Photo Credit: Nemes Laszlo
During AAO 2024, the annual meeting of the American Academy of Ophthalmology, researchers presented various studies on retinal changes, imaging, and procedures.
Kaushick Biswas, MBBS, aimed to investigate retinal changes in Sherpa climbers who summited Mount Everest multiple times, including at least once without oxygen support, focusing on potential retinal vascular and ultraviolet radiation–induced effects. A retina screening camp was conducted in a village in the Darjeeling Hills, where 20 male Sherpas aged 22–40 participated. Comprehensive eye examinations included visual acuity, anterior segment evaluation, intraocular pressure (IOP) measurement, and full dilated vitreoretinal assessment using indirect ophthalmoscopy. A single observer conducted the evaluations, and detailed retinal diagrams were created for each participant.
The findings revealed that 40% (8 out of 20) of the climbers exhibited retinal changes. Key observations included retinal hemorrhages, macular pigment epithelial changes, retinal vessel attenuation, and branch vein occlusion. These results suggest that repeated high-altitude exposure, especially without oxygen support, may contribute to significant retinal vascular alterations and potential damage linked to environmental factors such as hypoxia and ultraviolet radiation.
Similarly, Neil Sheth, MD, and colleagues analyzed trends in the utilization of retinal imaging and procedures in the United States from 2013 to 2021 using data from the Medicare Physician and Other Practitioners database. The focus was on procedural codes for intravitreal anti-vascular endothelial growth factor (anti-VEGF) injections, optical coherence tomography (OCT), fundus photography (FP), fluorescein angiography (FA), indocyanine green angiography, ophthalmic ultrasound, and panretinal photocoagulation (PRP).
The findings revealed significant shifts in practice patterns. OCT usage increased annually by 5.02%, while FA declined by 12.17%, and other imaging modalities decreased as a percentage of total retinal imaging ordered (P<0.001). Anti-VEGF injections saw an annual increase of 3.83%, whereas PRP utilization declined by 8.96% per year, with a notable 30% reduction from 2019 to 2020.
These trends suggest that OCT, due to its advanced diagnostic capabilities, has increasingly replaced FA in the evaluation of retinal diseases. Similarly, the rise in anti-VEGF therapy reflects its growing role in managing retinal conditions, supplanting PRP for certain indications. The COVID-19 pandemic accelerated these shifts, likely due to changes in healthcare access and procedural priorities.
