As the weeklong 36th Asia-Pacific Academy of Ophthalmology Virtual Congress (APAO 2021) draws to an end — and we all close our computers (rather than get on a plane home) — we’re reminded of a quote from Dr. Seuss: “Don’t cry because it’s over. Smile because it happened.”
And indeed, after COVID-19 caused the cancellation of APAO 2020, we were thrilled to attend this year’s Virtual Congress, after two long years of going without. The final days of APAO 2021 continued to impress: Experts discussed updates in treatment and surgical technique, awards were distributed, speeches were made … and the latest data and tips on providing ophthalmic care and education during a pandemic were revealed.
There is never enough space to include all the information we’d like to share; however, we’ve compiled a sampling of highlights from Days 6 and 7 below. So, be like Dr. Seuss (although he wasn’t really a doctor): Don’t cry — smile — and read on…
Impacts of COVID-19 echo in ophthalmology
At this point, we’re all accustomed to a virtual meeting format, and we’ve learned a few lessons from the ongoing pandemic. In the final days of APAO 2021 Virtual, several symposiums and free papers were dedicated to best practices in this new normal.
The AOI Symposium: Improving Education and Care by Telemedicine was one such symposium. The Academia Ophthalmologica Internationalis (AOI) is a global organization that strongly supports education in ophthalmology — and in the last year, it’s members, from some of the most prestigious institutions worldwide, have led the charge in virtual education.
Commenting on The Bascom Palmer Telehealth Playbook was Dr. Ranya Habash, who shared best practices for telehealth, including types of visits and virtual urgent care, as well as some surprising statistics and patient feedback. She reminded the audience not to overcomplicate things when it comes to virtual urgent care: “We just need to know: Does the patient need to come to the ER or not? This is a triage. We did this at the beginning of the pandemic and it’s been going strong ever since — in fact now, we have a tele-triage at Bascom Palmer.”
She then shared some surprising statistics from their tele-triage: “Seventy-five percent (75%) of the patients we see are new patients to our facility. Imagine, if everyone did this, you’re really gaining a big patient population because they want that type of convenience and service.”
Further, 91% of their tele-triage patients did not need an actual ER visit: “This means we could fix them, just with a video visit,” shared Dr. Habash.
Another symposium on Day 6 — COVID-19 Associated Mucormycosis: A Battle Within the War! — dealt with unmet needs as a result of the pandemic. In India and elsewhere, there has been a rising incidence of rhino-orbito-cerebral mucormycosis (ROCM) in the background of COVID-19. During this symposium — which you should definitely catch on-demand — experts uncovered best practices to understand the immunopathogenesis, diagnostic pathway, imaging, staging and management paradigm of COVID-19 associated mucormycosis (CAM).
To illustrate, data from a prospective multicenter study of 15 patients with ROCM were presented. The authors found that most patients had advanced mucormycosis at admission and the most common presentation was orbital apex syndrome (73%). Among the patient cohort, 13 were diabetic and seven had received intravenous dexamethasone. The authors concluded that “poor control of diabetes mellitus and corticosteroid therapy and severe pulmonary involvement during COVID-19 seem important underlying predisposing factors.”
But wait, there’s more…
Speaking of grave cases, Vitreo-Retinal Surgeons’ Nightmares! was another treat for attendees on Day 6, especially young retinal surgeons. Some of these topics included how to proceed when submacular hemorrhage occurs during vitrectomy for retinal detachment, as well how to manage uncontrolled bleeding during diabetic vitrectomy. This symposium is available on-demand — and it’s recommended viewing as nobody likes nightmares, especially of the surgical sort.
In the end, it’s the end
After a week-long Virtual Congress, APAO 2021 drew to a close on Day 7 with an array of symposiums, award lectures and industry-sponsored talks. Indeed, the final day included six industry-sponsored symposiums from companies including: Santen (Tokyo, Japan), Johnson & Johnson Vision (California, USA), Alcon (Geneva, Switzerland), Novartis (Basel, Switzerland), Nikon (Tokyo, Japan) and Lumenis (Israel). During these presentations, each company highlighted the latest developments in products, treatments and imaging devices.
One such device covered was the OptiLight from Lumenis. This device is the first FDA-approved IPL (intense pulsed light) solution for the management of dry eye due to meibomian gland dysfunction (MGD). Following the presentations, Dr. Richard Adler, Belcara Health (Maryland, USA) led the Q&A and asked panelist Dr. Laura Periman, Periman Eye Institute, (Washington, USA), how she measures success in patients with MGD who receive IPL treatment.
“I think, in essence, what you’re asking is how we define success? And it’s very multifactorial. There’s improvement in the physical metrics of the tears, whether it’s osmolarity or tear break-up time — or maybe it’s the patient and their speed scores, and their ability to wear contacts and have clear vision … so, there’s multiple ways to measure it,” she shared. “I think there’s a lot we can’t measure as clinicians and the temptation is to think ‘well, it’s not working.’ But you have to remember, there’s all this amazing stuff happening on an ultrastructural level, on an inflammation reduction level … there’s a lot going on and there’s multiple ways to measure success.”
Speaking of measuring success, the APAO also has its methods — in the way of Named Award Lectures, Achievement Awards, travel grants and more. The final day saw some of the most important moments, including the Jose Rizal International Medal Lecture from Prof. Ronald Kruger, who discussed new directions in refractive surgery, specifically the SMILE procedure. So, as Prof. Kruger looks toward the future, over here at Media MICE, we do as well … and to the next APAO Congress — where we hope to see our friends and colleagues in-person next time.