OSNSuperSite Education Lab CME

Three expert vitreoretinal specialists discuss Diabetic Macular Edema (DME): etiology, pathophysiology and incidence. The importance of timely diagnosis is emphasized in the clinical context of routine cataract surgery. Pivotal findings from leading clinical trials evaluating injectable VEGF inhibition, intravitreal corticosteroids, and focal/grid laser therapy are analyzed. Evidence-based DME treatment recommendations are presented.

Three expert vitreoretinal specialists analyze a series of challenging real-world cases of Diabetic Macular Edema (DME). Specific recommendations for the DME diagnostic workup are explored. Evidence-based DME treatment guidelines based on recent pivotal clinical trials are discussed. Scenarios include appropriate selection of VEGF inhibition, role of intravitreal steroids and/or focal/grid laser, and management of refractory cases.

Diabetic macular edema (DME) is the leading cause of vision loss among patients with diabetes. This monograph presents a variety of challenging real-world DME cases. The benefits of glycemic control on the preservation of vision will be highlighted. Precautions regarding antidiabetes medications that may exacerbate DME are also discussed. Evidence-based guidelines are utilized to develop effective DME treatment strategies that include laser, VEGF inhibition, intravitreal steroid delivery devices, and vitreoretinal surgery.

Ocular surface disease (OSD) is a well-established comorbid condition in patients with ocular hypertension and glaucoma. Like glaucoma, its incidence increases with age. Long-term IOP reduction with topical antiglaucoma pharmacotherapy is a serious challenge in this affected population - whether due to OSD or the medication. Faculty will engage learners in an evidence-based interactive expert panel discussion that will analyze the scope of the problem, identify modifiable risk factors which impede adherence to chronic antiglaucoma medication, and generate practical solutions that will succeed in a real-world ophthalmology practice setting.

Postoperative inflammation can lead to serious adverse outcomes. A thorough understanding of the pathophysiology of inflammation is essential in order to develop effective therapeutic strategies that will prevent the long-term ocular sequelae. Clinicians should be aware of the overall efficacy and safety of available topical anti-inflammatory agents as well as differences in drug potency and drug delivery mechanisms. A panel of expert eye surgeons discusses loteprednol etabonate ointment, a recently FDA-approved topical ophthalmic corticosteroid. Specific topics include the use of ophthalmic corticosteroids, comparative pharmacology, drug indications, as well as the collective clinical experience of the panelists.

Ocular herpes (HSV) is one of the leading causes of blindness from corneal disease worldwide. An estimated 50,000 cases arise in the United States each year, and the disease continues to be challenging to diagnose and treat. Another ocular surface infection, adenoviral disease, causes a severe keratoconjunctivitis that , like HSV, can cause vision loss. In this issue, expert clinicians address treatment paradigms for these ocular surface diseases.

In prior decades, good ophthalmologists followed patients with glaucoma according to IOPs alone. A risk factors approach—integrated with clinical analysis—permits a much more accurate determination of a patient’s chances for developing glaucoma. This issue is devoted to risk factors.

Patients’ initial impressions of their physicians lay the foundation for subsequent physician–patient interactions and influence patients’ confidence in their physicians. In all medical disciplines, patients are typically seeking a physician who, in addition to having the appropriate medical expertise, demonstrates professionalism and clinical competence.

Glaucoma is a major public health concern. More than 2 million U.S. adults are currently affected, and that number is expected to increase by 50% or more by the year 2020. Nearly half are unaware of their glaucoma and do not receive treatment. Each year, there are more than 7 million office visits related to screening, evaluation, and management of glaucoma. Glaucoma is a significant component of most comprehensive ophthalmology practices. Since patients experience no symptoms in the early stages, it is incumbent upon ophthalmologists to screen patients for undetected intraocular pressure elevation and features of glaucomatous optic neuropathy. This series highlights current practices and new developments in glaucoma diagnosis and management.

Leading clinicians with experience in the discovery and marketing of new medications discuss the differences between branded and generic medications, both in terms of their development and clinical efficacy and the implications this can have in practice, and address strategies on how to discuss these differences with patients to ensure the best outcomes. In addition, the legal, ethical and medical issues surrounding the off-label use of medications will be addressed.