Impressed with a 50% success rate?

Witnessing blinding acute angle attacks motivated Dr Judy Ku’s passion for primary angle closure disease. She explores how a 50% success rate sounds impressive, but its real-world outcomes are less, especially when factoring in the economic costs of large population screening and proactive treatment. So, while laser peripheral iridotomy is effective in reducing the risk progression to primary angle closure and acute angle closure attacks – what are the caveats? Listen in to find out.

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Superiority complex? It is complex

Associate Professor Susan Carden examines the RAINBOW study, which compared treatment of ROP with ranibizumab versus laser therapy. Noting the extension trial may uncover more, there might be a superior treatment method. Listen in to find out more.

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Susan Carden is an Associate Professor in the Department of Pediatrics, University of Melbourne.  She is a Consultant Ophthalmologist RCH and is head of the Education Vision Assessment Unit, RVEEH. She currently chairs the Victorian Branch, RANZCO.  Her areas of 

expertise includes retinopathy of prematurity, Low Vision, paediatric ophthalmology and general ophthalmology and international development.

For Fuchs’s sake, taking out the sting

Hyperosmolar Eye Drops for Diurnal Corneal Edema in Fuchs’ Endothelial Dystrophy

Professor Stephanie Watson talks taking the sting out of Hyperosmolar Eye Drops for Diurnal Corneal Edema in Fuchs’ Endothelial Dystrophy. Do the clinical outcomes support their use, and how robust was this Double-Masked, Randomized Controlled Trial?

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Stephanie Watson is the Head of the Corneal Research Group at the Save Sight Institute at the University of Sydney. She is the co-Deputy Director of Industry, Innovation and Commercialisation at Sydney Nano, the Head of the Corneal Unit at Sydney Eye Hospital and Chair of Australian Vision Research (formerly Ophthalmic Research Institute of Australia).

Talking “pulleyes”… and when they no longer hold tension 

When a trans-pacific collaboration results in need-to-know outcomes for the general ophthalmologist. The differences in patterns of sagging eye syndrome lead to different treatment paths. Dr Sonia Moorthy unpacks diagnosis, simple and effective management strategies and ways to reduce unnecessary investigations. 

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Sonia Moorthy is an adult and paediatric ophthalmologist with fellowships in paediatric ophthalmology and strabismus, at the prestigious Singapore National Eye Centre and Moorfields Eye Hospital, London. She has a Master of Public Health at the University of Melbourne and has a strong interest in indigenous health. She has volunteered as a field researcher in the Pilbara, WA as part of the National Indigenous Eye Survey and has been providing adult and paediatric eye care in Far North Queensland, privately and publicly. In particular, she has gained extensive experience in Indigenous eye care, serving communities up to Cape York. 

Rebounds are not limited to basketball.  Three-Year Clinical Trial of Low-Concentration Atropine for Myopia Progression (LAMP) Study: Continued Versus Washout. 

Rebounds are not limited to basketball. Dr Sarah Hull examines the rebound effect in the Three-Year Clinical Trial of Low-Concentration Atropine for Myopia Progression (LAMP) Study. What are the outcomes of continued atropine treatment, and what is the ideal concentration? 

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Sarah Hull is a UK-trained Ophthalmologist who completed a PhD in paediatric retinal genetics at UCL and Moorfields in 2016. She has been living in New Zealand since 2018, working as a consultant Ophthalmologist specialising in paediatrics, strabismus and genetics at Auckland District Health Board and Auckland Eye. She is also a Senior Lecturer at Auckland University. Her research focuses on inherited eye disease as well as optic neuropathies.

Beyond the surface. Latanoprost for open-angle glaucoma (UKGTS): a randomised, multicentre, placebo-controlled trial

A modern landmark glaucoma trial and first-of-its-kind that provides surprising and useful outcomes for current practice and research. Can the visual field be preserved with an intraocular-pressure-lowering drug in patients with open-angle glaucoma? Dr Jennifer Fan Gaskin explores Latanoprost for open-angle glaucoma.

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Jennifer Fan Gaskin is a Consultant Ophthalmologist at the Royal Victorian Eye and Ear Hospital and a Principal Investigator at the Centre for Eye Research Australia where she leads Ocular Fibrosis Research. In 2021 she was named a Superstar of STEM by Science and Technology Australia. She is a Director of Australian Vision Research (formerly known as the Ophthalmic Research Institute of Australia) and a board member of the Australian and New Zealand Glaucoma Society.

Considering it all. Myopia control effect of defocus incorporated multiple segments (DIMS) spectacle lens in Chinese children: results of a 3- year follow-up study

Dr Caroline Catt investigates myopia progression and axial elongation in children. Limitations on data impact treatment choices – what should be considered for DIMs lenses? Age, ethnicity, cost, access? Caroline considers it all, providing practical advice for anyone seeing children. 

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Caroline Catt is a Paediatric and general ophthalmologist working at The Children's Hospital at Westmead, Liverpool Hospital NICU and Sydney Ophthalmic Specialists. She is a fledgeling researcher - establishing an ROP database with Save Sight Registries - and a mother of 2 pre-schoolers.

Mucking out the stables. The Ruptured Globe, Sympathetic Ophthalmia, and the 14-Day Rule

Dr Freny Kalapesi examines the basis of the 14-day rule in treating ruptured globes to prevent sympathetic ophthalmia. A key takeaway is understanding the importance of whole-of-person care when considering treatment options.

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Freny Kalapesi is an Oculoplastic Surgeon who works at Westmead public hospital and the Chris O'Brien Lifehouse and in various private practices in and around Sydney since her return from the UK back in 2012. During her fellowship, she was involved in the CIRTED trial looking at immunosuppression and radiotherapy for Thyroid eye disease. She did her PhD in glaucoma and neuroprotection at the University of New South Wales.

Can weight loss cure eye disease?

Effectiveness of Bariatric Surgery vs Community Weight Management Intervention for the Treatment of Idiopathic Intracranial Hypertension.

Can weight loss cure eye disease? In the case of Idiopathic Intracranial Hypertension (IIH), yes! A/Prof Clare Fraser talks us through the much-awaited follow-up article examining the Effectiveness of Bariatric Surgery vs Community Weight Management Intervention for the Treatment of IIH. The main take-away is not pizza – listen in to find out what is it!

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Clare Fraser completed neuro-ophthalmic training at Moorfields Eye Hospital and the National Hospital for Neurology, London. She completed a research fellowship at Emory Eye Centre, Atlanta and was a consultant neuro-ophthalmologist for Moorfields Eye Hospital and Kings College Hospital, London. She is a senior clinical lecturer at the University of Sydney and Macquarie University and consults at St Vincent’s Hospital, Sydney Eye Hospital and Macquarie University Hospital. She holds several National and International committee positions as a Director on the RANZCO Board and a reviewer for Clinical & Experimental Ophthalmology and The American Journal of Ophthalmology. 

Factors Affecting Corneal Incision Position During Femtosecond Laser-assisted Cataract Surgery
Dr Kerrie Meades was the first female ophthalmologist to perform laser vision correct in Australia. In this podcast, Dr Meades discusses the article Factors affecting corneal incision position during femtosecond laser-assisted cataract surgery. Dr Meades was prompted to explore this topic due to a lack of precision from laser for the second incision. Tilt and displacement can affect the translation of the program of the laser and the actual incision. As such, OCT guidance is needed for the secondary incision, as you do for the primary incision. Dr Meades provides an insight into how patient behaviour and anatomy can affect docking, and therefore incisions.

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Associations Between Anterior Segment Parameters and Rotational Stability of a Plate-haptic Toric Intraocular Lens

At face value – does the data always support the conclusion? Dr Madeleine Adams,  a cataract surgeon and comprehensive ophthalmologist with a PhD from the University of Melbourne for her research into age-related macular degeneration, offers a cautionary message about always critically scrutinising data presented in papers and coming to your own conclusion as to whether the data supports the conclusions. In the case of associations between anterior segment parameters and the rotational stability of a plate-haptic toric intraocular lens, with a closer look, the data aren’t so convincing.

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Periocular Triamcinolone versus Intravitreal Triamcinolone versus Intravitreal Dexamethasone Implant for the Treatment of Uveitic Macular Edema: The PeriOcular versus INTravitreal Corticosteroids for Uveitic Macular Edema (POINT) Trial

Dr Priya Samalia is a medical retina and uveitis fellow working at the Royal Victorian Eye and Ear Hospital. She examines the POINT trail on effectiveness of Periocular Triamcinolone vs. Intravitreal Triamcinolone vs. Intravitreal Dexamethasone Implant for the treatment of non-infectious uveitic macular oedema. Dr Samalia explains that the trail is important because macular oedema is a common cause of vision loss for patient with uveitis and management can be challenging. The paper is a head-to-head comparison and broadly represents a real-world patient mix. While it finds intravitreal treatments are superior, Dr Samalia notes there are valid reasons to perform periocular injections.

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The Pneumatic Retinopexy versus Vitrectomy for the Management of Primary Rhegmatogenous Retinal Detachment Outcomes Randomized Trial (PIVOT)

Dr Mali Okada is a consultant at the RVEEH and senior researcher at CERA. In this podcast she discusses the various management options of retinal detachment. Pneumatic retinopexy is routinely used as the first line treatment in many parts of the world for superior retinal detachments, but this is not always the case in Australia and New Zealand, where vitrectomy is preferred. The PIVOT study unpacks the issues, looking at repeat visits, surgical and visual outcomes, requirement for follow-up cataract surgery and more. The study has some limitations but is thought-provoking. It is essential to define the markers of success to support surgeons in determining the best course of action for their patients.

Laser-assisted in Situ Keratomileusis Long Term Outcomes in Late Adolescence
Challenging the norms and parameters of safe LASIK surgery in late adolescents with Dr Tanya Trinh, cornea and refractive surgeon and staff specialist at Sydney Eye Hospital. Myopic disease burden is significant, increasing and contributes to serious comorbidities with progression over time. Laser-assisted in situ keratomileusis long term outcomes in late adolescence explores how ophthalmologists can use data and evidence-based outcomes to reduce the prevalence of myopia and begin to challenge what we know about preventing myopic progression. Specifically, the paper evaluates the long-term outcomes, including safety and risks of myopic-LASIK in a late adolescent population, but more studies are needed to critically review available data. It is imperative to properly define safety parameters for this technology in this age group.
 
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Accuracy of Intraocular Lens Power Formulas Modified for Patients with Keratoconus

Which IOL formula should we use prior to cataract surgery in patients with keratoconus?  Are the newer formulae with keratoconus modifications more accurate than the regular formulae that we are used to using?  What should be our refractive target for these cases and how does it vary according to severity of the cone?  Can we aim for spectacle independence? Dr Jacqueline Beltz - Cornea, Cataract and Refractive Surgeon from Melbourne explains why refractive outcomes are tricky to predict in eyes with keratoconus.  She explores a paper by Jack Kane and colleagues that seeks to answer these very questions. Tune in to find out!

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Clinical Results of Topography-based Customized Ablations in Highly Aberrated Eyes and Keratoconus/Ectasia with Cross-linking

On the laser’s edge – breaking taboos! Dr Aanchal Gupta is the Director of Training for the South Australian Training network and a Senior Clinical lecturer at the University of Adelaide. She reviews Clinical results of topography-based customized ablations in highly aberrated eyes and keratoconus/ectasia with cross-linking, the article as written by her fellowship mentors that started her interest in refractive surgery. The results demonstrate how laser platforms can go beyond routine vision correction. Irregular astigmatism, keratoconus patients and those with decentred ablations can be successfully treated with laser. This allows patients to avoid rigid contact lenses, transplants or glasses with suboptimal vision. Do the results last? What are the long-term outcomes? What can go wrong? Aanchal explores… 

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Eplerenone for Chronic Central Serous Chorioretinopathy in Patients with Active, Previously Untreated Disease for more than 4 Months (VICI): A Randomised, Double-blind, Placebo-controlled Trial

The VICI trial is highly topical. Dr Narme Deva, Consultant Ophthalmologist & Honorary Senior Lecturer at the University of Auckland, explores the Eplerenone for chronic central serous chorioretinopathy in patients with active, previously untreated disease for more than 4 months (VICI): a randomised, double-blind, placebo-controlled trial. She explains the results are unequivocal and based on a robust trial of 114 patients. Eplerenone does not improve BCVA in people with chronic CSCR after 12 months of treatment. As ever, Dr Deva reminds listeners that evidence-based medicine includes using reliable data to make decisions, even when patients and ophthalmologists are faced with limited treatment options to prevent vision loss.

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Selective Laser Trabeculoplasty: A Review Published in RANZCO’s own Clinical and Experimental Ophthalmology
Selective laser trabeculoplasty (SLT) has become an essential part of glaucoma management. In this 10 Minutes of Science, Dr Alina Zeldovich explores Selective laser trabeculoplasty: A review published in RANZCO’s own Clinical and Experimental Ophthalmology. Alina is a cataract surgeon who has been using SLT more frequently on her glaucoma patients. She discusses the significance of this review to her own clinical practice. Hear more about the article, including the various subgroups of glaucoma where SLT is being used and what outcomes it is achieving.

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Intravitreous Anti-VEGF vs. Prompt Vitrectomy for Vitreous Hemorrhage from Proliferative Diabetic Retinopathy (Protocol AB) 
Dr Cheryl Au, current medical retinal fellow at Westmead Hospital, explores Intravitreous Anti-VEGF vs. Prompt Vitrectomy for Vitreous Hemorrhage from Proliferative Diabetic Retinopathy. She was prompted to review the article due to frequent presentation of patients presenting with vitreous haemorrhage from PDR, and the desire to identify evidence-based guidelines for best visual outcomes once intervention is decided. Dr Au explores the robustness of the study, as well as explaining the outcomes and how these can be used to guide clinical practice.

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Is Rituximab a Wonder-drug?
 
Dr Diana Conrad, Director of the Uveitis Service at the Royal Women’s and Children’s Hospital (the only speciality uveitis service in Queensland) explores a review paper on the use of rituximab for the treatment of non-infectious uveitis and scleritis. Dr Conrad notes an impressive response rate to rituximab for patients where first and second-line treatments have failed. Given the success of rituximab, and the biosimilars entering the market, Dr Conrad includes some important messages for ophthalmologists using the drug. 

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