778th meeting of the New England Ophthalmological Society

ADVANCES IN CORNEAL AND ANTERIOR SEGMENT DIAGNOSTICS INNOVATION IN : BARRIERS AND BREAKTHROUGHS NEOS DISTINGUISHED ACHIEVEMENT AWARD RECIPIENT

March 13, 2020 Back Bay Events Center 180 Berkeley Street, Boston, MA the 778th meeting of

The New England Ophthalmological Society, Inc. A Public Foundation for Education in Ophthalmology

BACK BAY EVENTS CENTER March 13, 2020 180 Berkeley Street, Boston, MA 02210

ADVANCES IN CORNEAL AND ANTERIOR SEGMENT DIAGNOSTICS Nicoletta Fynn-Thompson, MD, Moderator Jeremy Kieval, MD, Program Committee Coordinator

INNOVATION IN OPHTHALMOLOGY: BARRIERS AND BREAKTHROUGHS Deborah S. Jacobs, MD, Moderator Joel Geffin, MD, Program Committee Coordinator

NEOS DISTINGUISHED ACHIEVEMENT AWARD RECIPIENT Ann Bajart, MD

AMA Credit Designation Statement The New England Ophthalmological Society designates this live activity for a maximum of 7 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Accreditation Statement This activity has been planned and implemented in accordance with the accreditation require- ments and policies of the Accreditation Council for continuing Medical Education. The New England Ophthalmological Society is accredited by the Massachusetts Medical Society to provide continuing medical education for physicians.

New England Ophthalmological Society PO Box 549127, Waltham, MA 02454-9127 | tel: 781-434-7656 email: [email protected] | www.neos-eyes.org

NEOS is now on Twitter and Instagram Follow us @NEOS_Eyes In Memoriam:

Lloyd M. Aiello, MD December 2019 Past President – 1992

Y. Jacob “Jack” Schinazi, MD January 2020 Past President – 1991

2 | New England Ophthalmological Society MESSAGE FROM THE PRESIDENT

MARY K. DALY, MD

Welcome to the 778th meeting of the New England Ophthalmological Society. This is our first gathering since we have entered the year 2020, a special and important year for our field. The last decade of the “20’s” began with our country roaring with innovation and spirit. Inventions and reforms from the 1920’s that would change all of our lives ranged from the quotidian such as Kool-Aid, the band-aid, Q-tips, the ice cube tray, bubble gum, to the incredibly transformative of penicillin and women’s right to vote. In the ophthalmology world, the 20’s brought us Jules Gonin’s first report from Lausanne that retinal detachments with tears could be treated by cauterizing the sclera in the area of the tear.

Our firmly grounded Society, which has reaffirmed its strength over the last 136 years, is not just a professional one, but a community which fosters friendships spanning decades, connects generations, and brings us all closer together. This year we lost two past presidents of NEOS, Jacob Y. Schinazi, MD “Jack,” and Loyd M. Aiello, MD. Their contributions were great, and their losses are heartfelt. There is no question they are both looking down with joy and hope at the great talent of our young ophthalmologists lead by our YO committee who will lead our great Society into the future decades to come.

No one ultimately knows what these next 10 years (the new ‘20’s) will bring……. What we do know is that our Society will continue to work collectively to bring perfect vision to our patients whenever possible. We know that the Board and committees of this great Society will venture tirelessly to ensure your educational and professional needs are fulfilled. And I, as a practicing ophthalmologist in New England who recognizes the tremendous value and history of NEOS, know that it is an absolute privilege to serve as your President.

On a personal note, I hope that you and your families will see good health, prosperity, and great happiness as we embark on this new decade. And, I have the same wishes for our wonderful institution, the New England Ophthalmological Society.

Best wishes, Mary K. Daly, MD President of NEOS

778th Meeting | 3 GUEST OF HONOR

DEEPINDER K. DHALIWAL, MD

Deepinder Dhaliwal, M.D. is a Professor of Ophthalmology, Director of Refractive Surgery, Division Chief of Cornea and External Disease Service, and the Program Director of the Cornea and Refractive Surgery fellowship, at the University of Pittsburgh School of Medicine, in Pittsburgh, Pennsylvania. She earned her Bachelor of Science and Doctorate of Medicine degrees in a six-year combined program at Northwestern University, in Illinois. In addition to being a member of the Honors Program in Medical Education, she was elected to the Alpha Omega Alpha Honor Society. She served as an intern in Internal Medicine at Evanston Hospital, Northwestern University/McGaw Medical Center, and completed her in Ophthalmology at the University of Pittsburgh, The Eye & Ear Institute in Pittsburgh, Pennsylvania. She was chosen to be Chief Resident in Ophthalmology, during her final year of residency. Immediately following, she moved to the University of Utah, Salt Lake City, for fellowship in Cornea/External Disease and Anterior Segment Surgery. After completion of her fellowship, she joined the Department of Ophthalmology at the University of Pittsburgh.

A well-recognized investigator in the field of cornea and refractive surgery, Dr. Dhaliwal has authored and co-authored over 80 published articles, book chapters, review articles, and abstracts in our field. Her research focuses on laser vision correction advancement and novel drug development.

As a respected leader and lecturer in our field, she is an active member of several national organizations including the American Academy of Ophthalmology, International Society of Refractive Surgery, American Society of Cataract and Refractive Surgery, Cornea Society, and the Eye Bank Association of America. She is the immediate past president of the Contact Lens Association of Ophthalmologist. Within these organizations, she has participated a Senior instructor, Invited Speaker, and Faculty at numerous annual meetings proving to be a valuable resource in her subspecialty. In addition, she serves on several committees within these organizations. She is active on the state level as a member of the Pennsylvania Academy of Ophthalmology, Pennsylvania Medical Society, and the Pittsburgh Ophthalmology Society. Dr. Dhaliwal is a proponent for advancing women in the field of ophthalmology through her active participation in Ophthalmic Women Leaders (OWL) and Women in Ophthalmology societies. Her honors and awards are extensive, highlighting her achievements throughout her professional career thus far. She has consistently been recognized in the listing of “Best Doctors in America”, selected by peers to be among the top 5% of doctors in the country, over the past two decades. In addition, she has received multiple “Top Doctor” awards over the past decade at the local, state, and national level. Of note, she has received the Senior Achievement Award, from

4 | New England Ophthalmological Society the American Academy of Ophthalmology, and was recently named “Outstanding Female Leader in Ophthalmology” from MillennialEYE.

She is the director and founder of the Center for Integrative Eye Care at the University of Pittsburgh. Beyond her ophthalmic professional accomplishments, Dr. Dhaliwal is also a licensed physician acupuncturist in the Commonwealth of Pennsylvania. She has an interest in researching alternative treatments for eye disease.

778th Meeting | 5 GUEST OF HONOR

MALVINA EYDELMAN, MD

Dr. Eydelman is a board-certified ophthalmologist. She received her M.D. degree from and a Doctorate in Health Sciences and Technology from Massachusetts Institute of Technology (M.I.T.). Dr. Eydelman received her undergraduate degree in Electrical Engineering, with a focus on Biomedical Engineering, from The Cooper Union for the Advancement of Science and Art.

Dr. Eydelman is the Director of the FDA Office of Ophthalmic, Anesthesia, Respiratory, ENT and Dental Devices. She leads a large, multidisciplinary staff in the development, implementation, execution and management of the premarket, postmarket, compliance and quality programs. For over 24 years, as an Expert Medical Officer, Senior Medical Advisor, Director of the Division of Ophthalmic, Neurological and Ear, Nose and Throat (ENT) Devices and Director of the Division of Ophthalmic and ENT Devices, Dr. Eydelman has played a key role in assuring the safety and effectiveness of medical devices. Dr. Eydelman organized multi-stakeholder public-private partnerships; oversaw development of regulations and guidance for industry; and convened over 30 public meetings of FDA Medical Device Committees. She originated numerous symposia and workshops to facilitate device innovation and has been instrumental in expediting development of novel endpoints for clinical trials of pioneering technologies.

To streamline the process for bringing more treatment options to the U.S. market, Dr. Eydelman led the development of the leap frog guidance for Minimally Invasive Glaucoma Surgery (MIGS) devices. Her vision for FDA/AAO Workshop on Developing Novel Endpoints for Premium Intraocular Lenses resulted in the Task Force’s Consensus Statements and multi-stakeholder collaboration to develop a patient-reported outcome measure for patients receiving novel IOLs.

Dr. Eydelman has spearheaded many clinical and laboratory studies designed to improve the safety and effectiveness of ophthalmic devices. She was the Principal Investigator for the FDA/National Institute of Health/Department of Defense LASIK Quality of Life Collaboration Project. This effort led to development of a valid web-based questionnaire to assess LASIK patients. Dr. Eydelman’s role as the Principal Investigator of laboratory studies included: Enhancement of safety and performance of contact lenses and their care products; and Intraocular Inflammatory Potential of Organic and Inorganic Contaminants and their contribution to Toxic Anterior Segment Syndrome. Currently, she leads FDA’s collaboration with the and the University of

6 | New England Ophthalmological Society California, San Francisco / Stanford Centers of Excellence in Regulatory Science and Innovation to determine patient preferences and develop PRO measure for glaucoma patients eligible for MIGS.

Dr. Eydelman has been granted a U.S. patent, published nearly 100 peer-reviewed articles, book chapters, and monographs, and presented over 250 lectures worldwide including 20 invited Visiting Professorships and Named Lectures. As the U.S. Expert Delegate to the International Standards Organization (ISO) and FDA’s Liaison to the American National Standards Institute‘s (ANSI) Committee, Dr. Eydelman has guided development of more than 50 ISO and ANSI standards for ophthalmic devices.

Dr. Eydelman’s expertise is relied on by a number of government and professional committees. She is a co-chair of the Translational Vision Summit Steering Committee and serves on the editorial/advisory committees for JAMA Ophthalmology, Eye & Contact Lens Journal, Ophthalmology Innovation Summit, Ophthalmology Futures Forums, Coordinated Registry Network and EnVision Summit.

Among Dr. Eydelman’s government and professional awards are: the Secretariat Award and the Achievement Award from the American Academy of Ophthalmology; the President’s Award from the American Glaucoma Society; the President’s award from Women in Ophthalmology; Special Recognition Award from Glaucoma Research Foundation; Special Congressional Recognition for outstanding and invaluable service; and Outstanding Service Award from the FDA.

778th Meeting | 7 2020 DISTINGUISHED ACHIEVEMENT AWARD

ANN BAJART, M.D. Boston, MA

It is a great privilege for NEOS to present the Distinguished Achievement Award to Ann Bajart, MD at our 778th meeting.

“There is an art to medicine as well as science, and warmth, sympathy, and understanding may outweigh the surgeon’s knife or the chemist’s drug.” Those are words from the original Hippocratic Oath, and continue on with, “If I do not violate this oath, may I enjoy life and art. May I long experience the joy of healing those who seek my help.”

Dr. Ann Bajart embodies those words. She is a patron of the arts and sciences, a sponsor of young people embarking on their careers. She has remarkably bridged the old guard with the new. She has celebrated tradition as well as change, and with the greatest of humility, she has supported so many. Dr. Bajart was one of the pioneers who broke the mold of the classic ophthalmologist when she became one of the first female residents not just at the Massachusetts Eye and Ear Infirmary, but in the field itself. Her ability to connect with different generations of ophthalmologists, past, present, and future is uncanny. Her generosity of spirit is unparalleled. Her entry onto the scene of Harvard Medical School and then at Mass Eye and Ear helped change the face of ophthalmology, and she did it in only the way Dr. Bajart could.

Dr. Bajart is a former president of this great Society. She received her training at Harvard Medical School. She completed her residency at the Massachusetts Eye & Ear Infirmary. She then went on to complete her Fellowship at Children’s Hospital Medical Center, in Pediatric Ophthalmology. She is a specialist in surgical and medical treatment of the cornea, and a partner at Ophthalmic Consultants of Boston where she has practiced for almost 30 years.

Dr. Bajart has served as a Diplomate for the National Board of Medical Examiners as well as the American Board of Ophthalmology. She is certified by the American Board of Ophthalmology and is a member of the American Academy of Ophthalmology, American Medical Association, Massachusetts Medical Society, American College of Surgeons and New England Ophthalmological Society. She has served as Medical Director of the New England Eye Bank for more than two decades.

Since 1950, NEOS has bestowed the Distinguished Achievement Award on a select few Ophthalmologists who have made valuable contributions to Ophthalmology and

8 | New England Ophthalmological Society to NEOS. Dr. Bajart is the second woman to receive this award. It is an honor for our Society to recognize the great impact Dr. Bajart has made on our field and in our community. Congratulations, Dr. Bajart. Well done and well deserved!

Mary K. Daly, MD President, NEOS

778th Meeting | 9 MORNING SESSION

ADVANCES IN CORNEAL AND ANTERIOR SEGMENT DIAGNOSTICS Nicoletta Fynn-Thompson, MD, Moderator Jeremy Kieval, MD, Program Committee Coordinator Professional Practice Gaps: Feedback from NEOS members and Program committee review identified the need for annual updates of latest developments in medical/surgical management of corneal and anterior segment disease.

Program Objectives: The content and format of this educational activity has been specifically designed to fill the practice gaps in the audience’s current potential scope of professional activities by: 1. Increasing the competence of the audience in cornea and anterior segment diagnostics 2. Improving the performance of the audience in clinical practice 3. Improving the outcome in diagnostic testing.

7:00 AM Registration / Exhibits 7:30 Best of the NEOS Hal Freeman Video Library ...... John Hancock Hall 7:30-8:15 Grand Rounds ...... Freedom Room 8:30 Introduction of Program ...... John Hancock Hall Moderator: Nicoletta Fynn-Thompson, MD 8:35 Tools for Diagnosing and Treating Endothelial Dysfunction...... Hyunjoo Lee, MD 8:45 Tear Film Testing and Meibography ...... Jason Rothman, MD 8:55 Optical Biopsies: OCT in the Evaluation of Ocular Surface Squamous Neoplasia ...... Jeremy Kieval, MD 9:05 Introduction of Guest of Honor ...... Nicoletta Fynn-Thompson, MD 9:10 Corneal Imaging Pearls in Keratoplasty Cases ...... Deepinder Dhaliwal, MD, L.Ac 9:40 NEOS Business Meeting / Distinguished Achievement Award Presentation Ann Bajart, MD ...... Mary Daly, MD ...... Michael Bradbury, MD 9:50 Refreshment break / Exhibits ...... Grand Ballroom (lower level) 10:20 Polymerase Chain Reaction for Diagnosis of Microbial Keratitis ...... Rohini Rao, MD

10 | New England Ophthalmological Society 10:30 Intraoperative Management of Astigmatism ...... JoAnn Chang, MD 10:40 Confocal Imaging in Infectious Keratitis ...... Pedram Hamrah, MD 10:50 Anterior Segment Imaging in Corneal Ectasia ...... Narae Ko, MD 11:00 Corneal Imaging Pearls in Refractive Surgery Cases ...... Deepinder Dhaliwal, MD, L.Ac 11:30 PANEL...... Nicoletta Fynn-Thompson, MD, Moderator JoAnn Chang, MD Deepinder Dhaliwal, MD, L.Ac Pedram Hamrah, MD Jeremy Kieval, MD Hyunjoo Lee, MD Rohini Rao, MD Jason Rothman, MD 11:45 Luncheon Seminar (pre-registration required): - Use of Real-World Evidence to Support Regulatory Decision-making ...... Malvina Eydelman, MD - Regulatory Decision-making and Corneal Disease ...... Deepinder Dhaliwal, MD, L.Ac - General interactive discussion ...... all luncheon participants

BE SURE TO SCAN IN AT REGISTRATION FOR AFTERNOON SESSION TO RECEIVE CREDIT

778th Meeting | 11 AFTERNOON SESSION

INNOVATION IN OPHTHALMOLOGY: BARRIERS AND BREAKTHROUGHS Deborah S. Jacobs, MD, Moderator Joel Geffin, MD, Program Committee Coordinator Professional Practice Gaps: Feedback from NEOS members and Program committee review identified the innovation pipeline, patenting, advances in dry `eye, telemedicine, impact of IRIS registry and the changing landscape the of practice ownership as areas of interest and knowledge gap. Program Objectives: The content and format of this educational activity has been specifically designed to fill the practice gaps in the audience’s current potential scope of professional activities by: 1. Providing update on initiatives for new device approval at FDA. 2. Reviewing changing trends practice ownership in the US. 3. Reviewing barriers to new drug approval in dry eye / ocular surface disease. 4. Reviewing impact of telemedicine on practice of ophthalmology

1:00 PM Introduction of Program ...... John Hancock Hall Moderator: Deborah S. Jacobs, MD 1:05 Innovation in Ophthalmology Practice Structure .... Macie Finkelstein, MD 1:15 Telemedicine: A Force for Change ...... Donald S. Fong, MD, MPH 1:25 The IRIS egistry:R Ophthalmology Breaking New Ground ...... Cynthia Mattox, MD 1:35 So You Think You Have a Good Idea? Key Steps in the Patent Process ...... Marc D. Friedman, PhD 1:45 Introduction of Guest of Honor ...... Deborah S. Jacobs, MD 1:50 FDA: A Look Inside the Black Box...... Malvina Eydelman, MD 2:10 Refreshment break / Exhibits ...... Grand Ballroom (lower level) 2:40 Addressing the Shared Challenge of Physician Burnout in Ophthalmology ...... Susannah Rowe, MD 2:50 FDA’s Role in Expediting Worldwide Innovation of Ophthalmic Medical Products ...... Malvina Eydelman, MD 3:10 Barriers and Breakthroughs in Dry Eye / Ocular Surface Disease: How Much Can New Technologies Help? ...... Reza Dana, MD, MSc, MPH

12 | New England Ophthalmological Society 3:20 Core Outcomes for Clinical Trials in Ophthalmology: Opportunities for Progress...... Ian J. Saldanha, MBBS, MPH 3:30 PANEL...... Deborah S. Jacobs, MD, Moderator Reza Dana, MD, MSc, MPH Malvina Eydelman, MD Macie Finkelstein, MD Donald S. Fong, MD, MPH Marc D. Friedman, PhD Cynthia Mattox, MD Susannah Rowe, MD 4:00 Adjourn

778th Meeting | 13 8:35 AM

TOOLS FOR DIAGNOSING AND TREATING ENDOTHELIAL DYSFUNCTION Hyunjoo Lee, MD BOSTON UNIVERSITY, BOSTON, MA

Objective: To understand the utility of various imaging modalities in diagnosing endotheli- al dysfunction, staging disease severity, and predicting the risk of corneal decompensation after cataract surgery. The corneal endothelium functions to pump fluid out of the cornea in order to maintain its clarity. Various conditions can disrupt this function, including most commonly Fuchs’ endothelial corneal dystrophy (FECD) and surgical trauma resulting in diffuse endothelial cell loss (bullous keratopathy). Before visible edema appears at the slit lamp, sub-clinical edema may be present. Specular microscopy has long been a tool for imaging of the corneal endothelium, and can help in the differential diagnosis of endothelial dysfunction, but has had limited utility when it comes to predicting the risk of corneal decompensation after cataract surgery in FECD. Central corneal thickness (CCT) was found to be a predictor for the risk of needing after cataract surgery, but is not an ideal measure as there are wide variations in normal CCT. More recently, in vivo confocal microscopy and Scheimpflug camera-based imaging have been proposed as useful tools for detecting early signs of decompensation and predicting the prognosis of FECD. Using imaging tools to determine whether endothelial dysfunction is visually significant, or likely to be after cataract surgery, could help guide treatment decisions to achieve optimal outcomes.

References: Seitzman GD, Gottsch JD, Stark WJ (2005) Cataract surgery in patients with Fuchs’ corneal dystrophy: expanding recommendations for cataract surgery without simultaneous keratoplasty. Ophthalmology 112: 441-446. van Cleynenbreugel H, Remeijer L, Hillenaar T (2014) Cataract surgery in patients with Fuchs’ endothelial corneal dystrophy: when to consider a triple procedure. Ophthalmology 121: 445-453.

Patel SV, Hodge DO, Treichel EJ, Spiegel MR, Baratz KH (2019) Predicting the Prognosis of Fuchs Endothelial Corneal Dystrophy by Using Scheimpflug Tomography. Ophthalmology.

14 | New England Ophthalmological Society 8:45 AM

TEAR FILM TESTING AND MEIBOGRAPHY Jason S. Rothman, MD OPHTHALMIC CONSULTANTS OF BOSTON, BOSTON, MA

Objective: To learn strategies how to incorporate point-of-care tear testing and meibography to better manage our dry eye patients.

Our greater understanding of the pathophysiologic mechanisms of dry eye has allowed for the development of tests to better diagnose and manage our dry eye patients. These tests have enabled us to better target therapeutic strategies and provide metrics during treatment. Tear film imaging can give insight into its stability and lipid layer thickness, while measuring lid closure dynamics can measure partial blinks, which can further contribute to both meibomian gland dysfunction and evaporative stress. Quantifying tear film osmolarity and inflammation (by measuring MMP-9) aids in early diagnosis and targeting treatment. These adjunctive tests, when interpreted in conjunction with a careful anterior segment examination, can help provide longitudinal metrics and tools for patient education. I will share strategies to interpret and incorporate these diagnostic modalities into practice.

References: Wolffsohn JS, Arita R, Chalmers R, et al. TFOS DEWS II Diagnostic Methodology report.

The Ocular Surface 2017; 544-579. Lemp MA, Bron AJ, Baudouin C, et al. Tear osmolarity in the diagnosis and management of dry eye disease. Am J Ophthalmol 2011; 151:792-8.

Sambursky R, Davitt WF, Latkany R, et al. Sensitivity and specificity of a point-of-care matrix metalloproteinase 9 immunoassay for diagnosing inflammation related to dry eye. JAMA Ophthalmol 2013;131:24-8.

778th Meeting | 15

8:55 AM

OPTICAL BIOPSIES: OCT IN THE EVALUATION OF OCULAR SURFACE SQUAMOUS NEOPLASIA Jeremy Kieval, MD LEXINGTON EYE ASSOCIATES, LEXINGTON, MA

Objective: To understand the diagnostic utility of anterior segment optical coherence tomography as a means of evaluating ocular surface squamous neoplasia.

Ocular surface squamous neoplasia (OSSN) is the most common type of malignant ocular surface lesions. The characteristic appearance of a gelatinous or leukoplakic lesion with feeder vessels makes diagnosis by clinical exam relatively straightforward. However, many lesions may have more subtle features complicating the diagnostic considerations of a benign versus malignant ocular surface lesion. Incisional or excisional biopsy with cryotherapy may be necessary in such cases to obtain a pathological diagnosis, carrying the risk of conjunctival scarring or limbal stem cell deficiency. The introduction of anterior segment optical coherence tomography (AS-OCT) has enabled assessment of the conjunctiva and cornea with high axial resolution of tissue planes. Several recent studies have demonstrated the diagnostic capabilities of AS-OCT in evaluation of OSSN with high correlation of optical images to histopathologic specimens. The use of OCT has also been studied in other applications outside of ophthalmology as a means of providing an in vivo diagnosis of carcinomas. Although histopathologic analysis remains the gold standard for diagnosis for ocular surface lesions, the application of AS-OCT as a diagnostic tool can potentially enable a non-invasive, optical biopsy for OSSN.

References: Shousha MA, Karp CL, Perez VL, Hoffmann R, Ventura R, Chang V, Dubovy SR, Wang J. Diagnosis and management of conjunctival and corneal intraepithelial neoplasia using ultra high-resolution optical coherence tomography. Ophthalmology. 2011;118:1531-7.

Kieval JZ, Karp CL, Abou Shousha M, Galor A, Hoffman RA, Dubovy SR, Wang J. Ultra-high resolution optical coherence tomography for differentiation of ocular surface squamous neoplasia and pterygia. Ophthalmology. 2012;119:481-6.

Karp CL, Mercado C, Venkateswaran N, Ruggeri M, Galor A, Garcia A, Sivaraman KR, Fernandez MP, Bermudez A, Dubovy SR. Use of High-Resolution Optical Coherence Tomography in the Surgical Management of Ocular Surface Squamous Neoplasia: A Pilot Study. Am J Ophthalmol. 2019; 206:17-31.

16 | New England Ophthalmological Society 9:10 AM

CORNEAL IMAGING PEARLS IN KERATOPLASTY CASES Deepinder K. Dhaliwal, MD, L.Ac UNIVERSITY OF PITTSBURGH SCHOOL OF MEDICINE, PITTSBURGH, PA

Objective: To understand use of OCT in preoperative and postoperative decision-making with lamellar corneal transplantation

We have experienced a revolution in keratoplasty over the past 15 years. “Selective keratoplasty” in which only the pathologic portion of the cornea is removed and replaced with donor tissue has now become standard of care. These lamellar keratoplasty techniques include endothelial keratoplasty (DSAEK and DMEK), superficial anterior lamellar keratoplasty (SALK), and deep anterior lamellar keratoplasty (DALK). Corneal imaging has become very important in diagnosing patients preoperatively, planning a surgical approach, and managing postoperative complications. Optical coherence tomography provides high resolution imaging of the cornea and anterior segment. This optical cross- section is particularly useful in situations where the cornea is edematous or opacified and the view through the slit lamp is suboptimal. Precise depth of pathology is clearly delineated with this technology.

References: Yeh, Ru-Yin et al. Predictive Value of Optical Coherence Tomography in Graft Attachment after Descemet’s Membrane Endothelial Keratoplasty. Ophthalmology, Volume 120, Issue 2, 240 – 245

Moutsouris, K., Dapena, I., Ham, L. et al, Optical coherence tomography, Scheimpflug imaging and slit-lamp biomicroscopy in the early detection of graft detachment after Descemet membrane endothelial keratoplasty. Cornea. 2011;30:1369–1375

778th Meeting | 17

10:20 AM

POLYMERASE CHAIN REACTION FOR DIAGNOSIS OF MICROBIAL KERATITIS Rohini Rao, MD BOSTON MEDICAL CENTER, BOSTON, MA

Objective: To provide an overview of the utility of polymerase chain reaction (PCR) in the diagnosis of microbial keratitis

Background: Prompt and targeted antimicrobial therapy is critical for effective treatment of microbial keratitis. However, corneal scraping and culture suffers from a number of limitations, including low yield, delayed results, and inability to identify certain organisms. Recent developments allowing detection of pathogenic DNA through polymerase chain reaction (PCR) has improved the efficiency and accuracy of diagnosis.

Literature Review: This talk will first present a basic overview of the steps of PCR to develop a familiarity with this technique. It will then review some of the larger studies demonstrating the advantages of PCR over culture-based diagnostics in bacterial, viral, fungal, and acanthamoeba keratitis. It will also present practical information about PCR- based diagnosis, including the necessary infrastructure and associated costs. Finally, it will describe potential drawbacks of the technique relative to culture-based methods, including false positives and inability to detect the unknown or unexpected.

References: Kim E, Chidambaram JD, Srinivasan M, et al. Prospective comparison of microbial culture and polymerase chain reaction in the diagnosis of corneal ulcer. Am J Ophthalmol. 2008;146:714–23.

Tananuvat N, Salakthuantee K, Vanittanakom N, et al. Prospective comparison between conventional microbial work-up vs PCR in the diagnosis of fungal keratitis. Eye (Lond). 2012;26:1337–1343.

Eleinen KG, Mohalhal AA, Elmekawy HE, et al. Polymerase chain reaction-guided diagnosis of infective keratitis-a hospital-based study. Curr Eye Res. 2012;37:1005–1011.

18 | New England Ophthalmological Society 10:30 AM

INTRAOPERATIVE MANAGEMENT OF ASTIGMATISM JoAnn Chang, MD D’AMBROSIO EYECARE, LANCASTER, MA

Objective: Review current available methods to correct astigmatism intraoperatively with cataract surgery

With increasing patient expectations, refractive outcomes after cataract surgery have become a critical factor in the successful treatment of patients with cataracts. Cataract surgeons need to be familiar with correction of astigmatism. There are several options available for intraoperative treatment of astigmatism at the time of cataract surgery. Corneal astigmatic incisions (CAI), including limbal relaxing incisions (LRI) and astigmatic keratotomy (AK) are used to correct low levels of astigmatism. CAI’s can either be performed with a blade or with a femtosecond laser. Toric intraocular lens is excellent option for correction of lower and higher levels of astigmatism. In spite of currently available treatments, significant residual astigmatism can still be seen in patients following cataract surgery. Incorporating newer technologies such as intraoperative aberrometry and image guided systems can help achieve the refractive outcomes our patients expect.

References: N/A

778th Meeting | 19 10:40 AM

CONFOCAL IMAGING IN INFECTIOUS KERATITIS Pedram Hamrah, MD TUFTS MEDICAL CENTER, BOSTON, MA

Objective: To review the utility of in vivo confocal microscopy on microbial keratitis

In vivo confocal microscopy (IVCM) is an emerging technology that provides minimally invasive, high resolution, assessment of the ocular surface at the cellular level. Several challenges still remain but, at present, IVCM may be considered a promising technique for clinical diagnosis and management of infectious keratitis that will be reviewed in this presentation. Delayed diagnosis of Acanthamoebaand fungal keratitis is typical, resulting in significant vision loss. This is partially due to the low sensitivity and time delay of corneal cultures. IVCM allows prompt diagnosis, disease course follow-up, and management of potentially blinding atypical forms of infectious processes, such as Acanthamoebaand fungal keratitis, among others. IVCM is emerging as a tool for rapid diagnoses in severe infectious keratitis with high sensitivity. In addition, it can be used to monitor treatment response, allowing guidance to clinicians for medical or surgical management.

References: Villani E, Baudouin C, Efron N, Hamrah P, Kojkoj T, Patel S, Pflugfelder S, Zhivov A, Dogru M. In vivo confocal microscopy of the ocular surface: from bench to bedside. Curr Eye Res. 2014; 39:213-231.

Kumar R, Hamrah P. Current State of In Vivo Confocal Microscopy in Management of Microbial Keratitis. Semin Ophthalmol. 2010; 25(5-6):166-170.

Labbé A, Khammari C, Dupas B, Gabison E, Brasnu E, Labetoulle M, Baudouin C. Contribution of in vivo confocal microscopy to the diagnosis and management of infectious keratitis. Ocul Surf. 2009 Jan;7(1):41-52.

20 | New England Ophthalmological Society

10:50 AM

ANTERIOR SEGMENT IMAGING IN CORNEAL ECTASIA Narae Ko, MD NEW ENGLAND EYE CENTER, BOSTON, MA

Objective: Understand the advances in corneal tomography and anterior segment optical coherence tomography and their utility in evaluation of corneal ectasia

Advances in anterior segment imaging have improved our ability to detect early keratoconus, document disease progression, monitor efficacy of corneal cross-linking, and assess for ectasia risk in refractive screening. Modern corneal tomography, such as Pentacam (OCULUS, Germany) and Gallilei (Ziemer, Switzerland) use Scheimpflug camera to measure anterior and posterior corneal surfaces and anterior lens. This allows detection of early ectasia which typically manifests in posterior changes prior to anterior. Use of Enhanced Reference Surface in Pentacam, which excludes 3.0 to 4.0mm optical zone from the Best Fit Sphere, exaggerates any posterior ectasia. Belin-Ambrosio Enhanced Ectasia Display (BAD) and ABCD Grading System available in Pentacam are useful programs for refractive screening and keratoconus staging. Epithelial thickness mapping using Optical Coherence Tomography (OCT) has expanded our understanding of epithelial remodeling. The epithelial thinning observed in early ectasia versus thickening observed in contact lens warpage over maximal corneal power in suspicious cases can be beneficial in refractive screening.

References: Hwang, ES et al. Surv Ophthalmol (2019); 1-18.

Duncan, JK et al. Eye and Vision (2016); 3 (6).

Schallhorn, JM. J Cataract Refract Surg (2017); 43 (1).

778th Meeting | 21 11:00 AM

CORNEAL IMAGING PEARLS IN REFRACTIVE SURGERY CASES Deepinder Dhaliwal, MD UNIVERSITY OF PITTSBURGH SCHOOL OF MEDICINE, PITTSBURGH, PA

Objective: To understand benefit of OCT imaging of the cornea and anterior segment for preoperative and postoperative refractive surgery management.

Refractive surgery in 2020 is very exciting with options for patients with a broad range of refractive errors. Both corneal-based (LASIK, PRK, SMILE) and lens-based (Visian ICL) procedures are available. It is important to have proper patient selection and to match the correct procedure for each patient. Corneal imaging with topography and tomography is critical to understand corneal shape in order to screen patients for refractive surgery and to assess postoperative results and stability. Scheimpflug imaging is particularly helpful in identifying early ectasia and in assessing anterior chamber depth.

Anterior segment OCT is an important tool in assessing depth of corneal scars, residual corneal stromal bed thickness in cases that may need enhancements, and in sizing for phakic IOLs.

References: N/A

22 | New England Ophthalmological Society 1:05 PM

INNOVATION IN OPHTHALMOLOGY PRACTICE STRUCTURE Macie Finkelstein, MD BOSTON EYE GROUP, BROOKLINE, MA

Objective: To discuss changes in how ophthalmology practices can be structured, with an emphasis on the recent role of private equity.

50 years ago most ophtahlmologists had 2 practice structures- private and hospital based. Over the decades there were “tweaks” to these 2 models. Multispecialty practices flourished, and hospital practices expanded both within hospitals and out into the community. HMO’s developed their own in house practices, to take advantage of captive “members” (i.e. patients). And, private equity has become aware that there are inefficiencies in the health care system, including in ophthalmology, that make them attractive targets for restructuring. I will discuss how PE firms plan to recoup their investments, and what benefits they can bring to practices they acquire.

References: N/A

778th Meeting | 23

1:15 PM

TELEMEDICINE: A FORCE FOR CHANGE Donald S. Fong, MD, MPH Kaiser Permanente, Irwindale, CA Bobeck Modjtahedi, MD SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP, BALDWIN PARK, CA

Objective: Discuss impact of telemedicine on ophthalmology Changes in patient expectations and market forces require re-thinking our approach to care delivery. Both physicians and patients want care that’s affordable and high quality. At Kaiser Permanente, efforts have been made to leverage technology and systems to create new care delivery paradigms to screen and monitor diabetic retinopathy, hydroxychloroquine toxicity screening, age-related macular degeneration monitoring, and glaucoma suspect monitoring. This talk will discuss methods that improve patient outcomes and access, while creating more sustainable solutions utilizing telemedicine.

References: Hudson SM, Contreras R, Kanter MH, Munz SJ, Fong DS. Centralized Reading Center Improves Quality in a Real-World Setting. Ophthalmic Surg Lasers Imaging Retina. 2015 Jun. 46(6):624-629.

Modjtahedi BS, Theophanous C, Chiu S, Luong TQ, Nguyen N, Fong DS. Two-Year Incidence of Retinal Intervention in Patients with Minimal or No Diabetic Retinopathy on Telemedicine Screening. JAMA Ophthalmol. 2019;137:445-448.

Modjtahedi BS, Chu K, Luong TQ, Hsu C, Mattox C, Lee PP, Nakla ML, Fong DS. Two-year outcomes of a pilot glaucoma suspect telemedicine monitoring program. Clin Ophthalmol. 2018; 12:2095-2102.

24 | New England Ophthalmological Society 1:25 PM

THE IRIS REGISTRY: OPHTHALMOLOGY BREAKING NEW GROUND Cynthia Mattox, MD AAO, MAKAWAO, HI

Objective: To understand the use of the IRIS ™ clinical data registry in clinical research and care outcomes

The IRIS clinical data registry has become the largest clinical registry of any medical specialty in the world. By capturing electronic data from the medical record seamlessly throughout the U.S., many critical aspects of clinical care and outcomes can be investigated. Research and publications are emerging that will help guide future care and identify gaps in care that will ultimately improve eye health and quality of life for our patients. The data in IRIS and recent research findings will be reviewed.

References: Endophthalmitis after Cataract Surgery in the United States: A Report from the Intelligent Research in Sight Registry, 2013–2017 Suzann Pershing, Flora Lum, Stephen Hsu, Scott Kelly, Michael F. Chiang, William L. Rich III, David W. Parke II Ophthalmology Published online: August 28, 2019. Treatment Patterns for Diabetic Macular Edema: An Intelligent Research in Sight (IRIS®) Registry Analysis Ronald A. Cantrell, Flora Lum, Yifeng Chia, Lawrence S. Morse, William L. Rich III, Craig A. Salman, Jeffrey R. Willis Ophthalmology Published online: October 23, 2019.

Return To The Operating Room For Removal Of Retained Lens Fragments After Cataract Surgery: Iris® Registry Analysis Michael A. Mahr, Flora Lum, Danielle Fujino, Scott P. Kelly, Jay C. Erie Ophthalmology Published online: November 28, 2019.

778th Meeting | 25

1:35 PM

SO YOU THINK YOU HAVE A GOOD IDEA? KEY STEPS IN THE PATENT PROCESS. Marc Friedman, PhD PRAGMATIC IP, LLC, NEEDHAM, MA

Objective: Participants will come away with an understanding of what a patent is and why they might want a patent. They will appreciate the importance of creating an initial budget and learn how to perform the initial steps in the Patent Process.

A patent is a limited right granted to an inventor by a government to exclude others from making, using, selling or importing that invention for a specific period of time. For this limited right, the inventor agrees to share the details or teachings of the invention with the pubic to encourage innovation and therefore economic growth. The first step in the patent process is to determine “Why” you want a patent. Companies typically utilize patents to allow them freedom to operate and to generate funds through sale or licensing. Most patents do not make the inventor money, therefore having a good economic argument is essential as the patent process is laborious and expensive. Create a limited budget of what you are willing to initially spend. The next step is to research your invention on the USPTO website to see if it is unique or novel. You can’t patent something that has already been invented by someone else. If you decide to go forward, you should initially consider filing a provisional patent as the Patent System is based on a “First to file” system. The inventor that gets to the patent office first owns the invention. A Provisional Patent Application never becomes a patent, but it allows you to lock in a priority date for your invention and the potential right to that invention for 1 year. This can be done by a Patent Agent or Lawyer but can also be done by you on the USPTO website. The USPTO has complete instructions and the filing cost for a small entity is currently $140. There are also a number of on-line “kits” to help you through the process. If you do it yourself, it is extremely important that you describe and document your invention as thoroughly and completely as possible. Having completed these steps, it is time to find, consult with and hire a Patent Agent or Lawyer to file a Non-provisional Utility Patent Application which, after successfully being prosecuted at the USPTO, becomes the granted patent for your invention.

References: USPTO Website: https://www.uspto.gov/; Manual of Patent Examining Procedure (MPEP) https://www.uspto.gov/web/offices/pac/mpep/index.html; IPWatchdog.com “Do it yourself Provisional Patent System” https://www.ipwatchdog.com/patent/invent-patent-system/

26 | New England Ophthalmological Society 1:50 PM

FDA: A LOOK INSIDE THE BLACK BOX Malvina Eydelman, MD U.S. FOOD AND DRUG ADMINISTRATION, WASHINGTON, D.C.

The Food and Drug Administration is responsible for protecting the public health by ensuring the safety, efficacy, and security of human and veterinary drugs, biological products, and medical devices; and by ensuring the safety of our nation’s food supply, cosmetics, and products that emit radiation.

This talk will focus on FDA’s impact on Ophthalmology. The following topics will be included: Organizational components; Regulatory framework; Definition of all medical products; Regulation of Total Product Life Cycle of Medical Devices and its implications.

References: N/A

778th Meeting | 27 2:40 PM

ADDRESSING THE SHARED CHALLENGE OF PHYSICIAN BURNOUT IN OPHTHALMOLOGY Susannah Rowe, MD BOSTON MEDICAL CENTER, BOSTON, MA

Objective: Describe the prevalence, drivers and features of physician burnout in ophthalmologists, and review strategies to reduce burnout and increase professional fulfillment Physician burnout is epidemic, with approximately half of physicians nationally reporting significant symptoms. Burnout in physicians is a syndrome characterized by emotional exhaustion, a loss of a sense of meaning and effectiveness in work, and emotional distancing from others. While burnout has been associated with an increased risk of suicide, it is neither a mental illness nor evidence of personal weakness, but rather a predictable response to prolonged, unmanageable work stress. Ophthalmologists are not immune to burnout, although we appear to fare better than surgeons in some other specialties. We will review findings from a multicenter validated survey examining rates of burnout, professional fulfillment and intent-to-leave and related drivers among ophthalmology faculty and trainees in the US in comparison with national benchmarks from other surgical fields. We will then provide an overview of systems- based and organizational interventions that have proved effective in reducing burnout. We will close by highlighting some individual and community-based strategies that can be employed even in the face of difficult systemic challenges, and that can be powerful tools to reduce burnout and increase professional fulfillment.

References: Physician burnout: contributors, consequences and solutions. West CP, Dyrbye LN, Shanafelt TD. J Intern Med. 2018 Jun;283(6):516-529. doi: 10.1111/ joim.12752. Epub 2018 Mar 24. Addressing Physician Burnout: The Way Forward. Shanafelt, T et al: https://mfprac.com/ web2019/07literature/literature/Misc/Burnout2_Shanafelt.pdf. AMA Steps Forward https://edhub.ama-assn.org/steps-forward/module/2702509. Rowe, S. et al: Defending the Term “Burnout”: A Useful Tool in the Quest to Ease Clinician Suffering. https://catalyst.nejm.org/doi/full/10.1056/CAT.19.0631.

28 | New England Ophthalmological Society 2:50 PM

FDA’S ROLE IN EXPEDITING WORLDWIDE INNOVATION OF OPHTHALMIC MEDICAL PRODUCTS Malvina Eydelman, MD U.S. FOOD AND DRUG ADMINISTRATION, WASHINGTON, D.C.

Objective: This talk will describe FDA’ Center for Devices and Radiological Health (CDRH) multi-prong approach to increase patient access to innovative ophthalmic medical devices in the United States and world-wide. FDA is responsible for advancing the public health by helping to speed innovations that make medical products more effective, safer, and more affordable and by helping the public get the accurate, science-based information they need to use medical products and foods to maintain and improve their health.

References: N/A

778th Meeting | 29

3:10 PM

BARRIERS AND BREAKTHROUGHS IN DRY EYE / OCULAR SURFACE DISEASE: HOW MUCH CAN NEW TECHNOLOGIES HELP? Reza Dana, MD, MSc, MPH MASS EYE AND EAR, HARVARD MEDICAL SCHOOL, BOSTON, MA

Objective: To introduce the audience to the challenges the field has faced in development of new treatments for dry eye / ocular surface disease

Dry Eye Disease (DED) and related ocular surface disorders comprise the most common ophthalmic conditions affer refractive disorders. While less than 20% of DED sufferers use medications, in the US alone the DED therapeutics market is over 1.5 billion USD, a fact that underscores the immense pent up need in this space. However, the vast majority of new technologies being developed in this space fail in late stage (post-phase II) clinical development. Why? Causes are numerous, but the most common failure is the lack of strong correlation between signs and symptoms using the commonly used metrics for symptoms (e.g. OSDI) and ‘signs’ (corneal fluorescein staining using the NEI grading scheme). This lack of correlation has led, in our opinion, to the erroneous conclusion that the objective signs of disease in DED are fundamentally poor measures of disease severity. This has led to the search for new ‘biomarkers’, which in turn have also had a poor record of correlating with symptomrs. So where is the field now? There is general confusion as to how to ascertain disease severity, how to use biomarkers to diagnose disease vs. assess response to therapy, and defining the best metrics to use to assess patient comfort. This talk will provide a brief overview of these factors, and introduce some of the new technologies that have been introduced to bring power and accuracy in the assessmemnt of the signs and symptoms in ocular surface disease.

References: Web-based longitudinal remote assessment of dry eye symptoms. Amparo F, Dana R. Ocul Surf. 2018 Apr;16(2):249-253. doi: 10.1016/j.jtos.2018.01.002. PMID: 29409963.

The Ocular Redness Index: a novel automated method for measuring ocular injection. Amparo F, Wang H, Emami-Naeini P, Karimian P, Dana R. Invest Ophthalmol Vis Sci. 2013 Jul 18;54(7):4821-6. doi: 10.1167/iovs.13-12217. PMID: 23766472.

Evaluating Corneal Fluorescein Staining Using a Novel Automated Method. Amparo F, Wang H, Yin J, Marmalidou A, Dana R. Invest Ophthalmol Vis Sci. 2017 May 1;58(6):BIO168-BIO173. doi: 10.1167/iovs.17-21831. PMID:28693042.

Characteristics and Risk Factors Associated With Diagnosed and Undiagnosed Symptomatic Dry Eye Using a Smartphone Application. Inomata T, Iwagami M, Nakamura M, Shiang T, Yoshimura Y, Fujimoto K, Okumura Y, Eguchi A, Iwata N, Miura M, Hori S, Hiratsuka Y, Uchino M, Tsubota K, Dana R, Murakami A. JAMA Ophthalmol. 2019 Nov 27. doi: 10.1001/jamaophthalmol.2019.4815. 30 | New England Ophthalmological Society 3:20 PM

CORE OUTCOMES FOR CLINICAL TRIALS IN OPHTHALMOLOGY: OPPORTUNITIES FOR PROGRESS Ian J. Saldanha, MBBS, MPH BROWN UNIVERSITY CENTER FOR EVIDENCE SYNTHESIS IN HEALTH, PROVIDENCE, RI

Objective: To summarize challenges with diversity in outcome use in ophthalmology research and the opportunities that core outcome sets can present.

Inconsistency in the outcomes that are reported in clinical trials in various areas of ophthalmology presents great challenges to decisionmakers (clinicians, patients, guideline developers) when deciding which treatments work best for which patients.1 Additionally, the outcomes reported in clinical trials are often not relevant to those decisionmakers.2

A “core outcome set” is a minimum set of outcomes (usually 5 to 7), agreed on by various stakeholders, that will be measured and reported in all clinical trials addressing a given disease or treatment.3 In other fields, core outcome sets have often streamlined outcome and measurement and reporting, which facilitates decision-making. This presentation will discuss the opportunities that core outcome sets can present to the field of ophthalmology, highlight some of the ongoing work on this front, and explore some of the challenges and potential solutions.

References: Saldanha IJ, Le JT, Solomon SD, Repka MX, Akpek EK, Li T. Choosing core outcomes for use in clinical trials in ophthalmology: Perspectives from three Ophthalmology Outcomes Working Groups. Ophthalmol. 2019. 126(1):6-9. 2.

Heneghan C, Goldacre B, Mahtani KR. Why clinical trial outcomes fail to translate into benefits for patients. Trials. 2017;18(1):122. 3.

Williamson PR, Altman DG, Blazeby JM, et al. Developing core outcome sets for clinical trials: issues to consider. Trials. 2012;13:132.

778th Meeting | 31

FINANCIAL DISCLOSURE INFORMATION

As a provider accredited by the Massachusetts Medical Society, NEOS must ensure balance, independence, objectivity, and scientific rigor in all its individually and jointly provided educational activities. All individuals in a position/role to control the content of an activity are expected to disclose to NEOS any relevant financial relationships they and their spouse/partner have with commercial interests.

The ACCME defines a commercial interest as any entity producing, marketing, reselling or distributing health care goods or services consumed by, or used on, patients. Relevant financial relationships are financial relationships in any amount, which occurred in the twelve-month period preceding the time that the individual was asked to assume a role controlling content of the CME activity, and which relate to the content of the educational activity.

Financial relationships are those relationships in which the individual benefits by receiving a salary, royalty, intellectual property rights, consulting fee, honoraria, ownership interest (e.g., stocks, stock options or other ownership interest, excluding diversified mutual funds), or other financial benefit. Financial benefits are usually associated with roles such as independent contractor (including contracted research), consulting, promotional speaking and teaching, membership on advisory committees or review panels, board membership, and other activities for which remuneration is received or expected. The MMS/ACCME considers relationships of the person involved in the CME activity to also include financial relationships of a spouse or partner.

Arroyo, Jorge: Ownership Interest: Envision Diagnostics

Bradbury, Michael: Ownership Interest: Regeneron, Chase and Associates, Inc (Iviews imaging system)

Chang, JoAnn: Fees for Non-CME Services Received Directly from Commercial Interest or their Agents: Restasis, Speaker

Dagianis, John: Fees for Non-CME Services Received Directly from Commercial Interest or their Agents: Lumenis, Speaker Bureau

Dhaliwal, Deepinder K.: Consulting Fees - Name of Relevant Commercial Entity(ies): Johnson & Johnson; Novartis Fees for Non-CME Services Received Directly from Commercial Interest or their Agents: Lecture Fees: CorneaGen; Ocular Therapeutix; STAAR Surgical. 32 | New England Ophthalmological Society Friedman, Marc: Salary - Name of Relevant Commercial Entity(ies): Pragmatic IP, LLC

Ownership Interest - Name of Relevant Commercial Entity(ies): Glaukos

Heier, Jeffrey: Consulting Fees - Name of Relevant Commercial Entity(ies): 4D Molecular Technologies, Adverum, Aerie, Aerpio, Akros, Aldeyra, Alkahest, Allegro, Apellis,Array, Asclepix, Bayer, BVI, BioMarin, Daiichi- Sankyo, Eloxx, Galecto, Galimedix, Genentech/Roche, Generation Bio, Helio, Interface, iRenix, Janssen R&D, jCyte, Kala, Kanghong,Kodiak, Notal Vision, Novartis, Ocular Therapeutix, Omeicos, Orbit Biomedical, Oxurion, Regeneron, Regenxbio, Retrotope, Scifluor, Shire, Stealth Biotherapeutics, Voyant, Zeiss Contracted Research - Name of Relevant Commercial Entity(ies): Aerpio, Apellis, Clearside, Daiichi Sankyo, Genentech/Roche, Genzyme, Hemera, Janssen R&D, Kalvista, Kanghong, Novartis, Ocudyne, Ophthotech, Optos, Optovue, Oxurion, Regeneron, Regenxbio, Scifluor Ownership Interest - Name of Relevant Commercial Entity(ies): Adverum, Aldeyra, Allegro, Digital Surgery Systems, jCyte, Ocular Therapeutix

Kieval, Jeremy: Consulting Fees: Shire, Johnson & Johnson Vision, Sun Pharmaceuticals, Biotissue Fees for Non-CME Services Received Directly from Commercial Interest or their Agents: Shire, Johnson & Johnson Vision, Sun Pharmaceuticals, Biotissue

Mattox, Cynthia: Consulting Fees: Aerie, Alcon, Allergan, Glaukos, Ivantis, New World Medical, RegenXBIO

Modjtahedi, Bobeck: Contracted Research: Genetech

Reza, Dana: Royalty: Royalty payments through licensing by Mass Eye and Ear of the SANDE questionnaire in dry eye patients Receipt of Intellectual Property Rights/Patent Holder: Inventor on MEE IP on targeting cytokines for management of ocular surface disease and inflammation and using biologic agents to suppress corneal inflammation and induce tissue regeneration

778th Meeting | 33 Consulting Fees: Aldeyra, Dompé, GSK, Kala, Santen Ownership Interest: Aramis Biosciences, Claris Biotherapeutics

Rizzo, Joseph: Receipt of Intellectual Property Rights/Patent Holder: Bionic Eye Technologies Consulting Fees: GenSight Ownership Interest: Bionic Eye Technologies

NO FINANCIAL INTEREST None of the other individuals in a position to control the content of this activity, including planners, CME Review Committee members, faculty presenters, moderators, panelists and reviewers have any relevant financial relationship with an ACCME-defined commercial interest to disclose.

34 | New England Ophthalmological Society FUTURE NEOS MEETINGS

BACK BAY EVENTS CENTER 180 Berkeley Street, Boston, MA DATE TOPIC MODERATOR New Drugs in Ophthalmology – Lucia Sobrin, MD April 24 Drips to Drops Retina Peter Chang, MD Ocular Trauma Magdalena Krzystolik, MD June 5 Subday: Neuro-ophthalmology Crandall Peeler, MD Uveitis Ninani Kombo, MD Strabismus Oren Weisberg, MD

HOTEL COMMONWEALTH 500 Commonwealth Avenue, Boston, MA DATE TOPIC MODERATOR Retina-Diabetes Nauman Chaudhry, MD October 30, 2020 Plastics – Trauma Daniel Lefebvre, MD Infectious Uveitis Pryja Janardhana, MD December 4, 2020 Cataract Lauren Shatz, MD TWO DAY MEETING Glaucoma Manishi Desai, MD (Friday/Saturday) March 12, 2021 Neuro-ophthalmology Emergencies Marc Bouffard, MD

Ethics and Risk Management Mary Daly, MD March 13, 2021 Practice Management John Mandeville, MD Excimer Based Refractive Surgery Jason Brenner, MD May 14, 2021 Corneal Surgery Peggy Chang, MD

778th Meeting | 35 THE BOARD AND COMMITTEES 2019-2020

The Board Mary Daly, MD, President Jorge Arroyo, MD, President-elect Jay Duker, MD, Vice-President, Chair Admissions Committee Donna Siracuse-Lee, MD, Secretary Laura Fine, MD, Immediate Past President, Chair Nominations Committee John Dagianis, MD, Past President, Chair Policies Committee Jeffrey Heier, MD, Past President Joseph Rizzo, MD, Treasurer, Chair Finance Committee Joel Geffin, MD, Chair Program Committee Michael Price, MD, Chair Educational Endowment Fund Committee Phil Aitken MD, Chair Ophthalmic Services Committee Brendan McCarthy, MD, Chair Public Health and Education Committee Angela Turalba, MD, Director of Continuing Education Anita Shukla, MD, Chair Young Ophthalmologists Committee Michelle Liang, MD, Chair, I.T. Committee Michael Bradbury, MD, Executive Director

COMMITTEES: ex officio members: Executive Committee Drs. Bradbury, Siracuse-Lee, Fine, Heier, Levy) Mary Daly, President Jorge Arroyo, MD, President-elect Joseph Rizzo MD, Treasurer Program Committee Michael Bradbury, MD, Joel Geffin, MD, Chair Executive Director (ex officio) Fina Barouch, MD Edward Feinberg, MD Admissions Committee Gena Heidary, MD Jay Duker, MD, Chair Jeremy Kieval, MD Mary Daly, MD John Papale, MD Shlomit Schaal, MD Finance Committee Lucia Sobrin, MD Joseph Rizzo, MD, Chair Angela Turalba, MD Mary Daly, MD Michael Yoon, MD Jorge Arroyo, MD (ex officio) Laura Fine, MD (ex officio) Michael Bradbury, MD (ex officio) Mary Daly, MD (ex officio) Michael Bradbury, MD (ex officio) Nominations Committee Laura Fine, MD, Chair Public Health and Education Committee Ann Bajart, MD (MA) Brendan McCarthy, MD, Chair Mitchell Gilbert, MD (CT) Sherleen Chen, MD Elliot Perlman, MD (RI) Robert Daly, MD Christopher Soares, MD (VT) Macie Finkelstein, MD David Weinberg, MD (NH) Magdalena Krzystolik, MD 36 | New England Ophthalmological Society Vasiliki Poulaki, MD Young Ophthalmologists Committee Christopher Soares, MD Anita Shukla, MD, Chair Cathryn Welch, MD Joanne Chang, MD Mary Daly, MD (ex officio) Jeffrey Heier, MD John Dagianis, MD (ex officio) Stephen Anesi, MD Nicole Siegal, MD Society Policies Committee Jennifer Cartwright Garvey, MD John Dagianis, MD, Chair Elizabeth Houle, MD Michael Bradbury, MD Hyunjoo Lee, MD Michelle Liang, MD Ophthalmic Services Committee Dan Lefebvre, MD Phil Aitken, MD, Chair Joshua Ney, MD Husam Ansari, MD Archana Seethala, MD Timothy Blake, MD Jorge Arroyo MD (ex officio) John Dagianis, MD Michael Bradbury (ex officio) Nicoletta Fynn-Thompson, MD Michael Price, MD (ex officio) Kathryn Hatch, MD Marc Leibole, MD David Vazan, MD Miguel G. Ocque, Administrative Director Robert Westcot, MD Peter Zacharia, MD Jorge Arroyo, MD (ex officio) Laura Fine, MD (ex officio)

Committee for Educational Endowment Fund Michael Price, MD, Chair Thomas Coghlin, MD John Dagianis, MD Francis D’Ambrosio, MD Richard Dornfeld, MD Matthew Gardiner, MD Grace Lee, MD David Lawlor, MD Joseph Rizzo, MD

Information Technology Committee Michelle Liang, MD, Chair David Ramsey, MD Naveen Rao, MD Ankoor Shah, MD Johanna Seddon, MD Jorge Arroyo, MD Elliot Perlman, MD, (emeritus) Mary Daly, MD (ex officio)

778th Meeting | 37 TODAY’S EXHIBITORS (at time of printing)

Aerie Pharmaceuticals Glaukos Optos 203.901.8851 949.367.9838 800.854.3039 www.aeripharma.com www.glaukos.com www.optos.com

Alcon - SPONSOR Horizon Therapeutics Optovue 817.293.0450 847.233.1044 510.623.8868 www.alconlabs.com www.horizontherapeutics.com www.optovue.com

Allergan Hunt Valley PharmaLAB ScienceBased Health 774.991.1187 410.667.6246 281.885.7727 www.allergan.com www.hvpcc.com/ www.sbh.com

Bausch & Lomb Iridex Shire - SPONSOR 215.671.8836 www.iridex.com 781.869.7620 www.shire.com Bio-Tissue Ivantis, Inc 508.808.3017 781.424.4982 Sun Ophthalmics www.biotissue.com www.ivantisinc.com 609.720.5629 www.sunophthalmics.com Capital One Spark Business J&J Surgical Vision 617.687.3395 TearLab Corp www.capitalone.com/small-busi- Mallinckrodt 315.657.0959 ness/credit-cards/ 908.238.6607 www.TearLab.com www.mnk.com CorneaGen Zeiss Meditec, Inc 336.516.9631 Microsurgical Technology 925.856.2574 www.corneagen.com www.zeiss.com/med Nova Bay Dompé 351.201.9593 833.366.7387 www.novabay.com www.dompe.com OSRX Eversight 855-466-1076 800.247.7250 OSRXPharmaceuticals.com www.eversightvision.org Ophthalmic Instrument Eyepoint Pharmaceuticals Company 833.393.7646 800.272.2070 www.eyepointpharma.com www.oic2020.com

Genentech Omeros Corp. 800.551.2231 206.676.5000 www.gene.com www.omeros.com

38 | New England Ophthalmological Society NEW ENGLAND OPHTHALMOLOGICAL SOCIETY EDUCATIONAL ENDOWMENT FUND DONORS

Diamond Patrons Dr. Delia Sang and Dr. Mark Hughes In memory of Dr. Charles L. Schepens $100,000 or more Dr. Gerald Spindel In honor of Israel and Rose Spindel and Dr. Michael J. Bradbury Benjamin Burch In memory of Dr. C. Davis Belcher In memory of Dr. Hal M. Freeman Dr. C. Stephen Foster Gold Patrons $3,000-$9,999 Massachusetts Eye and Ear Infirmary In honor of Dr. Dr. Jorge Arroyo Dr. and Mrs. Paul M. Pender Dr. William Atlee In Memory of Paul D. Pender and Dr. Ann Bajart Harry V. Carey In honor of Judy Cerone Keenan Dr. and Mrs. Richard J. Simmons Drs. A. Robert and Jean Bellows In memory of Dr. Ruthanne Simmons In memory of Dr. W. Morton Grant Ophthalmic Consultants of Boston Dr. Thomas Coghlin Physicians and Patients In honor of Dr. Mary Daly, Dr. Ira In honor of Dr. B. Thomas Hutchinson Asher, Dr. Kevin O’Brien, and Dr. Reid Appleby, Jr. Dr. and Mrs. Paul P. Dunn Platinum Patrons In memory of Dr. C. Davis Belcher and $10,000 to $99,999 in honor of Dr. A. Robert Bellows Dr. Joel Geffin Boston Eye Research Dr. C. Mitchell Gilbert In memory of Dr. Sanford Hecht In honor of Drs. Claes Dohlman, Dr. John Dagianis Kenneth Kenyon, and Martin Wand In memory of Dr. Hal M. Freeman, Dr. and Mrs. Donald Kaplan In honor of James and Eleanor In memory of Dr. Robert Vernlund Dagianis, and Paul and Verna Dobbins Jean Keamy for the Keamy Family Dr. and Mrs. Stuart DuBoff Foundation In memory of Dr. Ruthanne Simmons In memory of Donald and In honor of Samuel and Gloria DuBoff Yvonne Keamy and William and Diane Brown Maine Society of Eye Physicians and Dr. Hal M. Freeman Surgeons Dr. Albert R. Frederick, Jr. New England Lens Implant Society In honor of B. Thomas Hutchinson In memory of Dr. Sanford Hecht Dr. and Mrs. Joseph J. Greco Dr. and Mrs. Elliot Perlman The Health Foundation of Central In memory of Drs. C. Davis Belcher Massachusetts and Kathleen Maguire In honor of Dr. Michael J. Bradbury Dr. Michael Raizman HOYA Optical Laboratories Dr. Shiyoung Roh and Mrs. Myung Ja Dr. B. Thomas Hutchinson Roh New Hampshire Society of Eye Physicians Drs. Helen and Jack Schinazi and Surgeons In memory of Dr. C. Davis Belcher 778th Meeting | 39 Dr. and Mrs. John Sebestyen Dr. Bernard Heersink In memory of Dr. Taylor R Smith Dr. Jeffrey Heier Dr. Bradford J. Shingleton Dr. Ralph Hinckley In honor of Drs. Albert R. Frederick, Dr. William S. Holt B. Thomas Hutchinson, Silvio Von Dr. Robert T. Lacy Pirquet and A. Robert Bellows Dr. Joseph Levy Drs. Richard and Ruthanne Simmons In honor of Dr. Thomas Hedges III In memory of Dr. W. Morton Grant Dr. Byron S. Lingeman Dr. and Mrs. Richard J. Simmons Dr. Richard Low In memory of Drs. Paul A. Chandler, Dr. Kathleen Maguire and Stephen Burke W. Morton Grant, Ruthanne Simmons, In memory of Dr. Hal M. Freeman and C. Davis Belcher Dr. Lisa McHam Dr. and Mrs. Paul Wasson Dr. Clifford Michaelson In memory of Dr. Paul Wasson In memory of Dr. Jesse and Mrs. Ruth In memory of Dr. Oscar Hollander Lee Michaelson Dr. and Mrs. Hal Woodcome Dr. Stanislaw Milewski In memory of Dr. Harold Woodcome, In memory of Dr. Taylor R. Smith Sr. Dr. Peter B. Mooney Estate of Dr. Leon Zimmerman In memory of Dr. Henry F. Allen Dr. Paul Moulton Silver Patrons $1,000-$2,999 Dr. Dale Oates Dr. Stephen J. Phipps Dr. Reid S. Appleby, Jr. Dr. and Mrs. Michael Price In honor of Dr. Harold Woodcome, Jr., Drs. Shiyoung Roh and John Weiter and Associates in Honor of Dr. Robert Dr. and Mrs. George Santos Bahr Dr. Delia Sang Dr. and Mrs. Lloyd M. Aiello In honor of Dr. Lloyd M. Aeillo Dr. Robert Bahr Drs. Jack and Helen Schinazi Dr. C. Davis Belcher In memory of Mrs. Mary Santos In honor of Dr. Richard Simmons In honor of Dr. Irving L. Pavlo Dr. Harry Braconier Dr. Roger F. Steinert In memory of Drs Taylor Smith, Karl In honor of Drs. A. Robert Bellows, Riemer, Carl C. Johnson. S. Arthur Boruchoff, Albert R. In memory of Dr. Hal M. Freeman Frederick, and B. Thomas Hutchinson Dr. and Mrs. Sheldon M. Buzney Dr. J. Elliott Taylor Children’s Hospital Ophthalmology Dr. Felipe I. Tolentino Foundation In honor of Drs. Hal M. Freeman and Dr. and Mrs. William E. Clark, Jr. Roland Houle Dr. Mary Daly In memory of Dr. Charles L. Schepens In memory of Dr. and Dr. Trexler R. Topping Mrs. William J. Daly Vermont Ophthalmological Society Dr. Joseph L. Dowling, Jr. Dr. Martin Wand Dr. Jay S. Duker In memory of Dr. W. Morton Grant Eye Health Services Drs. Peter Wassermann, T. Gordon Hand, In memory of Dr. C. Davis Belcher Christie Morse and Bradford Hall, Dr. Laura Fine In memory of Dr. John Detwiller Dr. and Mrs. David Greenseid In honor of Dr. Lewis Stieglitz

40 | New England Ophthalmological Society Master William Weiter Sponsors $250-$499 In honor of Ann Bajart and Tony Schemmer, and Deborah and Elliot Dr. Caroline Baumal Perlman In memory of Dr. Jose Berrocal Dr. Kenneth Wolf Dr. Francis Y. Falck, Jr. Dr. Allen Zieker Dr. Ralph A. Goodwin, Jr. Dr. Dana Graichen Benefactors $500-$999 Dr. Payson B. Jacobson In memory of Dr. Abraham Pollen Dr. Phil Aitken Dr. Glenn P. Kimball In memory of Drs. Robert Guiduli and Dr. Peter Lou Simmons Lessell Dr. Carmen Puliafito Dr. Michael Cooper Dr. Sarkis Soukiasian In honor of Dr. Brendan McCarthy In Honor of Dr. Roger Steinert In memory of Dr. Robert Haimovici Dr. Caldwell W. Smith Dr. Behrooz Koleini and Dr. S. Arthur Dr. Neal G. Snebold Boruchoff Dr. Jonathan Talamo Drs. Elliot and Macie Finkelstein Dr. Yvonne Tsai Dr. David Fleishman In memory of Helena Toksoz In memory of Dr. Gary B. Fleishman Dr. Andrew Wong Dr. George Garcia In memory Dr. Charles L. Schepens Dr. Timothy Goslee Worcester Ophthalmology Associates In honor of Dr. Mary Daly Dr. Charles Zacks Dr. Robert Guiduli In memory of Dr. Kathleen J. Maguire Friends Up to $250 Dr. Lynne Kaplinsky Dr. Robert Lytle In Memory of Dr. Y. Jacob Schinazi Maine Eye Center Marion J. Goldsmith Dr. Brendan McCarthy Robert & Lorraine Kingsbury In Memory of Dr. Behrooz Koleini Diane Klaiber Dr. and Mrs. Howard Marton William & Ingrid Mercer Dr. Christopher Newton Dr. & Mrs. Samir Moubayed Maria Capone Beth Orson In Memory of Dr. Y. Jacob Schinazi Dr. Virginia Schmidt Parker Ophthalmic Consultants of Boston Retina Center of Maine In Memory of C. Davis Belcher Rhode Island Society of Physicians and Accent Eyewear Surgeons James Bernson Dr. Joel Schuman Dr. Charles Beyer-Machule Dr. Lewis Stieglitz Philip Cacciatore Dr. Dennis Stoler Eye Health Services Dr. Barry Wepman Milton Feinson Dr. Charles Wingate Dr. Richard Getnick Evelyn John Dr. Ernest Kornmehl Don Lesieur Joyce Marshall 778th Meeting | 41 Rebecca Murphy Dr. Theodore Renna Therese O’Keefe Molly-Jane Isaacson Rubinger Dr. Stephen Poor, III In honor of Trexler Topping Eileen Raffferty Dr. Donna Siracuse-Lee Elizabeth Reece Alice Sarno Dr. Richard Simmons In memory of B. Thomas Hutchinson Marian Spilner Dr. Domenic M. Strazzulla Dr. Ann Stromberg Dr. Carter Tallman Elizabeth Sullivan Dr. Michael Wiedman Andrienne Tashjian In honor of Dr. Claes Dohlman The Rivers School In Memory of Dr. Peter Gudas: Naomi Litrowinik Mercedes Sayler Needham Psychotherapy Associates New England Carpenters Health Fund Norfolk Lodge A.F. and A.M. James and Jean Twyning Jacqueline Pepper Jeanne Smith Dr. Peter Batson Dr. Richard Brown Dr. David Corbit Dr. Paul Cotran In memory of Dr. Mariana Mead Dr. Peter Donshik Dr. Stuart Fay In honor of Dr. Michael Bradbury and Dr. Tuck Melvyn and Eleanor Galin Foundation In honor of B. Thomas Hutchinson Dr. Andrew Gillies In memory of Dr. Moshe Lahav Dr. Timber Gorman Dr. Jay Gooze In memory of Kirstyn Smith Dr. Amy Gregory Dr. Walter Griggs Dr. Robert Herm Dr. Ted Houle Dr. Glenn P. Kimball Dr. David Lawlor Dr. Howard M. Leibowitz In memory of Dr. Behrooz Koleini Dr. Clifford Michaelson In memory of Dr. Behrooz Koleini Dr. Lawrence Piazza

42 | New England Ophthalmological Society NOTES www.neos-eyes.org

Follow us @NEOS_Eyes