Latest articles and publications

The current Pharmac Special Authority criteria leave two groups of patients with neovascular AMD and diabetic macular oedema stranded on monthly eye injections: those established on Eylea before Vabysmo was funded, and those who respond poorly to Vabysmo. On 28 April 2026, Dr Leo Sheck submitted a formal Pharmac funding application for Eylea HD (aflibercept 8 mg) with revised Special Authority criteria designed to close this gap. Endorsed by Macular Degeneration New Zealand, Ophthalmology New Zealand, Eye Health Aotearoa, and the New Zealand Save Sight Society. Read the full submission and proposed criteria.

Newer anti-VEGF agents are extending dosing intervals for patients with retinal disease. In this NZ Optics article, Dr Francesc March de Ribot and I review the evidence, discuss non-responders, and examine what's next, including the current Pharmac funding gaps for New Zealand patients.

Emerging evidence links higher intraocular pressure to atrophy progression in myopic maculopathy. Dr Leo Sheck reviews the mechanistic rationale, the clinical data, and proposes a practical treatment framework for clinicians managing high myopia.

The latest issue of Eye Health Research Review was published in February 2026. You can find my discussion on the latest ophthalmic research to update your clinical knowledge here.

Dry AMD is no longer an untreatable disease. Find out with Dr Leo Sheck on how to accurately assess dry AMD and his approach in traversing this rapidly evolving field.

Like you, I find management of pathological myopia challenging. As a result, I compiled a set of principles to avoid in the management of pathological myopia. This set of principles have been popular and useful for my registrars and ophthalmic nurses, and I hope you find them useful too.

A short report and Google Colab implementation of HCQuery, a novel algorithm for detection of hydroxychloroquine retinal toxicity

Join us for an evening unlike your typical journal club!

Unravel the complexities of Central Serous Chorioretinopathy (CSC). While many acute cases resolve spontaneously, learn when occupational needs or chronic presentations necessitate intervention. Discover why photodynamic therapy often stands out as the preferred treatment for its ability to address diffuse leakage and potentially lower recurrence risks.

It is safer, with possibly lower risk of day-one 'patch-off' vision loss, and has faster recovery time.

A guiding principle to my practice in Retina Specialists

This is a common question from my patients with wet AMD (neovascular AMD). Here I present two studies discussing the injection burden over time.

You will need to do this well to improve clinic attendance, adherence to treatment, and have happy patients!

How do the first, second and third generation anti-VEGF differ?

The US FDA approved the use of pegcetacoplan (Syfovre) and avacincaptad pego (Izervay) for the treatment of geographic atrophy (GA) in 2023. How can this help GA patients in New Zealand?

A patient came to see me wanting Vabysmo for his neovascular AMD. He is looking at delaying retirement and even selling down asset to fund for this treatment. How would I advise him?

A story on regaining independence against the odds

Cataracts, dementia and falls are all common, yet debilitating, health conditions of the elderly. Here I examine the evidence for cataract surgery and its link to reducing the risk of dementia and falls, and how improving access to this surgery is likely to benefit our New Zealand cataract patients.

The use of intravenous (IV) thrombolytic therapy, namely tissue plasminogen activator (tPA), is the current mainstay treatment for cerebral ischemic stroke. But what role could it play in CRAO? I review the evidence and provide some insights on how we can approach the treatment of CRAO in clinical practice.

A cautionary tale on Optos imaging.

My August 2023 Research Review article summarising the latest ophthalmic publications - approved for CME points by RANZCO, RNZCGP and The College of Nurses Aoteroa.

Are the newly FDA-approved Pegcetacoplan and Avacincaptad Pegol a game-changer for treating non-neovascular (dry) AMD? Here are my thoughts.

A patient with a blurred spot in his vision in the right eye. Examination shows a Weiss ring. Is the posterior vitreous detachment the cause of his symptoms?

Sometimes patients can present with vision loss, but despite a detailed assessment, no obvious cause is found. Here I demonstrated three useful techniques on the Spectralis viewing platform to help assess patients with vision loss of unclear cause.

You may come across Zaltrap, or ziv-aflibercept, in treating retinal disease. Exactly what is this, and when is it used in intravitreal injections? This post will answer your questions.

Most patients do not look forward to their intravitreal injections. Here I outline six techniques to ensure my intravitreal injections are as pain-free as possible.

A discussion of using artificial intelligence in geographic atrophy

This post will discuss the most recent literature surrounding OCT characterisation of geographic atrophy.

This post will summarise the recent trial of using Pegcetacoplan for the treatment of GA. Furthermore, we will look at the assessment of GA using different imaging modalities to help inform the risk of vision loss and to identify patients who maybe suitable for treatment when it becomes available.