Digital Public Defence: Øystein Kalsnes Jørstad
Cand.med. Øystein Kalsnes Jørstad at Institute of Clinical Medicine will be defending the thesis “A study of structure-function relationships in wet age-related macular degeneration and chiasmal compression. Promises and pitfalls of implementing optical coherence tomography in the management of a disease primarily affecting either the outer or the inner retina” for the degree of PhD (Philosophiae Doctor).
Photo: Eva Helene Storm Hansen (Moment Studio)
The public defence will be held as a video conference over Zoom.
The defence will follow regular procedure as far as possible, hence it will be open to the public and the audience can ask ex auditorio questions when invited to do so.
Digital Trial Lecture – time and place
- First opponent: Professor Michael Larsen, Rigshospitalets Øjenklinikk, København / Københavns Universitet, Denmark
- Second opponent: Associate Professor Dordi Austeng, Øyeavdelingen, St. Olavs hospital og NTNU, Trondheim
- Third member and chair of the evaluation committee: Professor Mona Kristiansen Beyer, Faculty of Medicine, University of Oslo
Chair of the Defence
Professor Olav Røise, Faculty of Medicine, University of Oslo
Professor II Morten Carstens Moe, Faculty of Medicine, University of Oslo
Knowledge about the relationship between a functional deficit and its structural correlate is a cornerstone of clinical ophthalmology. Throughout the last decades, optical coherence tomography (OCT) imaging has revolutionized the ability to evaluate the eye´s anatomy in detail. In consequence of OCT, however, the science of ophthalmological structure-function relationships must be rewritten. The aim of the thesis was to identify promises and pitfalls of implementing OCT in the diagnosis and management of a disease primarily affecting either the outer (1) or the inner (2) retina.
In part 1, wet age-related macular degeneration (AMD) was chosen as a disease primarily affecting the outer retina. Intravitreal anti-vascular endothelial growth factor (anti-VEGF) treatment of wet AMD is commonly OCT-guided; injection intervals are extended as long as macula remains dry on OCT. The study focused on a particular clinical setting: switching to second-line anti-VEGF treatment with aflibercept for eyes with persistent macular fluid. The results showed structural improvement and extension of injection intervals after switching. There was, however, absence of a definite functional benefit, suggesting a structure-function paradox of OCT-guided AMD therapy.
In part 2, optic neuropathy due to chiasmal compression was chosen as a disease primarily affecting the inner retina. Presence of visual field (VF) deficits is considered a strong indication for surgery of pituitary adenomas. The study focused on the need for establishing a reliable structural correlate in chiasmal compression. The results showed that OCT could detect characteristic changes in the macular ganglion cell complex (GCC), and structural findings might even precede functional deficits. Accordingly, OCT could offer an aid to diagnosis and also predict VF loss when watchful waiting was chosen as initial management.
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