It’s my honor to introduce you to another edition of New Retinal Physician. As always, this publication is composed of interesting cases and concepts that stem from our daily discussions within the American Retina Forum (ARF). We aspire to not only provide educational content, but also to remind each other that we are not alone in the challenge of retina practice.

There may not be enough space on the internet to discuss the sociopolitical aspects of COVID-19 and its associated vaccination. Medically speaking, it is possible that both the virus and the vaccination can lead to retinal diseases. From early on within medical training, we are taught to “listen to the patient.” Earlier this year, I presented a poll to the ARF members. We found that 79% of retina specialists have had patients claim their retinal disease was due to COVID vaccinations. It may be difficult to empirically confirm this, but we should never forget to take a thorough history and never dismiss a patient’s feelings. Doctors Michael Elman and Sid Schechet and their medical students, Eric Lai and Timothy Lee, report an interesting case of post-vaccination uveitis (p. 9). This case provides another reminder of how uveitis connects ocular and systemic inflammation.

Dr. Zack Oakey presents insight into a rare, but irreversibly blinding, pigmentary retinopathy (p. 13). Pentosan polysulfate sodium (PPS) is prescribed by urologists for pain associated with interstitial cystitis, but also has some off-label uses. Dr. Oakey recommends immediate discontinuation of the medication to limit further progression, and then monitoring for choroidal neovascularization. It may also be prudent for us to educate our technical staff about this potentially harmful medication, and even consider a proactive health record search. Another example of how a retina specialists’ patient care efforts aren’t simply limited to the anatomy posterior to the crystalline or intraocular lens.

As a testament to supporting the next generation of retina specialists, Dr. David Hunt and his medical student Tyler Bayliss present a unique case of bilateral symptomatic Central Serous Chorioretinopathy (CSCR), which presumably was precipitated by extreme exercise and then successfully treated with anti-VEGF therapy (p. 18). The authors postulate that intense exercise may have elevated the patient’s endogenous cortisol, a known risk factor for CSCR. In these scenarios, especially in those who consider themselves “fitness oriented,” we should make sure to ask about exogenous hormones such as testosterone, and also inquire about energy drink consumptions. Also, we should not forget that these maculopathies exist within a spectrum and can represent pachychoroidal vasculopathy.

This edition’s practice management section, authored by Dr Vivienne Hau, reviews important aspects of how mentorship has guided her career (p. 22). Within this edition, there are multiple medical students benefiting from kind mentorship—the proof is in the pudding! In particular, Dr Hau discusses the importance of breaking down your needs into professional and personal groups. As Dr Hau says, “You can’t join the club unless you knock on the door and introduce yourself first,” so if you are an early career retina specialist interested in contributing to New Retinal Physician, please feel free to contact me directly.

On behalf of myself, Mitul, and all members of the American Retina Forum, we hope you enjoy this edition of New Retinal Physician. We look forward to seeing you in person at a meeting in the near future! For more information, please check out our website, RetinaForum.org. NRP

— Hemang K. Pandya, MD, FACS
President, American Retina Forum
Co-Chief Medical Editor, New Retinal Physician

DR. PANDYA is president and vitreoretinal surgeon at Dallas Retina Center in Plano, Texas. He reports no related conflicts of interest. He can be reached at DrPandya@DallasRetina.com.