CCS 2025: Patient journey with neovascular retinal disease through advanced treatment and beyond

Video Transcript:

Editor's note: The below transcript has been lightly edited for clarity.

Emily Kaiser Maharjan:

Hi everyone. I'm here with Dr Deep Parikh, who is presenting at the Collaborative Care Symposium on advanced treatments in neovascular retinal disease. Thank you so much for being here, Dr Parikh. I'm really excited to learn more.

Deep Parikh, MD:

Thank you for having me, Emily.

Emily Kaiser Maharjan:

Of course, so you're giving a spotlight CE session on a patient journey with neovascular retinal disease through advanced treatment and beyond. Can you just give me a brief overview of what you're going to be discussing?

Deep Parikh, MD:

So I think it's going to be fantastic because we touch upon a couple of real-life cases where you kind of see these retinal treatments in action. We'll be touching upon vein occlusions, both branch and central retinal vein occlusions, wet macular degeneration and possibly even a diabetic macular edema case. So you know, sort of giving the real-life, real-world applications to some of the concepts we'll be discussing.

Emily Kaiser Maharjan:

Yeah, absolutely. And treatment burden is especially notable for patients with retinal disease. Is there anything that providers can do to help ease this burden?

Deep Parikh, MD:

So that, and I'm glad you asked that, because that's a real, a real problem, right? So as patients get older and they develop certain conditions, and these retina issues, these are chronic issues that require treatment, and you know, and it's a significant treatment burden for the patient, right? So you have a patient who doesn't see well, who might be older, has to come into your office for these monthly or, you know, now maybe 3-4 month injections, every 3-4 month injections, potentially. And you know, sometimes someone has to bring them. So there's a significant burden on the patient and the caregiver for these treatments. And, you know, with longer, more durable treatments in development, I think that can really ease some of that treatment burden that patients have.

Emily Kaiser Maharjan:

Absolutely and, you know, kind of digging a little bit more into some of those cases. I know that there's a lot of continuing research on more and more durable treatment options for retinal disease, and I'm sure that plays a role in your discussions on these advanced treatment plans. So do you think that we are reaching the limits on durable treatments, or is there further to go?

Deep Parikh, MD:

No, I definitely think there's, there's further to go, and it's sort of similar to all of medicine. And you know, medical advances in every field have been, have been pretty, pretty fantastic. And I think in the retina space too. I mean, at the rate of progression and the rate of developments is, is really something to look forward to. I don't think we're at the peak yet. I think there's a lot of talk about gene therapy for some of these, these conditions. And no, I'm pretty, pretty optimistic on the future of some of our treatments.

Emily Kaiser Maharjan:

So a lot of patients with advanced retinal disease require long-term care. It's not a short-term thing. So how do you collaborate with other care providers or optometrists on these cases that receive, you know, advanced treatment to make sure that they receive the best long-term care, and also managing, you know, maybe other ocular diseases.

Deep Parikh, MD:

I think that's a great question. And, you know, I think as patients get older, as they have more pathology, I think there's a lot of comorbid things that that happen, right? They have a lot of comorbidities. So you know, your patient that I'm treating in the office for macular degeneration, for example, you know, their vision may be limited from their macular degeneration, but you also want to be on top of their glaucoma, their dry eyes. And so I think collaborative care with specialists, focusing on different aspects, you know, of their care, is very important. I mean, you know, I often see a macular degeneration patient that I'm treating, and sometimes their vision goes down, and they think it's the macular degeneration getting worse, but oftentimes, if you look carefully, it's their dry eye and and especially when the vision is limited, those you know, the dry eye can make a significant impact on on the remaining vision. And so collaborative care for these patients is very important.

Emily Kaiser Maharjan:

Branching off of that, this meeting is all about collaborative care. So what do eye care providers gain by learning together? You know, across the aisle of optometry and ophthalmology.

Deep Parikh, MD:

Your office visit, and the amount of time you have in the day is is limited, and it's very difficult for one doctor to manage different conditions, right? So, you know, I think that the collaborative care is a way for things not to get missed, right? So you have multiple eye doctors looking at the patient, you have an optometrist looking at the patient, you might have a glaucoma specialist, you might have a retina specialist, and I think the patient really wins and really benefits from a different set of eyes, looking at the patient and focusing on different things. You know, our time in the day is limited as doctors and we want to do everything we can, but sometimes it's useful to lean on our colleagues.

Emily Kaiser Maharjan:

And do you have any clinical pearls for eye care providers who are managing or comanaging patients with neovascular retinal disease.

Deep Parikh, MD:

Learning how to interpret and read imaging, whether it's OCTs or now OCT angiography, is of utmost importance. That's my first clinical pearl. Learning how to read angiograms and being comfortable and familiar with them is very important. My second clinical pearl is listening to your patients. If your patient's telling you their vision is going down and you're not seeing anything obvious, look a little further. Send them for an additional test to see what's going on. Sometimes I'll send patients for an ERG, electroretinogram, when we when we can't find the etiology on on a fluorescene angiogram, for example. And if you still don't see anything and the patient's still complaining that their vision is going down, refer them to a colleague and get another opinion. You will never go wrong by getting a second or a third opinion.

Emily Kaiser Maharjan:

Is there anything else that you want to mention about this presentation that I haven't asked you about?

Deep Parikh, MD:

No, I just want to say this is going to be a really interesting presentation with me and my colleagues and and I think I think you're going to get a lot from from this presentation.