A SINKING FEELING

It causes a familiar, sinking feeling well known to every ophthalmologist: the diagnosis of a retinal vein occlusion (RVO). The consequences for the patient and his eyes, as well as the implications for the patient’s general health, lifestyle and quality of life are unpredictable and potentially grave.

Considering the many recent developments in the management of retinal venous occlusions, a concise, updated reference is welcome. Management of Retinal Vein Occlusion: Current Concepts, (Slack Incorporated), a 150-page manual edited by Seenu M Hariprasad, provides the ophthalmologist with a useful update.

Chapter 1 introduces the reader to the background information of RVOs: epidemiology, pathophysiology, risk factors, classification of the occlusions, recommended laboratory assessments, systemic workup and prognosis.

Chapter 2, titled “Clinical Trials: Historical Perspective and Current Relevance,” covers pivotal early studies such as the Branch (BVOS) and Central Vein Occlusion Studies (CVOS) and outlines the role of retinal laser photocoagulation. Chapter 3 discusses the role of anti-VEGF agents and provides useful information on trials.

Chapter 4 moves on to corticosteroid therapies. Chapter 5 covers that most frustrating of RVO complications: macular oedema. It focuses on the role of imaging in managing this complication. Chapter 6 provides the most useful information to those practitioners versed in RVO management but who might be looking for expert advice on combination-therapy and the management of recalcitrant cases.

This book is primarily useful for general ophthalmologists looking for an in-depth review of RVO treatments, and retina fellows who are learning to apply these modalities for the first time.

Bottom-up science primer

On a different note, Basic Sciences in Ophthalmology: Physics and Chemistry (Springer), by ophthalmologists Josef Flammer and Maneli Mozaffarieh and theoretical physicist Hans Bebie, “aims to link clinical ophthalmology to its basic science roots.” This is a very scientific book, with a stronger resemblance to a high-school physics book than to a medical text.

The first several chapters delve into the details of light: what is it, how does it react with matter and how can we use it to examine and treat the eye? Later chapters cover chemistry from oxygen, CO2, chemical reactions and biological macro-molecules like DNA and proteins. This book is intended for residents preparing for their basic science examination and other eye care professionals and researchers who require a detailed look at the eye from the bottom up.