The Future of Hyperopic LASIK: Debates and Advances

William F. Wiley, MD, and Wesam Silk, MD

Eyetube

In this episode of CRST: The Podcast, host William F. Wiley, MD, and Wesam Silk, MD, take a deep dive into the evolving world of hyperopic LASIK and its alternatives. They explore the technological advances that have reshaped the treatment of hyperopia, examine the shift toward lens-based solutions, and speculate about future innovations in refractive surgery. 

Hear the Journey of the OD Behind the Crystal Tear Report

Eyetube

Jackie Garlich, OD, FAAO, and Jessilin Quint, OD, MBA, MS, FAAO, catch up with Crystal M. Brimer, OD, FAAO, to talk about her prolific journey in dry eye. Dr. Brimer discusses opening her own practice, creating the Dry Eye Institute to promote education among eye care providers, and shares tips to help other ODs to get started or revitalize their dry eye services.

The Utility of En Face OCT for Detecting Neovascularization in DR

We conducted a study of our own to better understand this association.

Mizuki Hamada, MD, and Kotaro Tsuboi, MD

Retina Today

AT A GLANCE In a recent longitudinal study, the authors detailed the early stages of retinal neovascularization using both en face OCT and en face OCT angiography (OCTA) in eyes with diabetic retinopathy. OCTA’s capacity to detect flow signals above the internal limiting membrane has provided a more reliable method to categorize lesions. By pinpointing neovascularization precursors instead of relying on indirect retinal features to forecast progression risk, we may be able to achieve greater precision in identifying eyes on the verge of developing proliferative diabetic retinopathy. While OCT has enhanced the objective diagnosis of diabetic macular edema (DME), early detection of proliferative diabetic retinopathy (PDR) remains challenging for ophthalmologists and often requires a thorough dilated fundus examination or fluorescein angiography (FA).1 Recent advances in OCT angiography (OCTA) not only enable the identification of retinal neovascularization (RNV) above the internal limiting membrane (ILM), but also offer a wider field of view, making OCTA a promising tool.2-4 Additionally, structural OCT can be instrumental in detecting RNV, particularly in distinguishing it from intraretinal microvascular abnormalities (IRMA).5,6 In a recent longitudinal study, we detailed the early stages of RNV using both en face OCT and en face OCTA in eyes with DR.7,8 PUTTING THE THEORY TO THE TEST We conducted a cross-sectional study to analyze the sensitivity and specificity of en face OCT and en face OCTA for the detection of clinically occult RNV in nonproliferative DR (NPDR).9 We obtained four high-resolution scans (600 x 600 sampling densities over 9 x 9 mm) and generated a 17 x 17 mm widefield OCTA scan. We created two different custom slabs for en face OCT and en face OCTA to optimize RNV detection (Figure 1). RNV lesions were identified using a combination of en face OCT, en face OCTA with custom vitreoretinal interface slab, and cross-sectional OCTA. Figure 1. RNV lesions (yellow arrows) on en face OCTA (A) and en face OCT (B). Cross-sectional images (C and D) from the location of the dashed lines show a small RNV tuft. Of the 63 enrolled eyes, 27 (43%) had severe NPDR, 16 (25%) had moderate NPDR, and 20 (32%) had mild NPDR.