Laird Harrison

September 11, 2015

NICE, France — Organizers expect to hear guidance on which treatments work best in age-related macular degeneration, diabetic macular edema, and retinal vascular occlusion here at the European Society of Retina Specialists 15th EURETINA Congress.

There will also be hundreds of studies presented at what might be the biggest retina conference in the world, EURETINA President Francesco Bandello, MD, from University Vita-Salute, Scientific Institute San Raffaele, in Milan, told Medscape Medical News.

Some of the studies explore combination treatments, such as antivascular endothelial growth factor (VEGF) therapy plus dexamethasone. Others pit one treatment against another.

Researchers from the Navina trial, for example, will present data on phenotype differentiation in patients with diabetic macular edema treated with ranibizumab (Lucentis, Genentech, Inc) alone or in combination with focal laser or dexamethasone (multiple brands).

And several teams will present data on the real-world use of anti-VEGF treatments first proven effective in clinical trials.

"Patients may do well initially, but longer-term vision gradually deteriorates," said EURETINA board member Pravin Dugel, MD, from the University of Southern California, in Los Angeles. "Patients may develop macular atrophy, so there are papers and posters that look at that," he told Medscape Medical News.

Dr Dugel said he is interested in learning results from the HARBOR trial, in which macular atrophy in patients with neovascular age-related macular degeneration is treated with ranibizumab. He said he is also looking forward to discussion of the Protocol T study, which compares ranibizumab with aflibercept (Eylea, Regeneron Pharmaceuticals) and bevacizumab (Avastin, Genentech) in patients with diabetic macular edema.

Surgical Advances

Dr Dugel said he is equally intrigued by surgical trials. There is a move toward "smaller-gauge surgery, for reasons that go beyond the entrance," he explained. "It really talks to the fluidics in terms of the accuracy, a parameter that we call sphere of influence."

For example, Brazilian researchers will present data on corneal topographic changes after 20-, 23-, and 25-gauge pars plana vitrectomy.

The smaller-gauge instruments have new applications in complicated detachments, among other conditions, he pointed out.

As for imaging, one of the most interesting new technologies is angio-optical coherence tomography (OCT), said Dr Bandello. Angio-OCT can reveal images of the choroids and retina without the need for an injection of dye into the veins.

Imaging Technologies

"We are still deciding the clear role for this instrument in clinical practice," he said. "When can you avoid performing fluorescein angiography? This is something that will change clinical practice, like OCT did years ago."

Data from one such study — Sequential Morphological Changes in the CNV Net After Intravitreal Anti-VEGF Evaluated With OCT Angiography — will be presented by a team of Portuguese researchers.

The Congress will attract around 5000 attendees, Dr Bandello reported. In an effort to build international relationships, the meeting will feature World Retina Day, which will be celebrated with the presentation of scientific contributions from 20 retina societies from around the world. "It's not just people from the EU coming in, it's people from all over," said Dr Dugel.

In fact, registration numbers so far suggest that this will be the largest retina meeting ever. "The number of presentations is higher," said Dr Bandello. "And the number of courses is higher. Everything seems larger than before."

Many of the world's top researchers are expected to attend. The program includes two featured lectures: Alain Gaudric, MD, from Paris-Créteil University, will address the broad range of cystoid maculopathies; and Bill Aylward, MD, from Moorfields Eye Hospital in London, United Kingdom, will discuss a logical approach to retinal detachment.

And when delegates have had their fill of science, the French Riviera, with its sandy beaches and azure waters, is just a short drive from the convention center.

Dr Bandello reports financial relationships with Alcon, Allergan, Almira Science, Bayer, Bausch + Lomb, Farmila Thea, Genentech, Hofmann Laroche, Novagali Pharma, Novartis, sanofi aventis, and Thrombogenics. Dr Dugel reports financial relationships with many ophthalmologic product companies and stock ownership in Alimera, Macusight, Ophthotech, and Digisight.

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