The San Diego View

Inside this Issue:

• SDCOS Announcements
• Retina Corner
• CooperVision® Expands MiSight® 1 day to Cover Nearly 100% of Spherical Prescriptions for Children with Myopia
• What Do You Really Know About Omegas?
• Eye See
• CE Corner
• Classifieds
• Volunteer Corner

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Welcome, new members!!

• Fabian Luna
• Michael Ventura
• Rosina Cullins
• Catherine Tan
• Ruby Bello
• Flora Huang
• Ashley Tang
• Susan Daniel

Please update your information on www.eyehelp.org

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SDCOS Announcements

PLEASE BE ADVISED:
Taken from the DEA website:

The Drug Enforcement Administration is warning the public of a widespread fraud scheme in which telephone scammers impersonate DEA agents in an attempt to extort money or steal personal identifiable information. DEA personnel will never contact members of the public or medical practitioners by telephone to demand money or any other form of payment, will never request personal or sensitive information over the phone, and will only notify people of a legitimate investigation or legal action in person or by official letter. In fact, no legitimate federal law enforcement officer will demand cash or gift cards from a member of the public. You should only give money, gift cards, personally identifiable information, including bank account information, to someone you know.

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For updated information and resources regarding COVID in San Diego, please register using this link. This will sign you up to receive weekly emails from the San Diego Health and Human Services Agency, including weekly tele-briefings on everything COVID.

• Click here for most recent SDCOS Board Meeting Minutes
• Click here for the 2022 CE schedule!
• Click here for COA membership benefits!

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Retina Corner Geographic Atrophy: Update on the Quest for a Treatment Option

By Nikolas J.S. London, MD FACS
President and Director of Research, Retina Consultants San Diego
Chief of Ophthalmology, Scripps Memorial Hospital La Jolla

Hey SDCOS! I hope that everyone is doing well. Congratulations to Drew and Lucia on getting married!! They are an incredible couple, and I am sure we all wish them decades of happiness, adventure, laughter, and love.

On a totally opposite topic, I wanted to update you on our search for a treatment option for geographic atrophy (GA). As many of you may know, we are finally and hopefully on the cusp of having our first FDA-approved treatment option for GA – Pegcetacoplan from Apellis Pharmaceuticals. This pending approval has spurned a movement to educate the comprehensive ophthalmology and optometry community on GA, including a COPE-approved course I am serving as a faculty member for from Evolve Medical Education. It starts with a nice set of online questions on GA, dry AMD, and future treatment options for dry AMD, followed by two small live group discussions. A very small group of ODs and I are running through the course, but if anyone else is interested, it may not be too late to participate – just email me and I can definitely try to invite you.

Before getting to an update on the data for pegcetacoplan, I thought it would be educational to review the process of FDA approval for new drugs. Let’s use pegcetacoplan as an example. Based on phase 2 and 3 clinical trial results, Apellis filed for approval of the drug with the FDA, which was accepted on July 19, 2022, and granted priority review. At this point the clock starts ticking for the FDA based on the Prescription Drug User Fee Act (PDUFA), which established a fee schedule and review timelines for New Drug Applications (NDA). Typically the FDA would have 12 months to review the NDA, but Priority Review shortens this to six months or less. The PDUFA target action date for pegcetacoplan is November 26, 2022. Priority Review designation is reserved for medications that treat a serious condition and would make a significant impact on clinical outcomes. If and when the drug is approved by the FDA, the FDA will set then forth a label that describes the conditions of use under which the product has been shown to be effective for marketing purposes, as well as provides information on how to use the medication safely under those conditions. Now the company can ramp up marketing and production of the medication and set a product launch date. In the case of pegcetacoplan, I can assure you that Apellis is fairly well prepared to launch and I am hopeful that we see the drug commercially available in early 2023.

So, what is all the fuss about? Well, in a graveyard of failed GA treatment options, and despite a bit of a roller coaster ride, Apellis appears to have its hands on the first “effective” molecule. Designed to regulate overactivation of the inflammatory complement cascade, pegcetacoplan appears to slow the progression of the RPE death that defines GA. The sham-controlled phase 3 DERBY and OAKS trials demonstrated this in a large population of over 1200 patients. GA lesion growth over 24 months was reduced by 19-22% compared to control, with a highly-significant p-value. This treatment effect accelerated in the last six months compared to previous periods, up to 36% with monthly treatment in the DERBY study (figure). This is very exciting as we all know that the vast majority of our patients with vision-threatening GA have much longer than 24 months to anticipate potentially blinding vision loss. If the treatment effect accelerates over time, it will be fascinating to see what happens at 5, 10, or 20 years.

Well, I think I’m out of space for this month. Thanks so much for reading. Please don’t hesitate to contact me with any questions. If anyone is interested in the online COPE course, please send me an email and I’ll see if I can get you added.

Best wishes, and until next time,

Nik

Nikolas London, MD, FACS
Retina Consultants San Diego
415-341-5456 (cell)
london@rcsd.com
www.rcsd.com

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CooperVision® Expands MiSight® 1 day to Cover Nearly 100% of Spherical Prescriptions for Children with Myopia

Expanded Range of up to -7.00D Makes Myopia Control a Possibility for More Children Than Ever Before

CooperVision MiSight® 1 day contact lenses are now available in higher prescriptions. The expanded range—covering -0.50D to -7.00D (0.50D steps after -6.00D) in the U.S.— covers nearly 100% of spherical prescriptions for age-appropriate children* (who were initially fit between ages 8-12) with myopia.‡ The two new powers for this innovative, specially designed lens will allow even more children to benefit from myopia control.

With myopia on the rise globally, an increasing number of age-appropriate* children may require the higher prescriptions that MiSight® 1 day lenses now offer.

“A greater range of MiSight® 1 day powers is excellent news for my practice and patients,” said Charles Morgan, MD, of Advocare Pediatric Eye Physicians in Morristown, NJ. “We have age-appropriate* patients with higher levels of myopia who will now be able to access MiSight’s proven myopia control benefits.”†

The expanded range is included in CooperVision’s OptiExpert™ Contact Lens Calculator, an app-based tool that helps eye care professionals by calculating back vertex distance and displaying the closest power-matched MiSight® 1 day prescription for a patient.

As a global leader in myopia management for children, CooperVision believes that options must be available for as many children as possible. With MiSight® 1 day’s range extension, eye care professionals in the U.S. and in more than 30 other countries can have even greater impact.

“Every diopter matters, particularly for children whose myopia progression may have already placed them at a higher risk for conditions such as myopic maculopathy and glaucoma,” said Elizabeth Lumb, BSc (Hons) MCOptom, FBCLA, Director of Global Professional Affairs, Myopia Management, CooperVision. “While early treatment is best, it’s never too late to start.”

*Indications for Use: MiSight® 1 day (omafilcon A) soft (hydrophilic) contact lenses for daily wear are indicated for the correction of myopic ametropia and for slowing the progression of myopia in children with non-diseased eyes, who at the initiation of treatment are 8-12 years of age and have a refraction of -0.75 to -4.00 diopters(spherical equivalent) with ≤ 0.75 diopters of astigmatism. The lens is to be discarded after each removal.

‡Includes prescriptions up to 0.75DC

†Compared to a single vision 1 day lens over a 3-year period.

¹ CVI Data on file, 2022. SERE coverage of childhood myopia prescriptions with MiSight® 1 day for 104,810 eyes in Asia (China, Korea) and 116,336 eyes in Europe and USA aged 8-18 years.

² Holden et al, Global Prevalence of myopia and high myopia and temporal trends from 2000 through 2050. Ophthalmology 2016. 123(5):1036-1042.

³ Chamberlain P, et al. A 3-year Randomized Clinical Trial of MiSight® Lenses for Myopia Control. Optom Vis Sci. 2019; 96(8)556-567.

⁴ Bullimore et al. Myopia Control: Why Each Diopter Matters Optom Vis Sci 2019;96:463–465

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What Do You Really Know About Omegas? Laura Periman, MD

Understanding Different Omegas

Omega-3 and 6 fatty acids play an integral role in our body’s ability to regulate and balance inflammation. Many inflammatory cytokines (both pro-inflammatory and anti-inflammatory) are produced from omega fatty acid building blocks. The mechanism of action of NSAIDs relies on targeting the metabolism of the pro-inflammatory omega arachidonic acid. Arachidonic acid is a pro-inflammatory omega-6 metabolite that is over-abundant in the Western diet and is the reason omega-6s have a bad name. But, as with most things in biologic systems, there is balance and nuance and more to the story.

The omega-6 gamma-linolenic acid (GLA) is different. GLA is the only truly viable precursor to the potent anti-inflammatory PGE1, and it has been shown in multiple controlled trials to have positive effects specifically for dry eye., PGE1 is found in the tears, the lacrimal glands and the conjunctiva. Importantly, GLA has been shown to increase PGE1 levels and increase tear production in Sjögren’s Syndrome.

It has been shown that when GLA is combined with the proper balance of eicosapentaenoic acid (EPA) you can inhibit production of arachidonic acid, while stimulating production of anti-inflammatory cytokines from both GLA and EPA. By blocking the pro-inflammatory pathway, you divert the metabolic traffic flow down to one lane towards the desirable anti-inflammatory PGE1 pathway.

Using Scientifically Proven Nutraceuticals

HydroEye (ScienceBased Health) is a patented oral nutritional supplement that provides a proprietary blend of GLA plus other omegas and key nutrients that work together to support all 3 tear film layers, maintaining eye moisture and providing comfort for those experiencing dry eye related to a variety of causes. A randomized, controlled, double-blind study demonstrated that consumption of HydroEye by dry eye patients significantly improved symptoms, suppressed markers of conjunctival inflammation, and maintained corneal smoothness.

I recommend HydroEye to all of my dry eye patients as it improves the tear film, the lids and the Meibomian glands in a more natural way.

Laura Periman, MD, is the Director of Dry Eye Services and Clinical Research at Periman Eye Institute in Seattle, WA.  She has studied the immunopathophysiologic mechanisms behind dry eye disease for more than 30 years and believes in taking an integrated approach to treatment. She has authored many articles and has lectured domestically and internationally. To contact Dr. Periman e-mail: lauraperiman@yahoo.com

This article is adapted from an article Dr. Periman previously published in Ophthalmology Times.

¹ Macri A, Giuffrida S, Amico V, Lester M, Traverso CE. Effect of linoleic acid and gamma-linolenic acid on tear production, tear clearance and on the ocular surface after photorefractive keratectomy. Graefes Arch Clin Exp Ophthalmol 2003;241(7):561-6.

² Kokke KH, et al. Oral omega-6 essential fatty acid treatment in contact lens associated dry eye. Contact Lens & Anterior Eye 31:141-6, 2008.

³ Aragona P, Bucolo C, Spinella R, et al. Systemic Omega-6 essential fatty acid treatment and PGE1 tear content in Sjogren’s syndrome patients. Investigative Ophthalmology & Visual Science 2005;46:4474-4479.

⁴ Viau S, Maire MA, Bruno P, Joffre C. Eficacy of a 2-month diatary supplementation with polyunsaturated fatty acids in dry eye induced by scopolamine in a rat model. Graefes Archive of Ophthalmology 2009;247(8):1039-50.

⁵ Barham JB, et al. Addition of EPA to GLA-supplemented diets prevents serum arachidonic acid accumulation in humans. J Nutr 130: 1925-31, 2000.

⁶ Sheppard, JD, Singh R, McClellan A, et al. Long-term Supplementation With n-6 and n-3 PUFAs Improves Moderate-to-Severe Keratoconjunctivitis Sicca. Cornea. 2013;32(10):1297–1304. doi: 10.1097/ICO.0b013e318299549c.

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Eye See written by Dr. Byron Y. Newman

Check out Dr. Newman’s website, www.thehumorfactory.com!!!

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CE Corner We are committed to helping you fulfill your CE requirements through our local virtual meetings with the support of our sponsors!

 

Featured Annual Sponsors

September 22nd: 2-hour CE

Location: Hilton San Diego Mission Valley 901 Camino Del Rio S. San Diego CA 92108.

https://bit.ly/HiltonMissionValley

Speaker: Dr Kimberly Cockerham
Topics: Diagnosis and Management of Eyelid Lesions

Pricing:
SDCOS Members: FREE
COA/AOA Members: $35
Non-Members: $130
Students: FREE
Sponsors: FREE
SDCOS Board Members: FREE

• See 2022 CE schedule

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Classifieds

Associate Optometrist for Saturdays Urban Optiks Optometry is currently interviewing for an outgoing and energetic optometrist to join our professional team for one day per week on Saturdays. This would be an excellent opportunity for an optometrist who has full-time employment and is looking to supplement their schedule with an additional day. Our digital, tech-centric practice & upscale optical boutique showcases one of the finest collections of luxury eyewear in San Diego. With a reputation for providing exemplary personalized customer service, along with the finest products and latest lens technology, Urban Optiks provides an unparalleled optical experience. Learn more about us at www.uoosd.com Qualities that make the ideal candidate stand out: •Experience in a high-end independent practice with a focus on providing quality, individualized routine eye care. • Strong communication skills with an ability to build patient trust and confidence in order to facilitate premium lens sales. • Excellent refractive & diagnostic skills. • Proficiency with contact lenses. • Familiarity with OfficeMate/ExamWriter EHR, Topcon CV5000 refraction system, Topcon CA-800 corneal analyzer, and Topcon Maestro 2 retinal imaging device. If you are a motivated individual with a passion for delivering a superb patient experience in an unhurried boutique environment, please email your cover letter and resume to hr@uoosd.com (09/22).

Optometrist needed for Tuesdays, Wednesdays, Thursdays, Saturdays, and Sundays, at the Mission Valley Costco.  If interested please contact rslikker@san.rr.com or text 619.977.7703 (09/22).

Build Ownership in a Growing Optometry Practice, Even as a New Grad.  Growing Practice at the Heart of San Diego with a 25+ Year Veteran of the Optometry Profession, with a successful history of growing multiple practices, is seeking a motivated, self-starter, entrepreneurial optometrist to join a growing optometry practice in City Heights. Practice is in a custom modern office setting, with great visibility, with a proven track record of success for medical practices. Working knowledge of Spanish is preferred. Opportunity to get involved (even as a New Grad) in a growing eye care practice from the ground up, earning equity toward part or full ownership. Please email your resume to spousti@live.com (09/22)

Former Optometrist office space built out in Carmel Valley for lease- 1755 sq feet available immediately in Trader Joe’s anchored center. Prior tenant merged practices and space is in “Move-In” condition. For Information please contact Reg Kobzi at 858-546-4604 reg.kobzi@cbre.com (09/22).

Poway Costco seeking permanent part-time for Mondays, Thursdays, and Saturdays.  Weekday hours 10-6 with 1 hr lunch and Saturdays 9:30-4:30 with 30 min lunch.  Base with production bonus.  If interested please emailmlmatt88201@yahoo.com (09/22).

Practice for sale: Long-time established practice for sale in La Mesa–seller wishes to retire–Seller has set a very low purchase price to facilitate an immediate sale—don’t miss out on this great opportunity to own your own practice.  Contact Dr. Levy at 619-743-1442 or email at drlevy@pacbell.net (09/22).

Optometrist needed for Vacation Relief:  Private practice off 805 in Chula Vista needs any or all of the following days: Saturday, Aug 6th, 9:00-1:00 pm, Tuesday, Aug 9th, 9:00-6:00 pm, Wednesday, Aug 10th, 9:00-6:00 pm, Friday, Aug 12th, 9:00-6:00 pm.  Please email angie@villaoptometry.com or text 858-260-9208 for more details (09/22).

Private practice in National City is seeking FT or PT Optometrist. The office has modern, integrated equipment, and staff complete full pre-test workups. Competitive pay includes a production-based incentive. Benefits include 401K with matching, PTO, and medical insurance.  Please call A.K. at 619-279-4055 for more information. (09/22).

For Sale: I have a Topcon chair and stand, a visual acuity monitor from Lombart, and an LED slit lamp for sale. Ideal for a second exam room. Make offer. All are in good condition. Please call 858 245 9143 and leave a message. I will return the call thereafter. (09/22)

 

Please contact Dr. Dave Sherman, Society Optometrist Relations Liaison at odjobs@sdcos.org or 760-208-3456 to be put on an official list for the following:

• fill-in/part-time work
• full-time work
• purchase/partner in/sell a practice

This service is offered free of charge to SDCOS members.

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Volunteer Corner

Monarch School Screening

Contact Dr. Bob Meisel for more information at rmeisel47@gmail.com ; www.monarchschools.org

Next Screening: October 3rd 900-2:15
Exams: October 24-25th 900-200: still need one OD for the 24th

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VSP Mobile Clinic Event

In partnership with the San Diego County Department of Education (JCCS), VSP Mobile Clinic will be offering free eye exams to those in need. Two volunteer doctors are needed for each of the following dates/locations:

October 18
North County Regional Education Center
San Marcos, CA
Hours: 9 am to 4:00 pm

October 19
East Region Community School of Greater La Mesa
La Mesa, CA
Hours: 9 am to 4:00 pm

October 20
Lindsay Community School
San Diego, CA
Hours: 9 am to 4:00 pm

October 21
South County Regional Education Center
National City, CA
Hours: 9 am to 4:00 pm

If you are able to help, please contact Linda Kendrick: lindke@vsp.com ­| Cell: 916-215-4491, or Dr. Bob Meisel at rmeisel47@gmail.com or Dr. Simona Grosu at dr.simona@yahoo.com

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Lion’s Optometric Vision Clinic

VOLUNTEER DOCTORS needed for flexible shifts throughout the year. 9-1:00 pm. Monday -Friday 1805 Upas St San Diego, CA 92103.  Can’t volunteer at the clinic? See patients in your office. Call 619-298-5273.

The LOVC has Reopened!!

Please call or email the clinic if you are interested in volunteering:

• 619.298.5273
• lionsvisionclinic@gmail.com

Alterations to the schedule to accommodate social distancing are in place and PPE will be provided for all volunteers/staff/patients.

New flooring was installed with the donation from the SDCOS 2019 golf tournament and a special thanks to Dr. Phil Smith!

Please think of the LOVC for your end of year charitable giving, visit our website:  lionsvisionclinic.org

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DONATE GLASSES
Please contact the society office at 619-663-8439.

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SDCOS keeps a list of all doctors willing to speak in front of groups about various topics, do home visits for patients, and assist in student mentoring. ODs interested in the Speakers Bureau, Home Visits, Student mentoring, and Low Vision OD’s, please contact the society office at 619-663-8439 or email sdcos@sdcos.org