Day 1 :
Volga State University of Technology, Russia
Time : 9:30-10:15
Victor V Sevastyanov is the Head of the Center for Speech Pathology and Neuro-Rehabilitation of Neurosensory and Motor Disorders and Professor of the Department of Radio-Technical and Biomedical Systems at Volga State University of Technology. He holds an MD degree from I.M. Sechenov First Moscow State Medical University and MSc degree in Radio Engineering from Ryazan State Radio Engineering University. He conducts research into the issues of the optic nerve regeneration and investigates the processes of neuro-restoration of the optic and auditory nerves. His research interests also include electro-stimulation of neuromuscular tissues with multi-channel portable electrical stimulators, prevention of oxygen deficiency and hypokinesia in astronauts during long-term space flights. He holds 10 international patents.
A novel method for treating inoperable cataracts has been proposed based on using a solution of dimephosphon whose active ingredient is dimethyloxobutylphosphonyl dimethylate. The medication has anti-oxidative and anti-inflammatory properties and stabilizes cell membrane functions. It increases blood flow and metabolism within the lens and improves protective functions of the eye. Treatment with dimephosphon was provided to 43 patients; five of them were children aged 2-3 years who received a 2% dimephosphon solution (eye drops) to treat bilateral congenital cataracts, 1 drop 4 times a day. One patient was diagnosed with Weyers-Fulling syndrome accompanied by bilateral polymorphic cataract and microphthalmos. Cataract surgery in such children is ineffective. Other children with bilateral congenital cataracts also had bilateral microphthalmos. The patients were denied surgery because of its low efficiency. Among the patients there were also elderly people (age 85 years and over) with cataracts who were treated with a 5% dimephosphon solution (eye drops), 1 drop 4 times a day. The initial change in blood flow in the vessels of limbal vascular plexus occurred 10 minutes after the drops were administered and lasted for up to 2-2.5 hours. The change in blood flow was recorded by a thermal imager. The first effects were observed 6 months after the beginning of treatment; a weak light response appeared. Parents continued giving medication to children for over 1.5-2 years. One child had reverse cataract growth, the other had partial cataracts. Similarly, vision of elderly patients improved, e.g., a 98-year-old female patient could watch television 6 months after the treatment started. The latest advancements in nanotechnology allow the use of medications that will improve quality of life for patients for whom cataract surgery is contraindicated.
Wolfson Medical Center, Israel
Keynote: A durable therapy for diabetic macular edema: All we need is to choose the right imaging approach
Time : 13:30-14:15
Avinoam Ophir completed his medical studies and Residency in Hadassah Medical Center in Israel. During his Retina fellowship in Bascom Palmer Eye Institute, he together with another young doctor, Mark Blumenkranz, introduced the antimetabolites, primarily 5-FU, to the ophthalmology world, in order to treat non-malignant proliferating cells, especially in the prevention of postoperative scarring. Due to 5-FU efficacy in trabeculectomy, Dr. Ophir moved to specialize also in glaucoma. He explained the mechanism of MMC on bleb toxicity and how to prevent it, and also introduced the "mini-trabeculectomy" approach without radial incisions. Meanwhile he and his team found that Zn-Desferal in the cat substantially inhibited reperfusion injury following CRAO. He was appointed as chairman in the department of Ophthalmology in Hadera in 1993, associated with the Technion School of Medicine. For the last 4 years he works at the retina unit in Wolfson MC.
Statement of the problem: Intravitreal anti-VEGF medications and steroids, and often laser photocoagulation, are routinely used in the major studies for treating diabetic macular edema (DME), including focal type, diffuse (DDME), epiretinal membrane (ERM) -associated and even ischemic-related. However, lucentis treatment, for example, failed in more than 50% of eyes. On the other hand, there are DDME eyes that respond well to grid laser prior to administration of any medication. And, there are many so called "non-tractional" DDME eyes, with neither vitreofoveal traction nor ERM that respond well to pars plana vitrectomy (PPV) after repeat failures of the alternative treatments. If we had known the distinctiveness of these DDME eyes, we could probably treat them rightly by either Early PPV or grid laser, avoiding intravitreal medications.
Methodology: Using full-field 3D SD-OCT (Topcon-1000) that scans point by point continuously, rather than by separate lines, and thus provides 3D data and 3600 video clips; and following search at extramacular sites, I present our published pathogeneses of DDME.
Conclusions & significance: By using full-field 3D-OCT imaging, we present the pathogeneses of diffuse DME. A proper durable treatment would be aimed towards the pathogenesis: PPV or observation in tractional DDME and laser photocoagulation in non-tractional DME, both in focal and diffuse types. The outcome of the hundreds of DME treatment studies is now clearer.