In This Edition

• Special Tech Issue
• Product Review: RHA^™
• New Technology: Cliradex^® Complete Advanced Lid Hygiene Kit
• New Technology: Macula Risk^®
• New Technology: iScan^™
• The 2015 Exchange^®
• Give Us Your Feedback

Quarterly New Technology Update

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• Issue 37
• Issue 36

Contact Vision Source^® at 888-558-2020 or [email protected]

Special Tech Issue

Read What's New and Impressive in the Quarterly New Technology Update

It is amazing the number of new technologies that we are able to see, as we travel to the various meetings across the country. Most of these companies with new technologies are eager to become vendor partners and offer these products and technologies to Vision Source^® members. As a new service to members, we will provide a quarterly update to members on the offerings from existing and new vendor partners with new technologies.

These products and services will be evaluated in a clinical setting, and we will try and point out the applications and advantages to these technologies so that you can gauge for yourself whether it is the right fit for your practice.

John A. McCall, OD Senior Vice President, Vendor Relations Vision Source®	Carl Spear, OD, FAAO Vision Source® Administrator Vision Source®

  Product Review: RHA^™

Multi-Spectral Imaging: The New Standard of Eye Care

By Carl Spear, OD, FAAO

The RHA^™ multi-spectral digital ophthalmoscope from Annidis Corporation combines advanced Multi-Spectral Imaging (MSI) technology with user-friendly software for early detection of ocular pathologies. It was designed as a platform to support ongoing improvements as new medical innovations become available.

Unlike traditional fundus cameras, the RHA provides eye care professionals with multiple successive en face views of the retina and choroid for early disease detection, diagnosis and management of a variety of ocular conditions including AMD, diabetic retinopathy, retinal dystrophies and retinal vascular disorders.¹ This is achieved by collecting and combining spectral information that highlights specific ocular signatures, particularly melanin, hemoglobin and lipofuscin.²

The instrument utilizes safe, discrete, light emitting diodes (LEDs) across a wavelength range from 520nm to 940nm to progressively examine the different layers of the retina and choroid, with the longer wavelengths penetrating deeper into the structures of the eye.³ The images obtained are based on a balance between light scatter and absorption of each retinal layer by a particular wavelength.

Early and subtle ocular pathologies are often difficult to isolate, identify and interpret by conventional means. This is even more pronounced when pathologies overlap within the retina as they do in the case of co-morbidity, such as hypertension in conjunction with diabetes.³ In addition, retinal pigment can restrict the view of deeper structures. MSI of the retina and choroid represents a major advancement in ocular diagnostics adding significant value over color photography during clinical examination. MSI allows eye care professional to detect more pathology, earlier in the disease process for optimal patient care.

For more information, visit annidis.com or email [email protected] or call 1-855-ANNIDIS (266-4347) ext. 800

References:
1. Hitchmoth DL. Multispectral Imaging: A Revolution in Retinal Diagnosis and Health Assessment. Advanced Ocular Care. 2013; 6: 76-79.
2. Weiter JJ, Delori FC, Wing GL & Fitch KA. Retinal pigment epithelial lipofuscin and melanin and choroidal melanin in human eyes. Invest Ophthalmol Vis Sci. 1986; 27(2): 145-52.
3. Zimmer C et al. Innovation in Diagnostic Retinal Imaging: Multispectral Imaging. Retina Today. 2014; 9(7): 94-99.

  New Technology: Cliradex^® Complete Advanced Lid Hygiene Kit

Cliradex^® Complete Advanced Lid Hygiene Kit Offers In-office Solution for Management of Lid Margin Diseases

Bio-Tissue, Inc., the industry leader in regenerative tissue therapies and ocular hygiene products, recently launched Cliradex^® Complete Advanced Lid Hygiene Kit, an in-office solution for management of lid margin diseases (LMD) that isolates scientifically-proven 4-Terpineol, the most important ingredient in tea tree oil.¹

"Historically, there has been a gap in professional treatment options that can immediately alleviate symptoms of lid margin diseases,” says Vision Source^® Senior Vice President of Vendor Relations John McCall, Jr., OD. "For practices looking to provide cutting-edge vision care and products, Cliradex Complete provides a turnkey integrated ocular hygiene protocol that can deliver improved patient outcomes."

LMDs can be classified into anterior and posterior blepharitis. Posterior blepharitis is often referred to as meibomian gland dysfunction, which can present as burning, stinging, redness, fluctuating vision and blurred vision. Anterior blepharitis can present as cylindrical dandruff, crusting of the lashes and inflammation. Symptoms can often be linked to demodex mites that live in the glands and cause blockages and inflammation. Demodex has also been implicated in dermatologic and ocular rosacea.

A component of tea tree oil, 4-Terpineol has been proven to be the most effective ingredient in killing demodex.¹ Additionally, many ingredients in tea tree oil neutralize each other, rendering them ineffective. Cliradex^® Complete features a formulation called Cliradex^® Advanced Care that contains nearly double the concentration of isolated 4-Terpnineol to jumpstart symptom management for patients presenting with moderate to severe lid margin diseases.

The kit also comes with a dual-sided applicator for removal of debris and a carton of Cliradex^® lid wipes for patients to use at home, making it a comprehensive solution.

"Cliradex Complete is very easy to use, and a great way to jump start blepharitis treatment," says Scott Schachter, OD, a Vision Source^® member in Pismo Beach, Calif. "In addition to billing a Level II or Level III office visit, it is a private-pay procedure that can be billed at approximately $150. For doctors already using Cliradex, the new Cliradex Complete is an excellent additional source of revenue and can bring relief to uncomfortable patients."

Cliradex^® products are a natural and preservative-free way to manage symptoms of lid margin diseases successfully and add a revenue stream to your practice.

To learn more about Cliradex Complete and special Vision Source^® promotions, call 888-296-8858 or visit biotissue.com.

1. Tighe et al, Terpinen-4-ol is the Most Active Ingredient of Tea Tree Oil to Kill Demodex Mites, Transl Vis Sci Technol, 2013,2(7):2.

  New Technology: Macula Risk^®

AMD Genetic Testing Provides Opportunities for Personalized Medicine

The way that eye care practitioners diagnose and initiate treatment for macular degeneration is changing. Many new discoveries in technology and nutrition are proving beneficial for the macular degeneration patient. DNA testing provides new insights for treating, managing and making nutritional recommendations for patients with age-related macular degeneration (AMD).

Macula Risk^® is a combined prognostic and pharmacogenetic DNA test intended for patients who have a diagnosis of early or intermediate AMD. Combined with a routine clinical eye examination, results of the Macula Risk test determine which patients are at the highest risk of vision loss from AMD and the most effective vitamin formulation, whether that’s an AREDS formulation with or without zinc. Identifying AMD patients who are at elevated risk allows a practitioner to develop increased surveillance, early referral and optimal treatment strategies.

While the Age-Related Eye Disease Study (AREDS) demonstrated that eye vitamins can protect some patients from developing advanced AMD, more recent data suggests that zinc may be helpful—or harmful—to some patients, depending on their genetic profile.

Indeed, nutritional supplements meant to slow the progression of AMD may actually accelerate the disease in people with a certain genotype¹. A follow-up study² also demonstrated accelerated vision loss in 19% of the patients studied, who had a genetic profile of a high CFH and low ARMS2 risk. When AREDS was compared to placebo in this cohort, those on AREDS experienced a 78% (Hazard Ratio = 1.78) increase in progression to advanced AMD with vision loss. The authors demonstrated that AREDS was not proven safe and effective in patients with this genetic profile.

Faced with this important evidence that an easily identifiable group of AREDS patients had worse outcomes if treated with the AREDS formulation than with placebo, physicians who treat patients with moderate AMD should first identify whether these patients might be harmed, rather than helped, before recommending AREDS-type supplements.

In 1,237 AREDS patients diagnosed with intermediate AMD and matched for nongenetic risk factors, genetic analyses is shown to differentiate those patients most likely to progress to vision loss. Macula Risk PGx includes 12 genes including CFH and ARMS2 all combined to provide a more accurate personalized result for you. The chart below identifies separate results from only two of the 12 genes (CFH and ARMS2) that are the strongest predictors of progression risk.

The DNA test for AMD patients is a simple, noninvasive swab of the inside of the patient’s mouth. In-office training through webinars and materials to help incorporate this procedure into your practice are available at no cost. Results are available typically within four weeks, so patients can be rescheduled to review the data and the most appropriate treatment steps, including the most appropriate nutritional supplement recommendation.

Sources:
1. Awh, C, Hawkin, S, Zanke, B, Treatment Response to Antioxidants and Zinc Based on CFH and ARMS2 Genetic Risk Allele Number in the Age-Related Eye Disease Study, Ophthalmology, September 2014.
2. Emily Chew, Michael Klein et al. AREDS Report #38: 2014 Nov;121(11):2173-80. doi: 10.1016/j.ophtha.2014.05.008. Epub 2014 Jun 26.

  New Technology: iScan^™

Optovue Introduces First Software-Assisted OCT Device to U.S. Market

User-friendly, affordable platform elevates eye care

Optovue is bringing to market its newest OCT device, the iScan^™. iScan introduces next-generation, software-guided scanning technology that offers the ultimate in ease-of-use. Operating iScan is as easy as entering the patient name, positioning the patient and pressing the "start" button. iScan vocally guides the patient through the entire exam, requiring minimal operator involvement. iScan also features a compact footprint and tabletop design making it ideal for practices with space limitations. And installing the system requires little more than plugging in the device, making it a truly portable OCT.

The iScan system is available in two configurations. iScan Essential features a wellness scan, a retina map and an optic nerve head scan, enabling the eye care professional to elevate the comprehensive eye exam and begin building a medically oriented practice. iScan Comprehensive includes all of the Essential scans plus 3D retina and optic nerve scans and an anterior segment package. Both systems feature a robust normative database to simplify interpretation and aid the doctor in diagnosing and managing ocular disease.

"iScan gives every eye care professional the ability to enhance patient care and begin moving towards the medical model. Space restrictions and lack of staffing resources are no longer barriers to integrating advanced diagnostic equipment, so any optometric practice can increase its eye health care services," says Optovue Senior Director of Clinical Education Larry Alexander, OD, FAAO.

"Bringing in an OCT has been a great medical and financial decision for my practice," says Georgeann Wade, OD, of Wade Family Eye Care, a Vision Source^® practice in Cameron, Wis. “We offer the iWellness scan to everyone 50 and older and the 'take' on this is very high. So the increased revenue has been wonderful. The information obtained from this simple scan really makes my clinical job a lot easier. And following glaucoma is much easier with this technology. I wouldn’t treat glaucoma without an OCT now. This technology is enabling us to see more and more medical patients, which also generates more revenue for the practice. It's just a win-win-win for the doctor, the patient and the practice."

iScan is being introduced at a very attractive price point, and the revenue generated from the iWellnessExam^® and billable medical scans deliver exceptional return on investment. For more information, visit optovue.com.

  The 2015 Exchange^®

See All the Technology Advances in One Place: The 2015 Exchange^®

Reserve your spot now for the Vision Source^® Exchange^® in Phoenix, April 29-May 2

One of the highlights of every Vision Source^® Exchange^® is the Exhibit Hall. The 2015 exhibit hall will feature more than 100,000 square feet of exhibits, allowing doctors to see advanced clinical equipment, the latest frame designs, the newest contact lens technologies and much more. The meeting will also feature show-only specials that offer tremendous savings.

Other highlights include the General Session and Learning Labs, up to eight hours of free CE credit and a chance to connect with colleagues and friends.

Register now for The 2015 Exchange^®. Click here to register or copy and paste this link into your browser: http://registration.experientevent.com/ShowVSM151/

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