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Volume 25, Number 2  | October 2017

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Dr. Sherif El-Defrawy
Message from the Chair

October 2017

Dear colleagues

The new Grand Rounds format began in September of this year with presentations from a mix of visiting professors alongside our own academic faculty.   While visiting professors will continue to bring cutting-edge clinical and basic science information from centers around the country and beyond, our own physicians have added a terrific component to  our grand rounds presentations. Not only have we been able to share the extensive expertise within our own Department of Ophthalmology and Vision Sciences, but also the internal rounds are a practical based rounds that have direct clinical relevance. These rounds are often patient based and very useful for highlighting cases and aspects of diagnosis and management.  The timing of the rounds is now between 7:30 and 8:30am on Friday morning instead of last year’s early 7:00am start.  Resident teaching continues to occur immediately following rounds for the rest of the morning and is the backbone of the department’s resident education program.  

We had hoped for the building of an auditorium at Kensington to house grand rounds, however we now know that this expansion will not take place.  Grand Rounds will continue to be held at Kensington for the remainder of 2017-2018. Kensington continues to provide free underground parking for our rounds.   In the coming years Grand Rounds will be circulated and hosted by our fully affiliated downtown hospitals. 

I hope you find these Grand Rounds as enjoyable and informative as I do.  Please do not hesitate to discuss with me any ideas you may have to further enhance this very important departmental activity.  

Sherif El-Defrawy, MD, PhD, FRCS(C)
Nanji Family Chair in Ophthalmology & Vision Sciences
Chair & Professor, Department of Ophthalmology & Vision Sciences
University of Toronto

Featured in this issue:

News

Dr. Asim Ali appointed as Interim Chief, Department of Ophthalmology & Vision Sciences, The Hospital for Sick Children

It is my pleasure to announce that Dr. Asim Ali will be appointed as Interim Chief of the Department of Ophthalmology & Vision Sciences at the Hospital for Sick Children effective August 31st, 2017.  Dr. Ali is a staff ophthalmologist and co-director of the Paediatric Cornea Fellowship, as well as the Director of Clinical Services for Ophthalmology.   In the Department of Ophthalmology and Vision Sciences at the University of Toronto, he holds the rank of Associate Professor and is the Fellowship Director as well as the Chief of the Paediatric Ophthalmology Service. 
 
Please join me in congratulating and welcoming Asim to this role.
 
An international search for the new Chief of the Department of Ophthalmology & Vision Sciences at the Hospital for Sick Children is currently being initiated and should be completed by the end of the 17/18 academic year.

Thank you to Dr. Agnes Wong for her outstanding contribution as Ophthalmologist-in-Chief at HSC.

New Vice Chairs in Basic Science Research and Clinical Research

(Left) Dr. Valerie Wallace - Vice Chair Basic Science Research;  (Right) Dr. Rajeev Muni - Vice Chair Clinical Research
I would like to inform you that the Vice Chair Research and Academic Affairs (previously held by Dr. Agnes Wong) will be replaced by two new positions, Vice Chair Basic Science Research and Vice Chair Clinical Research in order to further advance our research focus.

It is a great pleasure to welcome Dr. Valerie Wallace as the new Vice Chair Basic Science Research and Dr. Rajeev Muni as the new Vice Chair Clinical Research in the Department of Ophthalmology and Vision Sciences at the University of Toronto.
 
Dr. Valerie Wallace

Dr. Valerie Wallace obtained her PhD in the Department of Immunology at the University of Toronto and completed postdoctoral studies in developmental neuroscience at the University College London. From 1998-2013 she was at the Ottawa Hospital Research Institute (University of Ottawa) where she was Senior Scientist and Director of the Vision Research Program. Dr. Wallace joined the Krembil Research Institute/University Health Network in September 2013, where she is Senior Scientist and Co-Director of Donald K Johnson Eye Institute and Director of the Vision Science Research Program.  She holds appointments in the Departments of Ophthalmology and Vision Sciences and Laboratory Medicine and Pathobiology, at the University of Toronto. She is a molecular and developmental biologist by training, and has been recognized for her work on the role of Hedgehog signaling in neural progenitor proliferation in the central nervous system. Her lab is now applying this knowledge towards investigating the role of morphogen signaling in tumorigenesis and the development of cell-based approaches for the treatment of blinding eye diseases, including age related macular degeneration.

 
Dr. Rajeev Muni
 
Dr. Rajeev Muni has been a staff Vitreoretinal Surgeon at St. Michael's Hospital, The Hospital for Sick Children and the Kensington Eye Institute for the past eight years. Dr. Muni completed his residency in ophthalmology at the University of Toronto followed by a fellowship in Vitreoretinal Surgery.  He was awarded a Detweiler Fellowship from the Royal College of Physicians and Surgeons of Canada for advanced training in Paediatric Vitreoretinal Surgery at the University of Southern California. Dr. Muni went on to complete a Masters Degree in Clinical Epidemiology at the Harvard School of Public Health.  Since joining the University of Toronto, Dr. Muni has been the Director of Resident Research and the Chair of the Annual Department of Ophthalmology and Vision Sciences Research Day. He has also served as the Director of Retina Fellow Research at St. Michael's Hospital since 2009 and has recently initiated a Vitreoretinal Clinical Research Fellowship at the University of Toronto.  He also sits on the KEI Research Committee. Dr. Muni has been the recipient of several teaching awards over the years including the Dr. Clive Mortimer Executive Award for Excellence in Postgraduate Teaching, the J.S. Crawford Teaching Award, and several St. Michael's Hospital Ophthalmology Teaching Awards.  He has remained active in clinical research with a keen interest in randomized clinical trials for retinal detachment repair and prospective studies investigating the use of ocular fluid biomarkers to predict disease severity and treatment response for common Vitreoretinal conditions.

Please join me in congratulating Drs. Valerie Wallace and Rajeev Muni on their appointments. 
Thank you to Dr. Agnes Wong for contributions to the Department as Vice Chair Research and Academic Affairs.
 

Retirement of Dr. Robert Pashby

The familiar face of Dr. Robert Pashby is greatly missed since his retirement this year after 41 years of devoted service as an ophthalmic educator to the Department of Ophthalmology and Vision Sciences.  Since his appointment to the department in 1976, Dr. Pashby has made an outstanding contribution as a committed teacher and mentor for our undergraduate, postgraduate and fellowship programmes. 

As an Alumni, Dr. Pashby graduated with his MD from the University of Toronto in 1971, completed his residency in 1976 and was the first ever to win the Woywitka Cup for Best Resident. Over his teaching career Dr. Pashby has inspired generations of young ophthalmologists to become excellent doctors. His teaching has been acknowledged by the many teaching awards including the J.S. Crawford Award (1994, 2004), Silver Needle Award (1998), Resident Teaching Award (2001), Millennium Award (2002), J.D. Morin Award (2005), Golden Suture Award (2010, 2011, 2013), as well as the Hospital for Sick Children Dr. Ray Buncic Humanitarian Award (2013).

Dr. Bob Pashby comes from a strong ophthalmology heritage, his father Dr. Tom Pashby was renowned for his work with sports eye injury and in 2017 a new rink at Leaside Gardens was named after him (see story in the newsletter).

In 2016 to honour his teaching and service, the Hospital for Sick Children introduced a new award called the Dr. Robert Pashby Award to be presented annually to a DOVS resident at the Graduation Dinner.

The Department thanks Dr. Pashby for his outstanding contribution and congratulates him with the sincerest best wishes on his retirement.

New rink at Leaside Gardens to be named for Doc Pashby as part of a ground-breaking Safety Partnership with the Dr. Tom Pashby Sports Safety Fund


January 16, 2017/in News /by Leaside Gardens
(Original article link)

“Rink A” at Leaside Gardens will be renamed the “Dr. Tom Pashby Play Safely Rink,” arena board chair Ray White has announced, “and the Safety Partnership will be funded by a generous gift from the Dr. Tom Pashby Sports Safety Fund”. An agreement between the arena board, the East York Foundation and the Dr. Tom Pashby Sports Safety Fund was signed on December 21 st.

“We are grateful to the Pashby Fund Board of Directors for making this extraordinary gift possible,” said White; “it will be a lasting legacy to Doc Pashby, his community spirit and important work in sports safety.”

Bill Pashby, Pashby Fund Chair and son of Doc Pashby said: “Doc was passionate about head and neck injuries in hockey and he hated seeing young athletes cut down in their prime and confined to wheelchairs. He wanted to prevent these paralyzing injuries that had crept into the sport he loved
so much.”

The $500,000 gift and naming of “Rink A” as the “Dr. Tom Pashby Play Safely Rink” will set the stage for the Leaside Gardens to be a leader in the promotion of safe play and best practices for the prevention of catastrophic injuries in sports and recreation. A safety committee will be established with representatives from the Pashby Fund, the Arena Board and user groups to ensure that the Arena is a showcase for best safety practices, equipment and programs, and a constant reminder to Have Fun – Be Safe.

Dr. Pashby (1915 – 2005) was a lifelong Leaside resident and an advocate for mandatory helmets and face guards for minor hockey players; and for penalties for cross-checking. For his pioneering efforts he was awarded the Order of Canada, inducted into Canada’s Sports Hall of Fame, and was an inaugural inductee into the Leaside Sports Hall of Fame in 2013.

Residents' Report


Stephanie Low (PGY5) & Rebecca Stein (PGY3)
Taking place from September 22 to 24, 2017 in Collingwood, ON, the annual resident retreat was a great success. With clear blue skies during the day and warm starry nights, we could not have asked for better weather. We kicked off the event with a presentation of the Optic Cup - the prize for which the PGY teams competed through a series of team-building challenges. Then, following a barbecue at the chalet, we ended the night with a blazing bonfire on the beach. On Saturday, residents were tasked with completing the Amazing Race in teams generated at random. Teams raced around the village in search of checkpoints, where challenges awaited us in the form of brain teasers, skill testing questions, tests of gastronomical knowledge, and physical endeavours. In the evening, we were treated to dinner at the Huron Club with thought provoking talks on relational ophthalmology, as well as "thrival" strategies in residency and beyond. Our invited speakers were Dr. Rex Kay, the head of psychodynamic psychotherapy at the University of Toronto, and Dr. Harmeet Gill, assistant professor in the Department of Ophthalmology and Vision Sciences and specialist in oculofacial plastic and reconstructive surgery. Sunday was marked by a send-off brunch, after which residents headed back to the city a little fatigued, but energized by the weekend experience and newly formed relationships. 
 
Many thanks to Dr. El-Defrawy and Dr. Lloyd for their ongoing support of the annual resident retreat. Thank you to the fellows without whom this opportunity would not be possible.

Toronto Eye Review Course


Radha Kohly, MD, PhD, FRCS(C)
Dr. Radha Kohly (left) and Dr. Edward Margolin (right)
The Toronto Eye Review Course is a talk-like-TED Review Course highlighting practical pearls relevant to all practicing ophthalmologists including both the comprehensive and sub-specialist. It is designed for those who have been out in practice for a few years and require an overall review in areas outside their scope of practice and for senior residents to help prepare them for the royal college oral exams. Like traditional TED talks, the speakers use stories to engage the audience, but the stories are infused with clinical pearls to enhance recall when seeing patients.  The goal is to remove the minutiae and academese and highlight what you need to know and what you don't want to miss when seeing patients in both the on-call and everyday clinical setting. These practical pearls are presented by experienced clinicians who have been coached to present their tried and tested pearls without reliance on text-laden PowerPoint slides. We  hope you join us on May 31st, 2018 for our third talk-like-TED Eye Review Course.  

Date: Thursday, May 31st, 2018
Location: Metro Toronto Convention Centre

Website:
https://torontoeyereview.ca/

Update on the Research and Clinical Activities at the Donald K Johnson Eye Institute


Sherif El-Defrawy, MD, PhD, FRCS(C)
Please see the attached update on the research and clinical activities at the Donald K Johnson Eye Institute.  A big thanks to the leadership of Rob Devenyi and Valerie Wallace and congratulations to our entire team at the TWH/Krembil, you make DOVS proud!

Link:
http://www.uhn.ca/KNC/Research/Globe_Mail/Documents/2017/Vision/Krembil-Vision-Globe-2017.pdf

Randomized Clinical Trial Conducted at St. Michael's Hospital, University of Toronto, Demonstrates Superiority of Pneumatic Retinopexy over Vitrectomy in the Treatment for Primary Rhegmatogenous Retinal Detachment


Rajeev Muni, MD, MSc, FRCS(C)
Tina Felfeli, BSc, MD Candidate

 

Dr. Rajeev Muni from the Department of Ophthalmology and Vision Sciences at St. Michael’s Hospital presented The Pneumatic Retinopexy versus Vitrectomy Outcomes Trial (PIVOT) 1-year results at the American Society of Retina Specialists meeting this year in Boston.1 PIVOT is a randomized trial that compared pneumatic retinopexy (PnR) to pars plana vitrectomy (PPV) for primary rhegmatogenous retinal detachment (RRD). This was a collaborative effort over 6 years involving 5 Vitreoretinal Surgeons, 12 vitreoretinal fellows and over 30 residents at St. Michael’s Hospital and was supported by internal departmental funding. The trial included 176 eyes with RRD and breaks within 1 clock hour, above the 8 and 4 o’clock meridians. The study results demonstrated that 99% of all patients in both groups achieved final retinal reattachment. Of note was the finding that PnR has a significantly better ETDRS visual acuity score at 1 year by 4.93 letters (p=0.0244). Primary anatomical success rate was higher for PPV vs PnR (93% vs 81%, p=0.045), but those who failed pneumatic initially and went on to PPV still achieved good final visual acuity. Very few patients re-detached (1 Pneumatic and 2 PPV) beyond three months suggesting durability of pneumatic retinopexy. Proportion of phakic patients requiring cataract surgery was higher for PPV vs PnR (65% vs 16%, p<0.001). NEI-VFQ25 was significantly better with PnR at 3 and 6 months, but similar between the two groups at 1 year. Overall, the investigators concluded that PnR should be considered as first-line for both phakic and pseudophakic patients due to its superior final 1-year visual acuity and the reduced morbidity.  

The study group is now looking more closely at the vision-related quality of life (NEI-VFQ25) and visual function in patients undergoing PnR and PPV, as well as the correlation of micro and macro structural changes seen on optical coherence tomography with final visually acuity vertical and horizontal distortion measurements. The patients enrolled in the study will be followed for up to 10 years to determine long-term visual acuity and comorbidities in the two treatment groups. The current study has also inspired the PIVOT-extended trial which is currently evaluating PnR in a more diverse cohort.

The interview between Dr. Muni and Dr. Kasra Rezaei from the ASRS 2017 meeting was featured earlier this month on the AAO website homepage. Click here to watch the full clip:
https://www.aao.org/interview/1-year-pivot-data-pneumatic-retinopexy-vs-vitrecto

The study was also featured on the MD Magazine website:
http://www.mdmag.com/conference-coverage/asrs-2017/rajeev-muni-pneumatic-retinopexy-vs-vitrectomy-

1. Muni RH, Felfeli T, Mak MYK, Boghosian K, Wong DT, Berger AR, Altomare F, Giavedoni LR, Kohly RP, Hillier RJ. Randomized trial comparing pneumatic retinopexy vs. vitrectomy in the management of primary rhegmatogenous retinal detachment (PIVOT): 1-year results. Presented at: American Society of Retina Specialists 35th Annual Meeting, Aug. 11-15, 2017; Boston.
 

Diamox with Sulfonamide Allergy – Is it safe?


Jeff Martow, MD
It is commonly believed that since carbonic anhydrase inhibitors like Diamox have a sulfonamide chemical origin, that they shouldn’t be used in patients with sulfonamide allergies. The concept of sulfonamide cross reactivity began in 1955 when Moseley described a patient with a history of sulfonamide allergy who developed a reaction after receiving Diamox (1). He postulated that the reaction could have been related to a previous reaction to the other sulfonamide medication (1).

While it is true that sulfonamides share a common functional group (SO2NH2), they can further be divided into antibiotic and nonantibiotic sulfonamides. The core sulfonamide structure has been shown to be nonimmunogenic. There are chemical structures attached to the functional group that are known immunogens. These immune-inducing structures however are only present on antibiotic sulfonamides and are not present on nonantibiotic sulfonamides like Diamox; therefore theoretically, cross reactivity should not exist.

The issue of sulfonamide cross-reactivity was reported in 2003 in the NEJM where a UK-based retrospective cohort of more than 20,000 patients was analyzed for the risk of an allergic reaction within 30 days after receiving a nonantibiotic sulfonamide. Patients with a history of antibiotic sulfa allergy developed an allergic reaction after subsequent administration of a nonantibiotic sulfonamide 9.9% of the time. Patients with no history of sulfa allergy developed a reaction 1.6% of the time. These findings suggest that having a history of sulfonamide allergy increases the risk of an allergic reaction when the individual is subsequently exposed to nonantibiotic sulfonamides (2).

Interestingly, the same study found that patients with a history of sulfa allergy were at greater risk of a subsequent reaction to penicillin than individuals without a sulfa allergy and that the former were more likely to react to penicillin than to a nonantibiotic sulfonamide (2).  If the shared sulfonamide structure was the inciting agent, patients should have reacted to nonantibiotic sulfonamides more often than penicillin, but the opposite was true.

The concept of sulfonamide cross reactivity originated in 1955 and given the common sulfonamide functional group, it seemed a reasonable hypothesis. This belief has become entrenched within the medical community and was considered fact for many years.  Knowledge about the immune mechanisms involved and detailed epidemiological evidence has revealed that the concept, in reality, is myth. A patient with a history of sulfonamide allergy has a higher risk of subsequent reaction to Diamox, likely because of generally increased immune sensitivity, but the risk is not as great as might be expected of a cross-reactivity mechanism. In fact, in patients with a history of antibiotic sulfonamide allergy, the risk of an allergic reaction to penicillin is greater than for a nonantibiotic sulfonamide. As physicians it is our duty to remain appraised of treatment options and to provide an accurate assessment of risk to our patients.
 
  1. Moseley V, Baroody N. Some observations on the use of acetazolamide as an oral diuretic in various edematous states and in uremia with hyperkalemia. Am Pract Digest Treat. 1955;6(4):558-566.
  2. Strom BL, Schinnar R, Apter A, et al. Absence of cross-reactivity between sulfonamide antibiotic and sulfonamidenonantibiotics. NEnglJMed. 2003;349(17);1628-1635.

One Retinoblastoma World 2017 Meeting, Washington DC


October 11, 2017
 
Photo shows the Sickkids Retinoblastoma team (from L-R):
Dr Ashwin Mallipatna (former Sickkids Pediatric Ophthalmology Fellow; currently an ophthalmologist at Adelaide Women and Children's Hospital) -Morgan Livingstone (Child Life Specialist) -Dr Helen Dimaras (scientist) -Dr Brenda Gallie (ophthalmologist) -Beverly Griffiths (ophthalmic nurse) -Dr Stephanie Kletke (ophthalmology resident) -Kaitlyn Hougham (Retinoblastoma research manager) -Dr Sameh Soliman (ophthalmologist)
 

Honours and Awards

Dr. Yvonne Buys elected as the incoming President of the Canadian Ophthalmological Society

At the 2017 Canadian Ophthalmological Society’s (COS) Annual Meeting in Montréal, Dr Yvonne Buys was elected the incoming 68th President of the COS. This is a 4-year position starting as President-Elect (1 year), followed by President (2 years) and then Immediate Past-President (1 year). Dr Buys has a long history with the COS, first joining the Board in 2010 as Treasurer, followed by Chair of the Annual Meeting Planning Committee (AMPC) in 2013. She will continue in the role of Chair, AMPC, until June 2018. She is only the third woman to hold the position of President over the 80-year history of the COS. Dr. Buys brings previous leadership experience as President of both the Toronto Area Glaucoma Society (2001–2) and the Canadian Glaucoma Society (2007–9). She looks forward to representing the interests of Canadian Ophthalmologists both nationally and internationally and is especially excited as the COS grows in the areas of Advocacy and CPD.

Dr. Ike Ahmed receives Award of Distinction (Innovator of the Year) from the Eye Physicians and Surgeons of Ontario

During the Annual General Meeting held in Ottawa on September 14, 2017, the Eye Physicians and Surgeons of Ontario (EPSO), presented awards of distinction to Dr. Iqbal Ike K. Ahmed and Dr. W. Bruce Jackson.

Dr. Ahmed was recognized for his groundbreaking work in the diagnosis and surgical treatment of highly complex eye diseases, including glaucoma and surgical complications.

Dr. Ahmed is a fellowship-trained glaucoma, cataract, and anterior segment surgeon and is recognized as being one of the most experienced complex eye surgeons in the world. He has trained numerous surgeons in innovative surgical techniques. He has been at the leading edge of novel treatments for cataract surgery and the latest designs in intraocular lens implants. Patients are referred to him locally, nationally, and globally. In 2010, Dr. Ahmed was selected as one of Canada’s “Top 40 Under 40” – a prestigious national award recognizing significant achievements at a young age.

He is currently an Assistant Professor at the University of Toronto and a Clinical Assistant Professor at the University of Utah. He is the Director of Research at the Kensington Eye Institute and Director of the Glaucoma and Advanced Anterior Surgical (GAASS) fellowship at the University of Toronto. Dr. Ahmed has a large tertiary glaucoma/cataract practice at Prism Eye Institute in the Greater Toronto Area, and primarily performs surgery at the Trillium Health Partners and TLC Mississauga, and the Kensington Eye Institute, the University of Toronto.

Dr. Jordan Cheskes, President of the EPSO says, “Dr. Ahmed is likely the most famous and influential anterior segment surgeon in the world; we are fortunate to have him here in Ontario.”

Dr. John Fowler awarded the Eye Physicians and Surgeons of Ontario’s Excellence for Educational Leadership in Ophthalmology Award

Scarborough-Agincourt MPP Soo Wong (left) and Eye Physicians and Surgeons of Ontario (EPSO) chair Dr. Jordan Cheskes (right), present Dr. John Fowler with the EPSO award for Excellence in Educational Leadership in Ophthalmology during a recent ceremony at Queen's Park. - EPSO/photo
Please visit the following link for the complete story:

https://www.insidetoronto.com/news-story/7608718-ureport-ophthalmologist-dr-john-fowler-receives-career-award/

Dr. Sherif El-Defrawy receives Regional Mentor of the Year Award from the Royal College of Physicians and Surgeons of Canada

Dr. Sherif El-Defrawy received Mentor of the Year Award (Region 3) from the Royal College of Physicians and Surgeons of Canada. This award recognizes Fellows of the Royal College who have had a significant impact on the career development of students, residents and Fellows. Awards go to those who have shown themselves to be an excellent role model in demonstrating the qualities or competencies of Manager, Scholar and Professional as described in the CanMEDS Framework.


“Mentorship is the guidance given to a less experienced physician to help develop their abilities, attitudes, skills and objectives. It puts these teachings in the context of the mentor’s experience and allows for insights, coping strategies, mindsets that are not found in formal teachings. Personally I get many positives from mentoring (hardly an altruistic endeavor!). I get to know many of the young specialists in our field and understand the issues and problems they face.”
Why mentor?  Dr. Sherif El-Defrawy shares his answer:

For more information, visit:
http://www.royalcollege.ca/rcsite/awards-grants/awards/regional-mentor-year-award-recipients-e
 
Choudhry N. American Society of Retina Specialists Senior Honour Award

Choudhry N. The Ophthalmologist Power List 2017 - Rising Star 

Gupta N. Re-elected as Vice President, International Council of Ophthalmology, 2018-2020

Ing E. MPH Epidemiology from Harvard School of Public Health, May 25, 2017; CPH (Certification in Public Health) National Board of Public Health Examiners June 16, 2017

Kraft SP. Second Burton Kushner Medallist in Pediatric Ophthalmology.  Awarded January 21, 2017.  Webinar presented Jan. 21, 2017 entitled:  “Imaging of Ocular Muscles using UBM and OCT”.

Kraft SP. 2017 Annual Golden Suture Award  --presented by graduating ophthalmology resident class to best non-cataract surgical teacher in Univ. of Toronto Dept. Ophthalmology and Vision Sciences.  Awarded June 20, 2017

Kraft SP. 48th Richard Scobee Lectureship.  Annual named lecture of American Association of Certified Orthoptists.  Lecture to be given at annual American Academy Meeting in New Orleans, LA, Nov. 13, 2017  (Only second Canadian ophthalmologist selected to give the lecture.)

Tyndel F. Neurology Faculty Teaching Award (Division of Neurology)

Upcoming Events

October - December 2017

October 19, 2017 (5:30pm)
The Toronto Ophthalmological Society presents:
OCT Masterclass: Let's get started...
Casa Loma, 1 Austin Terrace, Toronto
Keynote Speaker:  Dr. SriniVas Sadda
Details:
tosconnect@gmail.com

October 27, 2017
VPP Rounds - Uveitis
Dr. Nupura Bakshi

November 3, 2017
VPP Rounds - Neuro Ophthalmology
Dr. Edward Margolin

November 11-14, 2017
AAO Meeting
New Orleans

November 17, 2017
VPP Rounds - CANMEDS
Dr. Joseph Mikhael

November 17, 2017 (1:30pm)
Faculty Research Day
Li Ka Shing Knowledge Institute, 209 Victoria St, Toronto

November 24, 2017
VPP Rounds - Cataract
Dr. Kylen McReelis

December 1-2, 2017
Walter Wright Day
Metro Convention Centre
255 Front Street W, Toronto
Details:
https://www.cpd.utoronto.ca/walterwright/

December 15, 2017
VPP Rounds - Paediatric Ophthalmology
Dr. Asim Ali


Full Upcoming Calendar and Events

Invited Lectures & Visiting Professorships

Dr. Yaping Jin presented at Knowledge Mobilization Series, Ontario Ministry of Community and Social Services


Yaping Jin, MD, PhD

I was an invited speaker in the Knowledge Mobilization series organized by the Ministry of Community and Social Services on September 26, 2017. The title of my presentation is "Visually disabled in the Ontario Disability Support Program: Trends in socio-demographics, financial support and use of vision care benefits from 2003 to 2013", coauthored by Jin YP, Liu SY, Buys YM, Khan A, Trope GE.

The audience is Ontario public policy professionals including representatives from the health and social policy Ministries (Ministry of Housing, Ministry of Advanced Education and Skills Development etc.).

The presentation went well and raised some interesting questions.

Choudhry N. Pan-American Association of Ophthalmology(PAAO) Annual Conference 2017. Lima, Peru. August 2017

  1. Swept-Source OCT vs. Spectral Domain OCT: Is it Time to make the Switch?
  2. Ultra-Wide Field OCT: The Next Frontier
  3. Imaging Diabetic Retinopathy: A Paradigm Shift
Chow DR. Retina Case Conference Montreal

Chow DR. Asia Pacific Association of Ophthalmology Hong Kong

Chow DR. Aspen Retinal Detachment Soceity

Chow DR. Frankfurt Retina Meeting

Chow DR. Brazilian Retina Society Iguazu Falls

Dimaras H. Patient Engagement in Retinoblastoma Research. Patient and Family Centered Care Week, The Hospital for Sick Children, Toronto, Canada. June 7, 2017.

Dimaras H. Retinoblastoma Genetics. One Retinoblastoma World Family Day. Washington DC, USA. October 9, 2017.

Dimaras H. Diagnosis and Staging of Retinoblastoma. One Retinoblastoma World Meeting. Washington DC, USA. October 11, 2017.

Dimaras H. Histological and Molecular Features of Retinoblastoma. Kenyan Association for Clinical Pathologists (KACP) Annual Meeting. Malindi, Kenya. November 16, 2017.

Gupta N. Keynote Speaker for 25th Anniversary of Glaucoma Service Symposium, Aravind Eye Care System, Madurai Oct 14th and Pondicherry Oct 15th, 2017

Kraft SP. McMaster University, Dept. of Ophthalmology, Hamilton, ON (Sep. 21, 2016) Visiting Professorship

Kraft SP. Anterior segment OCT demonstrating extraocular muscle insertions. 2016 Pediatric Ophthalmology Specialty day, at American Academy of Ophthalmology Annual Meeting, Chicago, IL (Oct. 15, 2016)  Invited Lecture

Kraft SP. The functional benefits of adult strabismus surgery –It’s never just cosmetic! Annual Fall Conference of The Vision Institute, Markham, ON (Nov. 5, 2016) Invited Lecture

Kraft SP. Diplopia after retina surgery: Leave or remove the hardware?  International Perspective of Pediatric Ophthalmology and Strabismus. Jaipur, India (Dec. 2-4, 2016) Invited Lecture

Kraft SP. OCT and UBM in localizing ocular rectus muscles: Historical context and current concepts. The 2nd Annual Burton Kushner Medallist Lecture. AAPOS 2017 Burt Kushner Webinar on Imaging modalities in Strabismus Management. Toronto, ON (Jan. 21, 2017) Invited Lecture

Kraft SP. Annual Meeting of Australia and New Zealand Strabismus Society (ANZSS), Auckland, New Zealand (Feb. 24-25, 2017) Invited Lecture
  • a) Acute comitant esotropia in children
  • b) Idiopathic enlarged extraocular muscles in children – differntial diagnosis
  • c) Vertical rectus transpositions with resections for total 6th nerve palsy
  • d) Resecting the lateral rectus in esotropic Duane syndrome – it can be done safely!
  • e) Cyclic strabismus in an adult – a case report and literature review
  • f) Adjustable sutures in strabismus surgery—do they lead to well-adjusted patients?
  • g) Case rounds – presentation and discussion of several strabismus cases
Kraft SP. Introduction: Les syndromes “CCDD” (The CCDD syndromes).  Congrès Strabomania 6:.La Maison d’Aubrac, Aveyron, France (June 2-3, 2017)

Kraft SP. Using UBM and OCT in strabismus management. Annual C.O.S. Meeting, Montréal, QC (June 15-18, 2017)

Varma D. The Future of MIGS. American Society of Cataract and Refractive Surgery 2017 Glaucoma Subspecialty Day. Washington DC, USA. Invited speaker (May 5, 2017)

Varma D. World Glaucoma Congress 2017 - Invited Speaker What’s new in anterior segment imaging?  Helsinki, Finland.(June 28, 2017)

Grants

Dimaras H. Determining Retinoblastoma Research Priorities (PI: Helen Dimaras) Canadian Institutes of Health Research, Meetings, Planning and Dissemination Grant: Cancer Research. Amount: $8,000

Dimaras H. Development of a Biobank for the Department of Ophthalmology & Vision Sciences. SickKids Ophthalmology Research Fund – Brandan’s Eye Research Fund. Amount: $11,387

Dimaras H. Development of a Pediatric Ophthalmology Academic Partnership Between Canada and Ethiopia
(PI: Asim Ali, Co-PIs: Helen Dimaras, Sadik Sherif) Canadian Institutes of Health Research, Meetings, Planning and Dissemination Grant: Neuroscience and Mental Health. Amount: $10,000

Gupta N & Yucel Y. Glaucoma Research Society of Canada – Protein Deposits in Dementia Patients – Similarities and Differences to Pseudoexfoliation

Varma D. Unrestricted education grant for $70,000 from Alcon to support development of a Halo measurement app

Recent Publications

Recent publications by DOVS Faculty, Staff, Residents and Fellows

August 2017 - September 2017
Chow DR:
OCT Angiography
Publication Date: November 2017
ISBN: 9781626234734

OCT Angiography by David R. Chow and a cadre of renowned authors is an authoritative, richly illustrated guide on a groundbreaking new ophthalmic imaging technique. Optical coherence tomography angiography is revolutionizing ophthalmologic diagnosis and management of retinal disease. The technology is transforming the ocular disease diagnostic paradigm - from the retina to the choroid - enabling precision-tailored patient management.

Noninvasive and more sophisticated than fluorescein angiography, OCTA obviates the need for dye and yields an unprecedented level of detail. The layered visualization of the retina and choroid vasculature delivers greater understanding of retinal disease. From sight-robbing eye diseases affecting millions such as age-related macular degeneration, diabetic retinopathy, and glaucoma - to rare conditions like adult-onset vitelliform macular dystrophy, readers will glean insights on the capabilities of this remarkable innovation.

Bai JW, Lovblom LE, Cardinez M, Weisman A, Farooqi MA, Halpern EM, Boulet G, Eldelekli D, Lovshin JA, Lytvyn Y, Keenan HA, Brent MH, Paul N, Bril V, Cherney DZI, Perkins BA. Neuropathy and presence of emotional distress and depression in longstanding diabetes: Results from the Canadian study of longevity in type 1 diabetes J Diabetes Complications. 2017 Aug;31(8):1318-1324. Epub 2017 May 10.

Baltaziak M, Chew HF, Podbielski DW, Ahmed IIK. Glaucoma following Corneal Replacement. Surv Ophthalmol. 2017 Sep 16. [Epub ahead of print] Review.

Basilious A, Benavides Vargas AM, Buys YM. Publication rate of abstracts presented at the 2010 Canadian Ophthalmological Society Annual Meeting. Can J Ophthalmol. 2017 Aug;52(4):343-348. Epub 2017 Jan 10.

Berk TA, An JA, Ahmed IIK. Inadvertent Cyclodialysis Cleft and Hypotony Following Ab-Interno Trabeculotomy Using the Trabectome Device Requiring Surgical Repair. J Glaucoma. 2017 Aug;26(8):742-746.

Chaudhry A, Chung BH, Stavropoulos DJ, Araya MP, Ali A, Heon E, Chitayat D. Agenesis of the corpus callosum, developmental delay, autism spectrum disorder, facial dysmorphism, and posterior polymorphous corneal dystrophy associated with ZEB1 gene deletion. Am J Med Genet A. 2017 Sep;173(9):2467-2471. Epub 2017 Jul 25.
 
Derzko-Dzulynsky L. IgG4-related disease in the eye and ocular adnexa. Curr Opin Ophthalmol. 2017 Aug 30. [Epub ahead of print]
 
Downie ML, Mulder J, Schneider R, Lim L, Tehrani N, Wasserman JD, Fuchs S, John R, Noone DG, Hebert D. A curious case of growth failure and hypercalcemia: Answers. Pediatr Nephrol. 2017 Aug 7. [Epub ahead of print]

Downie ML, Mulder J, Schneider R, Lim L, Tehrani N, Wasserman JD, Fuchs S, John R, Noone DG, Hebert D. A curious case of growth failure and hypercalcemia: Questions. Pediatr Nephrol. 2017 Aug 7. [Epub ahead of print]
 
Filek R, Hooper P, Sheidow T, Gonder J, Varma DK, Heckler L, Hodge W, Chakrabarti S, Hutnik CML. Structural and functional changes to the retina and optic nerve following panretinal photocoagulation over a 2-year time period. Eye (Lond). 2017 Aug;31(8):1237-1244. Epub 2017 Apr 28.
 
Fung SSM, Jabbour S, Harissi-Dagher M, Tan RRG, Hamel P, Baig K, Ali A. Visual Outcomes and Complications of Type I Boston Keratoprosthesis in Children: A Retrospective Multicenter Study and Literature Review. Ophthalmology. 2017 Aug 11 [Epub ahead of print]
 
Hussain A, Oestreicher J. Clinical Decision-Making: Heuristics and Cognitive Biases for the Ophthalmologist. Surv Ophthalmol. 2017 Aug 28. [Epub ahead of print] Review.

Ing E, Celo E, Ing R, Weisbrod L, Ing M. Quantitative analysis of the text and graphic content in ophthalmic slide presentations. Can J Ophthalmol. 2017 Apr;52(2):171-174

Jiang S, Choudhry N. OCT Angiographic Findings in Glucose-6-Phosphate Dehydrogenase Deficiency. Ophthalmic Surg Lasers Imaging Retina. 2017 Aug 1;48(8):664-667.

Kletke SN, Soliman SE, Gallie BL. Radiation compromised survival of patients with heritable retinoblastoma (H1): what will be the long-term consequences of current eye salvage therapies? Ann Eye Sci 2017;2:26.

Kraft SP. A practical approach to vertical strabismus:  It is not a ‘black box’!  S Afr Ophthalmol J 2016; 11: 12 - 16.

Kraft SP.  Special forms of comitant exotropia. In: Lambert SR, Lyons CJ, eds. Paediatric Ophthalmology and Strabismus,  5th ed. London: Elsevier Science, 2017: 818 - 826.
 
Kraft SP.  Abnormal head postures in children. Paediatric Ophthalmology and Strabismus,  5th ed. London: Elsevier Science, 2017, pp 992 - 995.
 
Leung VC, Hussain A, Krings T, DeAngelis D. Endovascular Management of a Traumatic Infraorbital Pseudoaneurysm Causing Orbital Compartment Syndrome. Ophthal Plast Reconstr Surg. 2017 Sep/Oct;33(5):e110-e112.
 
Leung VC, Micieli JA, Margolin EA. Profound Vision Loss After a Traumatic Work Injury. JAMA Ophthalmol. 2017 Aug 31. [Epub ahead of print] No abstract available.
 
Leung VC, Pechlivanoglou P, Chew HF, Hatch W. Corneal Collagen Cross-Linking in the Management of Keratoconus in Canada: A Cost-Effectiveness Analysis. Ophthalmology. 2017 Aug;124(8):1108-1119. Epub 2017 Apr 27.

Li DQ, Choudhry N. Swept-Source OCT Visualization of Macular Hole Closure in Gas-Filled Eyes. Ophthalmic Surg Lasers Imaging Retina. 2017 May 1;48(5):392-398.

Lionel AC, Costain G, Monfared N, Walker S, Reuter MS, Hosseini SM, Thiruvahindrapuram B, Merico D, Jobling R, Nalpathamkalam T, Pellecchia G, Sung WWL, Wang Z, Bikangaga P, Boelman C, Carter MT, Cordeiro D, Cytrynbaum C, Dell SD, Dhir P, Dowling JJ, Heon E, Hewson S, Hiraki L, Inbar-Feigenberg M, Klatt R, Kronick J, Laxer RM, Licht C, MacDonald H, Mercimek-Andrews S, Mendoza-Londono R, Piscione T, Schneider R, Schulze A, Silverman E, Siriwardena K, Snead OC, Sondheimer N, Sutherland J, Vincent A, Wasserman JD, Weksberg R, Shuman C, Carew C, Szego MJ, Hayeems RZ, Basran R, Stavropoulos DJ, Ray PN, Bowdin S, Meyn MS, Cohn RD, Scherer SW, Marshall CR. Improved diagnostic yield compared with targeted gene sequencing panels suggests a role for whole-genome sequencing as a first-tier genetic test. Genet Med. 2017 Aug 3. [Epub ahead of print]

Mathieu M, Gupta N, Ahari A,  Zhou X, Hanna J, Yücel YH. Evidence for Cerebrospinal Fluid Entry Into the Optic Nerve via a Glymphatic Pathway. Investigative Ophthalmology & Visual Science September 2017, Vol.58, 4784-4791.

Mothe AJ, Tassew NG, Shabanzadeh AP, Penheiro R, Vigouroux RJ, Huang L, Grinnell C, Cui YF, Fung E, Monnier PP, Mueller BK, Tator CH. RGMa inhibition with human monoclonal antibodies promotes regeneration, plasticity and repair, and attenuates neuropathic pain after spinal cord injury. Sci Rep. 2017 Sep 5;7(1):10529.
 
Park S, Bin NR, Yu B, Wong R, Sitarska E, Sugita K, Ma K, Xu J, Tien CW, Algouneh A, Turlova E, Wang S, Siriya P, Shahid W, Kalia L, Feng ZP, Monnier PP, Sun HS, Zhen M, Gao S, Rizo J, Sugita S.  UNC-18 and Tomosyn Antagonistically Control Synaptic Vesicle Priming Downstream of UNC-13 in Caenorhabditis elegans.  J Neurosci. 2017 Sep 6;37(36):8797-8815. Epub 2017 Aug 8.

Seamone ME, Choudhry N, Golding J, Turco B, Gupta RR, Duker JS. Diagnostic and Therapeutic Challenges. Retina. 2017 Mar 22.

Seamone ME, Lewis DR, Almeida D, Choudhry N, Gupta RR. MASSIVE SUBRETINAL GAS AFTER VITRECTOMY SURGERY: MECHANISM AND MANAGEMENT. Retin Cases Brief Rep. 2017 Mar 29.  [Epub ahead of print]

Sharma A, Foster S, Smith D, Suh D, Ali A, Kraft SP: Idiopathic enlargement of the extraocular muscles in young patients: A case series.  Am J Ophthalmol  2016; 161: 206 - 213. (CPA)

Showail MJ, Kus JV, Tsui GK, Chew HF. Fungal keratitis caused by Metarhizium anisopliae complex. Med Mycol Case Rep. 2017 Jun 23;17:28-30. eCollection 2017 Sep.
 
Sorkin N, Einan-Lifshitz A, Abelson S, Boutin T, Showail M, Borovik A, Ashkenazy Z, Chan CC, Rootman DS. Stepwise Guided Photorefractive Keratectomy in Treatment of Irregular Astigmatism After Penetrating Keratoplasty and Deep Anterior Lamellar Keratoplasty. Cornea. 2017 Sep 12 [Epub ahead of print]

Sorkin N, Einan-Lifshitz A, Boutin T, Showail M, Borovik A, Chan CC, Rootman DS. Topography-Guided Photorefractive Keratectomy in the Treatment of Corneal Scarring. J Refract Surg. 2017 Sep 1;33(9):639-644.

Sorkin N, Einan-Lifshitz A, Ashkenazy Z, Boutin T, Showail M, Borovik A, Alobthani M, Chan CC, Rootman DS. Enhancing Descemet Membrane Endothelial Keratoplasty in Postvitrectomy Eyes With the Use of Pars Plana Infusion. Cornea. 2017 Mar;36(3):280-283
 
Tam ALC, Côté E, Saldanha M, Lichtinger A, Slomovic AR. Bacterial Keratitis in Toronto: A 16-Year Review of the Microorganisms Isolated and the Resistance Patterns Observed. Cornea. 2017 Sep 21. [Epub ahead of print]
 
Tyndel F, Al-Farsi N, Kwan P.  Letter to the Editor concerning "One and a half syndrome following penetrating head injury: Case report" by Mathew R. Voisin, Sanskriti Sasikumar, Jeremy H. Russell, Gelareh Zadeh, Journal of Clinical Neuroscience 41 (2017) 88-90. J Clin Neurosci. 2017 Sep 6. [Epub ahead of print]
 
Varma DK, Simpson SM, Rai AS, Ahmed IIK.  Undetected angle closure in patients with a diagnosis of open-angle glaucoma.  Can J Ophthalmol. 2017 Aug;52(4):373-378. Epub 2017 Feb 23.
 
Varma DK, Kletke SN, Rai AS, Ahmed IIK.  Proportion of undetected narrow angles or angle closure in cataract surgery referrals. Can J Ophthalmol. 2017 Aug;52(4):366-372. Epub 2017 May 11.

Zhong A, Darren B, Dimaras H. Ethical, social, and cultural issues related to clinical genetic testing and counseling in low- and middle-income countries: protocol for a systematic review. Syst Rev. 2017 Jul; 6(1): 140.

 


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