believe it or not! amazing eye tech, astounding therapies

Believe It or Not! �Amazing Eye Tech,

Astounding Therapies, & Pioneering Procedures– Part 1�

��

COPE# 51847-PD

Chris Wroten, O.D., Dipl. A.B.O. [email protected]

Disclosures • No financial interest in any product or company discussed • Some past lecturing and/or paid research for Alcon,

Allergan, Bausch & Lomb/Valeant, Pfizer, & Inspire

• Mention of these products in no way implies endorsement by the presenter

• (mention of these products in no way implies expertise on behalf of the presenter either!)

Believe It or Not – Part 1 �

•  Pharmaceuticals •  Systemic w/ Ocular SE •  Ophthalmic •  New/Investigational •  Regenerative Medicine? •  Glaucoma Therapies & Theories •  “Repurposed”

•  Drug Delivery Systems •  3-D Printing in Healthcare •  Diagnostic & Imaging Technologies •  Genomics & Biotechnology

New & Emerging Treatments

Pharmaceuticals

SystemicMedswithOcularSE

• Velcade(bortezomib)•  Isaninjectable,pro-inflammatorydrug•  FortxofMulitpleMyeloma&MantleCellLymphoma• RiskofEyelidChalazia

• Reportedin24patients• MeandurationonVelcade=98days• Usuallymultiplelesions•  Favorupperlid• Resolvewithinfewwksofd/cmedication

SystemicMedswithOcularSE

• Pristiq(desvenlafaxine)• Serotonin-NorepinephrineReuptakeInhibitor(SNRI)• ForTxofDepression• Upto10%ofpatientstakingithaveocularsideeffects:

• BlurredVision•  EyePain/DryEyes• Mydriasis• Periorbitalswelling• VisualPhenomena(coloredrings)

• Levodopa(L-dopa)-forParkinson’sds.;mayholdpotentialforpreventingortreatingAMD(retrospectivestudiesshowavg.8yrlateronsetAMDvs.withoutL-dopa)

EverythingOldisNewAgain...

• Remicade(infliximab)&Humira*(adalimumab)• Tumornecrosisfactor(TNF)inhibitors• 97%&95%overallresponseratesrespectivelywhenusedfornoninfectiousuveitis

• Adalimumabisamonoclonalantibody&>2xeffectivevsplaceboinmethotrexate-refractorypediatricJIAuveitis

*FDA-approvedfornon-infectiousIntermediate,Posterior,&Pan-Uveitis7/6/16(1st&onlyNon-corticosteroidapprovedforthis!)


NonsurgicalTreatmentofPterygia?• Dypyridamole

•  Initiallydosedbid,thenqd• After12mos,33%reductioninlesiondiameter&

70%reductioninheight,aswellasmarkedimprovementinsubjectivesymptoms&completeresolutionofconjunctivalhyperemia&vascularization

“Pterygium:NonsurgicalTreatmentUsingTopical

Dipyridamole–ACaseReport”,Ophthalmology,CarlockBHetal.,2014


NonsurgicalTreatmentofPterygia?http://dipyridamoleeyedrops.org


CoenzymeQ10(a.k.a.ubiquinone)• Ubiquitousinmosteukaryoticcells• Resemblesavitamin• Mainlyfoundinmitochondria• Participatesinaerobiccellularrespiration&isafreeradical-

scavengingantioxidant• AdjuvanttopicaldroptherapyforrefractoryKulcers?• 6casestudyfoundmayhelppromoteepithelialwoundhealing


TopicalInsulin?• InsulinmixedwithArtificialTears• DosedBID-TID• Completere-epithelializationofRefractoryNeurotrophicK

Ulcersin6patientswithin1-3wks(WangAL,WeinlanderE,MetcalfBM,etal.Useoftopicalinsulintotreat

refractoryneurotrophiccornealulcers.Cornea,2017;July24)


SHP640

• Combobroadspectrumantiseptic(betadine?)+corticosteroid• Expectedindicationforinfectiousconjunctivitis(adenoviral&bacterial)• Topical• ForAdults&Children• FDAPhaseIIIasof2017

•  ~33%ofpatientstreatedhadcompleteclinicalresolution6daysp-tx•  ~80%ofpatientsshowedcompleteviraleradication

New/InvestigationalOphthalmicMeds

Reproxalap(Aldeyra)• Reactivealdehydespecies(RASP)scavengers

• Proprietaryfamilyofaldehydetraps(newchemicalentities) • Sequester&allowfordegradationoffreealdehydes

• Indicatedfor:• DryeEye• Sjogren’s• NoninfectiousAnteriorUveitis• AllergicConjunctivitis

• FavorablycompletedPhaseIIbtrial...Phase3Trials2019


ONL1204(ONLTherapeutics)• Firstinclasssmallmoleculepeptidedesignedtoprotectkeyretinalcells,includingphotoreceptors,againstapoptosis

• Recent$1MgrantfromNEItocontinueadvancement• Indicationforretinaldetachment,aswellaswet/dryAMD,amongotherchronicretinaldiseases


Optina(AmpioPharmaceuticals)

• Ultralow-dosedanazol(syntheticderivativeoftestosterone)• EnhancesendothelialcellbarrierfunctionfortxofDME• Large,late-stageclinicaltrialsunderwayinU.S.• Oral


PAN-9086(PanOptica)• Potent&selectiveinhibitorofVEGF• PreclinicaltrialscompletedbyWilmerEyeInstituteatJohnsHopkins• CompletedPhaseI/IIClinicalTrials• Treatmentof:WetAMD,DiabeticRetinopathy,&MacularEdema• Effectivein50%oftreatedindividuals

• (betterthancurrentintravitrealanti-VEGFs!)• It’sTOPICAL



SF0166(SciFluorLifeSciences)• PhaseIIpositiveresults• TreatmentDME• Topical&dosedBID

BX795(Univ.Illinois-Chicago)• Moleculesoldtolabstouseinexperiments• InhibitsTBK-1

• TBK-1=enzymeinvolvedininnateimmunity&neuroinflammation• TrialswithHSV-1Keratitis

• Smalldoses=infectionpromoter• Highdoses(butstill5x’slessthancurrentanti-virals)=helpedcellsquicklyclearthevirus!• Doesnothingtothevirus;onlyaffectsinfectedhostcells

New/InvestigationalMeds

RegenerativeMedicine?

• Axolotl(akaMexicanSalamander)• Originallynativeto2lakesinCentralMexico• Cancompletelyregenerateseveredlimbs,spinalcord,etc.,inwks• Canalsoregenerate damagedretinaltissue!

• Genomesequenced2018

• Numerousotherdehydratedamnioticmembrane(amnion)manufacturers...

•  Eclipse•  10mmor16mm•  Singleordoublelayer

•  9,12,or15mmdisc


• Regenesol(BioTissue)•  FullTransplantAmnioticMembraneUmbilicalCordDrops•  Launchplannedearly2018

• HAMT-EU/AMX(Italy)

• AmnionExtractDrops:• RegenerEyes(Florida)• Genesis(California)• OptiSerum(umbilicalcordextractdrops)•  9,12,or

15mmdisc


Cacicol(Othea)–CEmark,notyetFDA• Orig.tohealchronicskinwoundsinDM• 1stophthalmicmatrixtherapyagent...“triggersREGENERATIONofdamagedtissuesforENHANCEDHEALING”byrestoringcornealmatrixarchitecture

• Canhealcorneainlittleas2dayspost-sx;dose=1-2x/wk• Study:60k-conuspatients,randomtx30eyesp-CCXL

• ByDay2,83%ofeyeshealedwithvs13%without• Alsolesspain/stinging/ephipora/photophobiaintxgroup


BIIB033(Biogen)• Investigationalmonoclonalantibody• Anti-LINGOagent(LINGO-1isaCNS-specificmembrane

glycoproteinthatsuppressesoligodendrocytedifferentiation&myelination)

• Intravenousadministration• Earlyresults:

• ImprovedVEPlatencyinacuteopticneuritis,aswellasfelloweye• Indicatingremyelination!!!• Poss.1sttrueneuroprotectiveagentforopticneuritis?

• NowinPhaseIITrials


FromNatureNeuroscience,7/11/16:• AndrewHuberman&fellowStanfordresearchers:“...HelpMiceWithDestroyedOpticNervesToSeeAgain”

• CombinedVisualStimulation&ViralActivationofthemammaliantargetofrapamycin(mTOR)

• Results:• In70%ofmice,retinalganglioncellaxonsregeneratedallthewaytochiasm&“reconnectedtotheircorrecttargetsinthebrain,”restoringpartialvision!!!


Lumify(Valeant/B&L)• FDA-approvedDec.’17• NewOTCrednessreliever• Brimonidinetartrate0.025%

“New”GlaucomaMeds

Xelpros(SunPharmaceuticals)• FDA-approvedSep.’18• BAK-freeLatanoprost


Vyzulta(LatanoprosteneBunod):(B&LviaNicox)• Breaksdownintolatanoprostacid&butanediolmononitrate(i.e.Latanoprost&amoleculeofNitricOxide)...NO=signalingmoleculeinIOP-regulation;actsonTM&Schlemm’s

• PhaseIIIendpointsmet(i.e.non-inferioritytoTimololBID)• FDA-approvedNovember2017


WeinrebRN,RealiniT,VarmaR.USOphthalmicReview,2016;9(2):80-7DOI:https://doi.org/10.17925/USOR.2016.09.02.80.LatanoprosteneBunod,aDual-actingNitricOxideDonatingProstaglandinAnalogforLoweringofIntraocularPressure.

Aerie Pharmaceuticals Rhopressa(netarsudil)

RhoKinaseinhibitor(ROCK)+NorepinephrineTransporterinhibitor(NET)TripleMechanismofActionQDdosageHyperemia(~35%),Drift?,Bestfor<26mmHg?Avg.6mmHgIOPreductionPhaseIIIcompleted2016*NDAaccepted&FDA-approvedDec.2017

NewGlaucomaMeds

Aerie Pharmaceuticals Roclatan(Rhopressa+ProstaglandinAnalog)

QuadrupleMechanismofActionProstaglandinanalog(latanoprost*)QDdosage&34%IOPReductionPhaseIIbcomplete/PhaseIIIresultslookpromisinginEuropeCommerciallyavailable2018?

AR13533-2ndgenROCK/NETinhibitorPotentiallygreaterIOPloweringthan1stgen.Pre-clinicaltrialsunderway

NewGlaucomaMeds?

Other ROCK Inhibitors in Trials

• Kowa

• AmakemTherapeutics

• Others?

NewGlaucomaMeds?

• Trabodenoson(InotekPharmaceuticals)• HighlyselectiveAdenosineA1mimetic(agonist)• AvtivatesMMPstoactdirectlyonTM• MonotherapyPhaseII:EfficacylikeLatanoprost?• MonotherapyPhaseIII:

• Placeboresponsewassignificantlylargerthaninanyothertrialsodidnotmeetendpoint

• Anti-tachypylaxiseffect(i.e.wasmoreeffectiveatday84thanday14)• COMBOTherapyPHASEII:TRABODENOSON+LATANOPROST

• At1month,wassuperiortolatanoprostalone,buteffectlostafterwards• PhaseIIITrials0for2sofar

NewGlaucomaMeds?/EverythingOldisNewAgain

AnecortaveAcetate(Retaane)–(Alcon)•  OriginallyfortxofWetAMD•  êIOPwhenadministeredviasub-Tenon’sinjection• 2smallstudies:

• Singledose=meanIOPêfrom31.3to19mmHg(@3,6mos)• SunsettedatPhaseIIbutresearchersstillstudying


• Aminoguanidine• OriginallystudiedforDiabeticNephropathy,thensunsetted•  iNOSinhibitor• 6monthratstudywithhighIOP:

• Untreatedgrouplost36%ofganglioncells• Treatedgrouplost<10%ofganglioncells

• IOP-independent!• Oral


“LessDrops”GlaucomaTherapy

BimatoprostSR•  ExtendedReleaseBimatoprost•  ExpectedNDA2Q19&Avail.early2020?•  Subconjunctivalinjectionx4-9mosduration

TravoprostIntracameralExtended-Release

GraybugVision

“New”GlaucomaMeds?

NB1111•  ProdrugofTetrahydrocannabinol(THC)•  Beingdevelopedastopicalglaucomatherapy

inconjunctionwithNanomerics(London)June25,2018,FDAapprovedEpidiolex,

ananti-seizuremedicalmarijuana

derivative...DEA:Sched.V

MAN-01(QBIOMed)

• PrimaryCongenitalGlaucoma•  10mutationsinTIE2gene&itsligand,Angiopoietin1

• ActivatesTIE2receptor• Topical• AlsoworkingoninitialProof-of-ConceptonbiologictargetingofTIE2

(willaidincreationofbiologic-basedtherapeuticplatform)• Phase1trials2019

ErythrocyteVelocity?

• OsamahSaeedi,MD(Univ.ofMaryland)• InconjunctionwithHeidelbergEngineering• Newtechnique:labelRBCswithfluorescentdye&measurespeed

• Quanitifiesvascularperfusionofopticnerve• Couldhelpunderstand&perhapsonedayevendiagnoseglaucoma,aswellasretinaldiseases

NewGlaucomaTheory/Therapy?

• ResearchatMIT• Glaucomaasanautoimmunedisease?

• RetinalGanglionCellreplacement?• AnimalmodelsshowRGCsdeliveredintovitreousmigratedto&integratedintoretina,&grewlengthyaxonsdowntheopticnervetothebrain!!

NewGlaucomaTheory/Therapy?• SECO&ASCRS2016

• JohnBerdahl,M.D.:Glaucomanotjustanocularcondition,ratherametabolicconditionwithimbalancebetweenIOP&ICP

• HisresearchrevealedpatientswithglaucomahavelowerICP,(i.e.largerpressuregradientbetweenIOP&ICP),producingopticnervedamage

• ProposedTreatment:BalanceGoggles™(Equinox)toequilibrateIOP/ICPpressureacrosstheopticnerve

NewICPDiagnostic?• NiSonic• AI-directedultrasounddevice•  Infirst44patientsstudied,accuratelydiagnosedelevatedICP100%time• Nowto200-patienttrial

SurgicalGlaucomaUpdates

MicroPulseLaserTrabeculoplasty(MLT) • MoreeffectivethanSLTforGlaucoma?

• SpecificdiodeLaser• Usesshortmicroburstsofenergy• Nopost-opinflammation• Smallerspotsize• Repeatable

CycloG6MicroPulseP3forGlaucoma(Iridex)

•  CyclophotocoagulationofCiliaryBody•  Reported>30%IOPreductionupto18monthspost-procedure

CLASS(iOptima)• CO2Laser-AssistedSclerectomySurgery• Minimallyinvasive• SaferthanTrabeculectomybut

aseffective(~50%IOPê)


GlaukosiStentTitaniumHeparin-coatedtoself-prime1mm“Snorkel”design

SurgicalGlaucomaUpdates:Minimally/Micro-InvasiveGlaucomaSurgery(MIGS)

•  1stFDA-approvedMIGSdevice•  Weighs60μg•  Issmallestknownmedical

deviceimplantedinhumans!•  ~400KimplantedasofAug.2018

InnFocusMicroshunt• Safe,Easy,Effective• ~50%êinIOPwith>80%gttêx3yrs

SurgicalGlaucomaUpdates:MinimallyInvasiveGlaucomaSurgery(MIGS)

AlconExPressShunt

MoresuccessfulthanTrabeculectomy

SurgicalGlaucomaUpdates:MinimallyInvasiveGlaucomaSurgery(MIGS)

FDA-Approved July 2016

Butwait!...

• CyPass voluntarily pulled from market Aug. 2018 r.e. concerns with endothelial cell density (ECD) loss @ 5 yr post-op study!

•  >27% pts had >=30% ECD Loss!FDA Advisory Update Oct. 24, 2018...!• Correlation with how far implant extends into AC!

•  3.1% Loss if No Retention Rings Visible!•  8.4% Loss if 1 Retention Ring Visible!•  21.0% Loss if 2 Retention Rings Visible!•  31.4% Loss if 3 Retentaion Rings Visible!

•  Surgeons should consider trimming, removing, repositioning!• All patients with Cypass should be periodically evaluated for ECD Loss

FDA-approvedforrefractoryglaucomatherapy

iDoseTravoprost

iStentInject

iStentSupra

SolxGoldShunt

STARflo

•  EuropeanTrials

HydrusMicrostent FDAApprovedAug.2018

Canaloplasty

• Newer(?)surgicalalternativetoêIOP• Microcatheter(currentlyusedinother

ophthalmicapplications)• PlacedinSchlemm’sCanal• Consideredsafe&effective• ABiC=15minuteprocedure• Failurerates*equiv.toTrabeculoplasty• Phacocanaloplasty=<10%failurerate*3yrspost-op!

*IOP>18mmHg(withorw/ogtt)x2consec.visits

Goniotomy

KahookDualBlade

Goniotomy

Trab360

Goniotomy

•  Trabectome

TUG (Eye Sonix) • Therapeutic Ultrasound for Glaucoma • Low power, low ��frequency • Enhances outflow • In Clinical Trials: Prelim. 20% IOP ê x 1 yr in 74% with elevated IOP


Eye Tech Care (France)


New & Emerging Ocular Treatments

DrugDelivery

• 7μLdrop• Piezo-electricdispensation

ofmicrodrops• App-baseddosing

reminders/compliancetracking

Helios(ForSightVision5)

ImplantforGlaucomaRestsonsurfaceofeye,undereyelidDeliversLatanoprost6mosDurationofTreatment?AlsodevelopingforDES&Allerg.Conj.

Evolute (Mati Therapeutics) PunctalPlugDeliverySystemPhaseIII2015Latanoprost,Olopatadine,UnnamedGlcAgent

• Dextenza&Dexamethasone(OcularTherapeutix)Intracanalic.Plug• ReducePain&Inflammationpost-CatSx&forAllergicConjunctivitis• PhaseIIItrialsnow

• Dextenza&Travoprost(OcularTherapeutix)IntracanalicularPlug•  ForsustainedreleasetxofGlaucoma;inPhaseIItrials


• Miniature,injectable/implantable,sustained-releasedeliverysystems:• ILUVIEN–licensedtoAlimeraSciences;intra-vitrealsteroidforDME;approvedlate‘14

• RETISERT–licensedtoB&L;intravitrealsteroidforposterioruveitis• DURASERT–Pfizer;latanoprostforGlc;subconjinjection• VITRASERT–B&L;GanciclovirforCMVretinitis• MEDIDUR–DryAMD;Uveitis;RVO;trials• TETHADUR-nanotech;trials

pSivida

NanotechContactLensDrugDelivery

AnujChauhan,Ph.D.Chem.Eng.,Univ.Fla.

NanotechCL–Timolol,Ciprofloxacin

Mass.Eye&Ear:CLdeliveryofLatanoprostviadrugpolymerfilmbetterthangtt

EyegatePharma:EyeGateII

Iontophoresis

Ocular Iontophoresis – Phase IIb studies r.e. mac. edema with EGP-437 soln promising & no serious tx-emerg. adverse events

March2,2017

ElectricitytoHeal?

• Whenwounded,bodyuseselectricalsignalsaroundinjurysitetohelpcellsmigrateaspartofhealingprocess

• UC-DavisStudy:• Diabetesinmice(viageneticengineering,highfatdiet,&drugs)• Cornealabrasions• Foundelectricalcurrents@edgeofabrasionssignif.weakerinDMmicevs.healthycontrols=slowerhealingtime

• Nowdeveloping2treatmentstospeedhealing:• 1)Pharmacologicalagentstoenhanceiontransport&strengthen

endogenouselectricalsignals• 2)ExternalelectricalcurrentapplicationviaCLwithmultipleelectrodes

OralDrugDeliveryDevelopments?

MucoJetSprayPill

Pharmaceuticals:3-DPrinted?!?!

NowFDA-Approved...

3-DPrinting:PharmaceuticalApplications?•  NationalUniversityofSingapore•  3-Dprinted,multiplemedication,time-releasedtablet

New & Emerging Technology

Other3-DPrintingTechnologies

Australian Co. Anatomics/Lab 22 @ CSIRO 3-D printed Ti sternum/rib cage successfully implanted in cancer patient in Spain

3-DPrinting:SurgicalApplications?

3-DPrinting:SurgicalApplications?WakeForestBaptistMedicalCenter:IntegratedTissue&OrganPrintingSystem(ITOP)

• EpiBone• Employs3-Dbioprintingtoproducelivinghumantissues&bone


3-DPrintingOphthalmicapplications?•  Frames•  DiagnosticLenses

3-DPrintingOphthalmicapplications•  ContactLenses?

3-DPrinted...Corneas??

3-DPrintedBionicEye

New & Emerging Ocular Technology

Diagnostic/ImagingTechnologies

Compass(Centervue)

MP-3Microperimeter(Nidek)

• Measuresfunctionallocalretinalsensitivity• Visualfieldperformed“directlyontheretina”• Resultsdisplayedsuperimposedoncolor

fundusimage

VIS-OCT• Bascom-Palmer&FloridaInternationalUniversity• VisiblelightOCTcapableofimagingrhodopsin• Mapshealth/functionofphotoreceptors

Fundus Autofluorescence (FAF)

ArcScanInsight100

FDAApproval&CEMarkReceived2016

2Minute,Quasi-NoncontactScanHighFrequencyUltrasound(20-60MHz)=1μmresolution!!!

ArcScanInsight100

RTVueXRAvantiwithAngioVuesoftware(OptoVue)• Non-invasive,dyeless• Hi-res,3-Dvisualizationofretinalvasculature• ImagesmotionofscatteringparticlessuchasRBCsusingsequentialcross-sectionalOCTb-scan

• OCT-AFDA-approvedforsaleinU.S.asof2016

AngioPlex(Zeiss)• Ultra-Clear,3Danddye-freevisualization

ofmicrovascularbloodflowinasinglescan

• ImagesmotionofscatteringparticlessuchasRBCsusingsequentialcross-sectionalOCTb-scans

• FDA-approvedinU.S.2016

•  UsingOCT-A•  Also...

•  Parkinson’s?•  Glaucoma?

PlexElite9000(Zeiss)• FirstFDA-Approved

(2017)Swept-SourceOCTtoimagepost.seg.

• Mainlyforresearchnow,butnextgenerationcoming

SweptSourceOCT:TopconDRIOCTTriton•  FDA-approvedFeb.2018•  100KA-scans/sec(vs.~80KwithSD-OCT)• Axialresolution=8μ• Bettersub-RPEvisualizationthanSD-OCT

•  ZeissPlexElite9000awaitingFDA-approval

OptovueAvanti-EpithelialThicknessMapping

•  FDA-ApprovedJune2018•  PredictiveforKeratoconus?•  OtherKdisease?

CornealConfocalMicroscopy(CCM)• Examinesunmyelinatedcornealnervefibers@highmag,usinglaser-scanningCCMtoimagecornealsub-basalnerveplexus

• PredictsinsipientperipheralneuropathyinType1DM(63%Sensitive;74%Specific)

• ReducedCornealNFLlength&Cornealsensitivity=increasedseveritydiabeticperipheralneuropathy

• PreviousstudiesdemonstrateutilityforCCMinotherneuropathies

NewStudies:PredictiveforMultiple

Sclerosis?

• UsingLensFluorescenceBiomicroscopecalibratedwithstandardstraceabletoNationalInstituteofStandardsandTechnology(NIST):

• Type2DMDetection(viaAGEsonlens)• Sensitivity=67%,Specificity=94%(HemoglobinA1C:Sens.=44%,Spec.=79%)(FastingPlasmaGluc.:Sens.=50%,Spec.=95%)

• Takes6secs,non-invasive,doesn’trequirefasting

LensAutofluorescence

LensAutofluorescence

FDAMarketClearance2013

SightSync•  JeffreyKrall,O.D.(SouthDakota)• Patientscansufferfromocularmisalignment&convergenceinsufficiency(CI)

leadingtoheadache&symptomsmirroringdryeye•  Linkbetweenneurology&visionasHAtriggeronlyrecentlydiscovered•  Isolatesperipheral&centralvisiontothoroughlyassess

totalbinocularvision&measuringamountofcompensationatnear&atopticalinfinity

• NeuroLenstechnologyincorporatespatient’sindividualrx•  Progressiveprismlensthatcompensatesfordifferencesin

fixationalignmentfromdistancetonear

BloodTestforConcussion?

BrainTraumaIndicatorTest• FDA-approvedFeb.2018• Testsforbiomarkersreleaseduponinjurytobrain• Canbetakenwithin12hoursofinjury(3-4hourprocessingtime)

PortableConcussionDetectionDevices

IndianaUniversitySchoolofOptometry• Eye-trackingGoggles&abalanceplatform(Wii-like)• Comparesathlete’sbaselinenumbersvs.post-blow


Eye-Sync(bySyncThink)• JustFDA-approved• Usesinfraredcameras&VRgogglestotrack&compareeyemovements

• Claimstodxconcussionin1minute

RightEye

FDA-Approval10/9/18Dyslexia,SportsVision,&OtherNeuroConditions...Parkinson’s,Concussion

RightEye

Examples of Vision Skills Trends: Top Amateur Baseball Players to the Top 1% of Major League Baseball Players

Vision Skills Make All The Difference

RightEye

IDENTIFIES WEAKEST AREAS RECOMMENDS EXERCISES

RightEye:HorizontalpursuitsPre-&Post-Therapy

myVisionTrack(a.k.a.mVT)fromVitalArtandScience• FDA-approved• Rxonly,free

download*• Homemonitor• AMD&DR

*Chargetosharedatawithdoctor

New & Emerging Ocular Technology

Genomics&Biotechnology

23andME• FDA-approved• Direct-to-consumergenotyping• 36conditionscurrently(Sjogren’s,SickleCell)• Glaucoma?,AMD?,RP?,ColorDeficiency?• Salivarysample

Natalis• Cheekswabgenetictestingfornewborns,children,adults• Allconditionstestedforhavemedicalinterventionsavailable• Screensfor193conditions• Alsoscreensforvariantsin10genesassoc.with

sensitivity/sideeffectsto38diff.commonlyrx’dmeds• $649(includesconsultwithgeneticcounselor)• Canorderindividualtestsa-la-carte

• ReportcoverageacrossmostinsurancesthruMountSinaipayerrelationships• ComprehensiveVisionLossPanel

•  Includes249genesforretinaldisease,albinism,developmentaleyeds.,&cataractamongothers

Epigenetics

• Obtaingenetictesting• Seekstomodifygenesviacustomized:

• Nutrition• Nutriceuticals• HormoneReplacement

Ocufolin

MEIRAGTx

ColorDeficiency

• App-basedproducts• Diagnostic?• Dailyuse...

Chromagen&X-ChromColorDeficiencyContactLenses

enchroma

•  Clear•  Tinted•  Plano•  Rx(incl.PAL)

enchroma

THANK YOU!

Chris Wroten, O.D., Diplomate A.B.O. [email protected]

cell: (225) 287-6641

believe it or not! amazing eye tech, astounding therapies

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