Episode 514: September Retinal Physician Review Including Proteomics for Choroidal Melanoma and Retinoblastoma, Radiation Retinopathy Prevention, and Uveitis Treatment

Yeah, I

saw a great talk.

Oh, go ahead, Mara.

No, sorry, I just wanted to add, since we're doing kudos, I also wanted to say kudos to the retinal specialists that do take care of uveitis because, you know, we've been saying, you know, it's not always right to, you know, continue to inject, but the truth is that there's a national shortage of uveitis specialists.

It is not always easy to get a patient to see a uveitis specialist.

I myself have a hard time sometimes collaborating with rheumatologists as a uveitis specialist because it's also hard to get in a patient to see rheumatology and sometimes their wait times are very long.

So, you know, doing something instead of nothing, you know, even like, you know, injecting steroids is fine.

Like you're helping the patient, you know, once you've appropriately rolled out infection, we know all of that, but you're doing something to quiet down the inflammation and then plan afterwards, you know, plan to move forward.

But yeah, I just wanted to say, you know, just want to put in a word for those of, you know, those in retina that do do the hard work like that.

Yeah,

absolutely.

And that was nice to give a shout out.

I just saw a talk by Tomaso Rossi from Italy yesterday.

And his group has been doing proteomics and detachments, for example, to try to say, hey, what proteins are more likely to happen in detachments that fail or not? And it's really fascinating.

And, you know, they still have to dig more.

It's a small sample size.

But they kind of showed that regardless of surgical technique, the proteomics is very fast.

It was very fatalistic in a way.

It was basically the proteomics at the time of the initial surgery determined the outcome more than any other technique.

component of the surgical outcome, which was very interesting that it was not, and again, there's a small data set, we have to get more information, but it would suggest that it's similar almost like the prognostic information in oncology, that it isn't your treatment decision isn't what ultimately is influencing the outcome as much as the proteomics associated with that detachment, which might have other confounders associated with it.

There may be other confounders, but if that turns out to be true, then that means we're still using a very old school approach of this is like kind of the way we treat everyone and we get different outcomes and we don't know why.

But if we actually get information that says this is how we differentiate, then it doesn't mean that things are like predetermined.

It doesn't mean that our treatments don't work.

It means that we just need to choose different treatments for the person based on that information.

And so that's really exciting because we can actually kind of modify our approach according to what the patient needs, as opposed to according to being like, well, every patient like this is going to get this treatment.