Invited Speakers

Please see the PDF for the invited speakers at the TMU International Symposium 2015.

Neuroprotection aims to augment the benefit provided by IOP lowering in order to slow the rate of RGC cell death and preserving the remaining level of vision. Neuroregenerative approaches are a key target of the National Eye Institute Audacious Goals Initiative and therapies that stimulate regeneration of the optic nerve have recently been shown to restore some visual function in animal models of optic nerve injury. There is a compelling argument for a combined neuroprotective/neuroregenerative approach when considering future treatment strategies for glaucoma.
In this lecture, some of the techniques being explored to protect and regenerate the optic nerve using gene therapy, stem cells and other approaches will be considered. Particular attention will be paid to those strategies that are most likely to be useful clinically and how they might be assessed in cost-effective clinical trials within a realistic timeframe.

Brief Curriculum Vitae:
Keith Martin was elected as the first Professor of Ophthalmology at the University of Cambridge in 2010. He is the Head of Ophthalmology at the University of Cambridge, Deputy Director of the University's John van Geest Centre for Brain Repair and an Affiliate Principal Investigator at the Wellcome Trust -MRC Cambridge Stem Cell Institute. He is also the Academic Lead for Ophthalmology and Lead Clinician for Glaucoma at the Cambridge University Hospitals NHS Foundation Trust. He graduated from the University of Cambridge with a 'Triple First' in Medical Sciences and Neuroscience before completing clinical training at Oxford University Clinical School, Ophthalmology Residency in Cambridge and Clinical and Research Fellowships in Glaucoma at Moorfields Eye Hospital in London and the Wilmer Eye Institute in Baltimore.
Professor Martin established and runs the Glaucoma Research Laboratory at the University of Cambridge, working to develop new treatments for eye disease using stem cells, gene therapy and other techniques. In 2010, Professor Martin won the ARVO Foundation for Eye Research Translational Research Award, an international prize to a researcher from any country under the age of 50 years whose research is judged to have the potential to lead to major breakthroughs in the treatment of eye disease. He was also a winner of the World Glaucoma Association Senior Clinician Scientist Award in 2011.
Clinically, Professor Martin specializes in the medical and surgical management of complex glaucoma in adults and children. He is the Basic Science Section Co-editor of the Journal of Glaucoma and Vice President and President-elect of the World Glaucoma Association. Despite being the commonest cause of uveitis, the pathogenesis of HLA-B27-associated anterior uveitis (AU) has remained an enigma since its description 40 years ago. Recent studies from our laboratory and others have given greater insight into the role of genetic factors and microbial triggers and the role of immune and molecular mechanisms in the pathogenesis of this disease.
The clinical features and associated systemic disease in HLA B27 individuals are distinctive and consistent across different populations. HLA B27 AU is polygenic with a number of genes predisposing to ocular inflammation, particularly ERAP-1, which has a role in antigen processing and presentation via HLA B27 on the cell surface. The microbiome and an increasing number of microorganisms have been implicated in AU, and serological evidence of previous Chlamydial trachomatis (CT) infection is present up to 50% of patients with AU. We have shown that peptides derived from CT selectively bind to the HLA B27 molecule and induce arthritis and AU when injected into experimental animals. Cytokines, adhesion molecules, toll-like receptors and proteases play a critical role in the pathogenesis of AU. Molecular studies have revealed new therapeutic approaches to the treatment HLA B27 AU, such as anti-TNF-alpha therapy, which prevents relapses and has the potential to change the natural history of this disease.

Brief Curriculum Vitae:
Prof Wakefield is a clinical immunologist with a longstanding research interest in the pathogenesis of inflammatory eye diseases (IED), such as uveitis, scleritis and pterygia. Significant scientific discoveries have been made in the areas of the role of HLA B27, cytokines, adhesion molecules, chemokines, toll-like receptors and MMPs, in the pathogenesis of IED and pterygia.
Prof Wakefield is the Director of the Laboratory of Ocular Inflammation and the Inflammation Research Unit, Professor of Medicine and Foundation Professor of the School of Medical Sciences in the Faculty of Medicine at UNSW and Director of the Centre for Immunology.
Prof Wakefield has published mostly in relevant highimpact journals with over 350 peer-reviewed publications and 20 book chapters. He has published in Stem Cells, Lancet, Diabetes, FASEB J, J Immunol, American J Pathol, Ophthalmology and Invest Ophthalmol Vis Science and has a H-index of 42 (Web of Science).
Prof Wakefield is a Foundation Member of the International Ocular Inflammation group and serves as an Editor of the Journal produced by this organization. He also serves on the editorial board of BMC Ophthalmology and Ophthalmic Inflammation and Infection and has previously sat of the editorial boards of Internal Medicine Journal and Ocular Immunology and Inflammation. Over the course of his career, he has given many invited lectures at international conferences including more than 30 in the last 10 years. He has supervised to completion 20 PhD, 5 MSc and 3 MD students. His excellence in research student supervision was recognized by UNSW with the award of the Vice Chancellor's Award for Teaching Excellence in 2008.
In 2015, he was awarded an Order of Australia for services to medicine. I will start my lecture with a short introduction of the Fyodorov Eye Microsurgery Institution, its history and present. Then, I will briefly describe the list of situations that complicate cataract surgery. Following is the update on the small pupils and IFIS, remarks and conclusions.

Brief Curriculum Vitae:
Prof Boris Malyugin is a world-renowned authority and expert in the field of cataract surgery. He is practicing in the S. Fyodorov Eye Microsurgery State Institution in Moscow, Russia.
Dr Malyugin is having multiple international awards and was invited to present guest lectures and live surgery sessions during numerous national and supranational meetings all over the world. He is a member of ESCRS Board, International Intraocular Implant Club and Academia Ophthalmologica Internationalis, ICO Advisory Board member, AAO and ASCRS member.
Dr Malyugin has made significant contributions to cataract and implant surgery. He is well known for his development of the Malyugin Ring, the device facilitating cataract surgery in patients with small pupils and IFIS. Other innovations include modified CTR, accommodative and multifocal intraocular lenses with pioneering concept of gradient refractive index optics, several instruments and devices.
Dr Malyugin is a Chief Medical of the Journals Ophthalmosurgery (Russia) and EuroTimes (Russian edition) and Associate Editor of the News in Ophthalmology (Russia). He is also an Editorial Board Member of the Journal of Cataract and Refractive Surgery, as well as some other national and international ophthalmic journals. Dr Malyugin publication list includes co-editing of five books and writing over 35 book chapters, contribution to the Video Atlas of Ophthalmic Surgery and Video Journal of Cataract and Refractive Surgery. Refractive surgery has advanced greatly over the last 100 years. This allows patients at most stages of life to take advantage of surgical options to reduce their dependence on glasses and contact lenses. Major advancements have been made in the last 30 years in corneal refractive surgery, with technologies like PRK and LASIK. Major advancements in corneal refractive surgery are customized treatments using either wavefront or topographic guidance to allow treatments based on individual characteristics of a patient's optical system. As the number of patients with prior corneal refractive surgery grows, the ability to manage changes in their optical system over time is increasingly important. Determination of refractive stability to decide if an enhancement procedure will have long-lasting results is important. We know that lenticular changes with age will eventually create an unstable refractive status the few years before the need for cataract surgery. Fortunately, in the last 20 years, there have been significant improvements in technology for cataract extraction and lens implantation including presbyopic IOLs and improved ability to manage astigmatism. Additionally, improvements in presbyopic technology such as a better understanding of monovision, corneal inlays and presbyopic IOLs add to our ability to help patients in the presbyopic age group. Foremost, we should work to have a long-term plan for our patient to meet their changing needs and goals.

Brief Curriculum Vitae:
Dr David R. Hardten, a board-certified ophthalmologist and founding partner of Minnesota Eye Consultants, is a prominent leader in the treatment of the cornea, external disease, anterior segment, cataract, refractive and laser surgeryas well as in research and education.
As The technology in diagnostic imaging of retinal disease has impressively improved during the last years switching from six radial scans only with the earliest time domain optical coherence tomography (TD-OCT) to three-dimensional full-volume raster scanning by spectral domain (SD) OCT and now thousands of scans being taken in a short time by swept-source (SS-) OCT. This explosion of available information can only be adequately exploited by corresponding digital analysis tools being able to extract all relevant information from big data sets. Algorithmic methods are being used for computational analysis of OCT images including noise removal, motion correction, segmentation of individual retinal layers, quantification of intraretinal (IRF) and subretinal (SRF) fluid as well as pigment epithelial detachment (PED) and drusen. A comprehensive set of such automated registration methods enables longitudinal and inter-patient alignment of OCT scans and precise monitoring of progression or resolution. In addition, machine learning methodology can be used to identify a large spectrum of clinically relevant biomarkers for disease progression or therapeutic response.
Indications for advanced image analysis are unlimited ranging from monitoring of progression of early AMD in respect to drusen volume progression or regression, a decrease in IRF or SRF in diabetic macula edema (DME) as well as monitoring of progressive degeneration of neurosensory elements in diabetic retinal disease (DRP). Neovascular as well as atrophic AMD are important fields for computational analysis to even predict treatment response and the frequency of disease recurrence.
Normal morphologic features of relevance are subretinal hyperreflective material (SHRM) and fibrosis which may be detected by using selective OCT imaging tools such as polarization-sensitive (PS) OCT. Scientifically, novel targets for innovative therapeutic strategies can be identified, and insight into the pathophysiology of retinal disease is greatly enhanced. Moreover, current and future disease management efforts require efficient risk prediction allowing cohort enrichment and streamlining of clinical trials.

Brief Curriculum Vitae:
Ursula Schmidt-Erfurth is a Professor and the Chair of the Department of Ophthalmology at the University Eye Hospital, Vienna, Austria, one of the largest academic institutions in ophthalmology in Europe. Professor Schmidt-Erfurth's clinical activities include surgical and medical retina. Her scientific research focuses on the development of novel diagnostic techniques, for example, retinal imaging and novel treatment strategies such as intravitreal pharmacotherapy. She has founded the Vienna Study Center (VSC), which serves as the principal site for multicenter clinical trials, and the Vienna Reading Center (VRC), an independent institution for digital imaging performing image analysis for over 140 clinical sites worldwide. She is the Head of the OPTIMA project, which is a continuation in the development of advanced image analysis (Christian Doppler Laboratory for Ophthalmic Image Analysis). Professor Schmidt-Erfurth is a member of many professional organizations, including the Association for Research Thyroid Eye Disease or Graves' orbitopathy (GO) is the most frequent orbital disease and one of the most frequent eye diseases at present. GO is a very complex autoimmune disorder with a multifarious presentation, a very disabling course in its more severe manifestations and with a treatment requiring every tool and trick an experienced orbitologist has in stock.
In the late eighties of the last century, consensus was reached about a general management plan consisting of both medical and surgical interventions. The introduction of parameters for disease activity allowed for an evidence-based choice between the two options. In the years to come, many randomized clinical trials were performed, which so far resulted in the achievement that intravenously administered high-dose methyl-prednisolone offers the best chances for patients with active disease. Although efficacious in up to 80% of patients, the outcome results must not be overestimated. Exophthalmos reduction, for instance, is exceptional.
Surgical rehabilitation consists of orbital decompression, squint surgery and eyelid corrections. Numerous papers have shown that orbital decompression is an effective and relatively safe procedure to reduce proptosis. The outcome depends on the number and extent of the removal of the bony walls of the orbit and whether orbital fat is removed. The most common complication is induction of diplopia.
Consensus on the treatment of squint in GO-patients still has to be achieved. In fact, in this field, very little has been published. Not before last year, the first proposal of success criteria for patients with squint within the framework of GO appeared. We are now waiting for comparative studies.
May be one of the greatest challenges for the orbital surgeon is putting the eyelids of GO-patients in their right positions. Several techniques are in use.
Slowly, progress is made unrevealing the immunologic cause of GO. Volumetric and other studies show that two different pathways seem to be involved: an early extraocular muscle inflammation and a late adipogenesis pathway.
At present, new generations of anti-inflammatory and immunoregulatory drugs are studied. So far, we are unable to identify new victims of GO and launch prevention strategies. Except of course of discouraging smoking!

Brief Curriculum Vitae
Maarten Mourits finished his medical studies at the University of Amsterdam in 1980. His first medical position was that of a general practitioner in Djoemoe, in the interior of Surinam. After 1.5 years of general surgery not in training, he specialized in ophthalmology with Professor R. A. Crone in Amsterdam. Thereafter, he superspecialized in orbital, lacrimal and eyelid surgery with Professor Leo Koornneef and in Moorfields. He did his PhD in 1990 on Graves' disease, in which he introduced the so called Clinical Activity Score. Next, he went to the University Hospital of Utrecht to initiate Holland's second orbital center. After the Chernobyl disaster, he was sent by his government to Belarus to set up thyroid eye clinics. Mourits has been executive editor of the Journal 'Orbit' for 10 years, president of the International Society for Orbital Disorders and of the European Society of Ophthalmic Plastic and Reconstructive Surgery. He is a reviewer of many journals, member of several national and internal societies and committees, founding father of the Dutch Society of Meningioma Patients and of the Dutch Foundation of Esthetic Surgery and currently president of the Dutch Orbital Society. He became chair of the department of Ophthalmology of the Academic Medical Center in Amsterdam in 2004 and at the same time got the final responsibility for the ophthalmic training of 20 residents. Mourits wrote more than 130 pubmed papers, among which in the Lancet and NEJM, and 23 book chapters. He trained more than 20 foreign and overseas fellows, presented more than 100 invited lectures and performed thousands of oculoplastic operations. He developed a duction-meter and a parallax-free exophthalmometer. Recently, he set up an Eye Hospital in Amsterdam, of which he became the medical director. Finally, he is involved in the training of residents and oculoplastic surgeons in Moshi, Tanzania. Mourits is married with two grown-up daughters, one of them is a PhD student in oculoplastic surgery. The afferent visual pathway is a functionally eloquent region of the central nervous system (CNS). Cardinal features of many inflammatory, ischemic, and compressive CNS lesions can be appreciated through detailed ophthalmic examination because these disorders cause vision loss and damage to the optic nerve and surrounding retinal nerve fiber layer. Merits of the afferent visual pathway, as a putative CNS model, include the fact that patients seek medical attention when they experience visual disturbances, thus providing a timeline during which manifestations of injury and repair can be monitored. Moreover, there are standardized tests of visual function that allow deficits in both form and motion perception to be reliably quantified. The afferent visual system is highly elegant in terms of its topographical arrangement. In the modern imaging era, optical coherence tomography provides high-resolution measures of neuroaxonal integrity in the CNS, which can be followed longitudinally as markers of neuro-degeneration. Finally, the contributions of cortical adaptation to visual recovery can also be measured, using motion perception and sophisticated magnetic resonance imaging techniques. In this lecture, I will outline how the afferent visual pathway can be used to develop a structuralfunctionalparadigm of CNS injury and repair with specific emphasis on demyelinating and compressive disorders. There are hundreds of eye diseases. Scores of them have blinding potential, and some are deadly. Many of these diseases have been virtually neglected in the developing world. Through my Hollows Lecture, I will be sharing a number of personal experiences that have had a powerful impact on me and on the direction of my career and have ultimately led to the establishment of Sight For All. These experiences have shown me that, as ophthalmologists, we can deliver high-impact and sustainable solutions that can not only broadly reduce blindness from many different causes but can also alleviate poverty and save lives in some of the poorest communities of the world.

Brief Curriculum Vitae:
Dr James Muecke graduated with honours from the University of Adelaide Medical School in 1987. Following his internship at the Royal Adelaide Hospital in 1988, Dr Muecke worked as a Resident Medical Officer at Tumu Tumu Hospital in Kenya. He trained as a general ophthalmologist in Adelaide from 1992 to 1994 and was awarded a fellowship to work at St. John Ophthalmic Hospital in Jerusalem in 1995. During his year in Jerusalem, he travelled to villages and refugee camps in the West Bank and Gaza strips to conduct weekly outreach eye clinics. Following subspecialty training in ophthalmic plastic surgery and ocular oncology in England, he returned to Adelaide in 1998 to take up positions as a Visiting Ophthalmologist and Director of the Ocular Oncology Units in the Departments of Ophthalmology at the Royal Adelaide and Women's and Children's Hospitals.
Dr Muecke has a strong interest in ophthalmic development and blindness prevention in the developing world. He was the Director of the Vision Myanmar Program (VMP) of the South Australian Institute of Ophthalmology and has been actively involved in surgical teaching, epidemiological studies, public health campaigns, infrastructure development and blindness prevention in Myanmar since 2000. He is an Author and Co-author of numerous publications generated from studies in Myanmar. He is the author, photographer and publisher of 'Visions of Myanmar', a fund-raising coffee table book that raised over $100 000 for eye care in Myanmar.
Dr Muecke has also been involved in blindness prevention activities in Bangladesh, Bhutan, Cambodia, Indonesia, Laos, Nepal, Sri Lanka and Vietnam. He is the Founding Chairman of 'Sight For All Foundation', a not-for-profit organization committed to fighting blindness in the developing world (www.sightforall.org).

Contact Details:
The University of Calgary, AB Canada Email: jsmuecke@bigpond.com