A Chat with Anat

My guest for this episode is Professor Nicole Eter, Professor of Ophthalmology and Chair of the Department of Ophthalmology at the University of Münster, Germany. In this episode, Nicole and I chat about the different macular neovascularization (MNV) subtypes, discussing the diagnostic tools used to classify MNV subtypes, their defining characteristics and variants, and the impact of these on our patients. Our conversation highlights why it’s important to tailor treatment to MNV subtype for our patients to have the best outcomes, and the significance of discussing lesions, prognoses and treatments with patients and their caregivers. Important resources, such as the Vision Academy Viewpoint on MNV subtypes and treatment algorithms and educational slide decks, can be found on the https://www.visionacademy.org/. Or can be downloaded directly from here; view point and slide deck. Always refer to local treatment guidelines and relevant prescribing information. Please review the product information before prescribing. If you enjoyed this episode, SUBSCRIBE to ‘A Chat with Anat’ to never miss an episode! Further information on content in other podcasts in this series can be found here at: https://www.amdbarometer.org/resources Speaker disclosures: Professor Anat Loewenstein Consultancy: Allergan, Annexon, Bayer, Beyeonics, Biogen, ForSight Labs, Iqvia, Iveric Bio, Johnson & Johnson, MJHEvents, Nanoretina, Notal Vision, Novartis, Ocuphire Pharma, Ocuterra, Ophtimedrx, Ripple Therapeutics, Roche, Syneos, WebMD, and Xbrane. Professor Nicole Eter Consultancy: Alcon, Allergan, Apellis, Bayer, Novartis, and Roche; Payments/honoraria: Allergan, Apellis, Bayer, Novartis, and Roche; Research grants: Bayer and Novartis; Support for meetings/travel: Roche. Further information on other studies mentioned in this episode: Mathis T, et al. Characterisation of macular neovascularisation subtypes in age-related macular degeneration to optimise treatment outcomes. Eye. 2022. https://www.nature.com/articles/s41433-022-02231-y Spaide RF, et al. Consensus Nomenclature for Reporting Neovascular Age-Related Macular Degeneration Data: Consensus on Neovascular Age-Related Macular Degeneration Nomenclature Study Group. Ophthalmology. 2020. https://www.sciencedirect.com/science/article/pii/S0161642019322432 November 2023 MA-PFM-OPHT-ALL-1182-1 This podcast is not intended for UK audiences. This podcast series is produced and funded by Bayer. The views and opinions expressed throughout this podcast are the speakers' own, based on their clinical experience and expertise. The Barometer Program is managed by clinical leaders in ophthalmology as well as representatives from the IFA, IAPB and Bayer. The activities of the Barometer Program are funded and facilitated by Bayer where the scientists and representatives from IFA and IAPB retain decision authority to the research scope, methods, analysis of findings, and dissemination of the outputs of the Barometer Program. The Vision Academy is a group of over 100 international experts who, through their collective expertise, provide consensus guidance for managing clinically challenging situations, especially in areas of controversy or with insufficient conclusive evidence. The Vision Academy is funded and facilitated by Bayer. The opinions and guidance of the Vision Academy outputs are those of its members and do not necessarily reflect the opinions of Bayer.

In this episode, Professor Paul Mitchell, Professor of Ophthalmology at the University of Sydney in Australia, and Dr Andrew Chang, Principal Retinal Specialist at the Sydney Retina Clinic and Day Surgery in Australia, share their thoughts on the optimal anti-VEGF therapy regimens to treat retinal vascular diseases, including nAMD and DME. They discuss how the best regimen should be effective in maintaining vision, proactive, individualized to the patient’s needs, and convenient for the patient. Using prctical examples from their own clinics, Professor Mitchell and Dr Chang explore how to treat different patients with different levels of starting visual acuity, and how treatments for retinal vascular diseases have changed over time. This podcast is produced in partnership with the Vision Academy, a group of internationally renowned retinal experts who collaborate to provide guidance to the retinal community on clinical challenges in ophthalmology and controversies in care. The Vision Academy viewpoints providing guidance on clinically challenging situations, and other important resources, can be found at https://www.visionacademy.org/. Always refer to local treatment guidelines and relevant prescribing information. Please review the appropriate product information before subscribing. If you enjoyed this episode, please listen to past episodes in this series to hear retinal experts discussing their thoughts on bilateral retinal disease and treatment, how to optimize treatment of patients with nAMD with macular neovascularization subtypes, and how patients’ emotions, experiences, and perceptions can influence their treatment adherence and persistence. SUBSCRIBE to ‘A Chat with Anat’ to never miss an episode! Further information on other studies mentioned in this episode: ARIES study: Mitchell et al., Efficacy and Safety of Intravitreal Aflibercept Using a Treat-and-Extend Regimen for Neovascular Age-Related Macular Degeneration. The ARIES Study: A Randomized Clinical Trial https://journals.lww.com/retinajournal/Fulltext/2021/09000/EFFICACY_AND_SAFETY_OF_INTRAVITREAL_AFLIBERCEPT.15.aspx July 2023 MA-PFM-OPHT-ALL-1183-1 This podcast is not intended for UK audiences. This podcast series is produced and funded by Bayer. The views and opinions expressed throughout this podcast are the speakers' own, based on their clinical experience and expertise. The Barometer Program is managed by clinical leaders in ophthalmology as well as representatives from the IFA, IAPB and Bayer. The activities of the Barometer Program are funded and facilitated by Bayer where the scientists and representatives from IFA and IAPB retain decision authority to the research scope, methods, analysis of findings, and dissemination of the outputs of the Barometer Program. The Vision Academy is a group of over 100 international experts who, through their collective expertise, provide consensus guidance for managing clinically challenging situations, especially in areas of controversy or with insufficient conclusive evidence. The Vision Academy is funded and facilitated by Bayer. The opinions and guidance of the Vision Academy outputs are those of its members and do not necessarily reflect the opinions of Bayer.

We are delighted to announce that we are expanding A Chat with Anat! We will be partnering with the Vision Academy, a group of retinal experts who collaborate to provide guidance to the retinal community. I will be joined by internationally renowned Vision Academy experts to discuss practice-focused topics covering clinical challenges in ophthalmology and controversies in care. In this episode of A Chat with Anat, Professor Paul Mitchell, Professor of Ophthalmology at the University of Sydney, and Dr Alex Hunyor, Associate Professor of Ophthalmology at the University of Sydney, discuss pragmatic considerations to reduce the burden of bilateral anti-VEGF injections. Professor Mitchell and Dr Hunyor explore how bilateral disease significantly impacts patient quality of life, and how bilateral treatment, especially if the eyes are being treated on different days, can lead to significant burden for patients, caregivers, and for their healthcare system. Their conversation also covers how to explain to patients the need for, and risks of, bilateral injections, and how we, as ophthalmologists, can minimise any potential risks with the treatment procedure. The Vision Academy viewpoint providing guidance on bilateral injections, and other important viewpoints and resources, can be found at https://www.visionacademy.org/. Always refer to local treatment guidelines and relevant prescribing information. Please review the appropriate product information before prescribing. If you enjoyed this episode, please listen to past episodes in this series to hear retinal experts discussing their experiences in navigating the importance of addressing anxiety and depression in our patients with nAMD, and how patients’ emotions, experiences, and perceptions can influence their treatment adherence and persistence. SUBSCRIBE to ‘A Chat with Anat’ to never miss an episode! Further information on content in other podcasts in this series can be found at: https://www.amdbarometer.org/resources This podcast series is produced and funded by Bayer. The views and opinions expressed throughout this podcast are the speakers' own, based on their clinical experience and expertise. July 2023 MA-PFM-OPHT-ALL-1181-1 This podcast is not intended for UK audiences. This podcast series is produced and funded by Bayer. The views and opinions expressed throughout this podcast are the speakers' own, based on their clinical experience and expertise. The Barometer Program is managed by clinical leaders in ophthalmology as well as representatives from the IFA, IAPB and Bayer. The activities of the Barometer Program are funded and facilitated by Bayer where the scientists and representatives from IFA and IAPB retain decision authority to the research scope, methods, analysis of findings, and dissemination of the outputs of the Barometer Program. The Vision Academy is a group of over 100 international experts who, through their collective expertise, provide consensus guidance for managing clinically challenging situations, especially in areas of controversy or with insufficient conclusive evidence. The Vision Academy is funded and facilitated by Bayer. The opinions and guidance of the Vision Academy outputs are those of its members and do not necessarily reflect the opinions of Bayer.

My guest for this episode is Professor Tariq Aslam, Professor of Ophthalmology and Interface Technologies at the University of Manchester and a Consultant Ophthalmologist specializing in the management of retinal disease. In this episode, Professor Aslam and I chat about how important it is to consider anxiety and depression when managing our patients with neovascular age-related macular degeneration. Our conversation covers the quick yet effective measures that Professor Aslam has implemented in his own clinic to identify patients with anxiety and depression, with tips for our listeners on how to do the same in their own busy clinics. We also discuss how patients with anxiety and depression can be supported and referred for treatment by ensuring we, as ophthalmologists, focus on the patient and not just the retinal disease or its treatment. If you enjoyed this episode, please listen to past episodes in the series to hear retinal experts explore how patients’ emotions, experiences, and perceptions can influence their treatment adherence and persistence, ways to engage and empower our patients, and the evolution of patient expectations in nAMD through the 21st century. SUBSCRIBE to ‘A Chat with Anat’ to never miss an episode! If you want to know more about the Barometer Program’s efforts towards patient-focused care in nAMD, visit our website: https://www.amdbarometer.org/ Further information on other studies mentioned in this episode: POPPIES study: Senra et al., Experience of anti-VEGF treatment and clinical levels of depression and anxiety in patients with wet age-related macular degeneration. Am J Ophthalmol.; https://www.ajo.com/article/S0002-9394(17)30108-3/fulltext Cimarolli et al., Anxiety and depression in patients with advanced macular degeneration: current perspectives. Clin Ophthalmol.; https://www.dovepress.com/anxiety-and-depression-in-patients-with-advanced-macular-degeneration--peer-reviewed-fulltext-article-OPTH Sivaprasad et al., Impact of injection therapy on retinal patients with diabetic macular edema or retinal vein occlusion. Clin Ophthalmol.; https://www.dovepress.com/impact-of-injection-therapy-on-retinal-patients-with-diabetic-macular--peer-reviewed-fulltext-article-OPTH Weinstein et al., Anxiety in patients with neovascular age-related macular degeneration. Ophthalmic Epidemiol.; This podcast is not intended for UK audiences. This podcast series is produced and funded by Bayer. The views and opinions expressed throughout this podcast are the speakers' own, based on their clinical experience and expertise. The Barometer Program is managed by clinical leaders in ophthalmology as well as representatives from the IFA, IAPB and Bayer. The activities of the Barometer Program are funded and facilitated by Bayer where the scientists and representatives from IFA and IAPB retain decision authority to the research scope, methods, analysis of findings, and dissemination of the outputs of the Barometer Program. The Vision Academy is a group of over 100 international experts who, through their collective expertise, provide consensus guidance for managing clinically challenging situations, especially in areas of controversy or with insufficient conclusive evidence. The Vision Academy is funded and facilitated by Bayer. The opinions and guidance of the Vision Academy outputs are those of its members and do not necessarily reflect the opinions of Bayer.

My guest for this episode is Professor Richard Gale, Professor of Ophthalmology at Hull York Medical School, University of York, UK, and Honorary Consultant Medical Ophthalmologist at the National Health Service’s York Teaching Hospital. In this episode, Richard and I will chat about how patients’ emotions, experiences, and perceptions related to anti-vascular endothelial growth factor (anti-VEGF) treatment can influence their treatment adherence and persistence. Despite this, the patient’s perspective is often not considered during the clinical management of neovascular age-related macular degeneration. To tackle this issue, Richard gives us some of his top tips to try in our busy clinics. We discuss a systematic literature review article recently published in Acta Ophthalmologica, which was authored by a group of international experts including Richard and myself. Find out more here: https://doi.org/10.1111/aos.15201 If you enjoyed this episode, go back and listen to our first episode with Richard, where we chat about how to further motivate our patients to be adherent, or try some of the past episodes to hear other retinal experts delve into ways to engage and empower our patients, and explore a history of patient expectations in nAMD through the 21st century. SUBSCRIBE to ‘A Chat with Anat’ to never miss an episode! If you want to know more about the Barometer Program’s efforts towards patient-focused care in nAMD, visit our website: https://www.amdbarometer.org/ Further information on other studies mentioned in this episode: ANCHOR study: https://doi.org/10.1016/j.ophtha.2008.10.018 MARINA study: https://doi.org/10.1016/j.ophtha.2006.10.045 Prevalence and risk factors for depressive symptoms in patients with nAMD; Australian study: https://doi.org/10.1111/aos.14635 This podcast series is produced and funded by Bayer. The views and opinions expressed throughout this podcast are the speakers' own, based on their clinical experience and expertise. This is not intended for UK audiences. This is not intended for UK audiences. Speaker disclosures: Professor Anat Loewenstein Consultancy, Research grants: Allergan, Bayer, Beyeonics Surgical, KHB, Novartis, Notal Vision, Oculis, Oxurion, Pres-By, Roche, Sensor, WebMD, Xbrane Professor Richard Gale: Consultancy, Research Grants: Alimera, Allergan, Bayer, Novartis, Roche This podcast is not intended for UK audiences. This podcast series is produced and funded by Bayer. The views and opinions expressed throughout this podcast are the speakers' own, based on their clinical experience and expertise. The Barometer Program is managed by clinical leaders in ophthalmology as well as representatives from the IFA, IAPB and Bayer. The activities of the Barometer Program are funded and facilitated by Bayer where the scientists and representatives from IFA and IAPB retain decision authority to the research scope, methods, analysis of findings, and dissemination of the outputs of the Barometer Program. The Vision Academy is a group of over 100 international experts who, through their collective expertise, provide consensus guidance for managing clinically challenging situations, especially in areas of controversy or with insufficient conclusive evidence. The Vision Academy is funded and facilitated by Bayer. The opinions and guidance of the Vision Academy outputs are those of its members and do not necessarily reflect the opinions of Bayer.

My guest for this episode is Professor Paul Mitchell, Emeritus Professor of Ophthalmology at the University of Sydney, Consultant Ophthalmologist at the Western Sydney Local Health District, and Principal of Sydney West Retina Pty Ltd in Australia. As treatment for neovascular age-related macular degeneration (nAMD) has evolved through the 21st century, so have the expectations of our patients. Paul joins me to chat about how developments in treatment modalities and regimens led to the evolution of patient expectations following diagnosis of nAMD, and what we can expect for our patients in the future. If you enjoyed this episode, try some of our past episodes to hear other retinal experts delve into ways in which we can engage and empower our patients, how to further motivate our patients to be adherent, and how clinic organization can be used to improve adherence and persistence. SUBSCRIBE to ‘A Chat with Anat’ to never miss an episode! If you want to know more about the Barometer Program’s efforts towards patient-focused care in nAMD, visit our website: https://www.amdbarometer.org/ Further information on studies mentioned in this episode: Blue Mountains Eye study (https://doi.org/10.1016/S0161-6420(95)30846-9) MARINA study (https://doi.org/10.1056/NEJMoa054481) ANCHOR study (https://doi.org/10.1016/j.ophtha.2008.10.018) LUCAS study (https://doi.org/10.1016/j.ophtha.2014.07.041) ALTAIR study (https://doi.org/10.1007/s12325-020-01236-x) ARIES study (https://doi.org/10.1097/IAE.0000000000003128) HOME study (https://doi.org/10.1016/j.cct.2014.02.003) Algorithm for suspending anti-VEGF treatment in cases of futility (https://doi.org/10.1097/IAE.0000000000002713) This is not intended for UK audiences. Speaker disclosures: Professor Anat Loewenstein Consultancy, Research grants: Allergan, Bayer, Beyeonics Surgical, KHB, Novartis, Notal Vision, Oculis, Oxurion, Pres-By, Roche, Sensor, WebMD, Xbrane Professor Paul Mitchell Consultancy: Allergan, Bayer, and Novartis This podcast is not intended for UK audiences. This podcast series is produced and funded by Bayer. The views and opinions expressed throughout this podcast are the speakers' own, based on their clinical experience and expertise. The Barometer Program is managed by clinical leaders in ophthalmology as well as representatives from the IFA, IAPB and Bayer. The activities of the Barometer Program are funded and facilitated by Bayer where the scientists and representatives from IFA and IAPB retain decision authority to the research scope, methods, analysis of findings, and dissemination of the outputs of the Barometer Program. The Vision Academy is a group of over 100 international experts who, through their collective expertise, provide consensus guidance for managing clinically challenging situations, especially in areas of controversy or with insufficient conclusive evidence. The Vision Academy is funded and facilitated by Bayer. The opinions and guidance of the Vision Academy outputs are those of its members and do not necessarily reflect the opinions of Bayer.

My guest is Dr. Jane Barratt, Secretary General of the International Federation on Ageing. In this episode, Jane and I discuss ways in which we can improve our communication with our patients to enable realistic expectation-setting. We also speak about how we can meaningfully engage with, and empower, our patients to support them in managing their nAMD. This is not intended for UK audiences. Speaker disclosures: Professor Anat Loewenstein Consultancy, Research grants: Allergan, Bayer, Beyeonics Surgical, KHB, Novartis, Notal Vision, Oculis, Oxurion, Pres-By, Roche, Sensor, WebMD, Xbrane This podcast is not intended for UK audiences. This podcast series is produced and funded by Bayer. The views and opinions expressed throughout this podcast are the speakers' own, based on their clinical experience and expertise. The Barometer Program is managed by clinical leaders in ophthalmology as well as representatives from the IFA, IAPB and Bayer. The activities of the Barometer Program are funded and facilitated by Bayer where the scientists and representatives from IFA and IAPB retain decision authority to the research scope, methods, analysis of findings, and dissemination of the outputs of the Barometer Program. The Vision Academy is a group of over 100 international experts who, through their collective expertise, provide consensus guidance for managing clinically challenging situations, especially in areas of controversy or with insufficient conclusive evidence. The Vision Academy is funded and facilitated by Bayer. The opinions and guidance of the Vision Academy outputs are those of its members and do not necessarily reflect the opinions of Bayer.

Today my guest is Mr James Talks, Consultant Ophthalmologist at the Newcastle Eye Centre in Newcastle, UK. He joins me to discuss how clinic organisation can impact adherence and persistence and what aspects we can modify to ensure a better patient experience and optimise adherence to treatment. This is not intended for UK audiences. Speaker disclosures: Professor Anat Loewenstein Consultancy, Research grants: Allergan, Bayer, Beyeonics Surgical, KHB, Novartis, Notal Vision, Oculis, Oxurion, Pres-By, Roche, Sensor, WebMD, Xbrane Mr James Talks Consultancy, Research grants: Allergan, Bayer, Boehringer Ingelheim, Novartis, Roche This podcast is not intended for UK audiences. This podcast series is produced and funded by Bayer. The views and opinions expressed throughout this podcast are the speakers' own, based on their clinical experience and expertise. The Barometer Program is managed by clinical leaders in ophthalmology as well as representatives from the IFA, IAPB and Bayer. The activities of the Barometer Program are funded and facilitated by Bayer where the scientists and representatives from IFA and IAPB retain decision authority to the research scope, methods, analysis of findings, and dissemination of the outputs of the Barometer Program. The Vision Academy is a group of over 100 international experts who, through their collective expertise, provide consensus guidance for managing clinically challenging situations, especially in areas of controversy or with insufficient conclusive evidence. The Vision Academy is funded and facilitated by Bayer. The opinions and guidance of the Vision Academy outputs are those of its members and do not necessarily reflect the opinions of Bayer.

My first guest is Professor Richard Gale, Consultant Medical Ophthalmologist, and the Clinical Director at the York Teaching Hospital NHS Foundation Trust, UK. In this episode, we discuss the latest publications and strategies that are employed to support patients in continuing to attend appointments and receive treatment. I have included below the links to the publications that we discuss during this podcast. Okada M, et al. Ophthalmology. 2021;128(2):234-47 Okada M, et al. JAMA Ophthalmol. 2021;139(7):769-76 This is not intended for UK audiences. Speaker disclosures: Professor Anat Loewenstein Consultancy, Research grants: Allergan, Bayer, Beyeonics Surgical, KHB, Novartis, Notal Vision, Oculis, Oxurion, Pres-By, Roche, Sensor, WebMD, Xbrane Professor Richard Gale: Consultancy, Research Grants: Alimera, Allergan, Bayer, Novartis, Roche This podcast is not intended for UK audiences. This podcast series is produced and funded by Bayer. The views and opinions expressed throughout this podcast are the speakers' own, based on their clinical experience and expertise. The Barometer Program is managed by clinical leaders in ophthalmology as well as representatives from the IFA, IAPB and Bayer. The activities of the Barometer Program are funded and facilitated by Bayer where the scientists and representatives from IFA and IAPB retain decision authority to the research scope, methods, analysis of findings, and dissemination of the outputs of the Barometer Program. The Vision Academy is a group of over 100 international experts who, through their collective expertise, provide consensus guidance for managing clinically challenging situations, especially in areas of controversy or with insufficient conclusive evidence. The Vision Academy is funded and facilitated by Bayer. The opinions and guidance of the Vision Academy outputs are those of its members and do not necessarily reflect the opinions of Bayer.