By Muhammad Adil Seelarbokus, Final Year Medical Student, Newcastle University.
With an ever-increasing ageing population with multiple co-morbidities presenting to clinics nowadays, the need for medical ophthalmologists is growing. The Medical Ophthalmological Society’s Annual Meeting seemed to be an excellent way to learn more about this evolving specialty, mostly unheard of in medical school.
Held in Bristol this year, it attracted physicians and surgeons alike, with backgrounds in rheumatology, neurology and paediatrics. Having a multidisciplinary attendance was conducive to extremely stimulating talks and discussions around key topics such as uveitis, giant cell arteritis and optic neuritis.
The morning began with a symposium on recent developments in uveitis. Mr Richard Lee, an ophthalmologist working alongside the NIHR, delivered a talk on key updates in adult uveitis. The following topics were discussed:
- The ADVISE trial
Following the results of the MUST trial - which showed moderately increased benefit of systemic therapy over local treatment for uveitis – the ADVISE trial is an upcoming study looking to compare the use of adalimumab with the use of conventional immunosuppressive treatment for uveitis.
- The MERIT trial
A study comparing the efficacy and safety of intravitreal ranibizumab, intravitreal methotrexate, and intravitreal dexamethasone implants for persistent uveitis macular oedema post-intravitreal steroid injection.
- The future of uveitis treatment with
- Filgotinib, a JAK inhibitor
- Plasmid injection with EYS606.
Professor Athimalaipet Ramanan provided an update in paediatric uveitis. He is well-known for the SYCAMORE trial, which established the key role of adalimumab, an anti-tumour necrosis factor agent, in paediatric uveitis treatment. However, a number of children remain with active disease despite treatment with an anti-TNF drug. The APTITUDE trial is looking into this cohort and whether or not the interleukin-6 inhibitor Tocilizumab can induce remission.
There was also a brief talk on the importance of the Uveitis National Clinical Study Group in allowing for multicentre trials of diseases that are relatively rare to be better researched.
Dr Sarah Mackie delivered the keynote lecture on giant cell arteritis, focusing on the clinical diagnosis of the disease, and the dangers of over-diagnosing GCA in biopsy-negative patients. There was also an interesting discussion around the often-underestimated dangers of long-term steroid use. Importantly, Dr Mackie raised awareness of the recently updated NICE guidelines around the use of Tocilizumab as a steroid-sparing drug in the management of GCA (guideline TA518).
The day was closed by original presentations from trainees (and myself), with an award for the best presentation.
Overall, this was an excellent day for anyone currently training in medical ophthalmology, or contemplating a career in ophthalmology – medical or not!