"Envisioning the Future of Retina" CE Series - December Webinars
Throughout 2020, Retina Consultants of Texas hosted several CE event webinars as part of our “Envisioning the Future of Retina” series. Each virtual webinar focused on various cases that had been treated by members of our team. The series, which was hosted by Dr. James Major and sponsored by the Greater Houston Retina Research Foundation (GHRRF), was designed to illuminate the numerous subtleties involved in diagnosing and treating retinal conditions while facilitating a deeper discussion. Ophthalmologists in attendance earned a CE credit equaling one therapeutic hour.
The webinar that took place in December featured presentations from two of the newest members of the RCTX physician team, Dr. Sagar Patel and Dr. Vy Nguyen. Together, they presented three unique cases, each of which involved symptoms, details, and potential risk factors that could be interpreted in different ways. Dr. Patel and Dr. Nguyen were joined by Dr. Rosa Kim, Dr. Eric Chen, Dr. Tien Wong, Dr. David Brown, and Dr. Charles Wykoff, who answered questions asked by the two panelists. Together, they reached various hypotheses of the cases as well as possible treatment approaches.
Case #1: Conditions that Resemble AMD
The first case, presented by Dr. Nguyen, focused on a 49-year-old man with blurry vision but good visual acuity. He presented with similar symptoms to age-related macular degeneration (AMD) but was too young for that to be the correct diagnosis. His optical coherence tomography (OCT) scans revealed neurosensory detachment in his right eye as well as subfoveal increased thickness. A fluorescein angiogram also showed that there was leakage. The doctors then discussed possible diagnoses as well as various treatment options.
Case #2: HCQ-Induced Retinal Toxicity
The second case, presented by Dr. Patel, featured a 65-year-old woman with retinal atrophy who was taking 300 mg of Plaquenil daily for ten years. Plaquenil is the brand name for hydroxychloroquine (HCQ), which is used to treat a wide range of illnesses and conditions, including malaria and certain autoimmune diseases. Dr. Patel and the doctors discussed how, given her medical history, the patient was at high-risk for developing HCQ-induced toxicity. HCQ toxicity is untreatable and can lead to irreversible vision loss in some cases, making it particularly concerning.
Case #3: Elmiron and Pigmentary Maculopathy
The third case featured a 46-year-old woman whose images revealed the presence of yellowish-brown spots in the macula and symmetrical abnormalities in both eyes despite having no symptoms, major vision issues, or medical problems.
After going through possible diagnoses, Dr. Nguyen revealed that the patient had been on pentosan polysulfate sodium (brand name Elmiron) for over a decade to treat a chronic bladder condition known as interstitial cystitis. As such, the patient was diagnosed with Elmiron-induced pigmentary maculopathy. Dr. Nguyen pointed out that this medication is rarely divulged to retina specialists unless patients are asked about it specifically. Dr. Wyckoff added that, because the symptoms of Elmiron-induced pigmentary maculopathy resemble AMD, it’s easy to misdiagnose and that these cases are likely far more prevalent than previously realized.