DR), one of the most serious ocular complications of diabetes. Studies involving a number of technologies in this area are currently ongoing both in Europe and the US.

Dr. Sadda gave the example of one FDA-approved tool, the EyeArt AI Eye Screening System, developed by EyeNuk (Woodland Hills, California, USA), reporting that it scored 95% sensitivity to correct testing for ‘more than mild’ DR with a 98% specificity rating, too. He said this highlights how AI-led tech can be used to reliably screen for DR, emphasizing that a large multicenter trial should be able to provide greater insight.

Photodynamic treatment for CSCR

Central serous chorioretinopathy (CSCR) is the fourth most common form of retinopathy and usually occurs in men aged 20 to 50, with symptoms of acute or sub-acute central vision loss or distortion being the most common.

This was according to the presentation, New Insights in Imaging of CSRS, which was given by Dr. Marten Brelen from the Chinese University of Hong Kong. What was particularly interesting to note was that, according to Dr. Brelen, in around 80% of patients with CSRS, the condition will spontaneously resolve after six months and will go on to attain the best corrected visual acuity (BCVA) of 20/30 or better.

However, that leaves 20% of patients who will develop more serious cases of CSRS, such as cases characterized by persistent foveal detachment occurring within three to six months; or when CSRS is persistent and recurring, vision loss can occur.

Dr. Brelen shared that for patients who are experiencing severe cases, there weren’t any standard treatment options available. However, there are several therapy options, including photodynamic treatment with verteporfin (used to eliminate abnormal blood vessels in the eye), laser, systematic mineralocorticoid antagonist treatment, and anti-VEGF.

He concluded that photodynamic treatment is particularly effective as it achieves short-term choriocapillary hypoperfusion along with long-term choroidal vascular remodeling.

Editor’s Note: The 15th Congress of the Asia-Pacific Vitreo-retina Society (APVRS 2022) was held on November 18 to 20, 2022, in Taipei, Taiwan. Reporting for this story took place during the event. A version of this article was first published in PIE magazine Issue 24X.

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