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Minisymposia

Adverse ocular outcomes from emerging therapies: Mechanisms, diagnoses and management (AP)
Organizers:
Mohamed Abdel-Rahman and Vivian Lee
Speakers: Thomas Albini, Stephen H. Tsang, Bahram Bodhaghi, Jasmine Francis and Ying Kai Chan

This symposium will bring together diverse experts to illustrate how emerging therapies produce untoward effects in the eye in expected and unexpected ways. It will highlight aspects of bench-to-bedside efforts in identifying mechanisms of toxicity and effective therapeutic interventions for managing complications of these therapies.

Epidemiology of diabetic retinopathy and age-related macular degeneration: Past, present and future — A tribute to Barbara and Ronald Klein (CL)
Organizers:
Ecosse Lamoureux and Leslie Hyman
Speakers: Barbara Klein, Lloyd Paul Aiello, Tien Wong, Caroline Klaver and Emily Chew

Over the past few decades, extraordinary progress has been made in understanding the epidemiology of diabetic retinopathy (DR) and age-related macular degeneration (AMD), with much of the groundwork laid by Professors Ronald and Barbara Klein. It is hard to think of another couple who have had a similar prolific and prodigious impact in Ophthalmology and vision research. Their combined work has yielded a rich array of extraordinarily important insights into the epidemiology of these two ocular pathologies. They established groundbreaking cohort studies, such as the Wisconsin Epidemiology Study of Diabetic Retinopathy (WESDR) and Beaver Dam Eye Study (BDES), and have been at the forefront of new advances in Ophthalmology and vision research, including imaging, genetics and disentangling gene-environment interactions. The world is facing an unprecedented age shift, and this “silver tsunami” has grave consequences for current and future approaches for clinical ophthalmic epidemiology for DR and AMD, notwithstanding the potential, but uncertain, roles of new retinal treatments, gene therapy, big data, and artificial intelligence. This mini-symposium brings together a platform of highly esteemed retinal epidemiologists and clinician-scientists who have trained or collaborated with the Kleins and will share how the couple’s body of work has shaped our understanding about these two ocular pathologies. They will discuss past achievements, current challenges, and future research in risk, diagnosis, treatment, and management of DR and AMD, while celebrating this unique opportunity to acknowledge our collective gratitude to Ronald and Barbara Klein for their extraordinary contribution to clinical ocular epidemiology and ophthalmic research.

Corneal epithelial homeostasis (CO)
Organizer: Shivalingappa Swamynathan
Speakers: Robert Lavker, Bogi Andersen, Nick Di Girolamo, Shivalingappa Swamynathan, Mary Ann Stepp, Shizuya Saika and Danielle Robertson

The corneal epithelium (CE) derived from the surface ectoderm cells during embryonic development is continually renewed throughout life. The most superficial cells lost by desquamation are replaced by the underlying cells derived from the basal cells which differentiate as they migrate upwards, and in turn, are replaced by the peripheral limbal stem cell-derived transient amplifying cells that migrate centripetally. Defective corneal epithelial development and/or homeostasis can have debilitating effects and potentially result in vision loss. The overall goal of this minisymposium is to elucidate the molecular mechanisms governing corneal epithelial development and homeostasis, and how they are altered during corneal wound healing, hyperglycemia, and neurotrophic keratopathy.

Making sense of ocular surface pain (CO)
Organizers: Anat Galor and Stephen Pflugfelder
Speakers: Anat Galor, Steven Pflugfelder, Pedram Hamrah, Randy Kardon, Juanita Gallar and Konstantinos D. Sarantopoulos 

Ocular surface pain is a common complaint that has been linked to dry eye disease but which often occurs independently from ocular surface pathology. Many clinicians lack the training and comfort to diagnose and manage pain. This minisymposium will highlight potential contributors to ocular surface pain, with a focus on its neurobiology, including both nociceptive and neuropathic mechanisms and considering both peripheral and central pathologies. The goal of the minisymposium is to highlight current knowledge and define research directions that will lead to improved diagnosis and management of ocular surface pain.

A new look at the optic nerve (EY)
Organizers:
Zia Chaudhuri and Joseph L Demer
Speakers: Dan Milea, Juan Manuel Chau de la Braca, Joseph L Demer, Michael B. Stenger, Jonathan G Crowston, and Alfredo A Sadun

The proposed symposium aims to provide an overview of novel concepts, research methods, and therapeutics of optic nerve disease, which is a major cause of irreversible blindness. Presentations include novel laboratory and animal studies, evaluation of imaging and deep learning biomarkers in clinical optic nerve disease, descriptions of a new syndrome affecting the optic nerve in microgravity that might be significant for interplanetary travel, repetitive strain during eye movements as a mechanical cause of optic neuropathy, and how functional vision and its restoration affect quality of life in optic neuropathy.

Genetics of strabismus (EY)
Organizers:
Zia Chaudhuri and Joseph L Demer
Speakers: Yutao Liu, Markus Preising, Joseph L. Demer, Mary C. Whitman, Zia Chaudhuri and Mervyn G. Thomas

There is an increasing emphasis on genetics as a cause, risk factor, or susceptibility modulator of most diseases, and this stimulated evolution as well as revolution in genomic medicine. Genetics has metamorphosed from a semi-epidemiological branch limited to pedigree analysis and genotype-phenotype correlations, into a highly sophisticated biotechnological science incorporating experimental, bioinformatics, computational and functional tools to validate hypotheses and to guide sight-saving therapeutics. Strabismus, or misalignment of eyes, demonstrates heredity, albeit non-Mendelian patterns. Genetic determinants of this common disorder have remained enigmatic.

Cellular biomechanics in the eye (GL)
Organizers:
M Francesca Cordeiro and Tatjana Jakobs
Speakers: Jeffery Holt, Darryl Overby, Vasanatha Rao, Kate Keller, Ian Sigal and Pedram Hamrah

This symposium will highlight recent advances in cellular and biophysical mechanisms involved in different aspects of biomechanics in the eye, with particular relevance to glaucoma. Increasingly it is recognized that biomechanics plays a major role at the cellular level in the lens, cornea, and glaucoma. Topics to be discussed include mechanosensitive channels including piezo, TMC and L-Calcium, immune cell trafficking, cell adhesive, and membrane scaffolding, fluid and outflow systems, adaptive tissue changes.

Emerging and re-emerging viruses: Pathobiology and ocular manifestations (IM)
Organizers:
Ashok Kumar and Steven Yeh
Speakers: Susan Shresta, SR Rathinam, Ashok Kumar, Jessica Shantha and Steven Yeh

Emerging and re-emerging viruses have the potential to cause localized outbreaks and epidemics leading to high morbidity and mortality as recently evidenced with Ebola outbreak in West Africa and Zika virus outbreak in the Americas. Owing to their evolving nature, an in-depth understanding of the biology and infectious potential of these viruses is lacking. The ocular manifestations of these viruses are considered relatively uncommon in part due to under-reporting leading to a lack of awareness. With an emphasis on pathogenic emerging and re-emerging viruses and their ocular pathology, this symposium will provide an international platform to bring together researchers and clinicians working on ocular and non-ocular disease models interested in host-virus pathogenesis, immunology, vaccinology, epidemiology surveillance, diagnostics, and important advances in new technologies. The formation of worldwide links and sharing of information will warrant that we are better well-equipped for forthcoming epidemics and investigate the involvement of viral infection in ocular diseases.

Ocular manifestations of autoimmune disorders (IM)
Organizers:
Richard Lee and Shiva Swamynathan
Speakers: Stephen Pflugfelder, Cintia De Paiva, James Rosenbaum, Rachel Caspi, Stephen Foster and Charles Egwuagu

Common autoimmune disorders including Sjögren’s syndrome, ankylosing spondylitis, systemic lupus erythematosus, sarcoidosis, multiple sclerosis, rheumatoid arthritis, and Graves’ disease have devastating systemic effects. In addition to their systemic effects elsewhere in the body, these autoimmune disorders have serious ocular manifestations which if left untreated can potentially result in vision loss. The overall goal of this minisymposium is to elucidate the ocular manifestations of autoimmune disorders and their mechanistic underpinnings, facilitating their early and accurate diagnosis and proper sight-saving therapeutic intervention.

Systems-level approaches to derive regulatory networks in eye development and disease (LE)
Organizers:
Salil Lachke and Ales Cvekl
Speakers: Peter Lwigale, Kristen Kwan, Seth Blackshaw, Salil Lachke, Ruth Ashery-Padan and Kevin Schey

While established approaches for studying eye biology and disease focus on one or a limited number of factors, new high-throughput methodologies are now making it possible to simultaneously evaluate whole biological processes and networks in the context of normal or disease conditions. This is largely due to advances in high-resolution imaging, genomics, epigenomics, transcriptomics, and proteomics approaches. This proposed minisymposium will highlight new and interesting applications of these approaches toward the study of the cornea, lens, and retina, informing on their development and disease in terms of global networks.

Rho Kinase Inhibitors, a new class of treatment for glaucoma and corneal disease (PH)
Organizers: Haiyan Gong and Mark Johnson
Speakers: Casey Kopczynski, Haiyan Gong, Arthur Sit, Dan Stamer, Jeffrey Goldberg and Shigeru Kinoshita 

As an excellent example of translational research, basic science studies led to the finding that cytoskeletal-active agents can significantly decrease aqueous humor outflow resistance. Clinical studies followed demonstrating that rho kinase inhibitors can lower IOP, which led to two new drugs: ripasudil in Japan and netarsudil in the United States have been approved for clinical use to treat glaucoma. This minisymposium aims to highlight the utility of rho kinase inhibitors for IOP lowering in glaucoma, plus discuss other interesting properties such as neuroprotection and regeneration as well as a new treatment for corneal endothelial diseases. Presentations will include basic science research for understanding the underlying mechanisms and clinical experience with this new drug class.

Yin and yang of inflammation in retinal degeneration (RC)
Organizers:
Brian Perkins and Neena Haider
Speakers: Diana Mitchell, Sean Wang, Wai T. Wong, Kip Conner, Jeff Mumm and Maria-Paz Villegas-Perez

Retinal degeneration and photoreceptor death activate the innate immune system. Activated microglia and macrophages release inflammatory cytokines that function in context-dependent manners. Modulation of microglial activity can play a neuroprotective role in mammalian systems, while microglia may facilitate retinal regeneration in zebrafish. This minisymposium will bring together a diverse group of leading scientists who will share their latest research on the role of immune cell signaling during retinal degeneration and regeneration in both mammalian and zebrafish models.

State of refraction: Etiology, comorbidities and treatments for the worldwide myopia epidemic (VI)
Organizers: Lisa Ostrin and Xiaoying Zhu
Speakers: Terri Young, Kathryn Rose, Machelle Pardue, Jost Jonas, Christine Wildsoet and Maria Liu

This symposium will allow participants to understand contributing factors to the worldwide epidemic of myopia, which is known to be a complex interaction between genetic and environmental influences. Associated pathologies and comorbidities will be presented. Current and potential treatment options, including pharmacological and optical modalities, will be discussed.

Focus on the fovea; What makes the fovea unique? (VN)
Organizers:
Erika Eggers and Steven H. DeVries
Speakers: Dennis Dacey, Constance Cepko, Raunuk Sinha, Joseph Carroll, Cynthia Toth and Christine Curcio

In primates, the fovea is the part of the retina that conveys the most important information that is necessary for daily life. Therefore, when considering sight-saving therapeutics in patients, conserving or restoring foveal vision is of eminent importance. The main questions to answer are: What makes the fovea unique and why is it vulnerable to disorders? This minisymposium will bring speakers who have studied the structure, physiology, and pathology of the fovea using different techniques. The minisymposium is of interest for basic and clinical researchers.

Vice Presidential Session

A brave new world of artificial intelligence (AI) and ophthalmology: Will you be replaced by robots? (RE)
Organizer:
Jennifer J. Kang-Mieler
Speakers: Aaron Lee, SriniVas Sadda, Michael Abramoff, Pearse Keane, Namma Hammel and Tien Y Wong

Artificial Intelligence (AI) is poised to revolutionize science and medicine. There is no question that AI is a tool with great potential for diagnosing and treating ocular diseases. AI can process vast quantities of information faster than humans but will it be better? Will you be replaced by robots? This mini-symposium will review the basics of AI, research projects already underway, potential benefits and pitfalls of AI in ophthalmology.

Mechanisms and biomechanics of traumatic retinal hemorrhage in children (EY)
Contributing Sections: RE
Organizers: Donny Suh, Brittany Coats and Gil Binenbaum
Speakers: Donny Suh, Cindy Christian, Gil Binenbaum, Alex Levin and Brittany Coats

Retinal hemorrhage is an important sign of abusive head trauma in infants, but much is unknown about the underlying biomechanical mechanisms and forces. Such knowledge is critical to accurately diagnosing child abuse. This mini-symposium will begin with a review of the clinical context and multidisciplinary biomechanical research approaches, then define fundamental questions in the field, review some of the work already done, identify key gaps in our understanding, and work in collaboration with the audience to map research priorities going forward.

Healthcare transformation with AI: Impact in glaucoma and ophthalmology (GL)
Contributing Sections: BI, CL, RE and VI
Organizers: M. Francesca Cordeiro, Ross Ethier and Michael Girard
Speakers: Alexander Thiery, Gustav de Moraes, Anil A. Bharath, Aaron Lee and Carlos Ciller

Artificial Intelligence (AI) is a field that has recently seen unprecedented growth with applications across all fields of medicine including ophthalmology. In ophthalmology, AI has strong potential to significantly improve disease screening, diagnosis, prognosis, and eventually lead the way to personalized treatment. AI may also help us re-define pathologies. While AI is not yet used in the ophthalmology clinic, within the next 10-20 years, it is extremely likely that clinicians and ophthalmic surgeons will need to rely on or interact with AI software/technologies in their day-to-day clinical routine. This Minisymposium aims to understand how AI will change the clinical landscape in Ophthalmology, particularly focusing on glaucoma as an example, as this is an important example of a chronic, aging disease with a significant health-economic burden. It will discuss current and future research and industry trends that are likely to make an impact in the clinic. It will also discuss the strong limitations inherent to AI. This symposium aims to gather clinicians and scientists with interest in AI, engineers and computer scientists that are developing the next generation of AI algorithms, and industry members and policymakers who will play a critical role in the introduction of AI to the ophthalmology clinic.

Innate immune memory and the eye (IM)
Contributing Sections: AP, CO and RE
Organizers: Mary E. Marquart and Andrew W. Taylor
SpeakersAntonio Ibarra, Andrew W. Taylor, Homayon Ghiasi, Martine Jager and Wai T Wong

Innate immune memory is defined as the effects of a tissue microenvironment or infection on innate cells that influence subsequent immune responses mediated by the programmed innate immune cells.

Precision through measurement: Biomarkers in health and disease (IM)
Contributing Sections: AP, RE and VN
Organizers: Richard Lee and Jonas Kuiper
Speakers: Sarah Coupland, Darragh Duffy, Pearse Keane and Russell Foster

Biomarkers are transforming medicine. In their various forms, they guide precision diagnosis and treatment and can be used to delineate health from the disease at both an individual and population level. Their discovery is not predicated by an understanding of the biological mechanism, but they nonetheless inform a deeper understanding of pathology. Most importantly, biomarkers help us to ensure the right patient gets the right treatment at the right time. In this symposium, we explore how characteristic mutations have recently been shown to define ocular malignancy and look outside the eye to consider the potential for heterogeneity in the human immune response to determine disease susceptibility and outcomes in a diversity of conditions. At a population level, algorithms have now been developed to shape healthcare delivery for common retinal diagnoses based on the automated analysis of images generated using widely available technologies, and this promises to change the landscape of global ophthalmic practice. The goal of the session is to touch on these broad-ranging subjects and give an overview of biomarker development in the context of the eye, concluding with a description of how light changes clock gene expression in our circadian pacemaker, and the impact this has on the ultimate biomarker of health (sleep).

Physiological biochemistry of the lens (LE)
Organizers: Kevin L. Schey and Paul J. Donaldson
Speakers: Paul J. Donaldson, Stephen Barnes, Julie Lim, Miduturu Srinivas and Xiaohua Gong 

This Minisymposium will present current knowledge on metabolism in the lens and how lens homeostasis is maintained over decades of life. Also, cutting-edge technologies such as imaging mass spectrometry and metabolomics analysis will be discussed in the context of studying metabolism and transport of key metabolites into, within, and out of the lens. Emphasis will be placed on the effects of aging and cataract.

P2X7 receptor: One target for inflammatory responses in different ocular diseases (PH)
Contributing sections: IM, CO, RC and RE
Organizers: Claudio Bucolo, Julie Sanderson and Claire Mitchell
Speakers: Julie Sanderson, Claire Mitchell, Erica Fletcher, Claudio Bucolo, Vichery Trinkaus-Randall and Darlene Dartt

Considering the high impact of purinergic signaling in ocular function, this Minisymposium aims to provide the complex role of the P2X7 receptor in different ocular systems; besides the Minisymposium will highlight current efforts to use P2X7 ligands for treatment

Emerging cell-based therapies to tackle retinal diseases (RC)
Contributing Section: RE
Organizers: Goldis Malek, James Fadool and Brian Perkins
Speakers: David Hyde, Sussana S. Park, Amir Kashani, Maria Valeria Canto-Soler and Rachel Pearson

Cell-based therapies represent a potentially progressive avenue to treat retinal diseases beyond the traditional use of conventional drugs. This Minisymposium aims to present findings from recent studies utilizing various cell-based strategies, ranging from cell transplantation to the use of stem cells for the treatment of retinal diseases such as age-related macular degeneration.

Repurposing drugs for the treatment of retinal diseases (RC)
Contributing Sections: BI and RE
Organizers: Goldis Malek and James Fadool
Speakers: Breandan Kennedy, Nawajes Mandal, Aparna Lakkaraju, Benjamin Kim, Alfred Lewin and Brian S. McKay

Repurposing of drugs used for other indications that may be successful in ameliorating pathogenic pathways important in retinal disease development is emerging as an important strategy for small molecule discovery in industry and academia. This minisymposium will focus on how already identified and approved drugs for other indications are being selected and considered as a potential treatment for retinal diseases. It will include an overview of platforms used in drug discovery, preclinical studies necessary to support the new indication for the drug, as well as protocols used to move forward to clinical trials.

New and emerging clinical trials endpoints (RE)
Contribution Sections: CL, GEN, GL, MOI, RE, RC and VI
Organizers: Amani Fawzi and Jacque Duncan
Speakers: Jacque Duncan, Srinivas Sadda, Ursula Schmidt-Erfurth, Emily Chew, Donald Hood, David Huang and Richard Rosen

The goal of this symposium is to introduce and discuss novel and new structural and functional endpoints that could serve as potential end-points in clinical trials. We will discuss existing well-validated end-points that are continuing to be important but also explore new emerging concepts in this field. The use of Artificial intelligence to enrich and screen study populations will also be discussed in the framework of clinical trials.

Clinical outcomes and visual quality with retinal prosthetic vision restoration (VI)
Contributing Sections: EY, LV and VN
Organizers: Lisa A. Ostrin and Thomas Raasch
Speakers: Richard Kramer, Yossi Mandel, Eli Peli, E. J. Chichilnisky, Avi Caspi and Gislin Dagnelie

Many new vision restoration approaches are being clinically explored. However, the expected visual outcomes are not well understood. This minisymposium focuses on clinical outcomes, potential visual quality, and visual adaptation that has been achieved or can be expected through retinal prosthetic devices.

Of mice and men: Comparing primate and rodent retina (VN)
Contributing Sections: AP, RE and RC
Organizers: Jan Kremers, Ulrike Grunert and Erika Eggers
Speakers: Ulrike Grunert, Yi-Rong Peng, Greg Field, Machelle Pardue, Jan Kremers and Jens Duebel

The visual system of humans and non-human primates is unique in several aspects. However, due to accessibility and the availability of molecular tools, mice and other rodents are often the models of choice to study the retina, the results of which are then extrapolated to the human situation. When taking results from bench to bedside and back again, it is extremely important to be able to understand the similarities and the differences between the retinae of rodents and primates. This minisymposium compares recent data on rodent and primate retinae at several levels (genetics, cellular properties, physiology, circuitry, etc.).