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Advances in the Treatment of Neurotrophic Keratitis New Approaches for Corneal Healing

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Advances in the Treatment of Neurotrophic Keratitis New Approaches for Corneal Healing CME MONOGRAPH VISIT HTTPS://TINYURL.COM/NKCME FOR ONLINE TESTING AND INSTANT CME CERTIFICATE. ADVANCES IN THE TREATMENT OF NEUROTROPHIC KERATITIS NEW APPROACHES FOR CORNEAL HEALING Original Release: June 1, 2020 Expiration: June 30, 2021 LEARNING METHOD AND MEDIUM FACULTY This educational activity consists of a supplement and ten (10) study questions. The participant should, in order, read the learning objectives contained at the beginning of this supplement, Kenneth A. Beckman, MD, FACS (Chair) read the supplement, answer all questions in the post test, and complete the Activity Evaluation/ Clinical Assistant Professor of Ophthalmology Credit Request form. To receive credit for this activity, please follow the instructions provided on Ohio State University the post test and Activity Evaluation/Credit Request form. This educational activity should take a Columbus, Ohio maximum of 1.0 hour to complete. Director of Corneal Surgery ACTIVITY DESCRIPTION Comprehensive Eye Care of Central Ohio The health of the corneal surface depends on a feedback mechanism that involves sensory Westerville, Ohio innervation. This feedback loop can be disrupted by both ocular and systemic conditions that damage trigeminal innervation of the cornea, leading to the corneal condition neurotrophic Mark S. Milner, MD, FACS keratitis, which is characterized by disrupted tearing and progressive corneal damage that does Associate Clinical Professor not readily heal. Until very recently, a lack of effective treatments to reinnervate and heal eyes Department of Ophthalmology affected by neurotrophic keratitis served to further hamper efforts toward timely diagnosis. Now that an effective treatment is available, clinicians must strive to identify patients who might Yale University School of Medicine benefit before the disease progresses to the point of corneal perforation and subsequent loss of New Haven, Connecticut visual acuity. The desired results of this activity are to aid clinicians in gaining knowledge and Partner closing practice gaps related to the pathophysiology of neurotrophic keratitis as well as current Director of Cornea best practices for screening, diagnosis, and treatment. Goldman Eye Palm Beach Gardens, Florida TARGET AUDIENCE This educational activity is intended for ophthalmologists. John Sheppard, MD, MMSc, FACS LEARNING OBJECTIVES Professor of Ophthalmology Upon completion of this activity, participants will be better able to: Eastern Virginia Medical School • Describe the pathophysiologic mechanisms driving neurotrophic keratitis President • Discuss the relationship between corneal innervation and ocular surface healing in Virginia Eye Consultants neurotrophic keratitis treatment Partner • Integrate evaluation of corneal sensitivity into assessment of ocular surface disease CVP Physicians • Review clinical trial data for approved neurotrophic keratitis therapy • Develop evidence-based treatment strategies for patients with neurotrophic keratitis Medical Director Lions Eye Bank of Eastern Virginia ACCREDITATION STATEMENT Norfolk, Virginia This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Elizabeth Yeu, MD Education (ACCME) through the joint providership of New York Eye and Ear Infirmary Assistant Professor of Ophthalmology of Mount Sinai and MedEdicus LLC. The New York Eye and Ear Infirmary of Eastern Virginia Medical School Mount Sinai is accredited by the ACCME to provide continuing medical education for physicians. Corneal, Cataract, and Refractive Surgeon AMA CREDIT DESIGNATION STATEMENT Partner The New York Eye and Ear Infirmary of Mount Sinai designates this enduring material for a Virginia Eye Consultants maximum of 1.0 AMA PRA Category 1 Credit™. Physicians should claim only the credit Partner commensurate with the extent of their participation in the activity. CVP Physicians GRANTOR STATEMENT Medical Director This continuing medical education activity is supported through an unrestricted educational Virginia Surgery Center grant from Dompé US, Inc. Norfolk, Virginia This continuing medical education activity is jointly provided by CME REVIEWER FOR NEW YORK EYE New York Eye and Ear Infirmary of Mount Sinai and MedEdicus LLC. AND EAR INFIRMARY OF MOUNT SINAI Angie E. Wen, MD Assistant Professor of Ophthalmology Icahn School of Medicine at Mount Sinai Cornea, Cataract, and Refractive Surgery New York Eye and Ear Infirmary of Mount Sinai This continuing medical education activity is supported through an New York, New York unrestricted educational grant from Dompé US, Inc. Distributed with DISCLOSURE POLICY STATEMENT Formula; Eyedetec Medical; EyeRx Research, Inc; It is the policy of New York Eye and Ear Infirmary of Eyevance; Lacrisciences LLC; LayerBio, Inc; Noveome INTRODUCTION Mount Sinai that the faculty and anyone in a position to Biotherapeutics, Inc; Oyster Point Pharma, Inc; ProVision Kenneth A. Beckman, MD, FACS control activity content disclose any real or apparent Network; Rapid Pathogen Screening, Inc; Scientifically conflicts of interest relating to the topics of the educational Developed Solutions, LLC; Strathspey Crowne; and Neurotrophic keratitis (NK) is a rare sight- activity in which they are participating. They are also TearLab Corporation. threatening corneal disease that often required to disclose discussions of unlabeled/unapproved Elizabeth Yeu, MD, had a financial agreement or affiliation presents a treatment challenge. Historically, uses of drugs or devices during their presentations. during the past year with the following commercial management has relied on a variety of New York Eye and Ear Infirmary of Mount Sinai is interests in the form of Consultant/Advisory Board: Alcon; committed to providing its learners with quality CME Allergan; ArcScan, Inc; Aurea Medical; Avedro, Inc; Bausch modalities aimed to protect the cornea, activities and related materials that promote improvements & Lomb Incorporated; Beaver-Visitec International; promote healing, and prevent NK in healthcare and not the proprietary interests of a Bio-Tissue; Bruder Healthcare; Cassini Technologies; progression, which results in corneal melting commercial interest and, thus, has established policies and CorneaGen; EyePoint Pharmaceuticals; Glaukos and perforation. These treatments, however, procedures in place that identify and resolve all conflicts of Corporation; Johnson & Johnson Vision Care, Inc; Kala were sometimes of limited or temporary interest prior to the execution or release of its educational Pharmaceuticals; LENSAR, LLC; Merck & Co., Inc; benefit because they did not address the activities. Full disclosure of faculty/planners and their Mynosys Cellular Devices Inc; Novartis Pharmaceuticals commercial relationships, if any, follows. Corporation; Ocular Science; Ocular Therapeutix, Inc; pathophysiology of NK, which is loss of OCuSOFT Inc; Omeros Corporation; Oyster Point Pharma, corneal innervation. DISCLOSURES Inc; ScienceBased Health; Shire; Sun Pharmaceutical Kenneth A. Beckman, MD, had a financial agreement or Industries, Inc; TearLab Corporation; and Zeiss; Contracted In 2018, the US Food and Drug Administration affiliation during the past year with the following Research: Alcon; Allergan; Bausch & Lomb Incorporated; approved cenegermin (recombinant human commercial interests in the form of Royalty: eyeXpress; Bio-Tissue; iOptics; Kala Pharmaceuticals; and Topcon nerve growth factor) ophthalmic solution, Consultant/Advisory Board: Alcon; Allergan; Avedro, Inc; Medical Systems, Inc; Ownership Interest (Stock options, 1 Bausch & Lomb Incorporated; Bruder Healthcare; Dompé 0.002%, for the treatment of NK. This topical or other holdings, excluding diversified mutual funds): agent acts through novel mechanisms to farmaceutici SpA; EyePoint Pharmaceuticals; Eyevance; ArcScan, Inc; CorneaGen; Ocular Science; Oyster Point Johnson & Johnson Vision Care, Inc; Kala Pharmaceuticals; Pharma, Inc; and Strathspey Crown. facilitate corneal healing, and it is the only Mallinckrodt; Ocular Therapeutix, Inc; Omeros modality that is specifically indicated for the Corporation; Refocus Group, Inc; Shire; Sun NEW YORK EYE AND EAR INFIRMARY OF treatment of NK. Pharmaceutical Industries, Inc; Takeda Pharmaceuticals MOUNT SINAI PEER REVIEW DISCLOSURE USA, Inc; and TearLab Corporation; Contracted Research: Angie E. Wen, MD, has no relevant commercial In this activity, cornea specialists review NK Avedro, Inc; Icare USA; Kala Pharmaceuticals; and Refocus relationships to disclose. pathophysiology, diagnosis, and treatment, Group, Inc; Honoraria from promotional, advertising or non-CME services received directly from commercial EDITORIAL SUPPORT DISCLOSURES and provide personal insights on these topics interest or their Agents (eg, Speakers Bureaus): Alcon; Cheryl Guttman-Krader; Melissa Carter-Ozhan, MS; through a series of case-based discussions. Allergan; Avedro, Inc; Bausch & Lomb Incorporated; Cynthia Tornallyay, RD, MBA, CHCP; Kimberly Corbin, Dompé farmaceutici SpA; Johnson & Johnson Vision Care, CHCP; Barbara Aubel; and Michelle Ong have no Inc; Refocus Group, Inc; Shire; Takeda Pharmaceuticals relevant commercial relationships to disclose. PATHOPHYSIOLOGY USA, Inc; TearLab Corporation; and Zeiss; Ownership DISCLOSURE ATTESTATION Interest (Stock options, or other holdings, excluding The contributing physicians listed above have attested to OF NEUROTROPHIC diversified mutual funds): Avedro, Inc; eyeXpress; Rapid the following:
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