The Changing Landscape: Options for the Symptomatic Vitreomacular Adhesion (SVMA) Patient

The Changing Landscape: Options for the Symptomatic Vitreomacular Adhesion (SVMA) Patient (Archived Webinar) CME Overview

Date of Taping: August 21, 2011

Activity Location: Internet

Launch Date: October 10, 2011
Expiration Date: October 10, 2012

Target Audience: Ophthalmologists
This activity is intended for ophthalmologists with an interest in treating and managing patients who suffer from vitreomacular adhesion.

Lippincott Continuing Medical Education Institute, Inc. is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Credit Designation
Lippincott CME Institute, Inc. designates this enduring material for a maximum of 1.5 AMA PRA Category 1 Credits. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Commercial Support
This CME activity is supported in part by an educational grant from ThromboGenics, Inc.

In-Kind Support
LCMEI received in-kind support from Retinal Physician magazine in the form of reduced advertising rates to assist with audience generation.

Statement of Need

Retina specialists are achieving a greater understanding of the role the vitreous structure plays in the pathophysiology of symptomatic vitreomacular adhesion (SVMA) and the many associated retinal disorders that accompany SVMA, and they are learning that effective management of these related pathologies is important to ocular health and visual outcomes.

While many physicians have a greater understanding of the vitreous structure, however, new research has emerged that must be evaluated, and strategies need to be developed to better treat and manage diseases involving SVMA, such as diabetic macular edema, neovascular age-related macular degeneration (nvAMD), retinal vein occlusion, and macular hole.

The prevalence of these serious ocular disorders is rising, and effective care and management of patients with these specialized diseases are currently limited to vitrectomy. Eyes with SVMA-related diseases can experience rapid visual deterioration and poor visual function if not managed quickly and effectively.1

During this CME activity, retina specialists will discuss current deficiencies and the challenges they face in treating these related diseases. They will review the latest data, and provide practical strategies for improving patient care and visual outcomes.

Surgical Intervention
The current method of resolution for SVMA is surgical intervention; however, vitrectomy is accompanied by potential complications and is advocated only in a limited number of patients diagnosed with the disease. The management strategy of observation and "watchful waiting" needs to be reevaluated if a safe treatment option becomes available to patients with SVMA, as early intervention would limit deterioration of visual acuity as well as visual function.

Pharmacologic Therapy
Pharmacologic options for the treatment of SVMA have seen tremendous progress over the past decade. The clinical development program of ocriplasmin as a pharmacologic option for the treatment of SVMA has provided very promising results. It has been well tolerated at the defined optimal dose of 125 μg, and has been proven to be effective in a large Phase III clinical program. Retina specialists participating in this CME activity will evaluate the basic science and preclinical studies surrounding ocriplasmin. They will evaluate case presentations and hold a question and answer session for learners. A pharmacologic option to manage patients with SVMA would satisfy a clinical need to provide a safer and more effective treatment early in the disease, thereby relieving vitreoretinal adhesion and its sequelae without the complications of surgery and the need for prolonged monitoring.

Addressing Physician Competencies
This activity will help physicians address the following competencies:

Core Competencies adopted by the American Board of Ophthalmology as the basis for Maintenance of Certification2
Evidence of professional standing
Evidence of a commitment to lifelong learning and self-assessment

Core Competencies adopted by the American Board of Medical Specialties3
Patient care
Medical knowledge

Core Competencies adopted by the Institute of Medicine4
Provide patient-centered care
Employ evidence-based practice

Faculty Credentials and Disclosure Information
Unless otherwise noted below, the speakers' spouse/life partners (if any) have nothing to disclose.

Julia Haller, MD (Moderator)
Wills Eye Institute
Professor and Chair, Department of Ophthalmology
Thomas Jefferson University
Philadelphia, PA

Dr. Haller has disclosed that she was/is a consultant/advisor to ThromboGenics; and was a member of the data safety monitoring board to ThromboGenics.

Kirk Packo, MD, FACS
Professor and Chairman of the Department of Ophthalmology and Director of the Retina Section, Rush University Medical Center, Chicago, IL
Senior Partner, Illinois Retina Associates, Chicago, IL

Dr. Packo has disclosed that he was the recipient of grant/research funding from ThromboGenics; is/was the recipient of grant/research funding from Alcon, Genentech, and Allergan; and was/is a consultant advisor to Alcon.

Pravin U. Dugel, MD
Clinical Associate Professor of Ophthalmology
Doheny Eye Institute, Keck School of Medicine
University of Southern California, Los Angeles
Managing Partner, Retinal Consultants of Arizona
Phoenix, AZ

Dr. Dugel has disclosed that he is a consultant/advisor to Abbott Medical Optics, Alcon, Allergan, Arctic DX, Genentech, MacuSight, Neovista, ORA, ThromboGenics, and Regeneron; and is a stock shareholder in Arctic DX, MacuSight, and Neovista.

Michael Trese, MD
Clinical Professor of Biomedical Sciences, The Eye Research Institute of Oakland University, Rochester, MI
Clinical Associate Professor, Wayne State University School of Medicine, Detroit, MI
Chief of Pediatric and Adult Vitreoretinal Surgery, William Beaumont Hospital, Royal Oak, MI
Partner, Associated Retinal Consultants, Royal Oaks, MI

Dr. Trese has disclosed that he was/is the recipient of grant/research funding from Genentech and ThromboGenics; was/is a consultant/advisor to Clarity Medical Systems, focusROP, Genentech, Nu-Vue Technologies, Retinal Solutions, Synergetics, and ThromboGenics; and is a stock shareholder in focusROP, Nu-Vue Technologies, Retinal Solutions, and ThromboGenics

All LCMEI staff members in a position to control the content of this CME activity have disclosed that they and their spouse/life partners (if any) have no financial relationships with, or financial interests in, any commercial companies pertaining to this educational activity.

Identification and Resolution of Conflicts of Interest
Lippincott CME Institute, Inc. has identified and resolved any faculty conflicts of interest regarding this educational activity.

Off-label Use/Unapproved Drugs or Products

The Faculty has disclosed that the U.S. Food and Drug Administration has not approved uses of bevacizumab, ocriplasmin, microplasmin, vitrase, and the dexamethasone intravitreal implant for vitreomacular adhesion and will disclose this to the audience. Use of any commercial product should be undertaken only after confirmation of information by consulting the FDA-approved indications, labeling and other authoritative information.

Clinicians should ensure that all diagnostic and therapeutic modalities are prescribed and used appropriately, based on accepted standards of care. Use of any drugs, devices, and imaging techniques should be guided by approved labeling/full prescribing information, best available evidence, and professional judgment.

Faculty have been instructed that their content should be fair balanced and based on best available evidence. The information presented in this activity is the responsibility of the faculty and does not reflect the opinions of the provider or supporter.

Learning Objectives
After participating in this CME activity, ophthalmologists should be better able to:

  1. Evaluate the pathoanatomy and pathophysiology of vitreoretinal interface abnormalities to ensure more accurate diagnoses and targeted therapy.
  2. Diagnose symptomatic vitreomacular adhesion (SVMA), and evaluate patients for treatment.
  3. Examine current perspectives on SVMA and its role as a component of other retinal diseases that can be potential targets for therapy.
  4. Evaluate treatment options for resolutions of VMA and SVMA.
  5. Assess upcoming treatments for SVMA.

Getting the Most out of the Activity
As you prepare to participate in this activity, please reflect on your practice and your patients with retinal diseases and identify clinical challenges you hope to have addressed.

While participating in this activity, identify ways you can use newly acquired knowledge, strategies, and skills to enhance patient outcomes and your own professional development.

Method of Physician Participation
To earn CME credit, a participant must register, view the entire activity online, and complete the evaluation questionnaire. A certificate will be available for print once a participant completes and submits the post exam with a passing score. Send questions to or request further information regarding CME credit or activity information from the Office of Continuing Education, Lippincott Continuing Medical Education Institute, Inc., Two Commerce Square, 2001 Market Street, 3rd floor, Philadelphia, PA 19103; fax: (215) 827-5614.

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  1. Koerner F, Garweg J. Advances in the management of vitreomacular traction syndrome and macular hole. Dev Ophthalmol. 1997;29:15-29.
  2. American Board of Ophthalmology. Visit
  3. American Board of Medical Specialties. Visit
  4. The Institute of Medicine's Health Professions Education Report. Visit

I have read the guidelines outlined.