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      Retinal Research in Latin America: How Did We Get Here?

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          Abstract

          Among the numerous contributions by the Pan-American Association of Ophthalmology (PAAO) to the improvement of ophthalmology in Latin America, it has played an invaluable role in the development of the retina and vitreous subspecialty in the region.

          The quality of the research published in Latin America demonstrates the development of the retina subspecialty at this region and also the worldwide collaboration pioneered by PAAO and the Pan-American Collaborative Retina Study Group (PACORES).

          We would suggest further academic relationship at the regional as well as international levels as well as funding research institutes to assist retinal researchers in the region since it is generally thought that there is frequently a lack of government funding at all levels, from patient education to support for health teams to tertiary health care centers.

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          Diabetic macular edema: changing treatment paradigms.

          J. Arevalo (2014)
          To review the current management and recent changes in treatment paradigm for diabetic macular edema (DME).
          Article 0 comments Cited 6 times – based on 0 reviews     Review now
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            [database on the Internet].

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              Diabetic Macular Edema: From Old Concepts to New Therapeutic Avenues

              Ahmad Mansour, Jose S. Pulido, J. Arevalo (2015)
              Diabetic macular edema (DME) is a significant cause of blindness in the working population and is currently challenging to treat. Current interventions include focal laser or intravitreal injections. This article outlines a new treatment protocol based on the theory that peripheral ischemia is the precursor to angiogenesis, which will ultimately gather its momentum at the fovea. Extreme peripheral light laser panretinal photocoagulation (PRP) back to the equator reduces excessive production of the vascular endothelial growth factor (VEGF) in the eye. This decreases VEGF-induced DME and provides long-term protection against the development of neovascularization. Initial exacerbation of DME often accompanies PRP. Therefore, injections of anti-VEGF agents (with or without dexamethasone implants) initially can forestall worsening of DME and prevent loss of vision. However, on the other hand, applying peripheral PRP and intraocular injections can induce posterior vitreous detachment (PVD). This could help release vitreomacular adhesions (VMA) and vitreomacular traction (VMT), thereby decreasing DME severity and improving the response to intravitreal injections. In the current approach, peripheral retinal photocoagulation should stop the drive for VEGF release; moreover, laser ablation should produce secondary, accidental, and beneficial PVD. This approach precludes focal laser therapy and paves the path for prolonged intervals between anti-VEGF therapy.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Med Hypothesis Discov Innov Ophthalmol
                Journal ID (publisher-id): mehdiophth
                Title: Medical Hypothesis, Discovery and Innovation in Ophthalmology
                Publisher: Medical Hypothesis, Discovery & Innovation Ophthalmology
                ISSN (Print): 2322-4436
                ISSN (Electronic): 2322-3219
                Publication date (Print): Spring 2017
                Volume: 6
                Issue: 1
                Pages: 19-21
                Affiliations
                [1]Retina Division, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
                Author notes
                Correspondence to: J. Fernando Arevalo, MD, FACS, The Wilmer Eye Institute, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Maumenee 708, Baltimore, MD 21287, USA. Phone: +1-443-287-9554. Fax: +1-443-287-5492. E-mail address: arevalojf@jhmi.edu
                Article
                Publisher ID: mehdiophth-6-019
                PMC ID: 5392229
                PubMed ID: 28428971
                SO-VID: d78c57f6-55d2-48d0-961b-5c686a135086
                Copyright © ©2017, Med Hypothesis Discov Innov Ophthalmol.
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial 3.0 License (CC BY-NC 3.0),( https://creativecommons.org/licenses/by-nc/3.0/) which allows users to read, copy, distribute and make derivative works for non-commercial purposes from the material, as long as the author of the original work is cited properly.

                History
                Categories
                Subject: Commentary

                Keywords: retinal research,latin america,association for research in vision and ophthalmology,pan-american association of ophthalmology
                Data availability:
                Keywords: retinal research, latin america, association for research in vision and ophthalmology, pan-american association of ophthalmology

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