Experts weigh in on Retina Subspecialty Day

NEW ORLEANS – Over the course of the two-day Retina Subspecialty Day, Modern Retina/Ophthalmology Times had five retina experts give their insights into the data presented.

Members of the inaugural Street Team were: David Brown, MD (Houston), Judy Kim, MD (Milwaukee, Wisc.), Richard Spaide, MD (New York), Rishi Singh (Cleveland, Ohio), and Charles Wykoff (Houston).

On Day 2, Drs. Kim, Spaide, and Wykoff gave their thoughts during a Facebook Live event on some of the highlights from this year’s conference.

All three experts were disappointed that the lampalizumab results confirmed those from September, that the compound did not meet its endpoint.

The Apellis data, while a smaller study (dubbed Filly), showed some potential in its phase 2 study on dry AMD. The drug is given by intravitreal injection once a month. Findings showed that regimen could cut progression of geographic atrophy (GA) by 29% over 12 months, while dosing every other month reduced the progression by 20%. From months 6-12, there was an even stronger effect, with a 47% rate of reduction GA progression in the monthly arm and 33% in the every-other-month arm.

 “When you’re blocking complement c3, maybe you can slow the growth there,” Dr. Wykoff said. But there was an increased risk of choroidal neovascularization membrane and infection, Dr. Kim noted (three cases of endophthalmitis).



Imaging was certainly a highlight of the conference and reclassifying dry AMD, Dr. Wykoff noted.

“We’re switching over to more multimodal imaging to classify GA,” Dr. Spaide said. “In addition, some patients have outer retinal atrophy” that is missed in color photograph.

During a pro-con debate on incorporating optical coherence tomography angiography (OC-A) into practice, the “con” side won.

Dr. Kim still plans on using OCT-A, but acknowledged that the lack of reimbursement may have been a deciding factor for some to wait to adopt.

“There’s still benefit for my patients,” she said.

Dr. Wykoff complimented the presentation on widefield imaging by Lloyd Aiello, MD.

“It validates what I’m doing and what I think others are doing as well,” he said. “Look at the periphery. If you don’t have widefield imaging, that’s fine, but make sure you take a good look in the periphery that can change prognostication of diabetic retinopathy.”

Click here to see the entire Facebook Live.