Dr David Almeida has over 150 peer-reviewed publications and numerous other communications. He has collaborated with students, physicians and researchers in the United States, Canada, South America, Europe and Middle East.
Dr Almeida continues to work on several exciting and dynamic ongoing projects with national and international collaborators.
Dr Robin Bruen MD visited for a clinical elective in 2019. He focused on clinical efficiencies including optimal clinic and patient workflow, procedure-based best practices and methods for scaling to capacity for high-volume intravitreal injections.
Dr Manreet Alangh MD visited for a clinical elective in 2019 looking at vireoretinal imaging and an in-depth review of macular optical coherence tomography (OCT) imaging.
Dr Jessica Ruzicki MD visited for a research elective in 2018. She helped developed a novel model of advanced vitreoretinal analytics for comparing efficacy of different vascular endothelial growth factor (VEGF) inhibitors.
Dr Parnian Arjmand MD visited for a research elective in July 2017. She analyzed outcomes in cases of proliferative vitreoretinopathy (PVR). Additionally, she collaborated on developing a novel surgical technique for optic pit maculopathy.
Dr Kunyong Xu MD MHSc visited for a research elective in March 2016. His work focused on predictive factors of proliferative vitreoretinopathy, accidental laser pointer injuries in pediatric patients and novel surgical techniques. He is now a vitreoretinal attending at the University of Arizona.
Recent Keynotes, Conferences & Publications
From the May 2021 issue of Eyes On Eyecare Ophthalmology, here is our review on The Role of Gene Therapy in Inherited Retinal Diseases.
We review the major advancements in the diagnosis and treatment of inherited retinal diseases, including novel gene therapies.
Recently published in Clinical Ophthalmology (March 2021), here is our review: Antioxidants for the Treatment of Retinal Disease: Summary of Recent Evidence.
In this narrative review, we address the mechanisms of retinal oxidative stress and provide a summary of the currently available evidence for antioxidants as a treatment modality for macular and vitreoretinal disorders.
Published in the American Journal of Ophthalmology Case Reports (2021), here is our case of idiopathic retinal arterial occlusive vasculitis in the setting of multiple arterial occlusions.
Idiopathic retinal arterial occlusive vasculitis represents a prototypical disease form of occlusive retinal vasculitis. We present this uncommon entity and review the clinical features and management challenges applicable to patients with retinal vasculitis.
From the April 2021 issue of Eyes On Eyecare Ophthalmology, here is our review on The Role of Corticosteroids in Diabetic Eye Disease.
Diabetic eye disease remains a major cause of vision loss in patients with diabetes. We review the role of corticosteroids in suppressing chronic inflammation and tissue injury specific to diabetic macular edema.
Boxer Mike Tyson once said, “Everyone has a plan until they get punched in the mouth!” What happens when your online voice gets punched in the mouth? This latest column offers guidance and strategy for retina specialists and physicians when they’re attacked on social media.
Live on Eyes On Eyecare Ophthalmology, our course, A Resident’s Guide to Diabetic Retinopathy Surgical Treatment Options, highlights the important variables to consider before, during, and after surgery for diabetic retinopathy.
Diabetic retinopathy is the leading cause of vision impairment in the middle-aged population in the United States. In our course, we review the surgical management for vitreous hemorrhage, retinal detachment, and membranectomy secondary to diabetic retinopathy.
Recently published in Clinical Ophthalmology (2021), our study – Vision Recovery Velocity, Momentum and Acceleration: Advanced Vitreoretinal Analytics (AVRA) as Measure of Treatment Efficacy for Neovascular Age-Related Macular Degeneration – presents novel metrics as a means of facilitating standardized comparison between different anti-VEGF agents.
Our “moneyball”-like AVRA model stipulates ideal VEGF inhibitors characteristics and allows comparisons across different trials to determine optimal anti-VEGF agents for the treatment of neovascular AMD.
From Eyes On Eyecare Ophthalmology – Assessing and Grading Diabetic Retinopathy: Updates for Ophthalmology Residents – provides an update and review on how ophthalmologists currently assess and grade diabetic retinopathy.
We cover what began as the O’Hare Classification, to the Airlie House Committee on diabetic retinopathy classification, to the Early Treatment Diabetic Retinopathy Study (ETDRS) Diabetic Retinopathy Severity Scale (DRSS).
This article details how modifications to describe diabetic retinal disease have been modified to improve both the accuracy and precision of disease morbidity stratification.
The Winning Pitch Challenge is an independent organization that empowers nascent ophthalmology innovators with resources and a support network to turn their ideas into reality. The signature event is a “Shark Tank”–style competition to help innovators in retina get their ideas off the ground.
We presented as finalists of the 2017 edition on CTX-1, a novel therapeutic for dry age-related macular degeneration.
What’s the difference between misinformation, disinformation and propaganda? In this column, I discuss what retina specialists can do to deal with misinformation, disinformation and propaganda. As a medical professional positing on social media, your opinion should have the jurisprudence of the best available evidence.
Check out our latest case, published in the Journal of VitreoRetinal Diseases: Iatrogenic Subretinal Triamcinolone During Primary Surgical Repair of a Retinal Detachment with Giant Retinal Tear.
Our case describes the outcome of a young patient undergoing complex vitreoretinal surgery for a macula-off rhegmatogenous retinal detachment secondary to giant retinal tear where triamcinolone inadvertently entered the subretinal space intraoperatively.
The subretinal triamcinolone deposits spontaneously absorbed over a 2-month period with no adverse sequelae. This supports avoiding aggressive mechanical removal of iatrogenic subretinal triamcinolone in the context of retinal detachment repair.
Pentosan polysulfate sodium (PPS) (Elmiron; Janssen Pharmaceuticals) received Federal Drug Administration approval for the treatment of interstitial cystitis in 1996. Recently, reports have surfaced of maculopathy secondary to PPS.
In this case study, we described maculopathy secondary to PPS mimicking pattern dystrophy. Although there is no ophthalmic screening guideline for PPS use currently, eye care providers should promptly identify this vision-threatening condition at an early stage among affected patients with serial examinations and imaging to prevent progressive vision loss.
Published in Covalent Ophthalmology Case Reports, here is our case report and photo essay of Simultaneous Bilateral Central Retinal Artery Occlusion (CRAO).
Cases of bilateral CRAO have previously been published in the setting of antiphospholipid syndrome, Hughes Syndrome, acute respiratory distress syndrome, metastatic Burkitt-type lymphoma, positive human immunodeficiency virus (HIV) status, sickle cell hemoglobinopathies, giant cell arteritis and cocaine abuse; however, this is the first published case of a bilateral CRAO in the absence of these conditions.
We discuss the patient’s risk factors and how to best approach and workup similar cases.
You can find the case report here.
Published in the Journal of Clinical Imaging Science, here is our case report and photo essay of a patient with lipemia retinalis and a serum lipids triglyceride level of 1504 mg/dL entitled, Lipemia Retinalis in a Patient with Familial Hypertriglyceridemia.
Ocular signs of hypertriglyceridemia manifest as lipemia retinalis, characterized by white vascular lesions and retinal lipid infiltration. The high comorbidity of hypertriglyceridemia and hypertension may warrant close monitoring hypertensive complications such as hypertensive retinopathy.
From the September 2020 issue of Retina Today, you can find selected excerpts from a recent edition of New Retina Radio: Are Today’s Protocols Tomorrow’s Routines?
In an interview with New Retina Radio, we explain why some new COVID-19 processes may become permanent fixtures and discuss which therapies and technologies in the pipeline would be particularly useful to have right now.
From the October 2020 edition of Covalent Ophthalmology Case Reports, you can find our Apremilast for Uveitis Associated with Behcet’s disease communication. Apremilast was approved for managing oral ulcers associated with Behcet’s disease in 2019 and we describe a case with recurrent unilateral uveitis associated with Behcet’s that was successfully managed by apremilast.
Our case suggests a potential role of apremilast in managing Behcet’s disease with uveitis but further studies are required to elucidate the efficacy of apremilast in treating ocular manifestations related to Behcet’s disease.
From the July/August 2020 issue of Retina Today, we present a case of Waardenburg Syndrome in a 47- year-old with congenital iris heterochromia, white forelock and bilateral hearing loss.
Note iris hypopigmentation in both eyes with focal areas of pigmentation superotemporally in the left eye. Hypopigmentation of the retina and choroid in both eyes can be seen with relative temporal hyperpigmentation in the left eye only. OCT of the macula showed relative choroidal thinning in the right eye compared with the left eye.
Published in September 2020 by Covalent Ophthalmology, my Social Media Strategies for Ophthalmologists article is an update on what physicians need to know about social media, branding and online practice promotion.
When promoting your ophthalmology practice, understanding the purpose and possibility of social media is critical. I provide tips and pearls for getting the most out of your social media marketing.
When it comes to retinal detachment repair, scleral buckling is a classic! Check out our pearls and techniques on the newly published, Scleral Buckle for Retinal Detachment, by Covalent Ophthalmology.
While it may be far less commonly performed compared to vitrectomy for retinal detachment repair, it still offers potentially more optimal outcomes in selective cases. While “hindsight is 20/20”, one rarely (if ever) will regret having placed a scleral buckle in cases of retinal detachment repair.
From the July/August 2020 issue of Retina Specialist Magazine, you can find my latest Social Media Specialist column: When apathy is not an option – how retina specialists can approach societal issues and racial injustice on social media.
Retinal detachment is an urgent diagnosis and, without timely intervention, there is significant risk of permanent vision loss. Our review and approach covers everything ophthalmology residents need to know.
What Ophthalmology Residents Should Know About Retinal Detachment Repair covers everything from primary scleral buckling, to pars plana vitrectomy, to the management of complex retinal detachments.
From the May 2020 issue of Retinal Physician, you can find our review on the Management of and Controversies in Autoimmune Retinopathy.
The diagnosis of autoimmune retinopathy (AIR) remains a clinical challenge because of its rare incidence, frequent dissociation between symptoms and signs, limited access to necessary investigations for diagnosis, and absence of an evidence-based treatment strategy.
I discuss how retina specialists can best address negative reviews and unfavorable comments on social media.
From the February/March 2020 issue of Retina Specialist, my latest Social Media Specialist column looks at the downsides of doctors on social media and how retina specialists can avoid the risks and pitfalls of putting their professional reputation online.
From the October 2019 publication of the Journal of VitreoRetinal Diseases, a special issue: Retina Young Investigators, you can find our study, Variables Associated With Culture-Positive Endophthalmitis After Intravitreal Injection of Vascular Endothelial Growth Factor Inhibitors.
Our work identifies predictive variables associated with culture-positive cases of acute endophthalmitis after vascular endothelial growth factor (VEGF) inhibitor injection.
From the November 2019 issue of RETINA SPECIALIST, you can find my Surgical Pearls column on surgical efficiency – Never use two steps when one will do: Step-saving tips when isolating rectus muscles and performing membrane peeling.
Twitter is the logical starting point for any physician or practice because anyone can read Tweets (although only registered users can post Tweets and comments).
You can find my latest Surgical Meditations column in the September 2019 issue of Retina Today – 1, 2, 3, 4, 5… How Many Trocars Do I Need for This Case? This surgical technique details five-port combined limbus-based vitrectomy and pars plana vitrectomy for complex vitreoretinal surgeries.
This handy technique can be use in eyes with anterior segment pathology impeding posterior segment view. Limbus-based vitrectomy with trocar-cannulas allows access to anterior segment pathology to clear the way for posterior segment maneuvers. In aphakic and pseudophakic eyes, the anterior infusion can be used throughout the case.
From the July 2019 issue of Retina Times, check out What’s News: ASRS Members Ride the Social Media Wave! This is a roundtable discussion with myself and Drs Brian Joondeph, Peter Karth & Rishi Singh. Here we ponder how a relevant social media presence can help build your practice and career.
On Friday 26 July 2019, I was part of the faculty for the Online and Social Media Content for Continuing Education and Marketing for the Retina Specialist course. This was held in Chicago, Illinois at the American Society of Retina Specialists (ASRS) 2019 Annual Meeting.
Engaging discussion and a real pleasure to share the stage with friends and colleagues Drs Jay Sridhar, Sunir Garg, Ajay Kuriyan and Audina Berrocal! As social media and online reputation continue to evolve in ophthalmology, and medicine as a whole, great to see the growing interest in this topic!
From the July 2019 issue of Retinal Physician, here is our surgical technique for maculopathy secondary to optic disc pit – Surgical Technique With Fibrin Glue for Optic Disc Maculopathy: An alternative that could aid in preserving retinal tissue.
This surgical technique is a viable approach to optic disc pit maculopathy that provides relatively rapid postoperative improvements in both function and anatomy.
“Surgery was the most difficult thing I could imagine. And so, I became a surgeon.” — Abraham Verghese, Cutting for Stone. This quote – along with the many chess games played with my sons – inspired this column found in the latest Retinal Physician issue.
From the opening, to the middle game, and to the final moves of the endgame, see how surgery is like chess! These surgical steps to success will help you down the right path.
Thanks Alcon and Retinal Physician for showcasing my surgical techniques in the July 2019 Surgical Maneuvers: Tip of the Month.
In it, I describe how retinal detachments are like onions! Learn how to peel off the layers of complex retinal detachments.
In this issue, I discuss Silicone Oil and the Goldilocks Principle: How to achieve the perfect silicone oil fill. Use of silicone oil tamponade during air-fluid exchange presents the risk of overfill or underfill. By setting a series of fail-safes, surgeons can achieve an optimum silicone oil fill while reducing the risk of overfill or underfill.
On 17 May 2019, I was part of the faculty of the 2019 University of Western Ontario Clinical Day in Ophthalmology in London, Ontario, Canada. Always a pleasure to return to Canada and see so many friends and colleagues. I spoke on retinal myths, infectious endophthalmitis and vitreoretinal diagnostic dilemmas. Grateful for the opportunity and many thanks to Dr Lulu Bursztyn and Dr Yiannis Iordanous for organizing a fantastic program!
Always a fantastic time with the Vit-Buckle Society! My talk this year – Above, In & Below: Onions and the layers of complex retinal detachments – was held on Saturday 6 April 2019 in Las Vegas, Nevada.
Complex surgical techniques is one of my favourite topics and it’s always fun to discuss this topic with so many top-tier surgeons!
Here is a case report entitled, Delayed Vision Recovery after Carotid Vascular Surgery for Branch Retinal Artery Occlusion (Jessica Ruzicki, Eric K Chin & David RP Almeida) published in the February 2019 issue of Case Reports in Ophthalmological Medicine.
Branch retinal artery occlusion (BRAO) is typically associated with irreversible vision and peripheral visual field loss. We report a case of a 62-year-old woman with a BRAO related to several cardiovascular risk factors. Our patient encountered gradual but significant vision recovery months following carotid artery endarterectomy for carotid stenosis.
From the November/December 2018 issue of RETINA TODAY, my new column SURGICAL MEDITATIONS discusses surgical techniques and shares pearls for both common and complex vitreoretinal topics. In the latest issue, I detail my preferred approach to drainage of choroidal hemorrhages and choroidal detachments. You can find the full article here.
From the October 2018 Ophthalmology Imaging Conference in Chicago, Illinois. My talk – Management of macula-involving choroidal granulomas – discussed multi-modality therapeutic options for inflammatory and infectious granulomas involving the macula. This case-based conference is one of the most interesting conferences filled with incredible pathology!
One of our recent publications is a unique case entitled, Atypical Presentation of Acute Macular Neuroretinopathy after Non-Ocular Trauma (Robin K Kuriakose, Eric K Chin & David RP Almeida) published in the January 2019 issue of Case Reports in Ophthalmology.
We report an atypical case of Acute Macular Neuroretinopathy (AMN) presenting with retinal hemorrhages and cotton-wool spots following non-ocular trauma.
AMN is a rare condition whose pathophysiological process remains speculative. Our atypical case supports the role of trauma in the pathophysiology of deep retinal capillary plexus compromise.
One of our latest study published in the Journal of VitreoRetinal Diseases – Infectious Endophthalmitis: Trends in Microbiology, Management, and Surgical Techniques. Many thanks to the Journal of VitreoRetinal Diseases for showcasing our review!
Our detailed review provides an update on etiologies, preventive practices, management options, and surgical techniques for infectious endophthalmitis. It covers a lot of our work on management and surgical options for this complex and devastating disease.
Thank you RETINA TODAY for publishing our photo essay, Proliferative Retinopathy Secondary to Chronic Myelogenous Leukemia!
This is what proliferative retinopathy – secondary to the BCR-ABL translocation [t(9:22)(q34;q11.2)] resulting in the Philadelphia chromosome – looks like! Vitrectomy with endolaser (pan retinal photocoagulation, PRP) stabilized both eyes with chronic myelogenous leukemia (CML).
You can find the article in the October issue of RETINA TODAY here.
Had a great time presenting at the International Joint Commission on Allied Health Personnel in Ophthalmology (IJCAHPO) meeting as part of the American Academy of Ophthalmology (AAO) conference in Chicago. My presentation – Insights and Innovation: Current Trends and Topics in Ophthalmology (Saturday 27 October 2018) – was a wonderful chance to catch up with a lot of fantastic allied health friends I have worked with over the years!
Update from the Innovation in Healthcare summit in picturesque Budapest, Hungary (October 3-5, 2018). A beautiful city and not far from where I completed my PhD at the University of Szeged. This is my first time in Hungary since 2004 and very grateful for the invitation to speak.
On Friday (October 5th), I presented my talk – Value of Brand in Healthcare Innovation – focusing on how to define, develop and deploy branding to facilitate innovation in the spheres of healthcare.
Check out the article here from the September 2018 issue entitled, “All the Right Moves: If putting down roots means relocating your practice, here are some tips for a smooth transition”.
Update from the 36th American Society of Retina Specialists (ASRS) Annual Meeting in beautiful Vancouver, British Columbia, Canada (July 20 – July 25, 2018). One of the largest retina meetings and a great opportunity to connect with colleagues and friends.
Very grateful for receiving an ASRS Honor Award at this year’s meeting! The Honor Points Program recognizes ASRS members for their time and contributions to the scientific programs of the Annual Meeting. Many thanks!
On Friday (July 20), I was part of the faculty of the first-ever instructional course “Online and Social Media Content for Continuing Education and Marketing for the Retina Specialist” moderated by Dr Jay Sridhar with panelists David Almeida, Sunir Garg, Ajay Kuriyan and Charlie Wykoff. I focused on building an online brand, Twitter presence and social media for practice building.
Our video, “The Great Subretinal Kenalog Adventure”(Kunyong Xu, Eric Chin & David Almeida), was showcased in the 2018 Annual ASRS Film Festival. It’s a case of complex retinal detachment with a giant retinal tear complicated by subretinal Kenalog. We illustrate how to manage the occurrence of intraoperative subretinal Kenalog.
On Sunday night (22 July 2018), I presented challenging macular degeneration and choroidal neovascularization cases at the FORCE Retina Dinner. Specifically, I focused on the management of outer retinal tubulations (ORT).
On Sunday (22 July 2018), Dr Parnian Arjmand presented our poster: Risk Score Model to Predict Final Visual Acuity Outcomes in Patients With Proliferative Vitreoretinopathy After Retinal Detachment Repair (Parnian Arjmand, Eric K Chin, Kunyong Xu & David RP Almeida). This study characterizes the clinical profile of patients who develop proliferative vitreoretinopathy (PVR) after rhegmatogenous retinal detachment (RRD) repair. Moreover, we developed a risk score model predicting visual acuity outcomes and identify unique variables predictive of PVR formation after RRD repair.
On Wednesday (25 July 2018), Dr Kunyong Xu presented our abstract, “Endophthalmitis After Intravitreal Injection of Vascular Endothelial Growth Factor (VEGF) Inhibitors: Management and Visual Outcomes” (Kunyong Xu, Eric Chin, & David Almeida). This recent publicationevaluates the management of patients who developed endophthalmitis after anti-VEGF injection. We reviewed a total of 258 357 intravitreal injections over the course of a 10-year period and found no difference in visual outcomes between initial treatment with immediate tap and injection of intravitreal antibiotics versus initial surgical pars plana vitrectomy.
Update from the 21st Annual Club Vit meeting @ Sea Island GA (June 27 – July 1, 2018).
Fantastic meeting with a wonderful group of colleagues and friends. Grateful to be part of this sun-loving retina crew.
On Saturday (June 30), I presented on endophthalmitis management and vision outcomes, looking at 10 years of intravitreal injection data.
Hot off the press! Check out our new publication in RETINA: Predictive Factors for Proliferative Vitreoretinopathy Formation After Uncomplicated Primary Retinal Detachment Repair by Xu, Chin, Bennett, Williams, Ryan, Dev, Mittra, Quiram, Davies, Parke, Boldt & Almeida.
We identify cigarette smoking and macular involvement as significant risk factors predictive of PVR formation after uncomplicated primary retinal detachment repair. Duration of retinal detachment symptoms, high myopia, lens status, lattice degeneration, location of retinal break, number of retinal breaks and surgical technique (e.g., scleral buckle with or without vitrectomy versus vitrectomy alone) were not found to be predictive of PVR formation.
Lots of news from Toronto, Ontario, Canada at the Canadian Ophthalmological Society (COS) Annual Meeting (May 31-June 3 2018). Wonderful to be part of the faculty for the Bimanual Anterior Vitrectomy course on Saturday June 2nd.
On Friday (1 June 2018), Dr. Parnian Arjmand won 3rd place in the 2018 COS Awards for Excellence in Ophthalmic Research Poster Competition! Congratulations as she was first author on our abstract: “Fibrin glue and internal limiting membrane abrasion for optic disc pit maculopathy”. She presented our novel surgical technique in the Current Concepts I session.
Also on Friday (1 June 2018), I had the honor to present my “Mentors Perspective” at the EYE2EYE meeting! Lots of fun insight and I went through my Sacred 7: Top Pearls I Have Learned Since Starting My Practice. I can summarize with one quote from General Fox Connor, who would regularly repeat this to his young protégé, Dwight D Eisenhower: “Always take your job seriously, never yourself.”
On Saturday (2 June 2018), Dr. Parnian Arjmand presented our abstract: Visual Outcomes & Risk Prediction Model for Patients with Proliferative Vitreoretinopathy. Congratulations to her and many thanks to the COS Annual Meeting Planning Committee for selecting this as a COS Hot Topic!
From Miami Beach FL, for the Vit-Buckle Society – VBS 6 – Annual Meeting, on Saturday (24 March 2018), I presented my talk, Steel to Heal: Surgical Techniques for Infectious Endophthalmitis.
I reviewed various approaches and surgical techniques for dealing with this devastating complication. Here is an example of me performing membranectomy using platform forceps to remove membranes in the anterior chamber via a 25-gauge valved cannula in the corneal limbus.
Many thanks for all the interest and support!
One of our recent publications in OPHTHALMOLOGY: Endophthalmitis after Intravitreal Injection of Vascular Endothelial Growth Factor Inhibitors – Management and Visual Outcomes
We evaluated the management of patients who developed endophthalmitis after anti-VEGF injection. We reviewed a total of 258 357 intravitreal injections over the course of a 10-year period and found no difference in visual outcomes between initial treatment with immediate tap and injection of intravitreal antibiotics versus initial surgical pars plana vitrectomy.
Sincere thanks to The Ophthalmologist for publishing my article on the framework of Decision Diagnosis and how to apply the PACT strategy for effective decision making. You can find this in the February 2018 issue entitled, Decision Diagnosis: Making a PACT to avoid decision procrastination.
PACT refers to Practice, Assess, Collect and Triage. If you are struggling with decision making, then Decision Diagnosis can help you make a PACT.
Many thanks to The Ophthalmologist for publishing our article, When primary scleral buckling should be considered – and how to succeed (Alexander Ringeisen, Ed Ryan and David RP Almeida) in the February 2018 issue!
We go over why scleral buckling is still the treatment of choice for certain retinal detachments and which patients are the best candidates for a primary scleral buckle. The article is aimed at ophthalmology residents and vitreoretinal fellows and provides an overview when primary buckling should be considered and provide guidance on which techniques will help success, as well as when to avoid a primary buckle.
Many thanks to Clinical Ophthalmology for publishing our study, Epiretinal membrane and cystoid macular edema as predictive factors of recurrent proliferative vitreoretinopathy (Kunyong Xu, Eric K Chin, D Wilkin Parke 3rd & David RP Almeida).
In it, we describe epiretinal membrane and cystoid macular edema as potential predictive factors for recurrent proliferative vitreoretinopathy. Early recognition and treatment of these conditions may be critical to prevent dreaded recurrent postoperative scarring and improve visual outcomes.
Earlier this year we published a photo essay on intraocular foreign bodies in the Canadian Medical Association Journal (CMAJ). Entitled, Five things to know about intraocular foreign bodies (Kunyong Xu MD MHSc & David RP Almeida MD MBA PhD) – here is a quick summary:
1. Risk of intraocular foreign body is associated with mechanism of injury.
2. Ophthalmic examination should include dilation of the pupil.
3. Imaging should be conducted promptly to diagnose and localize intraocular foreign bodies.
4. Antibiotics should be prescribed early to prevent endophthalmitis.
5. Patients with an intraocular foreign body require urgent referral to an ophthalmologist.
From Barcelona, Spain, for the EURETINA Annual Congress, on Friday (8 September 2017), I presented a talk on our recent findings and techniques for proliferative vitreoretinopathy (PVR).
My talk, Predictive factors for proliferative vitreoretinopathy formation after uncomplicated primary retinal detachment repair (David RP Almeida, Kunyong Xu, Eric K Chin & D Wilkin Parke III) looked at predictive tools for patients who develop this complex condition.
Many thanks for all the interest and international support!
Our case, The Adventure of the Upstate Traveler: A camper brings home an unintended souvenir from a camping trip (Robin Kuriakose, Lorna Grant, Eric Chin & David Almeida) will have you checking twice after going out in the woods…
Attachment of a deer tick to the conjunctiva is a rare event, with only a few reports in the literature. We report a unique case of tick penetration into the conjunctiva, specifically a black-legged deer tick (Ixodes scapularis). You can find the case here.
From Boston, for the American Society of Retina Specialists (ASRS) 35th Annual Meeting, you can find our study “Efficacy of Intravitreal Sustained-Release 0.7mg Dexamethasone Implant For Diabetic Macular Edema Refractory to Anti-VEGF Therapy: Meta-Analysis (Alexander L Ringeisen MD, Zainab Khan BHSc MD, Robin K Kuriakose MD, Maryam Khan, Eric K Chin MD & David RP Almeida, MD, MBA, PhD).
This study provides further insight into the benefits of multi-modality therapy for diabetic macular edema, the most common cause of vision loss in working age individuals.
Check out one of our recent publications, Novel Technique for Submacular Hemorrhage Removal Using 27-Gauge Pars Plana Vitrectomy and Recombinant Tissue Plasminogen) Activator (Kunyong Xu MD MHSc, Eric K Chin MD, John B Davies MD & David RP Almeida MD MBA PhD). Many thanks to the Journal of VitreoRetinal Diseases for publishing our work!
Many thanks to the Journal of VitreoRetinal Diseases and the American Society of Retina Specialists for publishing one of our recent reports, West Nile Virus Chorioretinitis With Foveal Involvement: Evolution of Lesions on Optical Coherence Tomography (Gary L. Yau, Eric K. Chin, D. Wilkin Parke, Steven R. Bennett & David R. P. Almeida).
It was published in the March 2017 issue of the journal and describes the clinical course of foveal West Nile virus chorioretinitis.
Best practices for the injection technique of the dexamethasone intravitreal implant (Ozurdex). Many thanks to my wonderful colleagues – Seenu M. Hariprasad MD, Kimberly Drenser MD PhD, Sunir Garg MD and Bruce Saran MD – for involving me in this excellent discussion!
One of our most recent publications, Dysfunctional Autonomic Regulation of the Choroid in Central Serous Chorioretinopathy (C Nathaniel Roybal, Elisabeth Sledz, Yasser Elshatory, Li Zhang, David RP Almeida, Eric K Chin, Brice Critser, Michael D Abramoff & Stephen R Russell), was published in the June 2017 issue of RETINA.
We describe the effect of changing perfusion pressures on retinal and choroidal structure in central serous chorioretinopathy (CSC). In this study, we found that choroidal thickness increased in response to increased perfusion pressures in patients with CSC and not in normal controls. These findings likely represent an autonomic dysregulation of choroidal blood flow in patients with CSC.
Another one of our recent publications, Proliferative Vitreoretinopathy (PVR) Update: Current Surgical Techniques and Emerging Medical Management (Robin K Kuriakose, Kunyong Xu, Eric K Chin & David RP Almeida) published in the Journal of VitreoRetinal Diseases (April 2017).
In this detailed review, we provide an update on current surgical techniques and emerging medical
management in proliferative vitreoretinopathy (PVR). PVR is the number one cause of failed retinal detachment repair and a still relatively unexplained phenomenon. We, along with Citrus Therapeutics are working hard to find treatment for this challenging disease process.
Another of our recent publications, Myelinated retinal nerve fibre, myopia, and amblyopia syndrome (Kunyong Xu & David RP Almeida) published in the Canadian Journal of Ophthalmology (April 2017).
We describe the complex relationship among myelinated nerve fibre, myopia, and amblyopia. We present the case of a 6-year-old boy who presented with blurry vision of the right eye over 2 months. The visual prognosis in these cases is variable.
Fantastic to be part of the faculty at the Vit-Buckle Society V meeting in Las Vegas (6-8 April 2017).
I presented a talk on proliferative vitreoretinopathy (PVR), including pearls and techniques, for this challenging group of patients. Patients who are current or former smokers are significantly more likely to have PVR formation after retinal detachment repair.
Check out one of our most recent publications, Efficacy of the Intravitreal Sustained-Release Dexamethasone Implant for Diabetic Macular Edema Refractory to Anti-Vascular Endothelial Growth Factor Therapy: Meta-Analysis and Clinical Implications published in Ophthalmic Surgery, Lasers and Imaging Retina (February 2017, Volume 48, Issue 2, pages 160-166, DOI: 10.3928/23258160-20170130-10).
In this meta-analysis, we examined a total of 3,859 patients among 15 studies and found that treatment with Ozurdex is associated with significant mean improvement in visual acuity in patients with diabetic macular edema who have a sub-optimal response to anti-vascular endothelial growth factor therapy. This is further support to a multimodality approach to treating diabetic macular edema.
One of our recent publications, Deer Tick Masquerading as Pigmented Conjunctival Lesion (Robin K Kuriakose, Lorna W Grant, Eric K Chin & David RP Almeida). Thank you American Journal of Ophthalmology Case Reports for publishing our study.
In it, we report a unique case of tick penetration of a black-legged deer tick (Ixodes scapularis) into the conjunctiva. Despite the low risk for Lyme disease, doxycycline was prescribed for prophylaxis. In any case of suspected tick penetration to the ocular surface, immediate ophthalmologic consultation and prompt removal as well as attention paid to the Infectious Diseases Society of America guidelines regarding prophylaxis.
Thank you, Retina Specialist magazine, for showcasing our work on complicated viral retinitis retinal detachment repair in the November 2016 issue. This is part of our evolving work on approaches to complex retinal detachments.
One of our published surgical techniques for endophthalmitis. The study entitled, Five-Port Combined Limbal and Pars Plana Vitrectomy for Infectious Endophthalmitis, was published in Case Reports in Ophthalmology (2016;7:289–291). In it, we describe a surgical technique combining limbal based vitrectomy and pars plana vitrectomy to manage acute infectious endophthalmitis. You can find the study here.
Wonderful to be part of the faculty in Toronto for the 56th Annual Walter Wright Symposium, Retina 2016: A Practical Approach to Navigating the Future.
I presented a talk on my approach and techniques for infectious endophthalmitis. The evolving paradigm calls for early surgery and aggressive treatment to salvage vision from this devastating infectious condition.
Check out our publication, Ocular Hypertension After Intravitreal Dexamethasone (Ozurdex) Sustained-Release Implant, published in RETINA. Our report shows that the intravitreal dexamethasone implant, Ozurdex, can be used in various types of patients – including glaucoma suspects – with a good safety profile.
Check out another of our publications, Chronic Recurrent Pseudophakic Endophthalmitis, published in JAMA Ophthalmology (JAMA Ophthalmol. 2016;134(4):455-456. doi:10.1001/jamaophthalmol.2015.3638).
This study details a case of an immunosuppressed patient with active chorioretinitis and chronic endophthalmitis after cataract surgery.
Previously, I described our technique for retinal embolectomy. This technique was published in Retinal Cases & Brief Reports. Retinal embolectomy involves the removal of emobli from the retinal vasculature in selective cases of arterial occlusions.
Check out another one of our publications, Elevated intraocular pressure following pars plana vitrectomy due to trapped gas in the posterior chamber, published in Retinal Cases & Brief Reports (Fall 2016, Volume 10, Issue 4, pages 334–337).
Clinicians should be aware of elevated intraocular pressure secondary to trapped gas in the posterior chamber. Aspiration of the trapped gas can alleviate both pupillary block and angle closure without compromising gas tamponade.
On Friday, 14 October 2016, I presented a talk on our technique for retinal embolectomy at the American Academy of Ophthalmology (AAO) Retina Subspecialty Day in Chicago. Retinal embolectomy involves the removal of emobli from the retinal vasculature in selective cases of arterial occlusions.
Thanks to everyone for their interest in our technique!
Check out our photo essay in the October 2016 issue of Ophthalmology entitled, Pigmented Paravenous Retinochoroidal Atrophy (Lucas T. Lenci MD, D. Wilkin Parke III MD & David R.P. Almeida MD MBA PhD)
Great example of prominent atrophy of the retina and choroid surrounding the retinal venous circulation. Check out the publication here.
Check out our feature in the September 2016 issue of Retina Specialist entitled, MIVS and Post-op Endophthalmitis: A look at evolving trends and techniques.
Thanks for the continued interest in our microincisional vitrectomy surgery (MIVS) technique for infectious endophthalmitis. Check out the publication here.
Check out our publication in the September 2016 issue of the Canadian Journal of Ophthalmology entitled, Low power and type II errors in recent ophthalmology research. We show that a large proportion of randomized clinic trials contain statistical errors. The results of these studies have dramatic effects on day-to-day clinical practice and need to be designed and evaluated carefully. Check out the publication here.
I presented 2 talks at the annual EURETINA meeting in Copenhagen, Denmark.
Comparison of microbiology and visual outcomes of patients undergoing small-gauge and 20-gauge vitrectomy for endophthalmitis
Long-term outcomes in patients undergoing vitrectomy for retinal detachment due to viral retinitis in the afternoon session.
Check out our publication, Retinal Injury Secondary to Laser Pointers in Paediatric Patients. Our study describes children who had laser-related retinal injury to the macula due to the mishandling of the laser pointer devices.
Thank you Pediatrics for publishing our study! Check out the study here.
Here is a brief summary of the work we presented at the American Society of Retina Specialists (ASRS) Annual Meeting in San Francisco, California in August 2016. Thank you for all the interest!
Comparison of microbiology and visual outcomes of patients undergoing small-gauge and 20-gauge vitrectomy for endophthalmitis. David RP Almeida, Eric K Chin, Benjamin Bakall & Vinit B. Mahajan
Long-term outcomes in patients undergoing vitrectomy for retinal detachment due to viral retinitis. David RP Almeida, Eric K Chin & Vinit B Mahajan
Ocular hypertension after intravitreal dexamethasone (Ozurdex) sustained-release implant. Eric K Chin, David RP Almeida, Gabriel Velez, Kunyong Xu, Maria Peraire, Maria Corbella, Yasser M Elshatory, Young H Kwon, Karen M Gehrs, H. Culver Boldt, Elliott H Sohn, Stephen R Russell, James C Folk & Vinit Mahajan
Bimanual pars plana vitrectomy for removal of a dislocated descemet stripping automated endothelial keratoplasty graft from the vitreous cavity. Kunyong Xu, Eric K Chin, Emmett Carpel & David RP Almeida
Intravitreal foscarnet with concurrent silicone oil tamponade for rhegmatogenous retinal detachment secondary to viral retinitis. Kunyong Xu, Eric K Chin, Vinit Mahajan, & David RP Almeida
Another of our publications, Acanthamoeba endophthalmitis after recurrent keratitis and nodular scleritis. Acanthamoeba species are ubiquitous free-living protozoa and are usually responsible for corneal disease. We present the first case with confirmed involvement of Acanthamoeba in all ocular layers, including choroidal involvement.
Thank you Retinal Cases & Brief Reports for publishing our case! Check out the study here.
Our publication, Depression and burden among the caregivers of visually impaired patients: a systematic review. It surveys depression and burden among caregivers of patients with visual impairment. While caregiving allows those with vision problems to better adapt, it has been shown to take a toll on the caregiver on various levels, such as invoking depression and burden. Recognition of this is key for awareness, prevention and management.
Thank you International Ophthalmology for publishing our study! Check out the study here.
One of our high-impact publications: Serologically Confirmed Zika-Related Unilateral Acute Maculopathy in an Adult shows novel posterior segment changes and maculopathy in a confirmed case of Zika. We hope this adds further knowledge to the growing spectrum of Zika-related pathology. Thank you Ophthalmology for publishing our case! Check out the study here.
Bimanual pars plana vitrectomy for removal of a dislocated DSAEK graft from the vitreous cavity, published in Retinal Cases & Brief Reports. We describe a new technique for removing dislocated grafts. You can review the study here.
Distinguishing optic pathway glioma and retinitis pigmentosa with visual field testing, published in the June 2016 issue of the Canadian Journal of Ophthalmology (Volume 51, Issue 3). You can review the study here.
Atypical chronic delayed-onset endophthalmitis, Delayed fungal endophthalmitis secondary to Curvularia, recently published in the American Journal of Ophthalmology Case Reports. You can review the case here.
Another one of our published cases, Central retinal artery occlusion in a young HIV-infected patient on Highly Active Anti-Retroviral Therapy (HAART), has been published online ahead of print by Retinal Cases & Brief Reports. Check out the study here
Work With Dr David Almeida
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If you are interested in collaborating or visiting for a formal research elective with Dr Almeida, please contact us, or take a moment to fill out the form below.