- COPE Accredited CE Series -
Colorado Retina's Virtual Visionaries takes place via Zoom on the third Wednesday of each month from 6-7PM MST. This educational lecture series covers a mix of retina and uveitis topics and complex cases, and features guest sub-specialty experts to highlight a variety of other vision threatening diseases and disorders including: diabetes, cataracts, glaucoma, tumors, nerve-related vision problems, pediatric eye issues, and more.
MISSED A PRIOR CE EVENT? Previously Recorded Past CE Activities are Available on our Website for your Viewing.
Uveitis & Rheumatology: A Crossroads

In last months edition of Virtual Visionaries, Colorado Retina's Uveitis Specialist, Dr. Mark Dacey and Colorado Center for Arthritis & Osteoporosis Rheumatologist, Dr. Joseph Lutt discussed the inter-disciplinary partnership between their sub-specialities. This lecture includes tips to identify ocular signs and symptoms and diagnostic and management techniques for a variety of systemic inflammatory and autoimmune disorders.
SUSVIMO. Colorado Retina Assists in FDA Approval of Genentech’s Novel Surgical Wet AMD Treatment Delivery Method
In October 2021, the U.S. Food and Drug Administration approved SusvimoTM, the first intraocular implant as an alternative to monthly anti-VEGF injections for the treatment of wet AMD. Susvimo, previously called Port Delivery System with ranibizumab, delivers medication continuously through a refillable implant, reducing the number of treatments required to as few as two per year. The implant is surgically inserted into the eye during a one-time outpatient procedure in both phakic and pseudophakic patients and has the potential to significantly decrease treatment burden of wet AMD.

Colorado Retina participated in the Phase II Ladder and Phase III Archway studies, leading to FDA approval of Susvimo. Primary analysis across all study sites showed that Susvimo maintained vision gains equivalent to monthly ranibizumab injections at 36 and 40 weeks of treatment. If necessary, supplemental ranibizumab injections can be performed in addition to Susvimo. Only 1.6% of Susvimo patients in the Archway study received supplemental ranibizumab treatment before their first refill. While generally well-tolerated with a favorable risk-benefit profile, Susvimo showed an increased rate of endophthalmitis compared to monthly intravitreal injections of ranibizumab. These events were largely associated with conjunctival retraction or erosion over the implant which may be averted by adhering to proper surgical technique at the time of device implantation, early detection, and intervention. Susvimo is expected to be available in the United States in the coming months and offers patients a groundbreaking alternative to lifelong monthly injections for sight preservation.

Click below to learn more about our actively enrolling clinical trials. To refer a patient, submit your referral as you normally would (Online, fax or email) and note *referral to research*. The patient must first be a patient of Colorado Retina and be pre-screened by a CRA physician in order to enroll in a clinical research study.

For more information or questions regarding clinical trials, email the Colorado Retina research department at [email protected] or 720-420-3265.
Murtaza Adam, M.D. Presents Data on Vitreoretinal Surgery Without Intravenous Anesthesia at National Retinal Meetings!
Colorado Retina's Vitreoretinal Specialist, Dr. Murtaza Adam presented data on his novel technique for performing vitreoretinal surgery without the assistance of an anesthesiologist at The Retina Society and American Society of Retina Specialists (ASRS) meetings this year.

Vitrectomy surgery for example is one of the most common ophthalmic procedures performed across the world. "Pars plana vitrectomy (PPV) is typically performed with the assistance of an anesthesiologist either with monitored anesthesia care (MAC) or general anesthesia (GA), combined with a local ocular block. Numerous factors, including the patient’s medical history, comorbidities, anxiety, dementia, medication or illicit drug history, along with surgical complexity, expected case time, and language barriers, can all influence the anesthesia modality selected for a particular case. For all cases supported by an anesthesiologist, patients are required to fast for at least 8 hours before surgery, and intravenous (IV) line placement is mandatory. With local block administration and anesthesiologist support, PPV with this approach has a proven track record of patient comfort and safety."

"While vitreoretinal surgeons have been performing cases with the same anesthesia approach for decades, our anterior segment colleagues have been rapidly evolving their approaches to anesthesia for cataract surgeries. Recent studies involving cataract surgery with topical anesthesia and oral sedation without an anesthesiologist have reported excellent outcomes with reduced costs, low intraoperative complication rates, and increased patient satisfaction."

If you are interested in further learning about Dr. Adam’s novel anesthetic approach for vitreoretinal surgery, click the link below.
Colorado Retina Joins Retina Consultants of America
Our team is excited to announce our merger with Retina Consultants of America (RCA), a comprehensive retina-only physician management services organization with the goal of providing the highest quality retinal care and cutting-edge clinical trials to patients across the United States. As a leader in vitreoretinal care in the mountain west, Colorado Retina was specifically sought out by RCA to join their team as a platform practice in the region.
RCA brings together national leaders in surgical and clinical retinal care with the common goal of eradicating blindness from macular degeneration, diabetic retinopathy, and a variety other retina diseases. In addition to providing highly specialized care expertise, the physicians of Retina Consultants of America are world renowned for their clinical research of retinal disease. Colorado Retina's Clinical Research division will be able to provide enhanced evaluations of new preventative and therapeutic treatments as we participate in RCA's supported 80 active clinical trials with an additional developing pipeline of over 70!
Being part of the RCA family allows our practice increased support, collegial experience, and resources to be able to provide our patients unmatched care and results in our rapidly evolving specialty. The physicians and management team of Colorado Retina deeply value the warm culture and patient-centric environment we are known for, and will continue to retain complete autonomy with regard to clinical decisions and day-to-day management. We look forward to this new partnership with stellar RCA retinal specialists across the country in our mission to provide sight-saving care to patients.
To learn more about Colorado Retina's partnership with RCA, click HERE.
Valsalva Retinopathy
Betty Zhang, O.D., Optometrist & Physician Liaison at Colorado Retina
Salil Shukla, M.D., Retina Specialist at Colorado Retina
A 24 year old male presents complaining of awaking with a scotoma in the superotemporal visual field of the right eye. The patient’s medical and ocular history are noncontributory. Vision is 20/20 OD and OS with normal intraocular pressures. Anterior segment exam is unremarkable in both eyes, and posterior segment exam of the left eye is within normal limits. Posterior exam of the right eye shows a boat-shaped preretinal hemorrhage inferonasal to the optic nerve head. OCT of the right eye through the area of hemorrhage revealed sub-ILM hyper-reflectivity. Peripheral exam was otherwise unremarkable. The patient disclosed emesis secondary to inebriation the prior evening and was diagnosed with valsalva retinopathy.

Valsava retinopathy is characterized by sudden and painless loss of vision due to preretinal hemorrhage caused by a sudden increase in intrathoracic or intraabdominal pressure. Lack of valves in the venous system of the head and neck lead to transmission of pressure to the eye during valsalva maneuver, resulting in the rupture of superficial retinal capillaries. Hemorrhage can present sub-ILM, subhyaloid, intraretinal, or intravitreal. The classic double ring sign hemorrhage involves both subhyaloid and sub-ILM hemorrhage concurrently. While most cases resolve with observation, larger hemorrhages can take months to resorb. Extended observation risks irreversible retinal damage due to toxicity from prolonged contact with hemoglobin. More invasive treatment to prevent permanent vision loss include Nd:YAG laser hyaloidotomy and/or pars plana vitrectomy.
Dr. Zhang's Curbside Consults

As a reminder, Dr. Betty Zhang is available to all members of our referring community to assist in the review of peculiar retina cases like the above. If you come across a diagnostic or clinical dilemma or have general questions pertaining to vitreoretinal disease don't hesitate to contact Dr. Zhang via TEXT: (785) 312-4682, email: [email protected] OR through the Colorado Retina website HERE.
AMD and COVID-19: What Do They Have In Common?
Brian C. Joondeph, M.D., Retina Specialist at Colorado Retina
At recent national retinal meetings hot topics included pivotal success and advances in the field of gene therapy for a variety of retinal diseases, including macular degeneration, diabetic retinopathy, and inherited retinal diseases. While absorbing content presented at these annual meetings Dr. Brian Joondeph couldn't help but notice the parallels between the novel COVID-19 vaccines and retinal gene therapy, both the benefits and the potential unintended consequences.

In this opinion piece, Dr. Joondeph addresses and explores the similarities, benefits, potentially concerning side effects and currently unknown domino effects of these cutting-edge technologies as we enter a new chapter in medicine and therapeutics.
Seen in: OpMed.Doximity.com, October 18, 2021. Op-Med is a collection of original articles contributed by Doximity members. All rights reserved.
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