The Benefits of a “Boring” Day

Paul Walton, MD; Blake Williamson, MD, MPH; and Gary Wörtz, MD

Eyetube

Paul Walton, MD, joins Blake Williamson, MD, MPH, and Gary Wörtz, MD, to share concepts to help cataract and refractive surgeons avoid horror stories in the OR. He says the goal should always be to have a “boring” day, emphasizing the importance of communication and understanding with patients. The surgeons also detail their approaches to anesthesia and how to best comfort patients before, during, or after surgery.

Management of Advanced Glaucoma

Nathan M. Radcliffe, MD; Blake Williamson, MD, MPH; and Gary Wörtz, MD

Eyetube

Nathan M. Radcliffe, MD, joins Blake Williamson, MD, MPH, and Gary Wörtz, MD, to share his experiences managing complex patients with advanced-stage glaucoma. He shares a specific case of an 83-year-old man with a cataract and exfoliation glaucoma with an IOP of 56 mm Hg. Dr. Radcliffe walks through how he managed complications he encountered during the combined cataract and glaucoma surgery, including vitreous prolapse and suprachoroidal hemorrhage. The surgeons also discuss how to educate and counsel patients with advanced-stage disease to help them understand realistic surgical outcomes.

A Reference Guide for OCT Angiography

An illustrative overview of OCTA findings to help you implement this tool in common clinical scenarios.

Ivy Zhu, MD; Nicole L. Decker, BS; and Amani A. Fawzi, MD

Retina Today

AT A GLANCE OCT angiography (OCTA) has several advantages over traditional imaging techniques, including being noninvasive, depth resolved, and rapid. OCTA can distinguish the various vascular networks without obscuration by leakage, making it helpful for characterizing neovascularization and nonperfusion. OCTA is particularly useful in cases of type 1 neovascularization, where sub-retinal pigment epithelium neovascularization can develop without active exudation. En face OCTA and OCT B-scans are complementary and, together, can provide the clinician with a wealth of knowledge. There are several conditions for which OCTA can provide detailed information that would otherwise be time-consuming or impossible to find with traditional techniques. OCT angiography (OCTA) is a noninvasive imaging technique that uses the principles of motion detection to reveal depth-resolved images of the retinal and choroidal vasculature, down to the capillary level.1 OCTA has several advantages over traditional imaging techniques, including being noninvasive (no dye injection), depth resolved, and rapid. A key benefit of OCTA is its ability to distinguish the various vascular networks without obscuration by leakage, making it very helpful for characterizing retinal neovascularization and nonperfusion with precision beyond dye-based angiography. Here, we detail several clinical scenarios in which OCTA can be a useful diagnostic tool and illustrate key imaging features. In general, absence of flow (nonperfusion) is best appreciated with en face images. The presence of abnormal flow is most accurately detected using a combination of en face imaging assisted by the OCT B-scan with flow overlay to pinpoint abnormal flow related to structural pathological changes.