The Royal College of Ophthalmologists Annual Congress

Abstract

The annual meeting of the Royal College of Ophthalmologists was held in the 2008 European City of Culture, Liverpool (UK). The Royal College of Ophthalmologists was celebrating the 20th anniversary of its founding. The congress scientific program included educational seminars; the presentation of courses and over 200 abstracts as rapid-fire papers; videos and posters; the highlights from the UK subspecialty meetings and the Royal College Eponymous Lectures were also delivered.

The Ashton Lecture was delivered by Gregory Hageman (Carver College of Medicine, University of Iowa, IO, USA). He lectured on the cellular and molecular mechanisms that are involved in the etiology of age-related macular degeneration (AMD). He also pointed out the clinical characterization of ocular drusen and basal laminar deposits, while postulating on why the pathology occurs at the macula. With complement factor H (CFH) playing a central role in AMD and 95% of CFH being produced by the liver, we look forward to the retrospective study results from Hageman’s team regarding liver transplant patients and early-onset AMD.

Roger Hitchings (Moorfields Eye Hospital, London, UK) delivered the Bowman Lecture. He introduced Bowman as a munificent clinician, whose interest in ophthalmology came from his teenage years as a surgical apprentice and whose generosity founded and supported the Ophthalmological Society of the UK. He guided us through the development of ophthalmology in Bowman’s time and the history of glaucoma to the present day. It was light-hearted and inspiring. Focusing on glaucoma, he discussed progression analysis and the variable speed at which an individual’s disease progresses. He reasoned that both trend and event analysis are of clinical value and being able to plot the time to progression can be a very powerful tool when informing patients about their disease.

Anthony Norcia (The Smith–Kettlewell Eye Research Institute, CA, USA) delivered the Edridge Green Lecture. His research has focused on the developing visual system. Using visual evoked potentials, magnetoencephalography and functional MRI, his team has studied neural activity and co-nscious visual perception in infants to see how the visual system is sculpted in the early years of development in normal and ambl-yopic children. Developing tools to investigate v-isual development, he postulated that they should be able to develop tools to manage amblyopia.

Wallace Foulds (Singapore Eye Research Institute, Singapore) was the first President of the Royal College of Ophthalmologists. He was invited to present a role for photoreceptors in retinal edema and angiogenesis: an explanation for laser treatment. Laser pr-oduces its therapeutic effect by a reduction in the photoreceptor load of angiogenic fa-ctors, for example VEGF and inducible nitric oxide synthase; this knowledge can now be used to develop less destructive medical tre-atment for both macular edema and neovascu-larization.

The symposia brought internationally renowned speakers. Graves’ Orbitopathy, chaired by Jane Dickinson (Newcastle, UK), focused on improving the quality of life in these challenging patients. Wilmar Wiersinga (University of Amsterdam, The Netherlands) discussed the use and misuse of medical therapies. He fully recommended the use of multidisciplinary clinics that enhance quality of care and ease collaborating for research. Geoffrey Rose (Moorfields Eye Hospital) advocated a role for surgery early in the disease. He demonstrated his elegant technique of a retrocaruncular approach for a one and half walled decompression. He reminded us to listen to the patient, particularly when avoiding the ‘goldfish to Garfield’ look! This symposium ended with Peter Foley, a patient from Lancashire, expla-ining the impact that Graves’ disease had on his life.

The neuro–ophthalmology symposium tackled ischemic optic neuropathy. Neil Miller (Wilmer Eye Institute, MD, USA) looked at the evidence base for risk factors for ischemic optic neuropathy. Taking a comprehensive history and asking about amiodarone and sildenafil use, as well as sleep apnea, was important. He also discussed perioperative visual loss, which is topical as it has been the subject of the American Society of Anaesthesiologists practice advisory document. Tim Matthews (Birmingham, UK) applied Bayes’ Theorem to the investigation of giant cell arteritis and explored the role of aspirin in giant cell arteritis m-anagement.

The ocular oncology symposium, chaired by Bertil Damato (Liverpool, UK), spoke on adult ocular oncology. Damato emphasized the psychological care that is required and the importance of a specialist team, which includes health psychologists and skilled pathologists. Jacob Pe’er (Jerusalem, Israel) covered all conjunctival tumors and their treatment. He described his no-touch technique for excisional biopsy and stressed that the first surgery needs to be the best, to reduce the risk of recurrence and metastasis. Sarah Coupland (Liverpool, UK) comprehensively discussed intraocular and conjunctival lymphomas.

The Advanced Medical Optics (AMO) prize for one of the highest marks in abstract marking was awarded to RL Ford (Central Middlesex Hospital, London, UK). The British Ophthalmological Surveillance Unit (BOSU) study of traumatic optic neuropathy found the incidence in the UK to be at least one per million population per year.

During the Ophthalmology showcase, chaired by David Wong (University of Hong Kong, PR China), The Societas Ophthalmologica Europaea (SOE) prize was awarded to AJ Shortt for obtaining one of the highest marks at abstract judging. The Moorfields team presented clinical, impression cytology and confocal microscopic outcomes of successful ex vivo cultured limbal epithelial stem cell transplantation performed to strict European Union legislation regulatory standards in humans.

The Foulds Trophy for the best basic science oral presentation was awarded to TZ Khatib (University of Oxford, UK). She presented work on the effect of indocyanine green (ICG) and light on retinal neurons, mimicking the effects of ICG usage in vitreoretinal surgery. The findings confirmed that IGC causes apoptosis above 0.015% concentrations in vitro.

The DVD exhibition was of a high quality, covering all subspecialty surgery. The Treacher Collins Prize for the best DVD was awarded to C Heatley and K Barton’s team (Moorfields Eye Hospital) for their well-designed and elegant presentation ‘Improved early flow control with the Baerveldt glaucoma implant – use of a stent suture without external ligation’. An external ligature is widely used to prevent early hypotony with the Baerveldt implant. The video demonstrated their technique of using a stent suture inserted through a tight scleral anterior chamber entry site. This avoids the sudden decompression experienced with nonvalved aqueous shunts when an external ligature is used.

The first British Isles Neuro-Ophthalmology Club poster prize – awarded in memory of Ivor S Levy – was presented to LJ Best (Belfast, UK) for the BOSU study of the incidence of blindness secondary to idiopathic intracranial hypertension in the UK. The study found that the incidence of blindness is much lower at 1–2% than previously reported at 6–10%.

The Royal Eye Hospital Manchester poster prize was awarded to CE Stewart (City University, London, UK), who presented the neural deficit in human amblyopia. The team used functional MRI and psychophysical methods to confirm that amblyopic observers show significant deficits of global motion for amblyopic and fellow eye stimulation, suggesting that there are extrastriatal deficits, in addition to documented dysfunction in the primary visual cortex.

The Royal Hospital London Poster prize was awarded to S Park (Institute of Child Health, University College London, UK) for the poster presentation investigating which developmental glaucoma genes were genetic risk factors for primary open-angle glaucoma. They found that anterior segment dysfunction caused by altered LIM homeobox transcription factor 1, β (LMX1B) allele function may predispose the general population to adult-onset glaucoma. More commonly associated with nail–patella syndrome, the LMX1B gene provides instructions for producing a protein that binds to specific regions of DNA and regulates the activity of other genes. The LMX1B protein appears to be particularly important during early embryonic development of the limbs, kidneys and eyes.

The 2009 Congress will be marked with the first Optic UK Lecture that will be delivered by Alfred Sommer from Harvard. There is an excellent scientific programme lined up with two eponymous lectures: the Edridge Green Lecture will be delivered by Irene Gottlob (Leicester University and Leicester Royal Infirmary, UK) and the Duke–Elder Lecture will be delivered by Anthony Moore (Moorfields Eye Hospital). We look forward to seeing you in Birmingham, UK on 19–21 May 2009 (for further details see [1]).

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.