Videos

Panelists discuss how novel intravitreal agents faricimab and high-dose aflibercept 8mg offer potential advantages in treating retinal diseases through their extended durability and dual mechanism of action.

Panelists discuss how faricimab’s bispecific antibody design uniquely targets both VEGF-A and Ang-2 pathways, addressing the complementary role of Ang-2 in vascular destabilization and inflammation in retinal diseases.

Panelists discuss how careful patient selection and management of potential complications - including surgical risks, device-related adverse events, and cost-benefit considerations requiring operating room resources - are crucial factors in successfully implementing the port delivery system in clinical practice.

Panelists discuss how ideal candidates for aflibercept 8 mg include patients with stable disease on current anti-VEGF therapy who seek reduced treatment burden, newly diagnosed patients, and those demonstrating good response to initial loading doses.

Panelists discuss how the port delivery system (PDS) refill procedure, while performed in an office setting, involves a different technique of accessing and replenishing the implant’s drug reservoir through the conjunctiva and requires specialized training compared with standard intravitreal injections.

Panelists discuss how the Port Delivery System (PDS) presents important considerations around adverse effects, patient selection criteria, and adoption challenges including surgical requirements and cost-benefit analyses that must be carefully weighed when integrating this technology into retinal practice.

Dr Jordan Graff highlights key steps in implanting the port delivery system, emphasizing incision and closure techniques with video clips.

Panelists discuss how the phase 3 PULSAR and PHOTON trials demonstrated the efficacy of aflibercept 8 mg through a design comparing 12- and 16-week dosing intervals to the aflibercept 2 mg standard 8-week dosing, with primary end points assessing noninferiority in visual acuity maintenance.

Panelists discuss how patients experiencing frequent anti-VEGF treatment burdens with 4- to 8-week intervals between injections are ideal candidates for PDS as an alternative delivery method.

Panelists discuss how the aflibercept 8 mg higher molecular concentration enables extended durability through increased VEGF binding capacity and longer intraocular drug levels, potentially allowing for less frequent dosing while maintaining efficacy.

Panelists discuss how successful implementation of the port delivery system requires careful attention to surgical technique during both initial implantation and subsequent refill procedures, with specialized training and protocols that differ significantly from standard intravitreal injections in terms of procedural steps, sterility requirements, and patient preparation.

Panelists discuss how patients experiencing a high treatment burden with frequent anti-VEGF injections every 4-8 weeks are optimal candidates for the port delivery system, which can help reduce their number of clinic visits while maintaining therapeutic effectiveness.

Panelists discuss how the port delivery system (PDS) with ranibizumab represents a paradigm shift in neovascular AMD treatment by utilizing a surgically implanted refillable device that provides continuous medication delivery for 6 months, offering patients a preferred alternative to frequent intravitreal injections while ensuring consistent therapeutic levels.

Panelists discuss how surgeons must complete specialized training and certification through the risk evaluation and mitigation strategy program to perform port delivery system implantation, which requires a sterile operating room environment and specific surgical instruments designed for the procedure.

Panelists discuss how aflibercept 8 mg demonstrates improved durability and maintenance of visual gains compared with 2-mg dosing, potentially reducing treatment burden while maintaining a similar safety profile.

Panelists discuss how successful port delivery system (PDS) implantation requires careful patient selection and meticulous surgical technique to minimize complications like vitreous hemorrhage and endophthalmitis, with certain patients being poor candidates due to factors such as active inflammation, thin sclera, or glaucoma filtering devices.

Panelists discuss how treat-and-extend dosing with aflibercept 2 mg allows for individualized treatment intervals while maintaining vision gains. However, optimal extension timing must be carefully determined based on disease activity markers.

Panelists discuss how the port delivery system (PDS) is a permanent, refillable ocular implant that continuously releases ranibizumab into the vitreous, with the Archway trial demonstrating noninferior vision outcomes compared with monthly ranibizumab injections while reducing treatment burden through 6-month refill intervals.

Panelists discuss how the chronic nature of retinal diseases requires consistent VEGF suppression through regular anti-VEGF injections, but this treatment burden leads to challenges including patient compliance, health care resource strain, and quality of life impacts from frequent office visits.

A panelist discusses novel treatments for retinal vascular diseases, including faricimab, aflibercept, and port delivery system with ranibizumab.

Panelists discuss how aflibercept’s molecular structure contributes to its clinical efficacy as a standard treatment for retinal vascular diseases.

Panelists discuss how anti-VEGF therapies have dramatically improved visual outcomes in patients with age-related macular degeneration and diabetic macular edema over the past decade. Key challenges persist, including treatment burden, adherence, and identifying optimal dosing regimens for individual patients.

Ferhina S. Ali, MD, MPH, discusses the management of progressive geographic atrophy in an 84-year-old man, focusing on the significance of patient education in optimizing treatment outcomes and adherence.

Ferhina S. Ali, MD, MPH, discusses management and treatment considerations for an 89-year-old woman with dry age-related macular degeneration (AMD) and geographic atrophy (GA), emphasizing the importance of monitoring for choroidal neovascularization and addressing the patient’s progressive vision loss.

Ferhina S. Ali, MD, MPH, discusses how to effectively manage geographic atrophy by considering treatment timing, utilizing imaging modalities, analyzing phase 3 trial data, and developing personalized treatment algorithms based on disease severity while highlighting the encouraging compliance of patients undergoing long-term therapies.

Fasika Woreta, MD, spoke about shattering glass ceilings in ophthalmology, highlighting the importance of diversity, mentorship, and empowering women in leadership roles within the field during her WIO Honorary Lecture and Award.

Hannah Chiu, MD, FRCSC, highlights some of the early benefits of an AI-operated telephone call system for postoperative patient care.

The final case is presented by Dr Adam, showcasing a 79-year old patient with multiple diagnoses and rapid progression of geographic atrophy.

A second case is examined by Dr Adam, examining a 79-year old diagnosed with cataracts and geographic atrophy.