New Retina Radio by Eyetube

Next-generation anti-VEGF agents are designed for durability. But does that actually change the rate at which they're administered? David Miller, MD, joins us to review a pair of ARVO 2025 presentations that examined his clinic's real-world administration patterns for bevacizumab (Avastin, Genentech), faricimab (Vabysmo, Genentech/Roche), and high-dose aflibercept (Eylea HD, Regeneron). What were the differences—and did they really matter?  Also, Robert Wang, MD, helped us understand the state of play in the TKI pipeline as he shared data from the phase 2b ODYSSEY study. What are the latest data on CLX-AX (Clearside Biomedcial)? And where does it stack up against the other TKIs in the pipeline? Stick with us to find out. 

How do GLP-1 drugs influence age-related ocular diseases such as macular degeneration and glaucoma? Moderator Lediana Goduni, MD, is joined by Alexis Warren, MD, and Joshua Uhr, MD, to examine a retrospective study published in Ophthalmology using TriNetX data to compare 5-year ocular outcomes across medication cohorts. Do these data suggest a protective benefit for GLP-1s—and does it matter for clinical practice? Tune in for their take on what's promising, what's premature, and what's next.

Questions abound about fellow eye rhegmatogenous retinal detachments (RRD). How often do fellow eye develop RRD after the first one is repaired? What concomitant conditions do fellow eyes with RRD have? What risk factors exist for fellow eye RRD? And which procedures are used to repair fellow eye RRD? Moderator Barton Blackorby, MD, and panelists Louis Cai, MD, and Hong-Uyen Hua, MD, dissect the latest data on these questions from the AAO IRIS Registry and then compare how these data align with their respective clinical experiences. 

What are the real-world safety data following administration of faricimab (Vabysmo, Genentech)? Maura Di Nicola, MD, and guests Sruthi Arepalli, MD, and Barton Blackorby, MD, review data from a real-world, single-center, retrospective study of approximately 4500 injections of faricimab in over 700 patients at Wills Eye Hospital. What did the data show? And do these data effect the clinical patterns of Drs. Di Nicola, Arepalli, and Blackorby? 

How can OCT angiography help retina specialists distinguish between retinal vein occlusion (RVO) and retinal artery occlusion (RAO) in patients who present without acute findings? Using real-world cases as a backdrop, Yasha Modi, MD, and Kat Talcott, MD, discuss Dr. Modi's approach to distinguishing RVO and RAO via OCT angiography and review which specific OCT angiography findings may indicate referral to cardiology. Later in the episode, they explore the utility and limitations of OCT angiography in patients with diabetic retinopathy.  This episode is supported by Zeiss Professional Education.

What role can OCT angiography play in tracking the development of central serous retinopathy (CSR)? Yasha Modi, MD, and Kat Talcott, MD, review the use of OCT angiography in a real-world CSR case, discuss the value of selecting OCT angiography over fluorescein angiography for patients with neovascularization, and parse which populations are not a good fit for OCT angiography.  This episode is supported by Zeiss Professional Education.

Does switching wet AMD patients from aflibercept (Eylea, Regeneron) to faricimab (Vabysmo, Genentech) improve disease outcomes? Join Ben Young, MD, MS, and his guests Lediana Goduni, MD, and Joshua Uhr, MD, as they explore this a recent peer review paper on this question. What are the potential benefits of such a switch? How should providers use findings such as these to inform their practice? And are significant improvements in anatomy relevant if vision gains are unchanged? 

What are the benefits and limitations to FDA-approved therapies for geographic atrophy? John Kitchens, MD, is joined by Saradha Chexal, MD, and Geeta Lalwani, MD, as they explore which patients are best suited for treatment, how best to succinctly set expectations for outcomes, and whether patients on GA therapy may also be well-suited AREDS vitamins.

How many real-world patients with proliferative DR were concordant with the treatment directions in Protocol S? Adrienne Scott, MD, explains how a database review of real-world patients with proliferative DR revealed how few patients are concordant with the strict dosing schedule of Protocol S, and shares which baseline factors were linked to lack of concordance. And Dilraj Grewal, MD, provides an update on the relationship between retinal imaging and detection of Alzheimer disease. Just how close are we from using noninvasive retinal imaging techniques to screen for potential neurodegenerative conditions?

Does metformin use reduce the risk of developing AMD in non-diabetic patients? Moderator Rebecca Soares, MD, and panelists Matt Starr, MD, and Nikisha Kothari, MD, review a decade-long case control-control study assessing risk of AMD in non-diabetic patients who have been taking metformin for any reason. They ask whether the study's blindspots undercut its findings, and speculate what other questions further research could answer.

We've got to keep our eye on the pipeline. What do the latest data tell us about two drug candidates? Durga Borkar, MD, MMCi, reviews data from a phase 2 study assessing the safety and efficacy ONL1204 (ONL Therapeutics) delivered prior to RRD surgery. Did injecting ONL1204, which prevents Fas activation, lead to any postsurgical differences? Alex Melamud stops by to discuss the phase 2/3 SAGA study assessing the safety and efficacy of gildeuretinol (Alkeus Pharmaceuticals), an oral agent for the treatment of geographic atrophy. Can this drug succeed where other oral options in retina have failed? 

The ELEVATUM study exclusively enrolled historically underrepresented patients in a study assessing faricimab (Vabysmo, Genentech/Roche) for DME. Were there any surprises in the data? Jeremiah Brown, MD, MS, sits down with New Retina Radio to review the philosophy behind the ELEVATUM study, discuss the study's findings, and preview the next phases of the trial. And Eric Schneider, MD, joins the program to discuss the findings of a pivotal study assessing home OCT (Scanly, Notal Vision) in wet AMD patients. Is home OCT equivalent to in-office OCT when it comes to visualization? And do expert graders agree with an AI algorithm's assessments of patient's pathology?

Are retina doctors seeing more retinal pathology following infection or vaccination? Or is there nothing to see here? Rahul Khurana, MD, joins us to discuss the findings of various health care database analyses seeking to clarify whether COVID infection or vaccination were linked to retinal manifestations. Was there a clear—or even an opaque—connection between the two? And Paul Hahn, MD, PhD, sits down with us to explain how inflation, new realities of reimbursement, and step therapy directives are playing out in retina clinics in the United States. Inflation-adjusted reimbursement is declining—but can anything be done about it? And is step therapy actually saving the system any cash? 

We finally have two FDA-approved treatments for geographic atrophy (GA)—and yet, many retina specialists have been reluctant to embrace them. Join moderator John Kitchens, MD, as he explores this question with Miguel Busquets, MD, and Esther Kim, MD. Further in the episode, they gameplan patient conversations centered around choosing a treatment, ask how heavily to weigh safety when selecting a complement inhibitor, and preview the GA pipeline.

In this episode of the New Retina Radio Journal Club with VBS, Maura Di Nicola, MD; Sruthi Arepalli, MD, and Barton Blackorby, MD, discuss a recent study comparing endophthalmitis rates following anti-VEGF injections with pre-treatment using either 5% Povidone Iodine or 0.05% Chlorhexidine. They highlight how prefilled syringes can reduce the risk of endophthalmitis and explore the implications for clinical practice, including antiseptic protocols, patient sensitivities, and how to navigate conflicting study outcomes. Tune in for valuable insights that could influence your injection protocols.

Tens of thousands of real-world geographic atrophy patients were analyzed in a retrospective database study. How did GA progress—and how do these data inform our understanding of GA? Ted Leng, MD, stopped by the show to share the findings from his research on the natural history of GA, which he recently delivered on the podium in Lisbon. And Michael Klufas, MD, joined us for a discussion about another real-world study. This time, it was a retrospective multicenter outcomes analysis following multiple injections of high-dose aflibercept (Eylea HD, Regeneron) for treatment of wet AMD, DME, and DR. How did treatment-naïve patients fare compared with previously treated patients? And did treatment intervals improve? Stick with us to find out.

What is the relationship between retinal artery occlusion (RAO) and death, stroke, or myocardial infarction? Moderator Katherine Talcott, MD, is joined by Kyle Kovacs, MD, and Phoebe Mellen, MD, to explore the latest contribution to the literature on this topic. After the break, they discuss how best to manage patients who present to the clinic with an RAO, review academic centers' model for rapidly assessing patients with RAOs, and strategize how best to perform work-ups for patients who present to the retinal clinic with an RAO weeks after reporting reduced vision. 

Could inhibition of C1q effectively halt the progression of GA? Joel Pearlman, MD, sat down to discuss findings from the phase 2 ARCHER study, which evaluated ANX007 (Annexon) in patients with GA. He tells us what happened when patients were dosed with ANX007 for 1 year—and what occurred when patients stopped receiving treatment. And later, Dimitra Skondra, MD, fills us in on the latest research regarding potential interactions between metformin and AMD development in non-diabetic patients. Does the future of care include metformin as prophylaxis? Stick with us to find out. 

Does switching long-term wet AMD patients to faricimab (Vabysmo, Genentech/Roche) result in meaningful change to disease presentation? Join New Retina Radio Journal Club host Ben Young, MD, MS, and panelists Lediana Goduni, MD, and Josh Uhr, MD, as they break down a recent real-world study published in the literature. After the break, they review whether the study's findings could inform clinical decision-making, weigh the value of anatomic improvement that doesn't result in significant improvement in vision quality, and review their comfort with switching from legacy anti-VEGF agents to next-generation therapies.

The Port Delivery System with Ranibizumab (PDS; Susvimo, Genentech) was shown to be effective for wet AMD treatment. What did the PAVILION study find when it came to treating diabetic retinopathy out to 100 weeks? Margaret Chang, MD, summarized the PAVILION study's 2-year safety and efficacy findings regarding the PDS in patients with DR but no DME. Plus, Dr. Chang offers her opinions on what it will take for retina specialists to trust the PDS now that the next-generation model has been released. Hear what she has to say in this one-on-one interview. 

Is avacincaptad pegol (Izervay, Astellas) effective in patients with major ellipsoid zone attenuation at baseline? Katherine Talcott, MD, stopped by our studio in Stockholm during ASRS with a top-line summary of her lecture at this year's meeting. And Sunir Garg, MD, joined us for a conversation about the GALE study, which assessed 36 months of continuous dosing of pegcetacoplan (Syfovre, Apellis Pharmaceuticals). What did microperimetry findings reveal about long-term dosing with C3 inhibition? Join us in this episode to find out. 

Patients with DME in DRCR Retina Network Protocol AC were switched from bevacizumab to aflibercept if they met specific switch criteria. Where there any baseline factors that predicted a switch? Moderator Rebecca Soares, MD, sits down with panelists Matt Starr, MD, and Nikisha Kothari, MD, to review this study, ask whether the findings are clinically relevant, and explore other risk factors that may be worthy of further investigation. 

One of the challenges associated with current anti-VEGF therapies for the management of DME is the need for frequent injections and the potential impact on adherence and vision outcomes. Join Dr. John Kitchens and Dr. Maria Berrocal as they share their experiences treating their DME patients using a therapy with a novel mechanism of action, and how those patient outcomes have influenced their extension decisions and treatment management approaches. This special episode of New Retina Radio, and its content, is supported by Genentech USA, Inc. 

What did a review of the AAO IRIS Registry reveal about the rates of retinal vein occlusion (RVO) during the COVID-19 pandemic? Moderator Katherine Talcott, MD, sits down with Phoebe Mellen, MD, and Kyle Kovacs, MD, to review the study's conclusion that RVO rates did not increase during the pandemic, discuss challenges about talking to patients seeking causality for an ocular phenomenon, and review the relative strengths and drawbacks of relying on the IRIS Registry. 

Recent studies have proven the therapeutic viability of a different approach in treating retinal vascular diseases. Join Dr. John Kitchens, Dr. Margaret Chang, and Dr. David Chin Yee as they discuss their clinical experiences using a therapy with a novel mechanism of action in patients with nAMD and DME. And, learn how they approach managing patients with macular edema. This special episode of New Retina Radio, and its content, is supported by Genentech USA, Inc.

In episode 1 of this 2-part series, moderator Paul Hahn, MD, PhD, and panelists Durga Borkar, MD, MMCi, and Ted Leng, MD, explored the conclusions of a cross-trial comparison focused on randomized controlled studies in wet AMD and DME therapy. In this episode, we turn to the findings of FARETINA-AMD and FARETINA-DME, which rely on real-world outcomes as documented in the AAO IRIS Registry. What can retina specialists learn from these studies, and how might these studies' findings affect treatment decisions? 

Protocol AA might be complete—but analysis of its data is far from over. What did that study's data tell us about the relationship between leakage and DR severity? Justis Ehlers, MD, breaks down what he and his team uncovered when examining ultra-widefield images from Protocol AA, and helps us understand how machine learning might be used in future retina clinics. And Lisa Faia, MD, explains what her claims database analysis uncovered about the overlap between GA diagnoses and rates of depression and anxiety. What new info do we have that can contextualize the value of GA care?

How do outcomes differ for RRD patients at risk of PVR following PPV alone or combined PPV/scleral buckling? Moderator David Xu, MD, hears from panelists Barton Blackorby, MD, and Prethy Rao, MD, MPH, about a recent peer-reviewed paper published in Ophthalmology Retina covering surgical outcomes of patients with RRD who were considered high risk for PVR and underwent either PPV alone or PPV/scleral buckling. After the break, the doctors discuss the specific mechanics of a PPV/scleral buckle that may lead to successful surgery and ask whether this paper helps us better understand risk factors for PVR.

Could next-generation anti-VEGF agents such as faricimab (Vabysmo, Genentech/Roche) and high-dose aflibercept (Eylea HD, Regeneron) be dosed as infrequently as every 20 weeks without sacrificing efficacy? And even if there are data that suggest that finding, would anyone actually adopt an interval that long in wet AMD patients? Philip Storey, MD, fills us in on TENAYA and LUCERNE data that explored, in part, how many patients could theoretically reach a 20-week dosing interval with faricimab, and which baseline factors predicted whether patients were conducive to such a strategy. And Prof. Sobha Sivaprasad joins us to review findings from PULSAR. In particular, she focuses on data examining whether wet AMD patients could be dosed as long as every 24 weeks on high-dose aflibercept. This is part 1 of 2 of NRR's ARVO 2024 coverage. 

David RP Almeida, MD, PhD, MBA; Lisa Faia, MD; and Chris Riemann, MD, return for the second episode in this podcast miniseries, in which they review a trio of real-world GA cases, explore what early responses to treatment look like, and ask how to address GA in the presence of wet AMD. 

Join David RP Almeida, MD, PhD, MBA; Lisa Faia, MD; and Chris Riemann, MD, as they assess which clinical and non-clinical characteristics drive their decision-making in patients with geographic atrophy (GA). After the break, Dr. Faia shares a real-world case from her clinic in which a patient who was lost to follow-up returns to consider treatment.

What conclusions can be drawn from a cross-trial comparison of randomized clinical trials assessing the safety and efficacy of anti-VEGF agents used in the treatment of AMD and DME? Paul Hahn, MD, PhD, sits down with Durga Borkar, MD, MMCi, and Ted Leng, MD, to review a recent presentation by Dr. Leng on this topic, and to examine the clinical relevance of the study's findings. 

Biosimilars in retina are here. How are practices integrating them into their clinics? And how do they navigate issues around payer policy, protocol changes, and ensuring continuity of care?  Moderator John Kitchens, MD, sits down with retina specialist Dave Brown, MD, and Kristin Yockus, the VP of Process Integrations at Retina Consultants of America, to answer these questions, and to preview how the coming increase in biosimilar options might play out in a real-world landscape. 

How do endophthalmitis rates after intravitreal injection differ after using povidone-iodine compared with chlorhexidine? Moderator Sruthi Arepalli, MD, hears from panelists Vaidehi Dedania, MD, and Rebecca Soares, MD, MPH, about a recent peer-reviewed retrospective cohort study on this topic. After the break, the trio discuss how to manage patients who do not tolerate antiseptics, the benefits of visualizing antiseptics on the conjunctiva, and the specific practice patterns that work best in their clinics. 

Performing surgery for symptomatic vitreous opacities (SVO) was once verboten in retina medicine, but the field has seen a sea-change in mindset over the past decade. In this podcast, moderator John Kitchens, MD, is joined by Edwin H. Ryan, MD; Christina Y. Weng, MD, MBA; and Alison Bozung, OD, to explore why surgery for SVO has become more palatable and how this evolution in mindset is impacting patients' quality of life. 

Do the status of the fovea and/or the timing of surgery affect visual outcomes following RRD repair? Join New Retina Radio Journal Club host Lediana Goduni, MD, as she and panelists Matt Starr, MD, and Joshua Uhr, MD, dissect the findings of a recent paper exploring this question. After the break, the trio discusses tactics for overcoming challenges to real-world conditions when patients present at times when immediate surgery is not an option. 

Sponsored by Apellis Pharmaceuticals. Scott Walter, MD, and Esther Kim, MD, join John W. Kitchens, MD, to discuss how they treat GA in their practices. Listen to gain expert insights as Drs. Kim, Walter, and Kitchens each share their experiences with this treatment. They also share best practices for dosing based on trial data.

Sponsored by Apellis Pharmaceuticals. John W. Kitchens, MD, invites Scott Walter, MD, and Esther Kim, MD, to discuss best practices for identifying appropriate patients with GA for treatment. Gain perspectives on patient selection, patient education, and safety considerations.

Two biosimilars are approved for use in retina by the US FDA—and more will be approved in the coming years. What exactly are biosimilars? What benefit might they provide? And how confident are retina specialist that biosimilars will deliver safe, high-quality care?  Moderator John Kitchens, MD, sits down with retina specialists Carl Awh, MD, and Firas Rahhal, MD, to answer these questions, and to ask whether the economic realities of biosimilars make them a good choice for modern retina practices.  This podcast is editorially independent, supported with advertising by Cimerli. 

The field of retina has made significant strides when it comes to diversity, equity, and inclusion since Julia A. Haller, MD, penned her inspirational 2015 JAMA Ophthalmology editorial, Cherchez la Femme. The ever-growing body of research on this topic stands as a testament to her commitment to understanding the gaps in diversity, particularly in terms of gender differences in leadership positions. Adrienne W. Scott, MD, and Steven Sanislo, MD, sit down with Dr. Haller to discuss the state of affairs in retina and just how far we have come—and how much is left to do.  How are we doing in terms of representation on the podium? How does diversity among retina specialists affect patient care? Why is it important to look for diversity when designing an ad board or conference agenda? What drove Dr. Haller to pursue a career in a traditionally male-dominated field? Check out this episode to hear what Dr. Haller has to say. 

Reimbursements for vitreoretinal surgery have plummeted in the past decade. How dire is the situation? John Thompson, MD, updates listeners on the trends in Medicare reimbursement for a variety of vitreoretinal surgeries, imaging tests, and E&M visits—all of which have implications for the future of care and access to providers.    After the break, Raymond Iezzi, MD, discusses the risks and benefits to using large language models (LLMs) such as ChatGPT in a retina clinic. How will LLMs better serve providers and patients? And what drawbacks might create more confusion than needed? Check out this episode to learn more.    This Editorially independent content is supported with advertising.

What are the consequences to intentional suspension of anti-VEGF therapy in wet AMD patients? Join moderator Sruthi Arepalli, MD, and panelists Rebecca Soares, MD, MPH, and Vaidehi Dedania, MD, as they explore the circumstances under which treatment might be suspended, examine a paper that described the consequences of treatment suspension, and review how they approach treatment suspension in their clinics.