Year : 2018 | Volume
: 66 | Issue : 12 | Page : 1667-
Revolution in evolution
Santosh G Honavar
Editor, Indian Journal of Ophthalmology Centre for Sight, Road No 2, Banjara Hills, Hyderabad - 500 034, Telangana, India
Dr. Santosh G Honavar
Editor, Indian Journal of Ophthalmology Centre for Sight, Road No 2, Banjara Hills, Hyderabad - 500 034, Telangana
|How to cite this article:|
Honavar SG. Revolution in evolution.Indian J Ophthalmol 2018;66:1667-1667
|How to cite this URL:|
Honavar SG. Revolution in evolution. Indian J Ophthalmol [serial online] 2018 [cited 2018 Dec 18 ];66:1667-1667
Available from: http://www.ijo.in/text.asp?2018/66/12/1667/245622
The learning and practice of vitreoretinal disorders have undergone a radical transformation in the past decade. The pace of innovation in this subspecialty is astounding. Treatments, techniques, and technologies that are the standard of care today did not even exist a decade ago. Advances in diagnostic technologies such as optical coherence tomography (OCT). OCT angiography and multimodal imaging and their widespread application in routine clinical practice have catalyzed paradigm changes in the medical treatment of several common retinal conditions. New-found delight in treating previously untreated or undertreated disorders and the quest to further excel have created a constant need for better and less invasive diagnostic modalities. Patient-centric approach and successful use of intravitreal injections for diabetic retinopathy, diabetic macular edema, wet age-related macular degeneration, and so on have not only transformed the prognosis but also dramatically increased the overall patient volume. This evolutionary process has triggered a demand for trained medical retina specialists. Monthly injections of OCT-guided intravitreal anti-vascular endothelial growth factor injections dominate the medical retina practice today.
The expansion of medical retina much beyond the old horizons, fortunately, has not taken the glamor away from surgical retina. In fact, imaging by OCT has fueled a marked expansion in the indications for vitrectomy for vitreomacular disorders. It is evident that 25- or 27-G vitrectomy has lower complication rates and improved patient comfort when compared with traditional vitreoretinal techniques and instrumentation. Incorporation of heads-up visualization system has drastically improved the surgeon's comfort and has escalated the level of immersive participation and learning by the trainees. We now seem poised for the next major evolutionary step with gene therapy and stem-cell transplantation for inherited retinal diseases, with a workable and affordable retinal prosthesis possibly held for the endgame.
These are exciting times indeed for ophthalmology in general and retina specialists in specific. While the retina specialists are duly enthused by the incredible new concepts and innovations, it is gratifying that our patients have tremendously benefited from the translation of most of the advances into clinical realities with improved efficiency, outcomes, and safety. Revolutionary concepts and disruptive technologies are dancing in tandem and will hopefully keep the mutual attraction and excitement perpetually young and alive in times to come. This Retina special issue of Indian Journal of Ophthalmology is an attempt to chronicle the revolution in the evolution of the subspecialty and will hopefully generate some positive interest among young ophthalmologists to enthusiastically jump on the bandwagon and take it up as their career option.