Day 2 :
Keynote Forum
Albert S Khouri
Rutgers New Jersey Medical School, USA
Keynote: Evidence-based decisions and real life applications
Time : 08:30-09:00
Biography:
Albert S Khouri, MD, is a Faculty, Program Director of the Ophthalmology Residency, and Associate Director of the Glaucoma Division at Rutgers University- New Jersey Medical School in Newark, New Jersey. Besides maintaining a clinical practice, he has several research interests, mainly related to telemedicinernin glaucoma. Being a part of the telemedicine research team examined the direct translation of such applications such as Non-mydriatic imaging combined withrndigital filters and tele-presence has brought revolution in the field of ophthalmology. He has received the American Glaucoma Society’s MAPS Award, which was instrumental in his telemedicine research.
Abstract:
Glaucoma is a group of blinding diseases characterized by optic neuropathy and visual field damage. The diagnosis ofrnglaucoma remains elusive due to its slow and chronic nature. Both structure and function testing are needed in manyrnpatients to confirm the diagnosis. Over the past two decades we have learned many lessons from clinical trials includingrnthe identification of new risk factors and guidelines to treatment. Lessons from clinical trials apply directly to the real lifernmanagement of glaucoma. However, despite the advances in our knowledge base challenges and obstacles remain in saving vision in glaucoma patients before permanent damage occurs.
Keynote Forum
Arpitha Parthasarathy
US Medical Innovations, USA
Keynote: Advances in Retinoblastoma
Time : 09:00-09:30
Biography:
Arpitha Parthasarathy completed her PhD in Biomedical Sciences from Aravind Eye Hospitals, India and Postdoc from National Institutes of health, Maryland. She\\r\\nhad her short Postdoctoral stints at GWU and University. She has published in many peer reviewed ophthalmic journals and is now the “Director of Translational and\\r\\nMolecular Biology Research” at Plasma Medicine Life Sciences and heads the Translational and Molecular Biology Division of Jerome Canady Research Institute\\r\\nfor advanced Biological and Technical Sciences, USA.
Abstract:
Retinoblastoma (RB1) is a progressive cancer which mainly occurs in children, which is caused by genetic or epigenetic\\r\\nalterations that lead to inactivation of both alleles of the RB1 gene. Retinoblastoma accounts for 11% of cancer in the\\r\\nfirst year of life. Recent studies have suggested the use of intravitreal therapy using VEGF as a photodynamic therapy,\\r\\nhowever, chemoprophylaxis for tumor treatment regimen still seems to be the best accepted approach for tumor bearing\\r\\nretinoblastoma. Recent studies have suggested that mRNA-365 targets cyclin dependent kinase 6/4 induces tumor progression\\r\\nand yet chemotherapeutic intervention has been the only available method as therapy. We report for the first time in the field\\r\\nof ocular tumors, that the cold atmospheric plasma induces an altered energy metabolism via redox potential and induces\\r\\nspecific receptors like TRAIL-R1 to be elevated causing cell death of retinoblastoma cells in vitro. The elevated expression\\r\\nof TNF-associated receptor TRAIL-R1 induces DNA nick and apoptosis possibly via p53 and Nf-kb pathway. The specificity\\r\\nand selectivity of tumor cell death/apoptosis with the use of cold atmospheric plasma suggests that a combination of cold atmospheric plasma along with reduced doses of chemotherapeutic drug will highlight the significance in the treatments of ocular tumors.
- Workshop on Telemedicine in Ophthalmology
Session Introduction
Albert Khouri
Rutgers New Jersey Medical School, USA
Title: Ophthalmic telemedicine and glaucoma management
Biography:
Albert S Khouri an Faculty at Rutgers New Jersey Medical School and Program Director of the only academic training residency program in Ophthalmology in New Jersey. Current research interest includes innovative trials for diagnosis, treatment of glaucoma and telemedicine. Mentors residents and medical students in clinical research Glaucoma, cataract and ocular trauma instruction and surgical education. Albert S Khouri is dedicated to the practice of Ophthalmology and the treatment of adult and childhood glaucoma’s.
Abstract:
Ophthalmic telemedicine enhances screening for blinding diseases and brings subspecialty expertise to the community. Screening for glaucoma poses distinct diagnostic challenges. About half of glaucoma patients are unaware of their disease. Screening with IOP measurement, functional and structural testing has limitations. The presentation will discuss challenges to glaucoma diagnosis and potential solutions to glaucoma screening. Stereoscopic optic nerve imagingand hardware/software solutions can be applied during telemedicine in community outreach programs. Software-assisted optic nerve analysis, applications of digital filters in imaging (RGB separation, depth analysis), and real-time teleglaucoma screening are constantly evolving fields that have significant potential applications both in telemedicine and in direct clinical care of glaucoma patients.
- Track 7: Ocular Microbiology, Pathology and Immunology
Track 8: Protective Eye Care and New Advancements
Track 9: Research Trends in Surgical and Medical Ophthalmology
Session Introduction
Valerie Sloane Jones
RayBiotech, Inc., USA
Title: The application of protein array technology to investigations of ocular disease
Biography:
Ruo-Pan Huang is a founder and CEO of RayBiotech, Inc. and adjunct Associate Professor of Emory University. As a pioneer in the development of protein array technology, he and his team have developed many innovative protein array technologies and products which now are widely used worldwide by many investigators. He has published about 100 scientific research papers. He also serves on the editorial board of several journals such as Cancer Genomics and Proteomics, journal of analytical oncology and open journal of proteomics and on several other committees, including an NIH study section and Chinese National Natural Science Fund. His research has been funded by NIH, ACS, Emory University and others. During his tenure, he has received several awards, including the American Cancer Society Young Investigator Award.http://eye.conferenceseries.com/
Abstract:
Eye-derived fluids including tears, aqueous humor and vitreous humor often contain molecular signatures of ocular disease states in particular cytokines, chemokines, growth factors, proteases and soluble receptors. However, the small quantities (<10 µl) of these fluids severely limit the detection of these proteins by traditional ELISA or western blot. To maximize the amount of information generated from the analysis of these low-volume specimens, we have developed several innovative protein array technologies to profile multiple protein expression levels in a semi-quantitative or quantitative manner. Such technologies have been employed in the study of many complex ocular diseases including diabetic retinopathy, glaucoma, age-related macular degeneration and keratoconus. Our system has demonstrated great promise in advancing our understanding of the molecular mechanisms of these diseases and in the development of clinically useful biomarkers or drug targets.
Biography:
Shunbin Xu received his MD in 1991 at Peing Union Medical College, Beijing, China, and his PhD in Human Genetics and Molecular Biology, Johns Hopkins University, in 2000. He is one of the pioneers in the field of miRNAs in retina and retinal diseases and made significant contribution to the current understanding on miRNAs in retina and retinal diseases.
Abstract:
Purpose: The purpose of our study is to identify miRNAs involved in diabetic retinopathy (DR) and test the potential of candidate miRNAs as therapeutic targets for the treatment of DR. Methods: miRNA expression profiling was performed in retinal endothelial cells (RECs) and retina of streptozotocin (STZ) diabetic rats, as well as in the retina of diabetic patients and normal control subjects. In vitro overexpression and knockdown experiments were conducted in human RECs. Lentivirus expressing pre-miR-146 and miR-146 inhibitor were produced and injected intravitreally and intravenously into STZ-induced diabetic rats to evaluate the potential of miR-146 as a therapeutic target for treatment of DR. Results: 1) We identified a series of miRNA signatures reflecting ongoing pathological changes in RECs and the retina in diabetic rats. These signatures include a) NF-kB responsive miRNAs; b) VEGF responsive miRNAs, and c) apoptosis and cell senescence related miRNAs. Some of these signature miRNAs showed similar changes in the retina of diabetic patients; 2) We demonstrated that miR-146 has negative feedback regulations on both IL-1R/TLR-mediated and G-protein-coupled receptor mediated NF-kB activation pathways by targeting key adaptor molecules in these pathways in RECs; 3) In vivo delivery of miR-146 in the eyes of diabetic rats by lentiviral infection resulted in protection against development of DR. Conclusions: miRNAs are involved in multiple pathological pathways of DR. miRNAs are novel therapeutic targets for the treatment of DR and other diabetic complications.
Patsy Nishina
The Jackson Laboratory, USA
Title: Chemical mutagenesis: Generation of novel mutants and elucidation of functional pathways in the eye
Biography:
Patsy M Nishina, Professor, is currently at The Jackson Laboratory. Her laboratory is actively involved in generating or identifying mouse models that carry mutations, which lead to retinal diseases. In the later case, models are acquired through screening either standard mouse strains for spontaneous mutations or ENU mutagenized mice. Classical genetic as well as molecular, biochemical, imaging, and immunological approaches are used to identify molecules and pathways that are important in retinal development, maintenance and function within these models. She is particularly interested in understanding how disruption of molecules and pathways affect RPE and Mueller glia cell development, function and maintenance.
Abstract:
Abstract With the exception of trauma and infectious disease, the majority of the reported eye diseases are genetic in nature. While some of these diseases have associated animal models, many do not. Through a chemical mutagenesis program, Translational Vision Research Models, we have identified 89 ocular models with defects ranging from cataracts to photoreceptor degeneration. The molecular basis has been elucidated in 54 mutants. Of these, 25 were remutations with some similarities to previously published alleles, 13 were remutations with at least one significant difference to previously reported models, 5 were caused by mutations in genes found in human patients but for which no mouse model had been described, and 12 were caused by mutations in novel genes that were previously not implicated in eye disease. The disrupted genes encode for proteins involved in retinal developmental, in cellular structure or adhesion, in cellular trafficking, in metabolism, in the visual cycle, in synaptic signaling, and in post-translational processing of retinal proteins. Chemical mutagenesis can be, not only, used to generate new disease models but can also be used in sensitized mutagenesis-driven modifier screens. In mice, this can be a powerful approach to reveal molecules/pathways that disrupted in the disease state, and as a consequence this approachcan potentially identify new treatment targets. A large number of disease-modified strains have been identified in a sensitized screen of B6/B6N-crb1rd8/crb1rd8 mice. Enhanced retinal lesions, neovascularization, and pigmentation phenotypes have been documented in the strains established from the sensitized screens.
Hongrui Jiang
University of Wisconsin - Madison, USA
Title: An accommodative contact lens for presbyopic correction
Biography:
Hongrui Jiang received his Ph.D. in electrical engineering from Cornell Universityin 2001. He was a Postdoctoral Researcher at the University of California-Berkeley, Berkeley, from 2001 to 2002. He is currently the Lynn H. Matthias Professor in Engineering and the Vilas Distinguished Achievement Professor at the University of Wisconsin – Madison. His research interests are in optical MEMS, bioMEMS, smart materials and micro-/nanostructures, lab on a chip, and biomimetics and bioinspiration. He received numerous awards, including the US National Institute of Health Director’s New Innovator Award in 2011. He has more than 150 peer reviewed publications and seven issued patents.
Abstract:
Presbyopia is the most common ocular affliction and presents an extraordinary public health issue. IN this talk I will discuss about a new strategy to correct presbyopia by developing a new type of contact lens called an accommodative contact lens (ACL) that incorporates a tunable liquid lens for accommodation and devices to convert light energy to electricity and store it in situ for the operation. I first demonstrate two types of flexible, variable-focus liquid microlenses: one driven by electrowetting and the other by dielectrophoretic force. Both types of liquid microlenses are fabricated onto soft polymers for ultimate integration and embedment into contact lenses. A tuning range of more than 10 mm in focal length and fast, sub-second tuning speed have been achieved for both types of lenses. I then discuss about light energy harvesting and storage devices that can potentially be integrated into contact lenses, including dye-sensitized solar cells (DSSCs) and micro-supercapacitors. We are especially interested in simultaneously achieving energy harvesting and storage within the same single device structure, so that it can provide steady photocurrent output under sunlight illumination, while part of the photo-generated electrical energy is stored. Lastly, I present a fabrication platform to integrate the accommodative liquid lens, control electronics, and energy harvesting and storage device into the soft contact lens for presbyopic correction.
Daniel Valverde
University of Guayaquil, Ecuador
Title: Transfer Factor Strengthened and its contribution to the Visual Health and integral.
Biography:
Daniel Valverde Solis, O.D. Optometrista Facultad de Ciencias Medicas Universidad de Guayaquil , Fellow en ion SuperiorPublica Interamerican University of Puerto Rico, Educacion continua en Optometria Clinica y Pediatrica, The New England College of Optometry Boston .USA, Diplomado en Educacion Superior, Especialista en Educacion Superior, Maestria en Gerencia en Educacion Superior Unidad de Post Grado de Investigacion y desarrollo Universidad de Guayaquil, Candidato a PHD, en Educacion Superior Atlantic International University Honolulu - USA, CEO FALECO Facultad Latinoamericana de Educacion Para el Cuidado Ocular, CEO Premium Team . www.premiumteasm4life.com, Miembro de la American Optometry Asociation. Pass Presidente ALDOO.
Abstract:
99% of diseases are directly related to the imbalance of the immune system, this surely also affects the visual and ocular system of our patients, if we have a stronger immune system then we have better prospects of overcoming the disease more quickly and more effectively, it's what we do in our daily clinical practice with very satisfactory results.
Cesar Gomezperalta
Vision Percepcion, Mexico
Title: The nobility of therapeutic and optical lamellar keratoplasty for restoring vision and eye threatening conditions
Biography:
Abstract:
Purpose: The aim of this study is to evaluate the effectiveness of combining tectonic/therapeutic and optical lamellar keratoplasty to restore eye in threatening conditions and vision. Method: This is a retrospective review of 5 patients (7 eyes) with peripheral ulcerative keratitis and progressive degenerations that threatened the eye's integrity. All eyes underwent a peripheral tectonic-therapeutic lamellar keratoplasty (LK) to restore its integrity followed 8-12 weeks later by a central optical LK to restore their vision. All surgeries were performed by a single surgeon. Results: After peripheral therapeutic LK the integrity of all eyes was accomplished. Central optical lamellar keratoplasty reduced significantly the refractive error, improved uncorrected and best corrected visual acuity as well as quality of vision. Conclusion: The combination of tectonic-therapeutic and optical lamellar keratoplasty for treating patients with peripheral corneal progressive thinning disease that threatens the eye and rehabilitating their vision is a reliable and trustable procedure. Although each case has its independent possible complications and difficulties, the combination of this procedure gives patients a high percentage grade of success for both tectonic and optical results.
Saffar Mansoor
Case Western Reserve University, USA
Title: Protecting retinal cells against cigarette smoke components
Biography:
Saffar Mansoor, Ph.D. completed his postdoctoral training in the Department of Ophthalmology, University of California Irvine. He is now a Research Associate in the School of Medicine, Case Western Reserve University. He has been working in the area of eye research for several years, and has been serving as a reviewer in well-respected journals and as an international editor of the medical journal MED PHOENIX.
Abstract:
Age-related macular degeneration (AMD), a macular neurodegenerative disease, is the leading cause of permanent vision loss in theelderly populationworldwide. The prevalence of this disease is expected to increase in the coming years as people live longer. Cigarette smoking is one of the strongest factors associated with developing the most severe form of AMD. Cigarette smoke components (CSC), such as acrolein, nicotine, benzo(e)pyrene, hydroquinone, catechol, chrysene and 2-ethylpyridine, are hazardous to human health including the eye. Several recent research studies have shown the damaging effects of CSC on retinal pigment epithelial cells, retinal neurosensory cells, microvascular endothelial cells and MUller cells involve many complex molecular pathways. The mechanisms of CSC-induced toxicity on these cells include oxidative stress, mitochondrial dysfunction, and apoptosis. However, genistein, resveratrol, memantine, epicatechin, and alpha-lipoic acid have shown potential to reverse the toxic effects of CSC on these retinal cells. Therefore, their administration may improve or delay development of AMD.
Chand Singh
Post Graduate Institute of Medical Sciences, India
Title: To study the role of OCT and P-VEP in early diagnosis of Glaucoma
Biography:
Chand Singh Dhull is a Senior Professor & Head of Department of Ophthalmology in Post Graduate Institute of Medical Sciences, India.
Abstract:
Background: Standard investigative techniques for diagnosis of glaucoma include intraocular pressure measurement, Optic disc evaluation and visual field testing by standard perimetry. However, field defects become evident only after 40% RNFL loss has already occurred. Early diagnosis is important so as to prevent irreversible blindness. Early detection of glaucoma has focused on evaluation of the RNFL and the ONH by techniques like OCT, HRT and GDx as these undergo early structural changes. Glaucoma produces latency and amplitude changes on P-VEP. This study was undertaken to evaluate the role of OCT and P-VEP in detection of glaucoma in glaucoma suspects. Methods: This study included 90 eyes of 45 patients divided into three groups. Group A involved 15 patients of POAG, group B involved 15 glaucoma suspects and group C included 15 healthy volunteers. After obtaining history, intraocular pressure measurement and visual field testing, patients were subjected to ONH and RNFL assessment by OCT and P-VEP was performed and amplitude and latency were noted. Results: RNFL thickness (overall and quadrant wise) was significantly low in glaucoma suspects (98.81±9.54μ) as compared to normal patients (105.29±10.18μ). P100 latency and N95-P100 amplitude in glaucoma suspects was insignificant when compared to normal patients. A correlation between latency and RNFL thickness was found in glaucoma suspects (r= -0.370, p<0.05). Conclusions: RNFL thinning appears earlier on OCT than abnormalities on P-VEP in patients with glaucoma and glaucoma suspects. Nevertheless, p-vep is a valuable tool that can be used as an adjunct to other investigations.
Nezar Damati
Certified International Professional Trainer, Jordan
Title: Using scleral contact lenses for keratoconus management
Biography:
Nezar Damati completed MBA degree obtained from Middle East University, Amman, Jordan, doctor of Optometry - B.S Optometry De Ocampo Memorial College, Manila – Philippines. Professional academic educator and highly motivated optometrist, CL practitioner and consultant in fitting for the most prestigious clinics and optical chains, extensive experience in ECP, an exposure in CL education, training trainers program and training programs on leadership in CL fitting.
Abstract:
Learning Objectives: Upon completion of this program, the participant should be able to: Understand the new generation of large RGP design lenses; learn more about fitting techniques for scleral lenses and understand the indication and patient candidate of scleral lenses Course Description: Keratoconus, often referred to as “KC,” is a slowly progressive, non-inflammatory eye disease that causes the cornea to thin and assumes an irregular conical shape appearance. The cornea refracts the majority of light that enters the eye so abnormalities or injuries to the cornea can significantly affect patient vision and impair the ability to perform simple tasks and duties like driving (especially night driving), daily activities, watching TV, or reading a book. This course describes keratoconus and treatment with RGP scleral contact lenses. Conclusion: Fitting the keratoconus patient is challenging. Scleral lenses represent one of the most important tools available to fitters today. Their use should continue to increase because they offer excellent vision, good initial comfort, and they eliminate centrationrelated problems that can occur with smaller diameter lenses.
Alexia Romanelli
Instituto Nacional de Oftalmologia, Bolivia
Title: Modified tecnique of Inferior oblique anterior transposition in DVD treatment reduces the Antielevation syndrome
Biography:
Alexia Romanelli has completed Ophthalmology in 1998 from Instituto Nacional de Oftalmología ,UniversidadMayor de San Andrés in La Paz, Bolivia, with and Observership at Primary Children’s Hospital and Moran Eye Center Salt Lake City, Utah; PhD in Ophthalmology at Universidad de Salta, Argentina. Strabismus Fellowship at Asociacion Para Evitar la Ceguera en Mexico, DF and Pediatric Ophthalmology at Hospital J Garrahan Buenos Aires Argentina. She is a member of several Latin- American Ophthalmologu Societies, Councils and WCPOS. She has published as author and coauthor in reputed journals, book chapters, and National Ophthalmology Guidelines in her country. Head of the Pediatric Ophthalmology and Strabismus Department at Instituto Nacional de Oftalmologia for 7 years. She is now serving as the National Representative for Prevention of Blindness in ROP.
Abstract:
Many authors had described the Antielevation Syndrome following an Anterior Transposition of the Inferior Oblique muscle for Dissociated Vertical Deviation treatment as an undesirablecomplication that resembles a pseudo hyper function of the inferior oblique, associated with anantiaesthetic outcomein lateroversions. The classical technique consists in placing the inferior oblique temporarily, up, down or right beside the inferior rectus muscle insertion. The incidence of Antielevation Syndrome occurs in approximately 20% of the patients. Purpose: To present a modification to the classical Anterior Transposition of the Inferior Oblique technique, which significantly lowers the incidence of the Antielevation Syndrome. Methods: All patients included had DVD associated with moderate to severe inferior oblique over action, which could coexist with horizontal deviations. The surgical technique modification consisted in reattaching the inferior oblique right beneath the inferior rectus insertion. Patients who did not reachfor at least 12 months of follow up were excluded. A video of this new technique is showed. Results: Since 2006, a total of 101 patients underwent symmetrical modified anterior transposition of the inferior oblique. Horizontal deviations, if present, were corrected within the same procedure. Of these, only 3 (3%) showed Antielevation syndrome. Eighty five (85%) patients showed a satisfactory corrected DVD. The Follow up average was 18 months. Conclusions: The modified Anterior Transposition of the inferior oblique, immediately repositioned beneath the inferior rectus insertion, considerably diminish the appearance of an Antielevation Syndrome.