San Diego County Optometric Society
The San Diego View
Inside this Issue:
- President’s Message
- SDCOS Announcements
- Retina Corner
- Eye See
- CE Corner
- Volunteer Corner
This is my last message to you as President of the Society. I would be lying if I said it was easy to be in this role. It was challenging, especially in these trying times post-Covid19, but rewarding at the same time. I’m proud that together with the Board we worked hard to bring back in person our valuable CE events, and continued to care for our community through free screenings and eye exams.
I want to thank my fellow Board members for placing their trust in me to lead SDCOS during a very difficult period. It was truly an honor. It was great to serve on the Board with such outstanding colleagues – Drs. Beverly Bianes, Katherine Witmeyer, Courtney Cape, Alexandra Scovill, Andrew Fasciani, Jennifer Chin, Amanda Dexter, Melanie Langford, Ilya Volk, Richard Skay, Justin Nguyen, David Sherman, Robert Meisel, Lucia Millet, David Ardakani, and Patty Cheng. Some have been in the trenches for decades, some made a comeback, and some served on the Board for the first time – to all, “Thank You” from the bottom of my heart.
I want to acknowledge the trustees as well – Drs. Andreea Nastasoiu, Tatyana Budarina, Alyssa Pack, Kathryn Ordonez, Sloan Rajadhyksha, Erin Swift. I appreciate everything you’ve done for the Society in this past year and all the hard work you put in to ensure the advancement of our great profession.
A big heartfelt thank you to our one and only, Nancy-Jo Sinkiewicz! She’s been the constant over all these years and the face of our Society! Thank you, NJ, for all of your hard work and dedication! You made my presidency so much easier.
Thank you to all Society members who generously volunteered their time in so many ways – going to Sacramento to talk to our political leaders about optometry on Legislative Day; all the calls and emails to our local senators and governor to support AB 2236; volunteering at LOVC, mobile clinic, and veterans’ event, recruiting new members – you were all instrumental in making this Society shine!
Lastly, I want to thank all of you for continuing to honor our profession through your membership. Your continued support says you’re invested in the betterment of our profession and our community, and in serving our patients in the end. And to take it a step further, I would strongly encourage you to join the Board of Directors in 2023! There are many reasons why you should join the board – like learning patience, how to run a meeting of people who don’t work for you, or how to ask for money, and stretching your intellectual and emotional muscles – but most of all, you will fall more in love with your organization. The closer you are to the work of your society, the more passionate you will become. And you will feel another emotion. You will feel lucky to be part of this society, organization, and profession.
I hope I will see many of you at our Holiday Brunch on December 4th at Farmer and the Seahorse. Let’s get together one more time this year, and celebrate all of our accomplishments in a fun and relaxed atmosphere.
Thank you for the honor of being your President. I look forward to an exciting new year with Dr. Beverly Bianes as your new President for 2023, and wish her all the best!
Welcome, new members!!
- Steven Thurston
- Jessica Tran
- Ryan Marr
- Yvette Diaz
- Nina Pham
- Kenny Hoang
- Tracey Huynh
- Julia Richardson
Please update your information on www.eyehelp.org
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.
2023 COA HOUSE OF DELEGATES
When: February 24 & 25, 2023
Where: Grand Hyatt San Francisco 345 Stockton St, San Francisco, CA 94108
Any active member in good standing is welcome to participate. Travel expenses (flight and hotel) are covered by SDCOS. Details will be provided for travel arrangements and the schedule of the event.
HOLIDAY PARTY DECEMBER 4th.
Don’t forget to reserve your space for our annual Holiday Get-Together! This year it will be a Brunch buffet-style event at the beautiful Farmer and Seahorse near Torrey Pines. There’s also going to be a photographer on site so feel free to wear Christmas-theme attire. Free and ample parking. One guest per member is allowed. Follow the link in the flyer below to register. The deadline to RSVP is November 25th, so don’t delay!
Open Board Positions for 2023
If you always wondered what the Board of this society does, come join us! We still have a few positions open for 2023 as Directors and Trustees. Email email@example.com or firstname.lastname@example.org to express your interest and we will send you more information. Thank you.
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 the 2023 CE schedule!
- Click here for COA membership benefits!
Delivering Gene Therapy into the Eye
By Nikolas J.S. London, MD FACS
President and Director of Research, Retina Consultants San Diego
Chief of Ophthalmology, Scripps Memorial Hospital La Jolla
Greetings SDCOS from Pasadena and the 55th annual Retina Society meeting! It has been a wonderful week of rapid-fire lectures covering the gamut of retinal pathology, pathophysiology, and cutting-edge treatment options. This is definitely one of my favorite meetings, involving a large, application-only retina honor society with excellent presenters and rich discussion. I do not know how I snuck into the society, but had the honor of presenting this year. While I could probably write a full article on any of the presentations from the meeting, I thought it would be nice to review a few that are near and dear to my heart involving the delivery of gene therapy products into the eye. We are seeing this concept flourish recently with multiple modalities being evaluated in different clinical trials and at least one set of trials comparing different delivery techniques.
To recap, gene therapy is used to introduce a strand of DNA into the body to permanently effect production of a new protein that, at least in the context of retinal disease, has a therapeutic effect. There are several approaches being evaluated, namely 1) injecting the Investigational Product (IP) into the vitreous akin to our standard intravitreal injections; 2) injecting the IP through the sclera into the suprachoroidal space using a short needle; 3) a transvitreal surgical approach to inject the IP directly into the subretinal (SR) space, and 4) a surgical, catheter-based approach to deliver drug into the SR space. At RCSD we are involved with clinical trials evaluating each of these options and have direct experience with each of them.
Starting with the simplest approach, several companies are evaluating intravitreal gene therapy delivery, including Adverum Biotechnologies (Redwood, CA) and Janssen Pharmaceuticals (Beerse, Belgium). The advantages of this technique are that it is one that is very familiar to all retina specialists, with essentially zero learning curve, and that in concept you deliver IP diffusely into the eye, potentially generating a broad production of the new protein directly where it is needed. One initial hurdle seen in a recent Adverum trial in DME patients unfortunately noted several cases of severe inflammation and hypotony leading to the cessation of that program. Fortuantely this was not seen in other populations, and the technique continues to be evaluated with concurrent corticosteroid treatment in studies for wet AMD (Adverum) and geographic atrophy (Janssen), which we will be participating in.
A small step up in complexity, in-office delivery into the suprachoroical space (SCS) uses a novel device called a Microjector. A 0.9mm needle penetrates through the external wall complex, and this approach is used for the FDA-approved corticosteroid produce, Xipere. Gene therapy delivery into the SCS is being evaluated in the AAVIATE and ALTITUDE studies from RegenxBio (Rockville, MD), studying RGX-314 (which produces a protein nearly identical to ranibizumab) for patients with wet AMD and diabetic retinopathy, respectively. This approach is technically simple, office-based, avoid morbidity associated with vitreoretinal surgery. While not quite as potent as other approaches, the treatment appears to work with good protein production. One downside is a possible association with transient post-treatment episcleritis, and this is being addressed with prophylactic corticosteroids.
The first surgical approach I wanted to mention involves transvitreal and subretinal drug delivery following vitrectomy. This technique uses a microcatheter to inject a small volume of IP into the SR space, and is being evaluated in several ongoing trials including the EXPLORE and HORIZON geographic atrophy trials from Gyroscope (London, UK) as well as multiple wet AMD trials from RegenxBio. This technique requires specialized training for the surgeon, but, after having performed several dozen, I can attest to it being a relatively simple technique to learn and a fun surgery to perform. The SR approach enables precise IP delivery in a very controlled fashion, with potent subsequent protein production. The approach is very well tolerated, but does carry the risk inherent with a surgical approach, and would be less ideal for phakic patients.
Finally, there is a fascinating approach used in the Gyroscope trials that uses the Orbit Subretinal Delivery System. This technically challenging compared to the SR catheter. It involves feeding a small, flexible catheter from the external sclera into the suprachoroidal space via a sclerotomy, starting near the pars plana and extending to the posterior pole. The catheter is directly visualized, but a vitrectomy is not performed. Once in the correct location, a small needle is extended from the tip of the catheter into the SR space, and the IP is injected to create a bleb. While more difficult, this approach avoids vitrectomy and associated lens changes, and may be the ideal technique if and when cell-based therapies (i.e. stem cells) come to fruition.
Hopefully this review is helpful and sheds a bit of light on the variety of ways we are approaching gene therapy for the eye. Each has a unique set of pros and cons that will be further illuminated as the associated clinical trials proceed. In the end it is likely that several will be available with any approved products, enabling us flexibility and a tailored approach to treat individual patients.
Thanks to much for reading. This is the last article until 2023. I hope that everyone has a wonderful holiday season with lots of happiness, laughter, and new family memories, possibly fueled by an alcoholic drink or two. Until next year!
Nikolas London, MD, FACS
Retina Consultants San Diego
written by Dr. Byron Y. Newman
Check out Dr. Newman’s website, www.thehumorfactory.com!!!
We are committed to helping you fulfill your CE requirements through our local virtual meetings with the support of our sponsors!
Featured Annual Sponsors
November 17, 2022, 2-hour CE and Annual General Meeting
Please be advised this is also our Annual General Meeting held at the end of the CE lecture when important things will be announced and voted on for 2023. Please attend. Thank you.
Location: Hilton San Diego Mission Valley 901 Camino Del Rio S. San Diego CA 92108.
Speaker: Dr. Nikolas London – Dr. Arash Mozayan – Dr. Alexa Li
Geographic Atrophy – the Next Frontier of AMD Treatment – RETINAL DETACHMENTS: Diagnosis, treatments, and outcomes – Updates and Emerging Therapies for Neovascular Age-related Macular Degeneration.
SDCOS Members: FREE
COA/AOA Members: $35
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, and 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 email@example.com (11/22).Best regards,
Part-time OD wanted: Consistent Saturday coverage for a busy private practice. Easy, young patient demographic. Competitive pay plus bonus pay. Please email: firstname.lastname@example.org Contact: Dr. Steven Thurston (01/23).
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 email@example.com (11/22).
Front Desk Receptionist. A temporary, Part-time position is available with the potential for regular employment. Answer phones, make appointments, and assist the doctor with other miscellaneous tasks. Oceanside office hours are Mon, Wed & Fri from 10 AM to 6 PM and Sat 9 AM to 3 PM. Santee office hours Tue & Thur 9 AM to 5 PM. $17.00 per hour. Contact firstname.lastname@example.org (11/22).
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, and 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 email@example.com (11/22).
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 firstname.lastname@example.org (11/22).
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 email@example.com (11/22).
Please contact Dr. Dave Sherman, Society Optometrist Relations Liaison at firstname.lastname@example.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.
Monarch School Screening
January 30th, 2023
Monarch School Exams on VSP Mobile Clinic
February 23rd – 24th, 2023
AMSA @ UCSD 12th Annual Health Fair
Location: Montgomery-Waller Park, San Diego, CA 92154 (corner of Beyer Blvd. & Palm)
Date: Saturday, April 15, 2023
Time: 10 A.M. – 3 P.M. (Set-up will be at 8 A.M.)
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:
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
Please contact the society office at 619-663-8439.
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 email@example.com
Phone: 619 663 8439
Fax: 800 643 8301