Presbyopia Correction: Can We Match Mother Nature?
Transcription
Presbyopia Correction: Can We Match Mother Nature?
ACADEMY 2014 DENVER Times Friday Edition Your AAO News Source Friday •This year’s Primary Care Symposium briefed attendees on the latest treatment protocols for posterior segment disease ....... 3 •This morning, Ezell Fellows Present: A Sampler of Current Low Vision Research.............. 4 Presbyopia Correction: Can We Match Mother Nature? P resbyopia is (or will be) everyone’s problem. To illustrate this, Paul Kaufman, MD, addressed the youngest optometrist in the packed ballroom: “As young as you think you are, you already have this disease.” At yesterday’s Monroe J. Hirsch Symposium, Dr. Kaufman and two other speakers presented their research to this presbyopic and pre-presbyopic audience. Imaging of Accommodation •Want to learn more about the Student Fellowship program?....................................5 •This year’s list of ‘Academy Award’ winners include several A-listers................................8,9 • List of Exhibitors...................10 Susana Marcos, PhD, professor of research at the Instituto de Óptica, in Madrid, Spain, talked about new imaging technologies to measure the optical and structural properties of the crystalline lens during accommodation and in presbyopia. Using 3D OCT, “we can assess the fluctuations of accommodation looking directly at the crystalline lens,” she said. Both lens geometry and another age-related property of the Credit: VioBio Lab •Join the Academy in recognizing its new Fellows and Diplomates tomorrow night at 7:00 PM......4 •Scientific discoveries and recent product updates presented at the AAO Press Conference....13 3D OCT biometry can be used to quantify accommodation, as shown by Susana Marcos, PhD. lens, the gradient index, contribute to the change of optical aberrations, Dr. Marcos said. The idea is to use the findings from these imaging technologies to quantify the performance of the latest accommodative IOL designs and, better yet, to design new multifocal lens designs for presbyopic correction. Eye to Eye with Mother Nature? Research in presbyopia has largely focused on the crystalline lens—but “the lens is not the only game in town,” said Dr. Kaufman, professor and chair of ophthalmology and visual sciences at the University of Wisconsin-Madison. Classical teaching holds that presbyopia is caused by age-related loss of lenticular elasticity. “But, there’s also a concurrent decline in movement of the ciliary processes,” he said. Interestingly, Dr. Kaufman described an ocular structure called the vitreous zonule that appears to play a role. It acts like a pulley to move the ciliary muscle during accommodation. But, stiffening of this vitreous zonule as we age may diminish accommodation. So, “when you cut it in a presbyopic eye [in monkey experiments], much of the movement of the ciliary muscle is restored,” Dr. Kaufman said. This, he indicated, would explain, to some extent, why full accommodation can’t be restored by accommodating intraocular lenses. “You wonder why Accommodating IOLs aren’t nearly as good as the lens Mother Nature designed, said Paul Kaufman, MD. you don’t get more than 2D out of an accommodating IOL? The answer is that [accommodating intraocular] lenses aren’t nearly as good as what Mother Nature designed [with the crystalline lens],” he said. Someday, a biochemical or genetic treatment might be found to alter the connective tissue, Dr. Kaufman said, but those developments are quite far off. Better Than Bifocals? Stephen D. McLeod, MD, professor and chair of the ophthalmology department at the University of California San Francisco, wrapped up the symposium with an analysis of the advantages and limitations of corneal, intrastromal and intraocular lens options for presbyopia. “There are many different ways to try to skin this cat,” he said. “We still have a lot of challenges ahead [with advanced IOLs], but hopefully in a few years, we’ll be doing better than bifocals and progressives.” AAO TIMES NOVEMBER 14, 2014 1 ACADEMY 2014 DENVER REVIEW OF OPTOMETRY WWW.REVIEWOFOPTOMETRY.COM Primary Care Goes Posterior A t yesterday morning’s Primary Care Section Symposium, “Primary Care of the Posterior Segment,” an all-star panel of lecturers provided attendees with a rapid-fire update on an array of retinal and macular disease topics. Don’t Pass Over New Plaquenil Protocols Following an introduction from symposium moderator Christopher Lievens, OD, MS, FAAO, Blair Lonsberry, OD, MS, FAAO, reviewed current screening guidelines for hydroxychloroquineinduced retinal toxicity. In 2002, the American Academy of Ophthalmology (AAO) established ocular examination guidelines for screening patients on Plaquenil (hydroxychloroquine, Sanofi-Aventis) therapy, Dr. Lonsberry said. Testing included a comprehensive eye exam that consisted of an assessment of the posterior segment with careful evaluation of associated macular changes or signs of retinal disease. An Amsler grid or central 10-2 visual field test was recommended, and baseline fundus photography was considered optional. But, following the advent of more sensitive objective testing capabilities—including multifocal electroretinogram, spectraldomain optical coherence tomography and fundus autofluorescence—the AAO revised its screening guidelines in 2011. “It is now recommended that, along with 10-2 automated fields, at least one of these advanced procedures be used for routine screening, where available,” Dr. Lonsberry said. Macular Edema Tx Update Next, Megan Hunter, OD, FAAO, discussed how treatments for macular edema secondary to central retinal vein occlusion (CRVO) have improved during the last decade. “Throughout the 1980s and 1990s, macular edema associated with vein occlusion was largely untreatable,” she said. Following publication of the Central Retinal Vein Occlusion Study, researchers learned that grid laser photocoagulation effectively reduced macular edema but didn’t yield an improvement in visual acuity. “Thus, observation became the only treatment option,” added Dr. Hunter. Then, in the early 2000s, retinal specialists began administering intravitreal corticosteroid injections to CRVO patients with significant macular edema. “This treatment approach reduced edema through antiinflammatory and antiproliferative effects,” Dr. Hunter said. “However, intravitreal steroid use carries the potential for significant side effects, including elevated intraocular pressure and an increased incidence of cataract formation.” Today, however, the most effective treatment option for macular edema secondary to CRVO seems to be intravitreal anti-vascular endothelial growth factor (anti-VEGF) therapy. “Anti-VEGF drugs, such as bevacizumab, ranibizumab and aflibercept, treat both neovascularization and macular edema effectively, and help increase patients’ best-corrected visual acuity,” Dr. Hunter said. The latest anti-VEGF agent, Eylea (aflibercept, Regeneron), has been shown to have a longer half-life in the eye than both bevacizumab and ranibizumab. “The retinal specialist I work with typically administers Eylea to macular edema patients once a month for three months, then once every six to eight weeks thereafter,” she said. Dialed-in on Diabetic Retinopathy Then, Mohammad Rafieetary, OD, FAAO, discussed how primary care optometrists can become more involved in the detection and management of diabetic eye disease. More Americans experience vision loss secondary to diabetic retinopathy and diabetic macular edema than to glaucoma, he said. “Interestingly, optometrists are able to treat glaucoma At yesterday’s Primary Care Symposium, directly with topical medicaDr. Rafieetary discussed how optometrists can tions––but unfortunately cannot become more involved in the management of patients with diabetic eye disease. do the same for diabetic eye disease. So, the best services we can provide to our patients are standard treatment, the adeducation about the underlying dition of anti-VEGF therapy condition and early monitoring reduces neovascularization via fundus photography and and helps restore lost vision in spectral-domain optical coherdiabetes patients, Dr. Rafieetary ence tomography.” said. “The only significant risk Once diabetic retinopathy is associated with anti-VEGF detected, primary care optomtherapy in this capacity is an etrists are well positioned to elevated potential for tractional refer the patient to a specialist retinal detachment. But, regular for appropriate treatment. “[In monitoring with SD-OCT can our clinic] we don’t often refer easily detect this,” he added. diabetes patients for Residents Day at Academy intravitreal steroidal 2014 Denver injections, because that approach is Saturday, November 15, 2014 not curative,” Dr. Sponsored by Rafieetary said. “Instead, we prefer sending patients out for combination Residents Day is a forum where residents have the anti-VEGF therapy opportunity to present their interesting grand rounds case and panretinal phoreports! Papers will be presented from 8:00 PM – Noon tocoagulation.” in Room 708/710/712 and posters will be presented While panretinal from 1:30 PM to 3:30 PM in the Four Seasons photocoagulation Ballroom. remains the gold AAO TIMES NOVEMBER 14, 2014 3 ACADEMY 2014 DENVER REVIEW OF OPTOMETRY WWW.REVIEWOFOPTOMETRY.COM EZELL FELLOWS PRESENT: A Sample of Current Low Vision Research Today, 10:00 AM – 12:00 PM, Rooms 401-403 O ffered by the American Optometric Foundation since 1947, the Ezell Fellowship program supports optometric research and education with the goal of improving clinical patient care. This year, three eminent researchers will review a variety of topics centered upon low vision rehabilitation. • Robert W. Massof, PhD, FAAO, professor of ophthalmology and neuroscience at the Johns Hopkins University School of Medicine, will begin the presentation with an overview of the relationship between low vision disorders and specific contributing factors, such as patient age, environmental variables and coexistence of other chronic diseases. Such individualized considerations inherently help us more effectively tailor patients’ comprehensive care plans, notes Dr. Massof. The lecture also will explore different methods of determining intervention efficacy—including performance measures like timed Instrumental Activities of Daily Living (IADL) testing; use of clinical techniques like the Functional Independence Measure (FIM) and Goal Attainment Scaling (GAS); and methods for determining intervention effec- tiveness like Visual Functioning Questionnaires (VFQ). • Next, Susana Chung, OD, PhD, FAAO, professor of optometry and vision science at the University of California, Berkeley, will discuss recent research on improving visual function via perceptual learning in patients with central vision loss. “Evidence suggests that the adult visual system retains [a] certain degree of plasticity and can be altered by experiences in life,” Dr. Chung says. “Recently, we observed evidence suggesting that the visual system of people with longstanding macular lesions is also capable of modifying its responses to visual stimuli based on experiences, even when the vision loss occurs late in life.” Dr. Chung’s lecture will cover the concept of the preferred retinal locus (PRL), a retinal region unaffected by lesions that is adopted by age-related macular degeneration (AMD) patients as their “new fovea.” Additionally, she’ll describe oculomotor re-referencing as an indicator of visual system plasticity despite macular lesions; psychophysical evidence for a shift in the reference location; and the clinical implications of the plasticity in Annual Fellowship Banquet Saturday, November 15 – 7:00 PM to 10:00 PM (Black Tie Optional) J oin us in recognizing the new Fellows and Diplomates! Enjoy the camaraderie as we celebrate those reaching this milestone in their careers and toast the ending of another great Academy meeting. Use your banquet ticket, which was printed with your badge at registration, to get into the event. Seating is first come, first served. Please note! If you do not plan on attending the banquet, please stop by the Academy’s booth in the Exhibit Hall (#437) to donate your ticket to a student attendee. 4 AAO TIMES NOVEMBER 14, 2014 a visual system affected by vision loss. Dr. Chung also will review a clinical case that illustrates the performance of an AMD patient both during and after a perceptual learning program. • Then, Bradley Dougherty, OD, PhD, FAAO, assistant professor of vision science at the Ohio State University College of Optometry, will close the seminar with an exploration of factors that may affect road safety in bioptic drivers. Bioptic systems supplement the patient’s natural vision with a small telescopic system to improve the sharpness of their far vision, allowing them to more clearly see street signs, traffic signals and other distant objects ahead, he suggests. Additionally, Dr. Dougherty will describe the history of bioptic driving, including how telescopic spectacles are designed and used, their role in current driving licensure and related controversies. He’ll then review research outlining the rate of motor vehicle collisions involving bioptic drivers vs. non-bioptic drivers; the effectiveness of bioptic testing and training; and the effect of different visual and demographic factors on bioptic drivers compared to non-bioptic drivers. Academy Education Online The Academy’s Live Learning Center connects you to educational session recordings from American Academy of Optometry annual meetings. Recordings from Academy 2014 Denver will posted online after the meeting, and learners can already access previous Academy meeting recording packages! • If you missed a particular presentation or couldn’t make it to the conference this year, here’s your chance to catch up on the sessions you were unable to experience live. Recorded sessions make great training tools between conferences and will enrich your professional development year-round. • As a thank-you to our valued members, we’re excited to offer complimentary session recordings for our members from the 2014 meeting, as well as the previous five meetings. • Additionally, tests are available for purchase online for just $25. Start claiming COPE-approved distance learning credits today! • Visit the Academy’s Live Learning Center at http://aaopt.sclivelearningcenter.com. If you encounter any technical issues or need your account login, please contact the support help line at 289-695-5400 (Monday through Friday, 9:00 AM - 5:00 PM eastern time), or send an email to multiviewMediaSupport@ multiview.com. ACADEMY 2014 DENVER REVIEW OF OPTOMETRY WWW.REVIEWOFOPTOMETRY.COM What Exactly is Student Fellowship? Y ou may have noticed the plethora of students attending lectures, sitting in on workshops, lingering in paper and poster sessions, and packing into the Academy Business Meeting. You may have even felt exhilarated by their passion for Academy education! While they very well could be trying to cram as much optometry knowledge into their brains as possible, it’s more likely that they’re participating in the Student Fellowship program. So, what exactly is Student Fellowship? The Student Fellowship program was created to encourage students to experience the entire meeting, hoping that it would stimulate improved integration of all the opportunities offered at the meeting and encourage future involvement in the Academy. To participate, students must attend a mandatory orientation breakfast followed by a certain number of CE hours, paper and poster sessions, special sessions, the Academy business meeting and a Section or SIG symposium. All students who complete the EyeMAP™ TODAY’S HIGHLIGHTS Scientific Program For Friday, November 14 What’s happening with the Scientific Program this year? The Scientific Program Committee has revamped the program this year to offer attendees different options in paper and poster sessions. Here are a few highlights: Today’s paper sessions: •Does Trans-synaptic Degeneration Exist? (Rooms 201-203, 10:30 - 11:30 AM) •Anterior Segment/Contact Lens 4 (Rooms 205-207, 10:00 AM - Noon) •Health Policy and Delivery (Rooms 201-203, 2:00 - 3:30 PM) •RGP Contact Lenses (Rooms 205-207, 2:00 - 3:00 PM) Today’s poster sessions: Posters will be displayed from 9:00 AM to 4:00 PM in the Four Seasons Ballroom. Odd-numbered authors will be present from 10:00 AM - Noon and even-numbered authors will be present from 2:00 - 4:00 PM. Topics include: •Cornea/Anterior Segment/Contact Lens •Glaucoma •Health Policy •Neuro-Ophthalmic/Orbit •Optometric Education •Posterior Segment •Systemic Disease Tomorrow’s paper sessions: •Anterior Segment/Contact Lens 5 (Rooms 201-203, 8:30 AM - Noon) •Low Vision (Rooms 201-203, 2:30 - 4:30 PM) Interested in presenting a paper or poster at Academy 2015 New Orleans? The Scientific Program abstract submission window will be open from May 1 through May 31, 2015. More information is available online at www.aaopt.org. 6 AAO TIMES NOVEMBER 14, 2014 requirements receive a Student Fellow certificate, an Academy lapel pin and complimentary student registration for Academy 2015 New Orleans. To date, over 700 optometry students have become Student Fellows. This year, nearly 500 enthusiastic students will participate. So, as you see students hurriedly walking through the halls of the convention center, kindly point them in the direction of the nearest contact lens session or scientific talk. They are likely to appreciate it greatly! (Meeting Activities Planner) W ith all the papers, posters, lectures, workshops, symposia and social events happening at Academy 2014 Denver, even the most organized can get a little overwhelmed! That’s why the Academy provides EyeMAP™ (Meeting Activities Planner), a program designed to help you create and manage your personal schedule during the meeting. Use EyeMAP™ to: •Browse and search all available lectures, workshops, papers and posters, and special events. •Add sessions and personal appointments to your schedule. •Access session handouts before and during the meeting. •Complete session evaluations. •Find information about the city of Denver. •Locate exhibitors in the Exhibit Hall. EyeMAP™ can be accessed online at http://aao-eyemap. org on your computer, smartphone or tablet, with no app download required. Please log in using the same username and password combination you used to register for the meeting. ACADEMY 2014 DENVER REVIEW OF OPTOMETRY WWW.REVIEWOFOPTOMETRY.COM The Academy Presents: 2014 Awards D on’t miss the 2014 Awards Ceremony, during which we will celebrate those who have demonstrated their contributions to the advancement of optometry and vision science. The 2014 award recipients will be recognized on Friday, November 14 from 8:00 to 10:00 AM in the Four Seasons Ballroom of the Colorado Convention Center. Join us to hear the Charles F. Prentice Lecture and the Glenn A. Fry Lecture (one hour of CE provided), and to recognize and honor these outstanding individuals. Charles F. Prentice Medal and Lecture The Charles F. Prentice Medal is the Academy’s top award and lecture at the annual meeting, and is presented to an individual who has made a significant contribution to the advancement of knowledge through research in the visual sciences. Brien A. Holden, PhD, DSc, FAAO, has made substantial contributions to our understanding of the mechanisms underlying the development and treatment of myopia, the evaluation of uncorrected refractive error, and the relationship between corneal physiology, contact lenses and the metabolic and physiological factors that are required for maintaining the integrity of the cornea. In addition, Dr. Holden has been able to develop a unique model for optometric research, collaborate with many colleagues worldwide, acquire considerable research funding, and develop methods and procedures that are utilized by many investigators and clinicians throughout the world. 8 AAO TIMES NOVEMBER 14, 2014 The Glenn A. Fry Award and Lecture The Glenn A. Fry Award and Lecture is sponsored by the American Optometric Foundation and recognizes a distinguished scientist or clinician for his or her current research contributions. Lyndon W. Jones’, PhD, FCOptom, FAAO, research is related to contact lenses and dry eye, meibomian gland function, and tear film characteristics. He has been actively involved in the ongoing issues concerning the ocular response to contact lens solutions. Dr. Jones has received significant research funding and has published more than 160 publications in peerreviewed journals. In addition, Dr. Jones is an outstanding instructor and superb clinician. Dr. Jones was in private practice in optometry for 12 years prior to assuming an academic position at an optometry school, and he has participated in several significant leadership positions throughout the years. Irvin M. and Beatrice Borish Award The Borish Award recognizes an outstanding young researcher who has shown exceptional promise to conduct independent optometric research directly related to etiology, prevention, detection, diagnosis or management of clinical eye disorders. Laura E. Downie, BOptom, PhD (Melb), FAAO, is a highly skilled clinician with expertise in anterior eye disease and contact lenses. She has also produced exceptional research related to vascular, neural and glial cell changes in the retina and their interactions, and was instrumental in demonstrating the neuro-protective potential of Valsartan, a renin-angiotensin modulator. AAO-Essilor Award for Outstanding International Contributions to Optometry The International Award recognizes an individual(s) or organization whose direct efforts and contributions have resulted in unquestionable significant and extraordinary advances in optometry and eye care internationally. Ms. Tone Garaas-Maurdalen is a Norwegian optometrist who has elevated optometry into a primary health care profession in Europe and has also extended these efforts to countries such as Iceland, Sweden and Switzerland. Additionally, she has been a tireless participant on the Legislation, Registration and Standards Committee of the World Council of Optometry (WCO), and has been the President of the WCO since 2011. Her contributions have had a significant positive impact on the expansion of optometry throughout Europe. Carel C. Koch Memorial Medal The Carel C. Koch Memorial Medal is awarded to a person who has made outstanding contributions to the enhancement and development of relationships between optometry and other professions. Serge Resnikoff, MD, PhD, has spent the majority of his career promoting public health initiatives worldwide through the World Health Organization (WHO). With his dedication, the World Council of Optometry became officially recognized as an organization within the WHO. This has strengthened the international collaboration between optometry and ophthalmology, as well as other health care groups. His efforts have greatly expanded and extended the role of optometry in providing low-cost eye care to individuals throughout the world. Vincent Ellerbrock Clinician Educator Award The Vincent Ellerbrock Clinician Educator Award is presented to a distinguished clinician who has made outstanding and sustained contributions to the Academy’s Lectures and Workshops program. The 2014 Ellerbrock Award recognizes two outstanding individuals, Drs. Ron Melton and Randall Thomas, for their achievements related to more than 20 years of participation in the Lectures and Workshop program. Both individuals are exceptional speakers who annually utilize their clinical experience and expertise to provide salient suggestions to clinicians related to the diagnosis and ACADEMY 2014 DENVER REVIEW OF OPTOMETRY management of ocular disease, inflammation, infection, trauma and a variety of other common topics that occur in clinical practice. Life Fellowship Award The distinction of Life Fellowship was created to provide recognition to those Fellows who, through long-time membership in the Academy, have rendered distinguished service to the science and art of optometry. Satya Verma, OD, FAAO, has held many leadership roles in optometry and has been the Cochair and Chair of the National Academy of Practice in Optometry. He is the President-elect of the National Academies of Practice, and has been a long-standing member of the National Council on Aging. In these and other roles, Dr. Verma has served as a spokesperson and leader for optometry and has dramatically improved the public awareness of the benefits and service that optometry has to offer the general public. His contributions and dedication have had a marked positive effect on the profession. WWW.REVIEWOFOPTOMETRY.COM Max Schapero Memorial Lecture Award The Schapero Award, which is the Section on Cornea, Contact Lenses & Refractive Technologies’ highest award, honors a clinician, researcher, or scholar who has made a significant contribution to the cornea and contact lens field by virtue of his/her publications, lectures or research efforts. This year’s honoree is Michel Guillon, PhD, FCOptom, FAAO, an educator and PhD candidate mentor and researcher at Aston University. For more than 25 years Dr. Guillon has been Director of the Ocular Technology Group, performing high level research focusing on contact lenses and dry eye. Michael G. Harris Award for Excellence in Optometric Education Presented by the American Optometric Foundation, the Harris Award recognizes an optometric educator who has demonstrated ongoing and consistent excellence in education of optometry students and/ or advancement of optometric education. Edward J. Revelli, OD, FAAO, is a tireless instructor and teacher who has been dedicated to providing the best instruction and training to optometry students over many years, and constantly upgrades and improves the optometric curriculum. Additionally, he has been able to enhance the clinical skills and expertise of faculty in new and expanding areas of Garland W. Clay Award The Garland Clay Award is presented to the authors of the manuscript published in Optometry & Vision Science that has been most widely cited in the world research literature in the preceding five years and has the vote of the Optometry & Vision Science Editorial Board. The 2014 Clay Award paper is: “Biomechanics of the Sclera in Myopia: Extracellular and Cellular Factors,” and its authors are Neville A. McBrien, MCOptom, PhD, Andrew I. Jobling, PhD, and Alex Gentle, PhD, FAAO. The article was published in the January 2009 issue of Optometry & Vision Science. optometry. His methods are highly effective and he is wellliked and greatly respected by students and his peers. Section on Cornea, Contact Lenses & Refractive Technologies Awards These awards will be presented at the Section Awards Ceremony and Max Schapero Lecture, Friday, November 14, 5:00 - 6:00 PM, in Rooms 601607 of the Colorado Convention Center. Founders’ Award The Founders’ Award is presented to the individual, group, or company who has made an outstanding contribution to the clinical aspect to the art or science of contact lens fitting. This year’s awardee is JeanLouis Blanchard, OD, an optometrist, clinician, researcher, and educator. Dr. Blanchard founded Blanchard Laboratories, which developed modern gas permeable, aspheric, multifocal technology. Exemplary Service Award The Exemplary Service Award honors those who have rendered extraordinary and/or distinguished contributions to the Section on Cornea, Contact Lenses and Refractive Technologies. This year’s awardee is David Rosenbloom, OD, FAAO (posthumously). Dr. Rosenbloom was an avid supporter of the profession as well as the Lion’s Clubs’ mission. A beloved colleague with an ever- present smile, he will continue to be missed. Public Health & Environmental Vision Section Award This award and lecture will be presented at the Public Health & Environmental Vision Section Symposium on Wednesday, November 12, 4:00 - 5:00 PM, in Rooms 405-407 of the Colorado Convention Center. Henry B. Peters Memorial Award in Public Health and Environmental Vision The Henry B. Peters Memorial Award recognizes an individual for his/her exemplary contributions to public health and/or environmental vision over many years. This year’s inaugural awardee is Alden N. Haffner, OD, PhD, FAAO. Dr. Haffner is an eminent educator and passionate advocate for public health optometry. He was the founding President of the State University of New York College of Optometry, and is credited with organizing the historic LaGuardia Conference in 1968 that launched optometry’s transition from vision care to eye care and the profession’s drive for pharmaceutical prescriptive authority and primary eye care recognition. We look forward to seeing you at these Awards Ceremonies to honor these distinguished individuals, acknowledging the countless contributions they have made in advancing our profession. AAO TIMES NOVEMBER 14, 2014 9 ACADEMY 2014 DENVER REVIEW OF OPTOMETRY WWW.REVIEWOFOPTOMETRY.COM AAO Exhibits T he Academy Exhibit Hall is the perfect place to experience cutting edge products and services. Remember, badges are required for admission into the Exhibit Hall. Hall hours are as follows: Friday, November 14, 2014 Company Name Booth Number Company Name ABB Optical Group 907 Abbott Medical Optics 903 AccuLens Inc. 1029 Acuity Pro/VisionScience Software, Inc 528 Advanced Ocular Care 311 Advanced Vision Technologies (AVT) 1108 Adventure in Colors, Inc 945 Akorn Pharmaceuticals 1002 Alcon418 Alden Optical 517 All About Vision 1122 Allergan721 American Academy of Optometry 437 American Board of Certification in Medical Optometry 1116 American Board of Optometry 545 American Optometric Foundation 737 Annidis Health Systems 1105 Art Optical Contact Lens Inc. 622 ARVO745 Bausch + Lomb 503 BIOD, LLC 747 Biosyntrx304 BioTissue403 Blanchard Contact Lens, Inc. 831 Blue View Vision 933 Brien Holden Vision Institute 529 Bruder Healthcare Company 911 Canon USA 306 CareCredit413 Carl Zeiss Meditec, Inc. 511 Carl Zeiss Vision, Inc 610 Chadwick Optical 334 Chemistrie Eyewear 919 Colorado Optometric Association 307 Compulink530 CooperVision, Inc. 729 Designs for Vision 333 DGH Technology, Inc. 829 Diagnosys LLC 341 Diopsys LLC 909 Elsevier, Inc. 1103 Enhanced Vision 329 Enovative Technologies 1114 Envision University 328 Eschenbach Optik of America 728 Essilor of America 308 Eye Designs 508 Eye Photo Systems, Inc. 442 Eyefinity611 EyeMed Vision Care 432 Fashion Optical Displays 941 10 11:00 AM – 3:00 PM AAO TIMES NOVEMBER 14, 2014 Booth Number Fellows Doing Research SIG 445 First Vision Media Group, Inc. 519 FOXFIRE Systems Group 914 Frame Displays 309 Freedom Scientific Inc. 335 Freedom Meditec 644 Good Lite 813 Haag-Streit/Reliance USA 629 HAI Laboratories, Inc. 615 HealthCare Professional Funding Corporation506 Heidelberg Engineering 708 Heine415 Hoya Vision Care 320 HumanWare330 Icare-USA916 iMatrix340 Infinite Therapeutics 930 Infinite Trading 305 Innova Systems 314 Johnson & Johnson Vision Care, Inc. 703 Keeler Instruments 912 King-Devick Test 1031 KMK Educational Services LLC 1018 Konan Medical USA 523 Leiter’s Compounding 302 Lippincott Williams & Wilkins, Wolters Kluwer Health 1117 Lombart Instrument 429 Lounge637 LS&S Products Inc. 331 M&S Technologies 620 Maculogix, Inc. 428 Marco1008 Marshall B. Ketchum University 943 Menicon704 Metro Optics 915 Modern Design Architects 407 MODO Eyewear 303 National Eye Institute 744 National Keratoconus Foundation 1110 National Vision Inc. 502 NBEO-Board Certification Inc. 342 NCI Vision Systems 1032 NEOD, Inc. 1040 Nicox, Inc. 815 Nidek409 NOVA Southeastern University 844 NovaBay Pharmaceuticals Inc. 1121 OASYS®803 Ocular Melanoma Foundation 645 Note to those interested in booth space for Academy 2015 New Orleans: Stop by the Exhibit Manager’s office located near Exhibitor Services and ask for Betty Taylor. She will be happy to help you select a prime booth location and get you registered for 2015. Company Name Booth Number Ocular Nutrition Society 510 Oculus, Inc. 616 Ocusci Inc. 944 Ocusoft, Inc. 1033 Ocutech Inc. 332 Optelec434 Optometry Times 343 Optos621 Optovue1020 Pain Point Medical Systems Inc 1109 PentaVision LLC 1009 Practice Director 1021 Precision Vision 1034 Presenta Nova Inc. 935 Primary Care Optometry News and Healio.com By SLACK Incorporated 1016 PRN Physician Recommended Nutriceuticals647 Reichert, Inc. 713 RETILAB746 Review of Optometry 404 Rysurg, LLC 512 Sensor Medical Technology 917 Shire402 Smart Vision Labs 646 Solutionreach931 Sonomed Escalon 1037 Stereo Optical 521 Synergeyes814 TearLab, Corp. 408 TearScience921 Topcon Medical Systems, Inc. 821 Tru-Form Optics 928 U.S. Jaclean, Inc. 547 Unilens Corporation 1015 US Ophthalmic 1004 Valley Contax, Inc. 1111 Veatch Ophthalmic Instruments 1120 Visionary Optics LLC 1010 Vmax Vision Inc 1028 VOLK Optical 929 VOSH International 411 VRMagic440 VSP Global 609 VSP Global/Vision Care 603 VSP Optics Group 607 Walmart Stores, Inc. / Sam’s Club 316 Wells Fargo Practice Finance 812 Williams Group 1021 World Council of Optometry 845 X-Cel Contacts 1003 Zeavision446 ACADEMY 2014 DENVER REVIEW OF OPTOMETRY WWW.REVIEWOFOPTOMETRY.COM Monroe J. Hirsch Memorial Research Symposium Adaptive Optics: The Next Ophthalmic Imaging Frontier? Thursday 8:00 AM –10:00 AM Hall 4E Clinical Application of AO Austin Roorda, PhD, Professor of Vision Science and Optometry at University of California–Berkeley School of Optometry, will discuss “Translating Advanced Retinal Imaging into Clinical Application.” “Over the past two decades, we have witnessed major advances in technologies for ophthalmic imaging and vision testing,” Dr. Roorda says. “The implementation of AO and eye tracking into scanning laser ophthalmoscopes and OCT systems are driving a paradigm shift in how retinal imaging is being used to study eye disease.” For example, the counting of cone photoreceptor cells—a technique that has traditionally required specialized laboratory microscopes—is now being done with an AO ophthalmoscope in a clinical trial to measure disease progression. Dr. Roorda’s talk will discuss the challenges and opportunities in translating these technologies for clinical application. Will you be using AO in your practice any time soon? “Tracking OCT with micro-vascular imaging will be common” in the average practice, he predicts. However, he says that “killer applications” for AO have yet to be developed. “But, if there is a disease that can be detected early using only AO technology AND there is a cure, then it’s possible that basic AO imaging systems will be common.” Photo by: Brandon Lujan, MD R ecent advances in ophthalmic imaging using adaptive optics (AO) and optical coherence tomography (OCT) have resulted in the ability to view unprecedented anatomical detail. These technologies are now being applied to clinical presentations in order to understand the anatomical changes associated with the disorder and to diagnose and treat clinical conditions. Tomorrow morning’s Hirsch Research Symposium, “Clinical Application of Advanced Ocular Imaging,” will highlight the applications of these newer imaging techniques for genetic retinal conditions, as well as for management of retinal diseases such as age-related macular degeneration. The presenters are among the foremost authorities on adaptive optics. Their discussions will include: Spectral-domain OCT combined with improvements in software and acquisition techniques have refined the quantification of pathological features, such as drusen volume and geographic atrophy area (shown here). AO for Cones and Color Vision Jay Neitz, PhD, a color vision researcher and Professor of Ophthalmology at University of Washington School of Medicine, will present “Retinal Imaging as a Window into Causes and Possible Treatment of Clinical Disorders of Cones and Color Vision.” “Mutations in the genes encoding the cone photopigments are associated with a spectrum of vision disorders, ranging from simple color vision defects to disorders associated with severe vision loss,” Dr. Neitz says. “The different mutations have very different effects on cone structure, function and viability. This has been revealed by new imaging technologies: OCT and AO imaging.” What is ‘Adaptive Optics’? And How Does it Involve Eye Care? Adaptive optics (AO) is not an imaging modality, but rather a technology that can be used in combination with imaging modalities to improve their performance. AO was originally developed for ground-based telescopes to remove atmospheric blur. Since the 1990s, it’s also been used for retinal imaging. Specifically, AO refers to systems that adapt to compensate for optical effects introduced by the medium between the object and its image (i.e., wavefront distortions). For instance, AO is used in telescopes and laser communication systems to remove the effects of distortions from the earth’s atmosphere. In retinal imaging systems, AO is used to reduce optical aberrations created by ocular structures, such as from the lens, pupil and cornea. Adaptive optics works by measuring the distortions in a wavefront and compensating for them with a device (such as a deformable mirror or a liquid crystal array) that corrects those errors. AO has become a valuable tool in vision research for studying structure and function of the microscopic retina, as well as the onset and progression of disease. 12 AAO TIMES NOVEMBER 14, 2014 Consequently, these new imaging technologies are providing information about which disorders are likely to be amenable to novel treatments, such as gene therapy, Dr. Neitz says. AO and OCT for AMD Brandon Lujan, MD, Medical Retina and Imaging Specialist at West Coast Retinal Medical Group and at UC Berkeley, will cover “Spectral Domain OCT Imaging of Age-related Macular Degeneration.” “I will discuss the many uses of spectral domain OCT (SD-OCT) imaging in AMD management and clinical studies, as well as future frontiers of SD-OCT used to improve the understanding of the pathogenesis of AMD,” Dr. Lujan says. “The speed and resolution of SD-OCT, combined with software development and improvements in acquisition techniques, have achieved refinements in the diagnosis of disease and quantification of pathological features, such as drusen volume and geographic atrophy area.” These advanced metrics are currently guiding clinical decision-making and will become increasingly important as key endpoints in clinical trials for novel therapeutic agents, Dr. Lujan says. ACADEMY 2014 DENVER REVIEW OF OPTOMETRY WWW.REVIEWOFOPTOMETRY.COM Science Shines in the Spotlight I n a unique pairing, clinician scientists and company representatives came together at the Academy’s annual press conference on Wednesday to present updates from their respective worlds. Here’s a look at some of the key findings from the scientific program: • A study showed that smokers exhibit increased hexanoyl-lysine (HEL) levels, a byproduct of an alteration in fatty acids that increases tear evaporation. Smokers also have higher tear thinning rates compared to nonsmokers, according to Ezell and BSK Research Fellow Daniel Powell, OD, PhD, FAAO, of the Ocular Surface Institute in Houston. Source: “Tear Lipid Peroxidation and Tear Film Measurements in Young Nonsmokers and Cigarette Smokers” Source: “Hands-free Phone Communication Decreases Throughput on Color and Luminance Tasks” • A new imaging modality called optical coherence elastography (OCE) successfully measures corneal stiffness after collagen crosslinking, using a micro air pulse to digitally palpate the cornea, then recording the spatial variations that result, according to Michael D. Twa, OD, PhD, FAAO, Associate Dean of the University of Alabama at Birmingham School of Optometry. “It’s noninvasive and sensitive to meaningful changes in tissue surface,” Dr. Twa said. Source: “Optical Coherence Elastography Imaging of the Cornea” • Human corneal epithelial cells (HCECs) treated with vitamin D increased genes associated with immunity and lowered pro-inflammatory cytokines, reported Ezell Fellow Rose Y. Reins, PhD, Graduate Research Assistant at the University of Texas Health Science Center at Houston. The results showed vitamin D’s protective role for HCECs. • To better understand how patients perceive contact lens discomfort, researchers tested different protocols for measuring patient response to mechanical stimuli. The study will enable future efforts to understand psychological factors at work in sensations of lens awareness and subjective ratings of comfort, according to Ezell Fellow William Ngo, OD, BSc, FAAO, of Waterloo, Ontario’s Centre for Contact Lens Research. Source: “Vitamin D Decreases IL-8 Expression After Induction of Inflammation and Influences Gene Expression in Human Corneal Epithelial Cells” Source: “Comparison of Two Sensory Panel Selection Strategies for Beginning and End of Day Lens Discomfort” • Stereopsis training that presents different stimuli to each eye improves stereoacuity thresholds and visual acuity in patients with amblyopia, Ezell Fellow Cristina Law, OD, FAAO, said. In the study, the patients viewed two rectangles through a four-mirror stereoscope with binocular disparity between the right and left eye and patients chose which rectangle looked closer. Neural plasticity allows some ambylopes to regain lost vision. • Patients with prior traumatic brain injury experienced worse photopotentiation than healthy control patients, according to Patrick D. Shorter, OD, a graduate student at the Ohio State University in Columbus. Source: “Dichoptic Varied-Contrast Stereopsis Training Improves Disparity Thresholds and Visual Acuity in Adult Amblyopes” • After 22 children with amblyopia underwent treatment with a headset that alternately occludes each eye at a rapid frequency, 92% showed improvement in visual acuity and stereopsis, according to Bruce Moore, OD, FAAO, Marcus Professor of Pediatric Studies at New England College of Optometry in Boston. The device improved upon conventional patching. Source: “Eyetronix Flicker Glass (EFG Treatment of Refractive Amblyopia)” • Hands-free cell phones do not reduce distracted driving, particularly during low-contrast visual tasks. Computer simulations show that sensitivity and response time are both impaired, according to Jeff Rabin, OD, MS, PhD, FAAO, of San 14 Antonio’s University of the Incarnate Word Rosenberg School of Optometry. AAO TIMES NOVEMBER 14, 2014 Source: “Altered Adaptation of the Pupillary Light Reflex in Photophobic Individuals with Traumatic Brain Injury” • When patients with primary openangle glaucoma had beta-zone peripapillary atrophy (ß-PPA), juxtapapillary choroidal volumetric (JCV) measures were reduced compared to normal healthy eyes, suggesting a relationship between glaucoma, ß-PPA and JCV, said Michael Sullivan-Mee, OD, FAAO, of the Albuquerque VA Medical Center. Source: “Relationship Between Juxtapapillary Choroidal Volume and ß-Zone Peripapillary Atrophy in Normal and Glaucomatous Eyes” • Lisa Young, OD, FAAO, of Chicago Glaucoma Consultants reported that optic disc size played a role in the accuracy of 261 exhibit hall attendees’ identification of glaucomatous optic neuropathy. The eye doctors showed the most variance when tasked with pinpointing glaucomatous optic neuropathy in small, glaucomatous nerves and large, typical nerves. Source: “Influence of Optic Disc Size and Neuro-retinal Rim Configuration on Accurate Identification of Glaucomatous Optic Neuropathy” Industry Innovations • Wenzel Peikert from Oculus presented unique dry eye assessment features of the Keratograph 5M corneal topographer, including the ability to noninvasively assess the tear film under white or infrared illumination, a high-res color camera, a video function to record the tear film at 32 FPS and meibomian gland imaging capabilities. • The BlephEx disposable micro-sponge exfoliates lid margin debris associated with blepharitis, and removes the food source that allows for Demodex mite proliferation, said Rysurg CEO James Rynerson, MD. He advised eye doctors to clean patients’ lids two to four times per year using a six- to eight-minute office procedure. • Volk Optical discussed two new diagnostic devices, the Volk Eye Check and the Pictor Plus handheld imager. The Eye Check measures 17 ocular characteristics to improve screening, diagnosis and corrective lens fitting, according to Pete Mastores. The Pictor Plus offers high-res imaging of the retina and anterior segment, a 45° view, a slit lamp adapter and WiFi connectivity. The portable device weighs only 1lb. • Extended depth of focus contact lenses for presbyopes will begin trials in 2015, said Brien Holden, PhD, DSc, FAAO, who noted they could reduce problems of ghosting common to conventional multifocals. Also under development by Brien Holden Vision: new retinal imaging technology and a neuro-ophthalmic device to analyze eye movement and pupil reactions in patients with traumatic brain injury, both slated for release in 2015 or 2016. • Hai Laboratories recognized that a shortcoming of most slit lamps is their inability to allow comfortable examination for patients with larger body types. The company’s new Hai Elevate Slit Lamp is a compact device with a platform that can be raised so patients can reach the chin rest easily in all patients, said Vice President of Marketing Jackie Hai. • Menicon introduced a thin, flat contact lens blister pack the size of a band-aid that, when opened, presents the contact lens convex side up, reducing patient confusion and error in lens insertion, said Vice President of Marketing and Sales Scott Orphanos. A disc in the packaging holds the contact lens in place with capillary attraction so it won’t fall out when opened. The pack contains enough saline to keep the lens hydrated but avoids waste and difficulty in lens handling. • The Sjö diagnostic test—a panel of seven biomarkers of Sjögren’s syndrome—offers greater sensitivity and specificity than other tests, said Mile Brujic, OD, FAAO, speaking on behalf of Nicox. Use of Sjö allows for earlier detection of Sjögren’s. The test, suitable for use in-office, contains blood and specimen collection kits that can be sent to a lab with results available in a few weeks. • Louise Culham, OD, of Sensor Medical Technology made the case for single-use diagnostic contact lenses in presenting its new 4-Mirror lens, a recent addition to its portfolio of disposable lenses. Benefits include reduced risk of infection, no need for cleaning and no degradation of optics over time, as found in reusable lenses. She also mentioned the company’s line of reusable binocular indirect ophthalmoscopy lenses that come in 20D, 28D, 60D, 78D or 90D. • Konan Medical launched the Evoke Dx, a new visual evoked potential device. The compact unit presents checkered stimuli to test the visual pathway. A significant advance is the use of an OLED (organic lightemitting diode) screen that’s better than LCD or LED displays because it doesn’t introduce a luminance artifact defect, according to Ian MacMillan, Vice President of Marketing. • Murray Fingeret, OD, FAAO, described a new software package for the Heidelberg Spectralis OCT called the Glaucoma Module Premium Edition that creates an anatomic map of the eye to pinpoint the optic nerve head and fovea, allowing for better anatomic registration that enables serial analysis. Subsequent scans are mapped to the same location to better ascertain change over time.