I write a lot about how ophthalmology is at the forefront of medical advances; that rather than being a window to the soul, it’s a window to not just the structures of the eye, but the vasculature and neural tissue too. We see exquisite engineering in instruments that can do incredible things – but surely innovation occurs in the rest of medicine too? Am I being blinkered, thoughtlessly repeating a mantra when the evidence to back it up in my mind is biased?
I don’t think so. Spark Therapeutics’ $850,000-a-dose Luxturna (voretigene neparvovec, which delivers copies of the functional RPE65 gene for the treatment of retinitis pigmentosa) is one of the first gene therapies to be approved by the FDA – and the very first non-cancer therapy by them. We have the ophthalmic microsurgery robots being developed for use in the eye, which are pushing the boundaries of precision in robotic surgery, and which will almost certainly push the entire field of medical robotics forward – you can see clear applications elsewhere, particularly in neurosurgery.
Only two issues prior, we had the story of Medisoft, an ophthalmology EMR that eschewed encoding billing information in all its forms for the data that’s genuinely useful to clinicians who want to follow their patients and audit their outcomes. A large chunk of why ophthalmology is leading the way in artificial medical intelligence (AMI) – and, in particular, the use of machine learning to analyze medical images – is thanks to the quality information contained in that EMR system, which has helped train these AMI algorithms, and is bringing about (to use a Terminator reference) ‘Judgement Day’ far sooner than later – that point when computers, not humans, are reading the images and making diagnostic suggestions. Even technology that’s considered ‘old news,’ like the excimer laser, continues to improve – so much so that, in combination with (I want to say ‘advanced’, but it’s actually ‘routine’) corneal biometry, suitable LASIK surgery candidates gain excellent outcomes virtually every single time. And I haven’t even started examining the incredible diagnostic instruments that are now available. So readers, I think you can start 2018 in the knowledge that you’re part of an elite cadre, leading the way in medicine and medical science. And, without wanting to stir up age-old inter-specialty rivalries, could dermatologists say the same? Happy New Year!
Mark Hillen
Editor
