Invited Speaker

Philip J. Rosenfeld, MD, PhD

Dr. Rosenfeld is Professor of Ophthalmology at the Bascom Palmer Eye Institute at the University of Miami Miller School of Medicine. He is a vitreoretinal specialist with a primary clinical research interest in age-related macular degeneration (AMD). His major contributions include the clinical development of anti-VEGF therapies, the use of optical coherence tomography (OCT) guided treatment regimens using anti-VEGF therapy, the clinical development of OCT instruments, and the development and use of novel OCT algorithms for the diagnosis and management of macular diseases. With a focus on age-related macular degeneration (AMD), Dr. Rosenfeld has been the principal investigator and study chairman for numerous AMD clinical trials. Of note, he was lead investigator in the Phase I/II/III ranibizumab (Genentech) trials, and he pioneered the use of bevacizumab for exudative macular diseases, first by performing a study of systemic, intravenous bevacizumab and then by performing intravitreal injections of bevacizumab. Dr. Rosenfeld performed the 2-year PrONTO Study in which he pioneered the idea of OCT-guided, as-needed treatment as an alternative to monthly dosing with ranibizumab. Remarkably, since 2008, the Medicare cost-savings from the use of bevacizumab and OCT-guided therapy in the treatment of neovascular AMD has exceeded $40 billion in the U.S. If eyes with diabetic macular edema and retinal vein occlusions with macular edema are included, then the cost savings from the use of OCT and bevacizumab would easily exceed $50 billion. In addition, Dr. Rosenfeld helped develop both spectral domain and swept source OCT platforms for commercial use in the clinics, along with their imaging algorithms. He has been applying OCT angiography to study both non-exudative and exudative AMD with a particular interest in developing new OCT clinical trial anatomic endpoints for use in investigating novel therapies. Most recently, his research team has collaborated Dr. Ruikang Wang’s research team and successfully used SS-OCT angiography to image non-exudative subclinical neovascularization and the choroid, with a major focus on the choriocapillaris.

OCT in the Diagnosis and Management of Age-Related Macular Degeneration

OCT is the gold-standard imaging technique for the diagnosis and management of both non-exudative and exudative age-related macular degeneration (AMD). The clinical convergence of of OCT and vascular endothelial growth factor inhibitors (anti-VEGF therapy) led to a revolution in the treatment of neovascular and exudative ocular diseases.  OCT-guided treatment with anti-VEGF therapy has become the global standard and has resulted in billions of dollars being saved by reducing the need for retreatment.  OCT structural imaging combined with OCT angiographic imaging have eliminated the clinical need for dye-based angiography in managing AMD, while the use of novel algorithms has provided all the tools a clinician needs to diagnose and manage AMD. Most recently, swept-source OCT angiography has allowed us to study the choriocapillaris, a vital vascular layer that previously couldn’t be routinely imaged, yet is thought to play a pivotal role in the development and progression of AMD.