On Jan. 25, 2020, the Chinese New Year officially began and was greeted with optimism and fanfare by much of the world. Less than 4 months later, any rosy expectations for “The Year of the Rat” scurried away with eruption of COVID-19. The worldwide pandemic left ophthalmic practices with paralyzed patient volume and revenue, and physicians and staff facing confusing combinations of furlough, unemployment and even job loss.

About 18 months later, gazing hopefully toward the pandemic’s nadir, our field has returned to a new normal of socially distanced patient volume, physician office mask mandates and a political climate nearly opposite of that when the terms “coronavirus,” “insurrection” and “Fauci” became household lexicon.

GRATEFUL

In recent months, many practices have been faced with more nuanced challenges. These include staff shortages, vaccine hesitancy and even the occasional patient mask rebellion, much to the consternation of our heroic but frazzled staff.

Nevertheless, certain lessons from the darkest days of the worldwide lockdown should never be forgotten. Along with proper handwashing hygiene and masks when appropriate, it is my hope that we never lose gratitude for the privilege of practicing such an erudite subspecialty of medicine that will never be unessential to our patient’s lives.

I am grateful to have been invited to be guest editor for OM’s annual retina issue. After a tumultuous year, the opportunity to review new instrumentation and pipeline innovations and to discuss these with my peers has been immensely satisfying. This experience has reassured me that — despite so many challenges — the world of retina will always be focused on achieving stellar patient outcomes through pharmacologic and technologic advances.

IN THIS ISSUE

Several illustrative case studies highlighting the function of OCT, ultra-widefield FA and telemedicine/home monitoring are reviewed by my colleague, Dr. Joshua Mali (page 18). Dr. Sidney Schechet follows up on this with an alluring vision of digital care models and remote monitoring to facilitate the detection of dry to wet AMD conversion. He reviews remote technology to monitor patients who have developed neovascularization between clinic appointments for fluid recurrence (page 28).

Focusing on increasing the duration between patient visits for intravitreal treatments is becoming increasingly relevant — Dr. David Eichenbaum gives us a look at the many new, longer-lasting target biologics for chronic retinal diseases that are emerging from successful late-term clinical trials, as (page 34).

Hot on the heels of these antibody-based therapies, even longer term, potentially curative solutions might be found in a DNA-altering approach to retinal disease. Dr. Christine Kay reviews gene therapies for both wet and dry AMD with geographic atrophy, the latter for which there still exists no effective options for attenuating progression (page 31).

Finally, several talented private practice retina veterans participated in a discussion on the use of subthreshold retinal lasers for effectively treating a variety of clinical conditions involving the fovea (page 22).

CONCLUSION

Thank you to each of our authors for their time and passion in contributing to this issue, and to the editorial team of Ophthalmology Management for consistently putting forth such an up-to-date approach to innovations in our field. Most of all, thank you, loyal reader, for continuing to do what you do best in your practice of medicine and ophthalmology. OM

Daniel F. Kiernan, MD, FACS, is a vitreoretinal surgeon with The Eye Associates in Sarasota, Fla., and on staff at Sarasota and Manatee Memorial Hospitals. During his vitreoretinal surgical fellowship at the University of Illinois Eye and Ear Infirmary, Dr. Kiernan was awarded several accolades for his research in imaging and treatment of retinal diseases, including the Raymond R. Margherio Award from the Retina Society. He continues his interests in investigating both noninvasive and surgical approaches for the diagnosis and treatment of sight-debilitating retinal diseases such as macular degeneration, diabetic retinopathy and inherited retinal diseases. Email him at dkiernan@theeyeassociates.com.