The Congress on Controversies in Ophthalmology (COPHy) highlights debates in surgical, medical retina

The 16th annual Congress on Controversies in Ophthalmology is being held in Seville, Spain. Image credit: ©Julián Maldonado – stock.adobe.com

The Congress on Controversies in Ophthalmology (COPHy) is underway in Seville, Spain. This year, the 16th annual congress will run from 4-5 April, with a series of debates on topics including retina care, uveitis, neuro-ophthalmology and glaucoma.

As in years past, medical and surgical retina serve as the two major topics of many COPHy sessions. Participants can also attend sessions in neuro-ophthalmology, uveitis and glaucoma.

The meeting kicks off with a retina-centred session, titled “Big controversies in retina and beyond in 2025.” Following the welcome remarks, Mark Humayun, MD, PhD, will deliver his keynote lecture on the use of retinal implants to restore vision. Prof Humayun is director of the USC Ginsburg Institute for Biomedical Therapeutics and university Professor of ophthalmology, stem cell biology and regenerative medicine and biomedical engineering at the Keck School of Medicine at the University of Southern California in Los Angeles, California.

Debates in the first session of the conference included hot-button topics such as myopia progression and age-related macular degeneration (AMD). First on the debate docket is the question, “Will topical therapy become the standard of care for prevention or delay of myopia progression?” That debate includes Andrzej Grzybowski, MD, PhD, MBA, MAE, arguing in the affirmative and Hakan Kaymak, MD, arguing the negative position. The second debate, titled “Gene therapy for neovascular AMD will be the preferred therapy in the future,” with Luis Arias, MD, PhD, defending the "yes" position and Paolo Lanzetta, MD, the "no" position.

The first session of the day is followed by a coffee break and special programming in the speaker's corner. Then, the retina sessions continue, beginning with a session focused on medical retina. The topic is neovascular (wet) AMD management. Subtopics serving as subjects of debate include the use of anti-VEGF agents for pigment epithelial detachment, home monitoring with optical coherence tomography (OCT) with resulting patient outcomes, and sustained drug delivery models for retinal diseases.

The first surgical retina series of COPHy 2025 focuses on controversial approaches to common surgical questions. Clinicians will debate whether the inverted flap technique is the best surgical approach for large recurrent macular holes in patients with high myopia; approaches for phakic macula-on retinal detachment, specifically comparing vitrectomy and scleral buckle; and pars plana vitrectomy in management of symptomatic vitreous floaters.

The first day of the meeting closes with a session titled “vision academy in retina,” which is focused on new challenges with retinal diseases and the evolving treatment landscape. The closing session for Friday breaks some conventions of the COPHy format, featuring rapid-fire presentations on AMD, geographic atrophy (GA) and use of anti-VEGF agents. These are followed by a panel discussion, featuring retina experts discussing one of the most controversial topics of the last 20 years in eye care. Following session close, attendees can continue to enjoy industry sponsored symposium and a welcome reception.

The second day of this year’s COPHy begins with a medical retina session. Debates focus on diabetic macular oedema (DMO) and proliferative diabetic retinopathy. Questions up for discussion include whether steroid therapy for DMO is still relevant, whether oral therapy for nonproliferative diabetic retinopathy will be adopted as the primary approach to its management; and exploring novel topical steroids as standard of care for mild DMO.

The third medical retina session is all about novel technologies and therapies. Clinicians will debate the multi-pathway or high-dose inhibitors, and if they improve DMO biomarkers more than previous treatments; if existing outcome measures are sufficient to demonstrate the efficacy of new therapies for inherited retinal diseases; and if blocking more than VEGF-A can help in improving visual acuity in retinal disease.

The fourth and final medical retina session is specific to new treatment strategies. The debates will include the value of photobiomodulation for non-neovascular AMD; functional outcomes for assessing treatment effects of drugs for non-neovascular AMD; and the risks VS benefits of complement inhibition for GA.

The second surgical retina session of the meeting, also on Saturday, spotlights controversies in cutting-edge vitreoretinal surgical technology. Participants will debate whether artificial intelligence can provide accurate predictions of success in retinal detachment surgery; if heavy silicone is the most beneficial adjuvant in management of a retinal detachment with proliferative vitreoretinopathy; and the success of employing multifocal or extended depth-of-field IOLs following repair of macula-off retinal detachment.

To learn more about this year’s COPHy meeting, see the interviews with co-chairs Anat Loewenstein, MD, and Baruch Kuppermann, MD, PhD, in the Ophthalmology Times Europe March/April cover story.