2019 Honorary Lectures
The honorary lecturers preview their presentations.
FRIDAY, OCT. 11
RETINA
Charles L. Schepens, MD, Lecture: Retinal Gene Therapy: From Theory to Practice, presented by Jean Bennett, MD, PhD, and Albert M, Maguire, MD.
When: Friday, 9:30-10:30 a.m., during Retina Subspecialty Day 2019.
Where: West 3002.
“It was not long ago that patients with inherited retinal degeneration (IRD) were told that nothing could be done to treat their disease," said Dr. Maguire. "With the great progress in identifying the genetic bases of IRDs and the development of gene transfer techniques, it became possible to evaluate gene-based treatments, first in animals with IRDs and then in humans. The durable reversal of the visual deficits revealed in gene therapy clinical trials for RPE65 mutations led to the first FDA-approved gene therapy drug for a genetic disease in the United States and in Europe. This drug—the first approved treatment for an IRD—establishes the path for development of other gene-based treatments for retinal disease.”
Presented during Retina Subspecialty Day 2019: I²—Inspire Innovation (Friday, 8:00 a.m.-5:28 p.m., and Saturday, 8:00 a.m.-5:30 p.m.), which is organized in conjunction with the American Society of Retina Specialists, the Macula Society, the Retina Society, and Club Jules Gonin.
REFRACTIVE SURGERY
Troutman Award: The Impact of Photorefractive Keratectomy and Mitomycin C on Corneal Nerves and Their Regeneration, presented by Carla Santos Medeiros, MD.
When: Friday, 2:42-2:57 p.m., during Refractive Surgery Subspecialty Day 2019.
Where: Esplanade Ballroom.
“Abnormal nerve regeneration often follows corneal injury, predisposing patients to pain, dry eye, and vision loss," said Dr. Santos Medeiros. "However, the mechanism is not yet completely understood. In order to determine how refractive surgery affects corneal nerves and their regeneration, we used photorefractive keratectomy as a model for nerve injury. By means of a three-dimensional analysis, we investigated the changes in corneal nerve tissue, layer by layer, to determine the mechanisms of neural damage and recovery as well as the effects of mitomycin C on this process. Based on these new histological findings, this lecture aims to provide insight into the neural remodeling after corneal refractive surgery.”
Presented during Refractive Surgery Subspecialty Day 2019: As Far as the Eye Can See (Friday, 7:00 a.m.-5:19 p.m.), which is the annual meeting of the International Society of Refractive Surgery.
SATURDAY, OCT. 12
GLAUCOMA
The American Glaucoma Society Subspecialty Day Lecture: A Lymphatic-like Pump Controls Aqueous Outflow: POAG Management & MIGS Implications, presented by Murray A. Johnstone, MD.
When: Saturday, 11:48 a.m.-12:18 p.m., during Glaucoma Subspecialty Day 2019.
Where: Esplanade Ballroom.
“Minimally invasive glaucoma surgery (MIGS) is changing the management of glaucoma with reduced morbidity and earlier intervention," said Dr. Johnstone. "In clinical glaucoma management, the questions of why, whether, when, what, and where to intervene with MIGS are not settled. The trabecular meshwork (TM) is in constant dynamic motion and requires motion to control intraocular pressure. TM motion slows and eventually stops in glaucoma. Novel noninvasive phase-based OCT (PhS-OCT) sheds new light on glaucoma mechanisms and management options by identifying reduced TM movement in glaucoma patients. This lecture will focus on answers to the MIGS questions posed above, based on knowledge of TM motion and the new ability to measure it with OCT.”
Presented during Glaucoma Subspecialty Day 2019: Crossing the Golden Gate to Exceptional Glaucoma Care (Saturday, 7:00 a.m.-5:11 p.m.), which is organized in conjunction with the American Glaucoma Society.
SUNDAY, OCT. 13
RETINA
Jackson Memorial Lecture: Age- Related Macular Degeneration: Nutrition, Genes, and Deep Learning, presented by Emily Y. Chew, MD.
When: Sunday, 8:30-10:00 a.m., during Sym67, Opening Session and Annual Business Meeting.
Where: West 3002.
“Age-related macular degeneration (AMD), a leading cause of blindness in the United States, still lacks effective therapy, especially for those with geographic atrophy (GA)," said Dr. Chew. "Lifestyle modifications such as high adherence to a Mediterranean diet (driven mostly by increased fish intake) are associated with decreased risk of AMD, especially for GA. The data are compelling for all stages of AMD. Genetic modifications and interactions are also being evaluated. In this era of big data, we have developed deep learning algorithms that may play an important role in both diagnosing and predicting progression of disease. The future implementation of such technology may indeed change how we manage our patients with AMD.”
Presented during the Opening Session and Annual Business Meeting (8:30-10:00 a.m.).
PEDIATRIC OPHTHALMOLOGY
Marshall M. Parks Lecture: How Artificial Intelligence Will Affect the Future of ROP Care, presented by Michael F. Chiang, MD.
When: Sunday, 11:35-11:55 a.m., during Sym15, How to Use the Latest Imaging and Diagnostic Technology in the Pediatric Patient.
Where: West 3020.
“Retinopathy of prematurity (ROP) is a leading cause of childhood blindness throughout the world, and the societal burden of infancy-acquired blindness is enormous," said Dr. Chiang. "Furthermore, clinical ROP diagnosis is often highly subjective and qualitative. Artificial intelligence (AI) is an emerging technology that has potential to improve the quality of ROP care through improved diagnostic accuracy and consistency. This talk will discuss basic principles of AI and how recent research is being applied to ROP care. More broadly, it will cover the implications of AI’s potential to significantly change the practice of ophthalmology.”
Presented during How to Use the Latest Imaging and Diagnostic Technology in the Pediatric Patient (10:30 a.m.- 12:00 p.m.), which is cosponsored by the American Association of Pediatric Ophthalmology and Strabismus.
OPHTHALMOLOGY AND THE ARTS
Michael F. Marmor, MD, Lecture: Blind Organists and the King of Instruments, presented by Bruce Lamott, PhD.
When: Sunday, 12:50-1:10 p.m., during Sym19, Michael F. Marmor Lecture in Ophthalmology and the Arts.
Where: West 2002.
“For centuries, vision-impaired musicians have turned to the organ, once acclaimed by Mozart as ‘the king of instruments,’ as their instrument of choice," said Mr. Lamott. "In the history of classical music, blind organists far outnumber other blind instrumentalists despite facing the unique physical and spatial challenges of multiple keyboards played by both the hands and feet, an array of dozens of stop knobs labeled in a variety of languages, and lack of standardization from instrument to instrument. Using examples from the 14th to 19th centuries, this presentation will be illustrated with the music they wrote, the instruments they played, and circumstances that may have led them to choose the most complex instrument of their time.”
Presented during the Michael F. Marmor Lecture in Ophthalmology and the Arts symposium (12:45-1:45 p.m.).
RETINA
Arnall Patz Lecture: The Evolving Pathophysiology and Treatment of Retinopathy of Prematurity, presented by Mary Elizabeth Hartnett, MD, FACS.
When: Sunday, 12:55-1:30 p.m., during Sym65, Arnall Patz Lecture.
Where: West 3020.
“In the 1950s, Arnall Patz, MD, identified high oxygen at birth as a cause of retinopathy of prematurity (ROP)," said Dr. Hartnett. "Despite technical advances, ROP remains a major cause of childhood blindness worldwide. Today, it is recognized that high vascular endothelial growth factor (VEGF) leads to several features of ROP; however, inhibition of VEGF can lead to unwanted outcomes in some infants. The Arnall Patz Lecture presents the current understanding of the pathophysiology of ROP, its risk factors, and challenges in treating preterm infants, as well as data from clinical trials and concerns that encourage the development of future treatments.”
Presented during Arnall Patz Lecture (12:45-1:45 p.m.), which is cosponsored by the Macula Society.
CORNEA
Castroviejo Lecture: Acanthamoeba Keratitis: Getting the Treatment Right, presented by John K.G. Dart, MD.
When: Sunday, 3:38-3:58 p.m., during Sym25, Picture This: Imaging for the Anterior Segment Specialist.
Where: West 2020.
“Acanthamoeba keratitis (AK) is a devastating cause of keratitis that affects predominantly young contact lens users," said Dr. Dart. "Twenty-five percent of those with AK suffer severe sight loss during a disease course that lasts more than nine months. Treatment is complicated by delayed diagnosis, lack of a licensed topical antiamoebic drug, difficulty differentiating between inflammation due to viable organisms or the immune response, scleritis, rapidly maturing cataract, glaucoma, and extracorneal spread. The lecture will focus on the evidence-based management of AK and its complications, and it will show how these management pathways are integrated into a comprehensive protocol developed for a current randomized controlled European trial.”
Presented during Picture This: Imaging for the Anterior Segment Specialist (2:00-4:00 p.m.), which is cosponsored by the Cornea Society.
CORNEA
Whitney G. Sampson Lecture: Expanding CXL From Keratoconus to Infectious Keratitis, presented by Farhad Hafezi, MD, PhD.
When: Sunday, 4:46-5:11 p.m., during Sym29, CXL for Corneal Ectasia: Real World Experience.
Where: Esplanade Ballroom.
“Corneal cross-linking (CXL), originally developed to treat ectasias such as keratoconus, involves applying riboflavin and ultraviolet light to the cornea to cross-link and biomechanically strengthen the stroma," said Dr. Hafezi. "CXL usually flattens corneas and is under investigation as a refractive procedure. Furthermore, the cross-linking biochemical reaction also reduces the microbial load in the cornea and can be used to treat infectious keratitis of bacterial, fungal, and mixed origins (a process termed PACK-CXL); and, in many cases, it accelerates time to healing. As antimicrobial resistance increases, the utility of an alternative/adjunctive treatment to antibiotics—especially in developing countries—becomes increasingly important.”
Presented during CXL for Corneal Ectasia: Real-World Experience (3:45-5:15 p.m.), which is cosponsored by the Eye and Contact Lens Association.
OCULOPLASTICS/PROSTHETICS
Ruedeman Lecture: An I for an Eye Removal: Innovation in Enucleation, presented by Jermiah P. Tao, MD.
When: Sunday, 4.59-5.15 p.m. during Sym28, Eyelid Malposition With Ocular Prosthesis in Place.
Where: West 3014.
“Surgical eye removal poses many reconstructive challenges," said Dr. Tao. "Adequate orbital volume and motility are keys to creating a realistic ocular prosthetic. A variety of implants and surgical techniques have been tried to optimize results, yet opportunities for improvement remain. This lecture will cover advancements in enucleation surgery as well as explore new frontiers such as digital microscreen technologies designed to improve eye prosthetic movement.”
Presented during Eyelid Malposition With Ocular Prosthesis in Place (3:45-5:15 p.m.), which is cosponsored by the American Society of Ocularists.
MONDAY, OCT. 14
ORGANIZED MEDICINE
Parker Heath Lecture: Precision Medicine, Health Economics and Practice Patterns, presented by Barbara McAneny, MD.
When: Monday, 8:30-10:00 a.m., during Sym30, The Evolution and Effect of Genomic Medicine, Blockchain, and Robot-Assisted Surgery on the Practice of Ophthalmology.
Where: West 3020.
“Ophthalmology is not practiced in a vacuum,” said Dr. McAneny. “This lecture will cover how the changes occurring in health care today, from precision medicine to health economics to value based care, will change the practice of ophthalmology. Health care is now a team sport, and we all must select our team carefully.”
The Evolution and Effect of Genomic Medicine, Blockchain, and Robot-Assisted Surgery on the Practice of Ophthalmology (8:30-10:00 a.m.) is cosponsored by the American Medical Association Ophthalmology Section Council.
GLAUCOMA
Robert N. Shaffer Lecture: The Future of Vision Restoration in Glaucoma, presented by Jeffrey L. Goldberg, MD, PhD.
When: Monday, 9:31-9:56 a.m., during Sym33, Focus on Quality of Life in Glaucoma: Measuring and Optimizing Functional and Patient- Centered Outcomes.
Where: Esplanade Ballroom.
“There is a significant unmet need for neuroprotection and vision restoration in glaucoma and other optic neuropathies,” said Dr. Goldberg. “In recent years, there have been considerable advances in discovery of candidate therapies that promote retinal ganglion cell survival, axon regeneration, and even cell replacement replacement. In parallel, advances in structural and functional biomarkers are entering clinical trial design as exploratory and confirmatory endpoints. This lecture will discuss these advances and present clinical data from early phase trials that are currently in progress.”
Focus on Quality of Life in Glaucoma: Measuring and Optimizing Functional and Patient-Centered Outcomes (8:30-10:00 a.m.) is cosponsored by Prevent Blindness.
OCULOPLASTICS
Wendell L. Hughes Lecture: Ocular Melanoma: Marching Forward With Imaging, Nanoparticles, and Immunorevolution, presented by Carol L. Shields, MD.
When: Monday, 11:20-11:40 a.m., during Sym38, Current Management of OID.
Where: West 3014.
“Ophthalmology is entering a fascinating new era in the management of ocular cancer,” said Dr. Shields. “Clinicians now have the ability to identify small choroidal melanomas using multimodal imaging, to treat with nanoparticles, and to re-educate the immune system to recognize and control metastatic disease. This lecture will explore autofluorescence, optical coherence tomography, and ultrasonography imaging of choroidal nevi at risk for transformation into melanoma.
“Does every incremental millimeter increase in nevus thickness really make a difference? After hearing this lecture, attendees will be convinced that a 3.1-mm thick nevus has an 11 times greater risk for transformation than a 1.1-mm thick nevus. Furthermore, the talk will explore a novel intravitreal nanoparticle therapy for small choroidal melanoma that has minimal impact on vision. Last, the presentation will investigate the role of several immunotherapies revolutionizing patient survival for those with metastatic disease.”
Current Management of OID (10:15-11:45 a.m.) is cosponsored by the American Society of Ophthalmic Plastic and Reconstructive Surgery.
CATARACT
Charles D. Kelman Lecture: Artificial Iris Implantation, presented by Kevin M. Miller, MD.
When: Monday, 11:40 a.m.-12:00 p.m., during Spo2, Spotlight on Cataract: Complicated Phaco Cases—My Top 5 Pearls.
Where: West 3002.
“Patients with large congenital and acquired iris defects experience light and glare sensitivity and reduced visual quality,” said Dr. Miller. “Nonsurgical treatments include patching, darkly tinted glasses, and artificial pupil contact lenses. Artificial iris devices have been available in many countries for decades to treat patients surgically. One such device recently became available in the United States. This lecture will review the problems associated with cosmetic anterior chamber artificial iris implantation and the indications, results, and complications associated with functional posterior chamber and capsular bag artificial iris implantation. Before and after clinical images and surgical videos will be shown. Artificial iris exchange will also be discussed.”
Spotlight on Cataract: Complicated Phaco Cases—My Top 5 Pearls (8:15 a.m.-12:15 p.m.).
UVEITIS AND IMMUNOLOGY
Stephen and Frances Foster Lecture on Uveitis and Immunology: Ebola, Emerging Infectious Diseases, and the Eye: Patient and Public Health Implications, presented by Steven Yeh, MD.
When: Monday, 12:50-1:15 p.m., during Sym42, C. Stephen and Frances Foster Lecture on Uveitis and Immunology.
Where: West 2002.
“During the past five years, two Ebola outbreaks of unprecedented magnitude have taught the world how disease in Africa could threaten the global health community,” said Dr. Yeh.“Outbreaks in West Africa and the Democratic Republic of Congo have resulted in thousands of survivors who are now susceptible to vision-threatening uveitis, driven by Ebola virus persistence in the eye. This talk will cover lessons learned related to Ebola and the Zika virus, as well as the role ophthalmologists play in facilitating better understanding of the ocular complications of these emerging infectious diseases. In addition, the talk will explore the unique challenges of learning about diseases at times when strengthening vision health systems is urgent.”
Stephen and Frances Foster Lecture on Uveitis and Immunology (12:45-1:45 p.m.).
PROFESSIONALISM AND ETHICS
Dr. Allan Jensen and Claire Jensen Lecture in Professionalism and Ethics: Ethical Aspects of Global Ophthalmic Practice, presented by Anthony J. Aldave, MD.
When: Monday, 3:20-3:50 p.m., during Sym48, Dr. Allan Jensen and Claire Jensen Lecture in Professionalism and Ethics.
Where: West 2002.
“An increasing number of ophthalmologists in training and in practice are interested in participating in global health activities and international ophthalmic care,” said Dr. Aldave. “However, with this growing interest, the ethical challenges presented to physicians and trainees who choose to work and teach internationally becomes increasingly important. This lecture will highlight many of these common ethical issues, including competence, informed consent, preoperative assessment, delegation of care, and postoperative care and patient privacy, and will present recommendations for addressing each.”
Dr. Allan Jensen and Claire Jensen Lecture in Professionalism and Ethics (3:15-4:15 p.m.).
REFRACTIVE SURGERY
Barraquer Lecture: Vector Planning Method: Residual Astigmatism Minimized—LASIK Surprises Avoided, presented by Noel A. Alpins, MD, FACS.
When: Monday, 4:52-5:12 p.m., during Sym49, Innovations in Refractive Surgery.
Where: Esplanade Ballroom.
“Vector planning for LASIK treatments incorporates corneal astigmatism with refractive cylinder in laser vision correction (LVC) treatment plans,” said Dr. Alpins. “For more than 25 years, since the inception of LVC, refraction has been the sole guiding parameter. Increasing evidence has shown that when differences greater than 1.00 D occur, as quantified by the ocular residual astigmatism, visual outcomes are more likely to be inferior.
“A smaller subset of these patients, whose corneal astigmatism parameters are disregarded, also suffer from glare arcing starburst and haloes (GASH), particularly in low illumination at night. These patients have made their dissatisfaction with this outcome known through attending public forums, by writing to the FDA and The New York Times, and on social media. GASH, which causes otherwise suitable patients to defer surgery, is both predictable and avoidable (e.g., predictable avoidable LASIK surprise, or PALS syndrome).”
Innovations in Refractive Surgery (3:45-5:15 p.m.) is cosponsored by the International Society of Refractive Surgery.
TUESDAY, OCT. 15
NEURO-OPHTHALMOLOGY
William F. Hoyt Lecture: CAR-Unexplained Visual Loss, presented by John L. Keltner, MD.
When: Tuesday, 9:32-9:57 a.m., during Sym51, Vascular Disease in Neuro- Ophthalmology.
Where: West 3014.
“While it’s rare to see a patient with cancer-associated retinopathy (CAR) syndrome, every ophthalmologist should know about this condition,” said Dr. Keltner. “Patients with CAR frequently lose vision before cancer is found. Thus, if a patient has a normal fundus accompanied by visual loss, the ophthalmologist may suspect CAR syndrome—and cancer. With CAR in mind, ophthalmologists may be able to discover the cancer before the patient dies or experiences further vison loss. This lecture will define CAR syndrome and cover how to diagnose and treat this condition.”
Vascular Disease in Neuro-Ophthalmology (8:30-10:00 a.m.) is cosponsored by the North American Neuro-Ophthalmology Society.
MICROBIOLOGY
Jones/Smolin Lecture: New Bugs, New Technologies, and New Drugs: Infectious Endophthalmitis in the 21st Century, presented by Harry W. Flynn Jr., MD.
When: Tuesday, 11:17-11:42 a.m., during Sym54, Recent Advances in the Diagnosis and Management of Endophthalmitis.
Where: West 2002.
“Infectious endophthalmitis is a rare but significant problem in clinical practice. New microbes and evolving nomenclature are recognized today,” said Dr. Flynn. “New technologies can help identify these infectious agents. New technology may allow earlier and more accurate identification of organisms. New and alternative drugs may achieve better therapeutic outcomes. Clinical cases and management strategies will be discussed.”
Recent Advances in the Diagnosis and Management of Endophthalmitis (10:15-11:45 a.m.) is cosponsored by the Ocular Microbiology and Immunology Group.
PATHOLOGY/ONCOLOGY
Zimmerman Lecture: Wonder and Doubt—The Vasculogenic Mimicry Story, presented by Robert Folberg, MD.
When: Tuesday, 11:18-11:43 a.m., during Sym55, Ocular Toxicities Associated With Targeted ACAs: A Brave New World for the Ophthalmologist.
Where: West 3014.
“What if you saw something that you hadn’t seen before? What if you discovered that no one else had seen this before? What would you do if experts doubted your observation’s validity and significance?” asked Dr. Folberg.
“What would you do if you amassed enough data to publish your observation after 15 years of research, only to be subject to scientific and personal attacks? How would you react if the editor of the journal that published your paper questioned his decision to publish your work?
“This is the story of vasculogenic mimicry, discovered first in uveal melanoma, told 20 years after the seminal publication.”
Ocular Toxicities Associated With Targeted ACAs: A Brave New World for the Ophthalmologist (10:15-11:45 a.m.) is cosponsored by the American Association of Ophthalmic Oncologists and Pathologists.
Read more news from AAO 2019 and the Subspecialty Day meetings.