VEW 2024: What the future holds for retina

Managing retinal conditions has come a long way in the past 10 or 15 years. To help keep up to date on current treatments and comanagement tips, Jeffry Gerson, OD, FAAO, gave talks on all things retina, entitled "Ask the Experts – When You Are Managing the Retina," given alongside Steven Ferrucci, OD, FAAO, and "Retina Update 2024 and Beyond," at this year's Vision Expo West conference.

Video transcript

Editor's note: This transcript has been lightly edited for clarity.

Jordana Joy:

Hi everyone. I'm here today with Jeffry Gerson of Grin Eye Care in Kansas. He is here to chat about retinal updates he gave in part of two presentations at this year's Vision Expo West in Las Vegas, Nevada. So welcome. It's a pleasure to have you today.

Jeffry Gerson, OD, FAAO:

Thanks. Pleasure to be here.

Joy:

Awesome, great. So first, could you give us an overview of your presentations?

Gerson:

Yeah, so right now we're talking about 2 different talks that I did, one, "Retina [Update] 2024 and Beyond," and the other one was an Ask the Experts kind of course that I did with my good friend and colleague, Steve Ferrucci. Both of them were kind of fast-paced courses. Retina 2024 and Beyond was talking about what's new in retina today and what might be coming over the next few years, so exciting stuff to look forward to. And then the course I did with Dr Ferrucci was very case-based, where we would pick a condition, share a case, and then talk about how we would manage it. We did it really back and forth, because there's certainly things that we both agree on, and then certainly things that we would do a little bit differently. [It] really opened it up to a more conversational course, rather than just one person talking the entire time.

Joy:

Absolutely. Could you give us a little bit of an overview or an inside scoop of what those cases were and maybe some of the more common ones or some of the less common ones that you had spoken on?

Gerson:

Yeah, really, we tried to pick things that are a little bit more common to make it really practical for the attendees. So we spent some time talking about diabetes from the perspective of: how do you grade diabetic retinopathy? When do you refer patients? If you refer patients, do you expect them to get treated? We did kind of the same thing with macular degeneration. As far as: when do you start having a patient take supplements and macular degeneration? When and if to refer patients with geographic atrophy, and the same thing for wet macular degeneration. We talked about central serous, again, kind of the same basic questions, because there's certainly some room for interpretation. And then we talked about something as common as vitreous detachments, and when do those patients get seen in your office? When do you see them back? What do you tell them? And just kind of going over our clinical protocols for all these different conditions. And there's some other ones that were maybe not quite as common, but we really spent a little bit more time focusing on the things that really are more likely to be walking into your office tomorrow or the next day.

Joy:

Absolutely, yeah. So what would you say are some of the golden rules for management of retinal conditions or diseases?

Gerson:

Yeah, I think probably the most important thing is to know what you know. And what I mean by that is, when you feel comfortable following something and you know the standard of care and guideline, then that's cool. That's okay. But if there's something that either you don't know or you're not comfortable with – and Steve and I talked about this – that sometimes you may not be sure, then when in doubt, refer to a retina specialist. And I think that's the ultimate golden rule, is that if you're not sure, then refer on to somebody else that might be able to take better care of that patient.

Joy:

So speaking of referrals, what role does comanagement or collaborating with other medical professionals play in that management of retinal conditions?

Gerson:

You know, it's a really big deal for a number of reasons. Number one, I think most of us think of when we send a patient to retina specialist, they're going to start getting injections and we may or may not ever see them back, because they're getting injections every month or 2. And the reality is, with some of the newer medications, more and more of our patients are going to be getting less frequent injections, which is a good thing, but it's important to know how the retina specialist is handling patients and for our patients to know that the retina specialist doesn't really do a refraction or treat their dry eye or their glaucoma. And so there definitely needs to be some back and forth there. Another interesting point I would make is one of the things that I spoke about in the Retina 2024 and Beyond, are some of the at home digital monitoring systems, in particular for macular degeneration, one that's for dry and one that's for wet and how that, again, could potentially be lengthening out the the time between visits to the retina specialist. That may make it even more important figuring out timing when patients will be coming into our offices.

Joy:

So what do you hope, ultimately, that attendees had taken away from both of these talks?

Gerson:

Yeah, so I would say for the one that Steve and I did together, I think really the takeaway is kind of what we already mentioned is to really know what you know, and when you don't know something, find a colleague or retina specialist to refer that patient to, whether it's a condition that's really common or something that may be a little bit more far out and not as routine. For the Retina 2024 and Beyond, I think really the takeaway there is that if we look back 10 or 15 years, our geographic atrophy patients had no hope. Our wet AMD or diabetic retinopathy or macular edema patients were getting injections every month. The monitoring from home or when do we see them back was kind of, "Well, we think this is what we need." And all those things have changed, that we have treatments for GA. Patients can go, oftentimes, 2, 3, 4 months in between injections. We have home monitoring technologies for both wet and dry AMD. And there's things on the horizon, whether it's genetic based treatments or newer, different drug classes. I just think it's a message of of hope, really, that things are pretty good now, but they're still going to get even better.

Joy:

Absolutely and we're looking forward to that, for sure.

Gerson:

Yeah, for sure.

Joy:

Was there anything else that you wanted to add that we haven't touched on yet?

Gerson:

No, I don't think so. You know, I guess the only thing I would touch on is, it's always impressive to me when when I'm at Vision Expo West, and we have so many people in the rooms for our talk, being in Vegas and having so many different opportunities for what you could be doing, I'm always impressed at how many people choose to come and learn and have discussions with us. So it always makes it fun and special to be able to talk at Vision Expo West.

Joy:

Yeah, absolutely. Well, thank you very much for taking the time today. Dr Gerson, we definitely appreciate it.

Gerson:

My pleasure. Thank you.