2021 Virtual PGC Series

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Joint Providership provided by the Oregon Medical Association.


Virtual Meeting:

Due the continuing COVID-19 restrictions, the Oregon Academy of Ophthalmology will be hosting a virtual meeting in 2021. 

You can begin viewing the courses on April 5, 2020 and all content will be available through October 3, 2021.


Date

April 5 – October 3, 2021


Registration

Click here to register for the OAO 2021 Virtual PGC Series.


Frequently Asked Questions

Click here to see a list of frequently asked questions regarding the OAO 2021 Virtual PGC Series. This list will be updated as new questions are received.


Materials

  • 2021 PGC Program – coming soon
  • 2020 PGC Course Evaluation – coming soon
  • PGC Online Course Checklist – coming soon

Target Audience

This activity has been planned for ophthalmology physicians (practicing and retired), and residents in the Pacific Northwest.


Accreditation | CME

This activity is currently being considered for 8 CME.


2021 Faculty & Lectures

Cataract | David F. Chang, MD

Altos Eye Physicians
Los Altos, CA

  • Strategies for Complex Cataract Surgery
  • Update on Refractive IOLs for Cataract Surgery
  • Lessons Learned from the Greatest Team of Cataract Surgeons

Uveitis | Quan Dong Nguyen, MD

Spencer Center for Vision Research, Byers Eye Institute at Stanford University, Palo Alto, CA

  • Ocular Manifestations of Systemic Autoimmune Diseases
  • Masquerade Syndrome: Intraocular Lymphoma and Others
  • Current Concepts in the Diagnosis and Management of Scleritis
  • Top Five Commonly Made Mistakes in Managing Non-Infectious Uveitis

Retina | Diana Do, MD

Vice Chair for Clinical Affairs, Professor of Ophthalmology, Byers Eye institute, Stanford University School of Medicine, Palo Alto, CA

  • Non-Proliferative Diabetic Retinopathy: Should We Treat?
  • Safety of Intravitreal Anti-VEGF Agents – Should We Be Concerned?
  • Which Anti-VEGF Regimen is Best for Your Wet Age-Related Macular Degeneration Patients?
  • How Will We Treat Wet AMD in 2023?

Neuro-Ophthalmology | Marc Dinkin, MD

Director of Neuro-Ophthalmology, Associate Professor of Ophthalmology, Departments of Ophthalmology and Neurology, Weill Cornell Ophthalmology, New York, NY

  • Neuro-ophthalmic Complications of COVID-19
  • Venous Sinus Stenosis in Idiopathic Intracranial Hypertension and the Role for Venous Stenting
  • Higher Order Cortical Visual Syndromes

Course Descriptions & Objectives

Strategies for Complex Cataract Surgery | David F. Chang, MD
This course will cover the rationale and practical application of a variety of strategies for complex cataract cases. These will include intraoperative floppy iris syndrome (IFIS), rock hard cataracts, weak zonules, and complex anterior capsulotomies, such as with mature white cataracts using a new technology called precision pulse capsulotomy. Learning objectives:

  • Recognize and characterize the wide spectrum of zonulopathy and employ appropriate strategies based on this recognition
  • Understand the risk factors for IFIS and better understand the prevention and management of IFIS during cataract surgery
  • Understand techniques to reduce morbidity associated with phaco in rock hard cataracts and the associated co-morbidities, such as zonulopathy, small pupils, poor red reflex, and crowded anterior segment

Update on Refractive IOLs for Cataract Surgery | David F. Chang, MD
This course will discuss ways to prevent and to manage toric IOL misalignment. A novel refractive IOL technology will be discussed with practical insights into adoption. Finally, a framework for more effectively explaining different advanced technology refractive IOLs to patients will be offered. Learning objectives:

  • Understand methods to prevent and manage toric IOL misalignment
  • Improved ability to communicate the differences between different advanced technology refractive IOLs to patients
  • Understand the practical aspects of adopting adjustable IOL technology

Lessons learned from the Greatest Team of Cataract Surgeons | David F. Chang, MD
This lecture will discuss 5 key lessons that we can learn from the Aravind Eye Care System in India – the greatest team of cataract surgeons in the world. A survey of North American surgeons on O.R. waste highlights the value of some of these lessons regarding cost-effectiveness and sustainability that we can learn from low to medium-resource settings. Learning objectives:

  • Understand the evidence supporting routine intracameral moxifloxacin prophylaxis for cataract surgery
  • Understand the extent of O.R. waste due to mandated single use of drugs and supplies for cataract surgery
  • Understand the relative pros and cons for manual ECCE in dealing with mature cataracts, particularly for less experienced surgeons

Ocular Manifestations of Systemic Autoimmune Diseases | Quan Dong Nguyen, MD, MSc
The presentation will discuss the ocular manifestations of selected autoimmune diseases including sarcoidosis, systemic lupus erythematosus, and rheumatoid arthritis, among others. Learning objectives:

  • Recognize that ocular manifestations are not uncommon in selected systemic autoimmune diseases
  • Understand that ocular manifestations may be the very initial signs of previously undiagnosed underlying systemic diseases
  • Comprehend that the management of ocular diseases in patients with underlying systemic diseases often require systemic therapy or combination of ocular and systemic therapy to provide complete control of the ocular diseases. 

Masquerade Syndrome: Intraocular Lymphoma and Others | Quan Dong Nguyen, MD, MSc
The presentation will discuss the proper diagnosis and management of intraocular lymphoma, which is a common cause of masquerade syndrome in patients with uveitis. Learning objectives:

  • Recognize the clinical manifestations of intraocular lymphoma
  • Understand that early diagnosis and vigorous therapy, can result in better outcomes
  • Comprehend that early diagnosis depends upon ophthalmologist suspicion of the diagnosis, early diagnostic procedure, and roper handling and analysis of the specimen

Current Concepts in the Diagnosis and Management of Scleritis | Quan Dong Nguyen, MD, MSc
This presentation will aim to assist the attendees to distinguish the various types of scleritis, initiate the suitable evaluations for patients who have scleritis, and recognize the importance of proper therapy, including immunomodulatory therapy, for scleritis, so that the patients with scleritis can be managed or referred to specialists properly and on timely manner. Learning objectives:

  • Distinguish the various types of scleritis
  • Initiate the suitable evaluations for patients who have scleritis
  • Recognize the importance of proper therapy, including immunomodulatory therapy, for scleritis

Top Five Commonly Made Mistakes in Managing Non-Infectious Uveitis | Quan Dong Nguyen, MD, MSc
The presentation will discuss the various mistakes that commonly occur in the diagnosis and management of non-infectious uveitis. Learning objectives:

  • Discuss the various common errors that can occur for physicians who manage patients with uveitis
  • Emphasize the importance of careful assessment of uveitis patients to enable proper diagnosis to be made
  • Provide guidelines in generating appropriate management plans for complex uveitis patients

Non-Proliferative Diabetic Retinopathy: Should We Treat? | Diana V. Do, MD
Millions of people worldwide have diabetes and diabetic retinopathy. The majority of people  have non-proliferativate diabetic retinopathy (NPDR) and are at risk of developing vision threatening complications. In the past, eyes with NPDR have been observed because there was no effective and safe therapy available. More recently, the FDA has approved intravitreal VEGF ihibitors (ranibizumab and aflibercept) for the treatment of NPDR. This course will discuss the clinical trial data, risks and benefits of anti-VEGF therapy for NPDR. Learning objectives:

  • Discuss the evidence for the use of anti-VEGF agents for NPDR
  • Review the safety of anti-VEGF agents in NPDR
  • Describe how anti-VEGF agents decrease vision threatening complications

Safety of Intravitreal Anti-VEGF Agents – Should We Be Concerned? | Diana V. Do, MD
Millions of intravitreal anti-VEGF injections are performed each year for a variety of retinal vascular diseases. Aflibercept, ranibizumab, and off-label bevacizumab are effective and safe therapies that are widely used. Recently, intravitreal brolucizumab was FDA approved for wet AMD, but safety concerns have developed due to the occurance of intraocular inflammation and retinal vasculitis. Learning objectives:

  • Review safety of commonly used intravitreal anti-VEGF agents including ranibizumab, aflibercept and bevacizumab
  • Discuss the recent safety events associated with brolucizmab
  • Understand how to assess for IOI and retinal vasculitis

Which Anti-VEGF Regimen is Best for Your Wet Age-Related Macular Degeneration Patients? | Diana V. Do, MD
The most commonly used treatment regimens for wet AMD include administering anti-VEGF agents at either: fixed dosing, as needed dosing, or treat and extend dosing. Review of clinical trial data will be discussed to evaluate each of these regimens. Learning objectives:

  • Review the clinical trial evidence for fixed dosing, as-needed dosing and treat and extend dosing
  • Discuss visual acuity outcomes at month 12 and 24 with anti-VEGF dosing regimens
  • Understand strategies to improve and maintain vision in wet AMD patients

How Will We Treat Wet AMD in 2023? | Diana V. Do, MD
Current therapies for wet AMD involve intravitreal anti-VEGF agents. New biologics are currently in clinical trials for wet AMD and retinal vascular diseases. These new agents may provide additional benefit by enhancing the durability of VEGF blockage in order to improve long term visual outcomes. In addition, additional targets to inhibit angiogenesis and vascular permeability are being explored. Learning objectives:

  • Review the current biologics in late stage development for wet AMD
  • Discuss the efficacy and safety of these new biologics
  • Discuss the dosing regimens for new biologics in evidence

Neuro-ophthalmic Complications of COVID-19 | Mark Dinkin, MD
Neuro-ophthalmic complications of COVID-19 will be described in detail.  These will be organized under the rubrics of efferent and afferent function.  Efferent complications include cranial neuropathy, as part of the Miller Fisher Syndrome, or as an isolated cranial neuritis, ocular myasthenia and nystagmus from brainstem encephalitis. Afferent complications include optic neuritis, which may or may not be associated with anti-myelin oligodendrocyte glycoprotein (MOG) antibodies, papillophlebitis, papilledema (in the setting of cerebral venous sinus thrombosis or as part of the pseudotumor cerebri syndrome associated with the post-COVID-19 multisystem inflammatory syndrome (c-MIS) and visual field loss related to stroke.  The mechanisms by which COVID-19 may lead to neuro-ophthalmic dysfunction, including endothelial dysfunction, hypercoagulability, para-infectious inflammation and direct neurotropism will be discussed. Learning objectives:

  • Understand the various types of vision loss associated with COVID-19, including cortical stroke, optic neuritis and papilledema
  • Understand the syndromes affecting eye movements associated with COVID-19 including cranial nerve palsy, Miller Fisher syndrome, myasthenia gravis and brainstem encephalitis
  • Understand the theoretical mechanisms by which COVID-19 may lead to neuro-ophthalmic dysfunction, including endothelial dysfunction, hypercoagulability, para-infectious inflammation and direct neurotropism

Venous Sinus Stenosis in Idiopathic Intracranial Hypertension and the Role for Venous Stenting | Mark Dinkin, MD
The theoretical contributions to the pathophysiology of IIH by venous sinus stenosis at the sigmoid-transverse sinus junction will be reviewed.  The association between stenosis and IIH will be examined.  The difference between intrinsic stenosis and extrinsic stenosis and the role that they play, will be elucidated.  The results of a prospective study following patients stented for medically-refractory IIH will be reviewed, with an emphasis on neuro-ophthalmic outcomes such as changes in visual field, Frisén grade of papilledema and retinal nerve fiber layer thickness.  Complications and secondary relapses will be discussed. Future research questions will be introduced. Learning objectives:

  • Understand the data arguing for and against a role of venous sinus stenosis in the pathophysiology of IIH
  • Describe the outcomes for patients undergoing venous stenting for IIH, including effect on symptoms, visual field loss, disc edema and retinal nerve fiber layer thickness
  • Enumerate the range of complications that have been associated with stenting for IIH and understand the frequency and likely etiology of secondary stent failure

Higher Order Cortical Visual Syndromes | Mark Dinkin, MD
The processing of visual input in post-striate cortex cortical centers will be described, focusing on the temporal-lobe centered ventral pathway most responsible for mage recognition (the WHAT pathway) and the parietal lobe-centered dorsal pathway most responsible for visuo-spatial analysis (the WHERE pathway). Syndromes affecting the ventral pathway such as alexia without agraphia, cortical dyschromatopsia and prosopagnosia will be reviewed using case presentations and historical descriptions. Syndromes affecting the dorsal pathway, most notably the Balint Syndrome will be reviewed, followed by a description of visual hallucinations. Learning objectives:  

  • Describe the organization of the post-striate visual processing pathways into the dorsal and ventral pathways and understand the basic anatomy of both
  • Enumerate several examples of ventral pathway dysfunction and describe the typical patient presentation for each
  • Enumerate several examples of dorsal pathway dysfunction and describe the typical patient presentation for each