Experts InSight

Dr. Peter Quiros joins host Dr. Amanda Redfern to discuss the recent JAMA Ophthalmology article "The Risk of Nonarteritic Anterior Ischemic Optic Neuropathy in Patients Prescribed Semaglutide," the first study to report a possible association between semaglutide (Wegovy, Ozempic, Novo Nordisk) and nonarteritic anterior ischemic optic neuropathy (NAION). Dr. Quiros provides an overview of what the study showed and what remains unknown, and how ophthalmologists should discuss these recent findings with their patients. Check out the Semaglutide and NAION patient brochure, courtesy of the North American Neuro-Ophthalmology Society (NANOS), and available from www.nanosweb.org. For all episodes or to claim CME credit for selected episodes, visit www.aao.org/podcasts.

Host Dr. Andrew Pouw welcomes Drs. Aakriti Shukla, Mahsaw Mansoor, and Alan Robin to discuss the latest sustainability initiatives in the ophthalmic OR and clinic that reduce waste, economic costs, and environmental impact. The participants gratefully acknowledge the joint support of the American Academy of Ophthalmology and the American Society of Cataract and Refractive Surgery, the inspiration from physicians at the Aravind Eye Hospital, and the following individuals for their commitments to sustainability in ophthalmology: David Chang, MD, Barbara Erny, MD, Cathleen McCabe, MD, David Palmer, MD, Emily Schehlein, MD, and Cassie Thiel, PhD. For all episodes or to claim CME credit for selected episodes, visit www.aao.org/podcasts.

Drs. Maura Di Nicola and Basil Williams join host Dr. Jay Sridhar to discuss the latest ongoing ocular oncology clinical trials for the treatment of uveal melanoma and associated complications of radiation therapy. Their review begins with the DRCR Retina Network’s Protocol AL, which is studying the use of anti-VEGF agents or corticosteroids to reduce the occurrence of radiation retinopathy and consequent vision loss. Drs. Di Nicola and Williams also offer insights about the use of belzupacap sarotalocan (bel-sar) for early-stage choroidal melanoma (CoMpass trial), as well as adjuvant treatment with darovasertib, a protein kinase C inhibitor. For all episodes or to claim CME credit for selected episodes, visit www.aao.org/podcasts.

Drs. Emmanuel Chang and Eric Nudleman join host Dr. Ben Young to review Stickler syndrome, when to suspect, and how to diagnose this condition that can lead to significant systemic manifestations and severe vision loss. The panel also discusses the role and evidence for prophylactic treatments to reduce the rate of retinal detachment, which can occur in up to 65% of affected patients. For all episodes or to claim CME credit for selected episodes, visit www.aao.org/podcasts.

Host Dr. Jay Sridhar welcomes Dr. Gareth Lema to discuss his group's recent study published in Ophthalmology that quantified the amount of eye drop waste in ophthalmic clinics and the implications for practice. When handled appropriately, argues Dr. Lema, eye drops can be used until the FDA-regulated expiration date, and thus help reduce both their carbon footprint and costs while still providing safe and effective patient care. Read more: Tan JM, Chen B, Vail D et al. Ophthalmic drop waste due to self-imposed use cessation dates. Ophthalmology. 2024, Jul 1:S0161-6420(24)00391-9. For all episodes or to claim CME credit for selected episodes, visit www.aao.org/podcasts.

Dr. Tamara Fountain joins host Dr. Ben Young to discuss strategies to avoid medical mistakes, how to recognize cognitive biases that can lead to diagnostic error, and what we can learn from the airline industry to improve patient safety. For all episodes or to claim CME credit for selected episodes, visit www.aao.org/podcasts.

The Centers for Medicare and Medicaid Services (CMS) created the new G2211 add-on code to address the resource cost and effort to build patient relationships with those impacted by chronic and complex conditions. Use of this new add-on code is dependent on ophthalmologists building strong long-term relationships with patients to benefit their longitudinal care. Drs. Lee Alward and Young Kwon join host Dr. Andrew Pouw to share their experiences and wisdom for building trust and rapport towards a valuable patient–physician relationship. Factsheet on HCPCS Code G2211 Visit Complexity Add-on Code: www.aao.org/g2211-code For all episodes or to claim CME credit for selected episodes, visit www.aao.org/podcasts.

Spaceflight-associated neuro-ocular syndrome (SANS) is a constellation of findings that often present in astronauts who have undergone long-duration space flight in microgravity environments. Astronauts with SANS may have disc edema, choroidal folds, cotton wool spots, nerve fiber layer thickening on OCT, globe flattening, and hyperopic shift. In today's episode, neuro-ophthalmologist and NASA consultant Dr. Andy Lee shares what we know about SANS and its implications on our terrestrial knowledge, technology, and the future. For all episodes or to claim CME credit for selected episodes, visit www.aao.org/podcasts.

Episode Description Drs. Avni Finn and Yoshi Yonekawa join host Dr. Jay Sridhar to discuss the current state of retinal reimbursements and the impact that the cost of certain diagnostic and surgical procedures is having on the delivery of patient care. For all episodes or to claim CME credit for selected episodes, visit www.aao.org/podcasts.

With increasing awareness that a retinal artery occlusion (RAO) is a type of stroke, ophthalmologists must be able to plan the next steps of care when an RAO is identified on exam. Drs. Amanda Henderson and Michael Carper join host Dr. Amanda Redfern to guide us through their recommendations and various tricky scenarios, notably whether or not to advise use of tissue plasminogen activator (tPA). For all episodes or to claim CME credit for selected episodes, visit www.aao.org/podcasts.