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Cecelia Koetting, OD, FAAO, DipABO, and Madeline Yung, MD, discussed emerging treatment and patient care options for those with presbyopia during CRU 2025.

CRU 2025: Presbyopia management from topicals to IOLs 

Videos

Jennifer Li, MD, details a talk she gave alongside Melissa Barnett, OD, FAAO, FSLS, FBCLA, at CRU 2025 in Napa, California.

CRU 2025: Neurotrophic keratitis and multidisciplinary approaches to enhance patient outcomes

Deb Ristvedt, DO, details a handful of presentations on glaucoma she gave during CRU 2025 in Napa, California.

CRU 2025: Interventional glaucoma as a proactive approach to glaucoma management

The decision to discontinue the trials comes shortly after the announcement that COAST missed its primary endpoint.

Opthea discontinues COAST and ShORe trials in wet AMD

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Catherine L. Heyman, OD, FAAO, FCOVD, shares highlights from her AOA 2022 presentation, "Evaluation and Management of Patients with Special Needs."

Tips on creating a space, treating patients with special needs

Alongside Rachelle Lin, OD, MS, FAAO, Nguyễn, MD, MSc, detailed what treatments are currently available for retinal vascular diseases, including neovascular age-related macular degeneration and diabetic retinopathy.

A retinal roundup with Dr. Quan Đông Nguyễn

At the 2025 CRU meeting in Napa, California, Quan Đông Nguyễn, MD, MSc discussed recent developments in retinal diseases, focusing on diabetic retinopathy, macular edema, geographic atrophy, and neovascular age-related macular degeneration (nAMD). He highlighted the availability of new medical therapies and the benefits and risks of anti-complement therapies for geographic atrophy. The discussion also covered the ineffectiveness of adding VEGF-C and -D blockers in neovascular AMD treatments. The session emphasized early treatment, the importance of collaboration between ophthalmology and optometry, and the potential of growth factor therapies like ciliary neurotrophic factor for macular telangiectasia.

Editor's note: The below transcript has been lightly edited for clarity.

Hi, I'm Quan Đông Nguyễn, currently professor of ophthalmology, Medicine and Pediatrics at the Byers Eye Institute and at Stanford University School of Medicine in Palo Alto. Certainly, it's great pleasure to be back here at the 2025 CRU meeting here in Napa. Yesterday, we were discussing about the various developments and investments in the field of retina, especially medical retina aspect as well as inherited retinal disease. So I had a wonderful time sharing with our colleagues some of the developments we have. The session covered 4 different parts, starting out with diabetic retinopathy, diabetic macular edema, then followed by geographic atrophy, and followed by neovascular AMD, and finished up with a session on treatment of different aspect of the disease and the treatment, the last aspect we covered, was macular telangiectasia. So during that 1-hour discussion, we went over many different aspects. Certainly, we talked about some of the latest developments, availability of medical therapy in medical retina, for example, with the availability of flotetuzumab, with the availability of the high dose of aflibercept, 8 milligram. Then we talked about how we can use them, when to apply them, when to switch, when to do certain things. 

Subsequently, we talked about geographic atrophy. Currently we have 2 different availability drug that we use for treatment of geographic atrophy: anti-complement 3 and anti-commitment 5. And so we discussed about the potential goods and benefits of both of them, knowing that even though they do not stop the growth of the disease, of the geographic atrophy, but they certainly can slow down. And so we talk about the risk and benefit for that. 

Then we move over to neovascular AMD, where we were able to look at different regimen, different study. Again, based on the development of that, we learned that it is very important to treat, certainly using anti-VEGF therapy, but also perhaps to consider other aspects. We learned that the addition of blockage of VEGF-C and D may not make a difference, given the result of the recent costudy that failed to show that addition of anti-VEGF-C and D make any difference for that in that aspect. So we learned about upcoming trials that may be helping to reset the goal for our patient with retinal vascular diseases like diabetic retinopathy and macular degeneration. 

Then we all finished the session about treatment for macular telangiectasia, showing that how the ciliary growth factor has been able to improve of that concept. So the CNTF treatment, ciliary neurotrophic factor, have been very helpful, and the trial positive, and it's recently been approved. So we look forward on perhaps consider managing outpatient with that condition with the latest treatment. So overall, the session was quite exciting. I was very pleased to be able to share our knowledge with our colleagues in both ophthalmology, as well teaching, educating some our colleague in optometry as well, some of the latest development we have.

One of the concepts that come out recently is that disease should be treated early and not waiting for end stages. So I think the collaboration between the 2 fields of ophthalmology and optometry is extremely important. Certainly, there's limited number of ophthalmologists, especially retina specialists, so therefore, many of our patients are being evaluated locally in different small cities, for example, by our colleagues in optometry. It would be very good to alert the patient, alert yourself also too, that disease can come or can reoccur unexpectedly. And we have learned from many of these trials that it is better to treat early and treat appropriately. So delay treatment may not be good, so it's very good that we could detect early and perhaps the optometrists can then send to the appropriate colleagues in retina, for example, to help out.

Alongside Rachelle Lin, OD, MS, FAAO; Nguyễn, MD, MSc, detailed what treatments are currently available for retinal vascular diseases, including neovascular age-related macular degeneration and diabetic retinopathy.

Conference

CRU 2025: A retinal roundup with Dr. Quan Đông Nguyễn

Cecelia Koetting, OD, FAAO, DiplABO, details a talk she gave among optometrists and ophthalmologists at CRU 2025.

The importance of comanagement and thorough examination in neurotrophic keratitis cases

Neurotrophic keratitis (NK) is a critical eye condition that is often misdiagnosed and misunderstood, according to Cecelia Koetting, OD, FAAO, DipABO. In her presentation "Neurotrophic Keratitis: Multidisciplinary Approaches to Enhance Patient Outcomes," presented alongside Melissa Barnett, OD, FAAO, FSLS, FBCLA; Jennifer Li, MD; and Quan Đông Nguyễn, MD, MSc; an overview of what to look out for in diagnosing neurotrophic keratitis was given.

Unlike typical dry eye, NK can progress to serious complications such as persistent epithelial defects, corneal ulcers, and potentially requiring a corneal transplant. The key to effective management lies in early detection through careful corneal sensitivity testing. 

Practitioners can use various tools to check corneal sensitivity, including cotton tip applicators, crochet bins, or even dental floss. The primary challenge is recognizing that what appears to be standard ocular surface disease may actually be NK. Misdiagnosis can lead to ineffective treatments, making accurate identification crucial. 

The approach to NK management is multifaceted and collaborative. Successful treatment often involves co-management across different medical specialties. For instance, oncology patients experiencing side effects from cancer medications frequently present with NK symptoms. Similarly, rheumatology patients with conditions like lupus, sarcoidosis, or Sjogren's syndrome may also develop NK. 

Each patient's NK management is unique. Some practitioners may take a more aggressive approach, treating the condition comprehensively, while others might refer to specialists for specific interventions. The goal is to create an approachable and flexible treatment strategy that addresses the individual patient's needs. 

Referral to a cornea specialist becomes necessary when surgical interventions are required. However, many stages of NK can be effectively managed through careful monitoring, appropriate treatments, and interdisciplinary collaboration. The most critical takeaway is the importance of thorough examination and corneal sensitivity testing. By recognizing NK early and understanding its potential progression, healthcare providers can prevent more severe complications and provide targeted, effective care for patients experiencing this complex eye condition.

Cecelia Koetting, OD, FAAO, DipABO, details a talk she gave among optometrists and ophthalmologists at CRU 2025.

CRU 2025: The importance of comanagement and thorough examination in neurotrophic keratitis cases

This poll is for optometrists and eyecare professionals, only. It will close on Friday, March 25, 2022.

E. Poor understanding of optometry by others

Poll: What is your biggest frustration with optometry as a whole?

Bausch + Lomb has announced the US launch of Arise, a lens fitting system that uses intelligent, cloud-based technology to aid in the orthokeratology lens design process. Arise is capable of syncing directly with topographers to create precise lens designs for the treatment of myopia in the matter of seconds. The system also utilizes the first orthokeratology lens design with toric peripheral curves approved by the US Food and Drug Administration to treat myopia overnight, according to a news release.

“Traditional orthokeratology lens fitting methods can be complex and time-consuming,” said Yang Yang, president of Global Vision Care at Bausch + Lomb, in the release. “The Arise platform’s streamlined fitting process will reduce chair time and increase efficiency for eye care professionals.”

Arise works by utilizing advanced algorithms to interpret corneal topography images and recommends lens designs without a fitting set required. The system evaluates lens centration and patient progress by using an overnight outcome map library and recommends any adjustments needed following overnight wear. Arise’s cloud-based platform also allows secure access to patient data and provides direct support from the Bausch + Lomb expert consultation team. The system is designed for lens fitters of all experience levels.

“Arise combines all aspects of the orthokeratology process—from topography capture to lens design and more—into one seamless, user-friendly technology,” said Brooke Messer, OD, FAAO, FSLS, of Vance Thompson Vision in West Fargo, North Dakota, in the release. “The ease and precision of Arise will be a welcome addition to my practice.”

Arise is now commercially available in the US, the UK, and Europe.

The Boston orthokeratology (oprifocon A) shaping lenses for overnight wear available with Arise are indicated for use in reduction of myopic refractive error in non-diseased eyes. The lenses can be used in part of the Bausch + Lomb Vision Shaping Treatment VST process for the temporary reduction of myopia up to 5.00 diopters with eyes having astigmatism up to 1.50 diopters.

Bausch + Lomb launches Arise orthokeratology lens system in the United States. News release. Bausch + Lomb. March 17, 2025. Accessed March 17, 2025.

The system aids in the orthokeratology lens design process by syncing directly with topographers to create precise lens designs for the treatment of myopia in the matter of seconds.

Bausch + Lomb launches new Arise lens fitting system

Okyo Pharma has filed an application for Fast Track designation with the US Food and Drug Administration (FDA) for urcosimod (formerly known as OK-101) for the treatment of neuropathic corneal pain (NCP).

Gary S. Jacob, PhD, CEO of Okyo Pharma commented on the application in a press release from the company.

“Fast track was first introduced by FDA to expedite development and review of drugs to treat serious conditions lacking any FDA-approved drug,” said Jacob. “Notably, neuropathic corneal pain falls into this category, and our application for Fast Track designation marks a significant milestone in our commitment to addressing the urgent needs of patients suffering from this type of pain. It is our belief that urcosimod has the potential to redefine the treatment paradigm for individuals grappling with this challenging condition.”

Fast track designation allows for the company to have more frequent meetings with the FDA to discuss the drug’s development plan, ensure collection of appropriate data needed to support drug approval, as well as the use of a rolling FDA review to expedite its regulatory path

NCP is a condition that causes severe pain and sensitivity of the eyes, face, or head, and the exact cause is unknown, but is thought to result from nerve damage to the cornea combined with inflammation. There is currently no FDA-approved drug to treat NCP.

Urcosmod is a lipid conjugated chemerin peptide agonist of the ChemR23 G-protein coupled receptor, typically found on immune cells of the eye responsible for the inflammatory response. Urcosimod showed clear statistical significance in multiple endpoints in a 

recently completed Phase 2, multi-center, double-masked, placebo-controlled trial to treat dry eye disease

presently being evaluated in a randomized, placebo-controlled, double-masked Phase 2 trial

 to treat 48 neuropathic corneal pain patients.

announced the United States Adopted Name (USAN) of urcosmid, formally OK-101.

 According to the company, the suffix “-mod” in urcosimod denotes its classification as a modulator of key inflammatory and neuropathic pathways, critical to addressing ocular conditions such as neuropathic corneal pain and dry eye disease.

OKYO Pharma files for Fast Track Designation with FDA for urcosimod to treat neuropathic corneal pain. Published March 10, 2025. Accessed March 10, 2025.

https://ir.4dmoleculartherapeutics.com/news-releases/news-release-details/4dmt-announces-first-patients-enrolled-4front-1-phase-3-clinical

Urcosmod is a lipid conjugated chemerin peptide agonist of the ChemR23 G-protein coupled receptor, typically found on immune cells of the eye responsible for the inflammatory response.

Canonical

OKYO Pharma files Fast Track designation application with the FDA for urcosimod for the treatment of NCP

Ocugen, Inc. completed dosing ahead of schedule in the Phase 2 portion of the Phase 1/2 ArMaDa clinical trial for OCU410. This candidate is a novel multifunctional modifier gene therapy candidate in development for the treatment of 

. OCU410 targets multiple pathways associated with GA.

Shankar Musunuri, PhD, MBA, Chairman, CEO, and Co-founder of Ocugen spoke to this milestone in the company’s press release, saying, “Dosing completion is a major accomplishment for our OCU410 program. Based on the multifunctional effect of our modifier gene therapy, the profound unmet medical need, limited treatment options, and the fact that it is designed as a one and done treatment, we believe OCU410 can be a potential blockbuster therapy and the gold standard for treating GA worldwide. The data from this trial will help us design a future pivotal Phase 3 study planned for 2026 and enable our commercial strategy for Biologics License Application (BLA) and Marketing Authorization Application (MAA) filings as soon as 2028.”

Huma Qamar, MD, MPH, CMI, is the Chief Medical Officer of Ocugen. In the press release he shared, “Given the safety concerns associated with currently approved GA treatments, the encouraging safety and tolerability profile of OCU410 offers a promising treatment option. With Phase 2 enrollment now complete, OCU410 has the potential to be a one-time treatment, reducing the burden of frequent injections, improving patient compliance, and ultimately enhancing quality of life.”

In the Phase 2 study, the safety and efficacy of OCU410 in patients with GA secondary to dAMD will be assessed. Fifty-one patients were randomized 1:1:1 into either of 2 treatment groups (medium or high dose) or a control group. In the treatment groups, subjects received a single subretinal 200-µL administration of 5 x 1010 vector genomes (vg)/mL (medium dose) or 1.5 x 1011 vg/mL (high dose), while the control group remained untreated.

The ArMaDa clinical trial for OCU410 is being performed at 14 retinal surgery centers across the US.

1. Ocugen, inc. Announces dosing completion in the phase 2 armada clinical trial for ocu410—a multifunctional modifier gene therapy for the treatment of geographic atrophy secondary to dry age-related macular degeneration. Ocugen, Inc. February 12, 2025. Accessed February 13, 2025. https://ir.ocugen.com/news-releases/news-release-details/ocugen-inc-announces-dosing-completion-phase-2-armada-clinical

OCU410 is a novel multifunctional modifier gene therapy candidate that targets multiple pathways associated with GA.

Catherine L. Heyman, OD, FAAO, FCOVD

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