Оригинальная презентация RevitalVision на английском

1. NeuroVision
(RevitalVision)

2. • Company background
• Product overview
• Scientific Background
• Technological Implementation
• Clinical Data

3. NeuroVision HistoryNeuroVision History
 Founded in Dec 1999 in Israel
 Company Relocated to Singapore in 2004
 Investment of ~US$35 Million
 Strategic Relationship with “SERI” (Singapore Eye
Research Institute)
 12,000 + Patients worldwide
 Many Clinical Studies & Publications
 Acquired by RevitalVision (USA) Sep 2009
 Acquired by Talshir (Israel) 2015

4. What Is NeuroVision And
How Does It Work?

5. Vision Depends On Two Things:Vision Depends On Two Things:
1.1. How Your Eye Receives The ImagesHow Your Eye Receives The Images
““Front End”Front End”
1.1. How Your Brain Interprets The ImageHow Your Brain Interprets The Image
““Back End”Back End”
How We SeeHow We See??

6. The Visual CortexThe Visual Cortex

7. How NeuroVision WorksHow NeuroVision Works??
Eye (Optics) Brain (Processor)
The Human Visual System
Object Perceived
image
• The Eye Care Industry Focuses Bending Light
• NeuroVision Focuses On Optimizing The Visual Processing
in the Brain

8. How NeuroVision WorksHow NeuroVision Works??
Trains Brain To Automatically Sharpen Image,Trains Brain To Automatically Sharpen Image,
Similar To How Computer Software EnhancesSimilar To How Computer Software Enhances
A Digital Low-resolution Image. (e.g.A Digital Low-resolution Image. (e.g.
PhotoshopPhotoshop))

9. Previous Advisory BoardPrevious Advisory Board
Scientific Advisory BoardScientific Advisory Board
 Prof. Michael Belkin, MDProf. Michael Belkin, MD
 Daniel Durrie, MDDaniel Durrie, MD
 Arthur P. Ginsburg, Ph. D.Arthur P. Ginsburg, Ph. D.
 Jack T. Holladay, MDJack T. Holladay, MD
 Ian MorganIan Morgan, Ph. D., Ph. D.
 Prof. Donald Tan, MDProf. Donald Tan, MD
 Dr. Uri PolatDr. Uri Polat
Professional Advisory BoardProfessional Advisory Board
 Daniel Durrie, MDDaniel Durrie, MD
 Richard L. Lindstrom, MDRichard L. Lindstrom, MD
 Jack Schaffer, ODJack Schaffer, OD
 Peter Shaw-McMinn, ODPeter Shaw-McMinn, OD
 Kirk Smick, OD, FAAOKirk Smick, OD, FAAO
 Robert Main, ABOM, FNAORobert Main, ABOM, FNAO
 Mike PackardMike Packard
 Judy F. Gordon, DVMJudy F. Gordon, DVM
 John Hunkeler, MDJohn Hunkeler, MD

10. Therapy OutcomeTherapy Outcome
Average vision improvement:
• 2.5 lines on the Visual Acuity eye chart
• 100% in Contrast Sensitivity
• Improvement is long lasting
Product status
FDA & CE-Mark
approved
12,000 commercial
patients

11. Contrast sensitivityContrast sensitivity

12. Treatment overviewTreatment overview
 Software based technology that provides special
visual stimulation on a PC screen.
 30 minutes each training session
 3 X per week.
 Complete after 30-40 training sessions (3 months)
 Prescribed by ophthalmologist/Opt, who examine
and follow-up patient progress.

13. Improving AmblyopiaImproving Amblyopia
 Amblyopia
 The number 1 cause for low vision
until the age of 40
 2% - 5% of adult population
 Can be cured during early
childhood
Considered untreatable after the
age of 9.
 NeuroVision is the only FDA
approved therapy for amblyopia age
9 – 55

14. Treatment IndicationsTreatment Indications

15. Scientific BackgroundScientific Background

16. The Building BlocksThe Building Blocks
 Gabor Patch
 Neuronal Lateral Interactions
 Brain (neural) plasticity
 Perceptual Learning

17. Gabor PatchGabor Patch
“Gabor Patches” 1
are widely used in the field of
visual neuroscience. Having been shown to
efficiently describe the shape of receptive fields of
neurons in the primary visual cortex they thus
represent the most effective stimulation.2
1. Gabor (1946), Theory of Communication. Journal of the Institute of Electrical Engineers, London, 93, 429-457).
2. Daugman. Two-dimensional spectral analysis of cortical receptive field profiles. Vision Res 1980; 20:847-56.
G(x,y)= Aoexp(-((x-xo)2
+(y-yo)2
)/σ2
)
*sin(2π/λ*(x•cos(θ)+y•sin(θ))+ ψ)

18. Cat Visual Cortex ExperimentCat Visual Cortex Experiment
An Important Experiment… (Nobel Prize)
Hubel & Wiesel (1959). Receptive fields of single neurons in the cat’s striate cortex. J
Physiol (Lond) 148:574-591

19. Lateral InteractionsLateral Interactions
Individual neurons respond to:
• Precise location
• Orientation
• Spatial frequency
Hubel & Wiesel (1959). Receptive fields of single neurons in the cat’s striate cortex. J Physiol (Lond) 148:574-591
Neuronal Interactions:
To characterize an image, visual processing
involves the cooperative activity of
many neurons

20. Lateral Interactions ExperimentLateral Interactions Experiment
Contrast response function and modulation of single neuron:
Contrast response function to Target Gabor patch optimally fitted to the CRF:
Recent research, utilizing cat subjects, demonstrated the linear relationship
between contrast and neuronal response (green line)
Polat U., Mizobe, K., Kasamatsu, T., Norcia A.M. (1998). Collinear stimuli regulate visual responses
depending on Cell's contrast threshold. Nature, 391, 580-584

21. Lateral Interactions ExperimentLateral Interactions Experiment
Contrast response function and modulation of single neuron:
Contrast response function to Gabor patch optimally fitted to the CRF:
Target alone (green line) and target + flankers positioned outside the CRF (blue)
Excitation is found near contrast threshold, inhibition at the higher contrast range

22. Lateral maskingLateral masking
Target Gabor Flankers without
Target Gabor
Target Gabor with
presence of
Flankers
Target
Flankers

23. Neural PlasticityNeural Plasticity
 Neural plasticity - relates to the ability of the
nervous system to adapt to changed conditions,
in acquiring new skills.
The new acquired skills are retained for years
 Evidence for Neural plasticity - Visual acuity
improvement in adults with amblyopia has been
reported after prolonged patching1 or when the better
eye’s vision has been lost2 or degraded, by age
related macular degeneration3, cataract4 or trauma5
1. Birnbaum MH, Koslowe K, Sanet R. (1977)
2. Vereecken EP, Brabant P. (1984)
3. El Mallah MK, Chakravarthy U, Hart PM. (2000)
4. Wilson ME. (1992)
5. Rabin J. (1984)

24. Perceptual Learning &Perceptual Learning &
Neural PlasticityNeural Plasticity
 The phenomenon -
Perception can be modified by experience.
Visual performance improves with practice
 The technique -
Repetitive performance of controlled and specific
visual tasks
 Perceptual learning has been evidenced in a variety
of visual tasks and was found to persist for years
without further practice1
 Clinical observations2
and experimental evidence3
indicate the presence of residual neural plasticity
well after the critical period.
1. Gilbert, (1998); Sagi & Tanne, (1994).
2. Moseley, Fielder (2001)
3. Polat, Sagi(1994); Levi, Polat (1996); Levi, Polat, Hu (1997)

25. Lateral Masking –Lateral Masking –
How Does it WorkHow Does it Work??
Enhance Neuronal Lateral Interactions using Perceptual Learning Technique
 Repetitive performance of specific visual tasks efficiently stimulates the specific neurons and
effectively promotes spatial interactions among these neurons
 Enhanced spatial interactions reduce noise level in neuronal activity and increase signal strength, therefore
improve neuronal efficiency inducing improvement of Contrast Sensitivity Function (CSF)
 Improved CSF induce improvement in Visual Acuity

26. SummarySummary
 Image quality depends both on the input receivedImage quality depends both on the input received
from the eye and the processing in the visual cortexfrom the eye and the processing in the visual cortex
 The visual system in the brain has mechanisms toThe visual system in the brain has mechanisms to
further ‘enhance’ the visual processing (lateralfurther ‘enhance’ the visual processing (lateral
interactions)interactions)
 Neural processing efficiency can be further enhancedNeural processing efficiency can be further enhanced
in most people, as it is yet not fully optimizedin most people, as it is yet not fully optimized
 In Amblyopia, NVC enhances the neural processingIn Amblyopia, NVC enhances the neural processing
to better process the clear image from the retinato better process the clear image from the retina
 In the 2In the 2ndnd
generation applications (Myopia, Presbyopiageneration applications (Myopia, Presbyopia
Post LASIK) NVC compensates for blurred inputsPost LASIK) NVC compensates for blurred inputs
coming from the retina, by enhancing the brain tocoming from the retina, by enhancing the brain to
optimallyoptimally process visual signalsprocess visual signals better than averagebetter than average

27. Technological ImplementationTechnological Implementation

28. NeuroVisionNeuroVision TechnologyTechnology
 The treatment is comprised of a series ofThe treatment is comprised of a series of
computer interactive treatment sessionscomputer interactive treatment sessions
 The treatment is delivered to the treatmentThe treatment is delivered to the treatment
workstations via the Internetworkstations via the Internet
 It can be performed in a centre, clinic or atIt can be performed in a centre, clinic or at
home.home.
 The treatment is personalized – tailored toThe treatment is personalized – tailored to
each individual unique needseach individual unique needs
 NeuroVision’s technology is formedNeuroVision’s technology is formed
around proprietary algorithmsaround proprietary algorithms

29. Treatment ImplementationTreatment Implementation
Subjects are presented with a series of visual
stimulations using Gabor patches with the
following parameters dynamically controlled:
 Numbers of Gabors
 Spatial arrangement of the Gabors
 Global and local orientation
 Spatial Frequency/size
 Contrast
 Exposure duration

30. Treatment ImplementationTreatment Implementation
Spatial Frequency
Local Orientation
Contrast
Target-Flankers Separation
Target Displacement
Global Orientation

31. Visual Perception Task – ExampleVisual Perception Task – Example
First Display Second Display
 Measures the contrast threshold of a Gabor target
(the middle Gabor) with the presence of flankers
(the peripheral Gabors)
 The patient is exposed to two short displays in
succession, in a random order; the patient
identifies which display contains three Gabors

32. Visual Perception Task – ExampleVisual Perception Task – Example
 If the first display, the patient should click the left mouse button (1); if the
second display, the patient should click the right mouse button (2)
 The system provides the patient with feedback when provided with a an
incorrect response
 The task is repeated and a staircase is applied until the patient reaches their
visual threshold level
21

33. Treatment FlowTreatment Flow
Treatment end – When patient’s vision
does not further improve
Treatment Set-Up
Baseline Test by
optometrist/ Ophthalmol
Computerized analysis
of neural inefficiencies
Administration
• Controlled home/clinic environment
• Sessions of 30 minutes each
• Course of approx. 30 sessions
• A pace of 3 sessions a week
Progress
VA tests
every few
sessions
• Results automatically
sent to Data Center
• Individualized sessions
adjust to progress
Customization
Each session
directly treats
neural
inefficiencies
Treatment

34. NVC System
Architecture
Analizer
Admin.
Applic.
Patients Database
CLINIC
Treatment Workstation
NVC
Treatment
Application
Internet
DATA CENTER
Administrative Workstation
Browser
CLINICNV System Architecture
Expert System

35. Clinical DataClinical Data

36. Contents
1. Adult Amblyopia Trial, NeuroVision 2000-2001
2. Children with Amblyopia 2009
3. Amblyopia study Turkey 2013
4. Congenital Nystagmus 2012
5. Low Myopia Trial, SERI 2003-2004
6. Early Presbyopia Trial 2005
7. Super Vision Pilot Study 2005
8. Pediatric Myopia, Evergreen Trial 2006
9. Low Myopia RCT – SERI-SAF, 2005-2007
10. US Trials 2006-2007
11. Summary

37. Treatment GroupTreatment Group Control GroupControl Group
Number of subjectsNumber of subjects 4444 1010
Average AgeAverage Age 35.035.0±±13.013.0 38.238.2±±9.49.4
Mean BCVA in Amblyopic EyeMean BCVA in Amblyopic Eye
Before Treatment in logMarBefore Treatment in logMar
0.410.41±±0.140.14
))20/5120/51((
0.410.41±±0.120.12
))20/5120/51((
Mean BCVA in Amblyopic EyeMean BCVA in Amblyopic Eye
After Treatment in logMarAfter Treatment in logMar
0.170.17±±0.140.14
))20/3020/30((
0.410.41±±0.120.12
))20/5120/51((
Mean BCVA in Amblyopic EyeMean BCVA in Amblyopic Eye
11Year After Treatment in logMarYear After Treatment in logMar
0.210.21±±0.140.14
))20/3320/33((
N/AN/A
Adult Amblyopia: 2000 - 2001
NeuroVision
Polat U, Ma-Naim T, Belkin M, Sagi D.
Improving vision in adult amblyopia by perceptual learning.
Proc Natl Acad Sci U S A. 2004 Apr 27;101(17):6692-7. Epub 2004 Apr 19.

38. Adult Amblyopia: 2000 - 2001Adult Amblyopia: 2000 - 2001
NeuroVisionNeuroVision
Spatial FrequencySpatial Frequency
BCVA=20/30
BCVA=20/33
BCVA=20/51
12 Months Post Treatment
At End of Treatment
Before Treatment Start
Polat U, Ma-Naim T, Belkin M, Sagi D.
Improving vision in adult amblyopia by perceptual learning.
Proc Natl Acad Sci U S A. 2004 Apr 27;101(17):6692-7. Epub 2004 Apr 19.
Contrast Sensitivity Average Improvement > 100%

39. Treatment GroupTreatment Group
Number of subjectsNumber of subjects 55
Average AgeAverage Age 77––88))7.37.3((
Mean BCVA in Amblyopic EyeMean BCVA in Amblyopic Eye
Before Treatment in logMarBefore Treatment in logMar
6/126/12--6/306/30
Mean BCVA in Amblyopic EyeMean BCVA in Amblyopic Eye
After Treatment in logMarAfter Treatment in logMar
6/96/9--6/186/18
20/3020/30((
Mean BCVA improvement inMean BCVA improvement in
ETDRSETDRS
2.122.12LinesLines
ChildChild Amblyopia: 2009Amblyopia: 2009
Polat U, Ma-Naim T, Abraham Spirere.
Vision Research 49 (2009) 2599–2603
Children with amblyopia after the conventionalChildren with amblyopia after the conventional
treatment of patching has failedtreatment of patching has failed

40. Adult Amblyopia: 2013Adult Amblyopia: 2013
Treatment GroupTreatment Group Control GroupControl Group
Number of subjectsNumber of subjects 5353 4646
AgeAge 5050--99 4646--1515
Mean BCVA in Amblyopic EyeMean BCVA in Amblyopic Eye
Before Treatment in logMarBefore Treatment in logMar
0.420.42
))20/5220/52((
0.400.40
))20/5020/50((
Mean BCVA in Amblyopic EyeMean BCVA in Amblyopic Eye
After Treatment in logMarAfter Treatment in logMar
0.160.16
))20/2820/28((
0.320.32
))20/4220/42((
Improvement in logMarImprovement in logMar
At 4-8 month follow upAt 4-8 month follow up
2.62.6logMarlogMar
P=0.001
0.080.08logMarlogMar
P=0.07
Elvan Yalcin, Ozlem Balci.
Efficacy of perceptual vision therapy in enhancing visual acuity and contrast sensitivity
function in adult hypermetropic anisometropic amblyopia
Clinical Ophthalmology. 2014:8 49-53

41. Adult Amblyopia: 2013Adult Amblyopia: 2013
Elvan Yalcin, Ozlem Balci.
Efficacy of perceptual vision therapy in enhancing visual acuity and contrast sensitivity
function in adult hypermetropic anisometropic amblyopia
Clinical Ophthalmology. 2014:8 49-53
Contrast Sensitivity
Function

42. Treatment GroupTreatment Group
Number of subjectsNumber of subjects 2828
Average AgeAverage Age 1111––5151
((Avg 24.8Avg 24.8))
DemographicDemographic 1616clinics, 5 countries, 18 M, 10 Fclinics, 5 countries, 18 M, 10 F
Albinism (5) , Retinitis PunctataAlbinism (5) , Retinitis Punctata
Albescens (1)Albescens (1)
BCVABCVA
Before Treatment in SnellenBefore Treatment in Snellen
6/96/9--6/606/60
((Avg 6/24Avg 6/24))
Average improvement end ofAverage improvement end of
treatmenttreatment
22lines (0-5lines (0-5))
Congenital NystagmusCongenital Nystagmus
Multi national study : 2011Multi national study : 2011
Y. Morad MD. Assaf Harofe Medical Center Zrifin, Tel Aviv University Israel.
Euoropean Strabismological Association 2012

43. Congenital NystagmusCongenital Nystagmus
Multi national study : 2011Multi national study : 2011
Distribution of BCVA gain from baseline to treatment end in 47 eyes that
showed improvement.
Y. Morad MD Assaf Harofe Medical Center Zrifin, Tel Aviv University Israel.
Euoropean Strabismological Association 2012

44. Low Myopia: 2003 - 2004Low Myopia: 2003 - 2004
Singapore Eye Research InstituteSingapore Eye Research Institute
Treatment GroupTreatment Group
Number of subjectsNumber of subjects 2020
Average AgeAverage Age 34.034.0((1616to 55to 55))
Mean Cycloplegic Spherical EquivalenceMean Cycloplegic Spherical Equivalence
Before TreatmentBefore Treatment
--1.08D (0 to -1.751.08D (0 to -1.75))
Mean Cycloplegic Spherical EquivalenceMean Cycloplegic Spherical Equivalence
After TreatmentAfter Treatment
--1.06D (0 to -1.751.06D (0 to -1.75))
Mean Unaided VAMean Unaided VA
Before Treatment in logMarBefore Treatment in logMar
0.310.31±±0.030.03
))20/4120/41((
Mean Unaided VAMean Unaided VA
After Treatment in logMarAfter Treatment in logMar
0.100.10±±0.030.03
))20/2520/25((
Mean Unaided VAMean Unaided VA
11Year After Treatment in logMarYear After Treatment in logMar
0.120.12±±0.030.03
))20/2620/26((

45. Low Myopia: 2003 - 2004Low Myopia: 2003 - 2004
Singapore Eye Research InstituteSingapore Eye Research Institute
Spatial FrequencySpatial Frequency
UCVA=20/25
UCVA=20/26
UCVA=20/41
12 Months Post Treatment
At End of Treatment
Before Treatment Start
Donald Tan, Bill Chan, Frederick Tey, Lionel Lee, Pilot Study To Evaluate The Efficacy of Neural Vision
Correction™ (NVC™) Technology For Vision Improvement in Low Myopia, ARVO 2004
Contrast Sensitivity Average Improvement ~ 100%

46. Presbyopia Trial - 2005Presbyopia Trial - 2005
Treatment GroupTreatment Group
Number of subjectsNumber of subjects 3030
Average AgeAverage Age 46.3746.37±±0.520.52))41-5541-55((
Mean Near AdditionMean Near Addition ++1.40D ± 0.05D1.40D ± 0.05D
Mean Unaided VAMean Unaided VA
Before Treatment in logMarBefore Treatment in logMar
0.330.33±±0.040.04
))20/4320/43((
Mean Unaided VAMean Unaided VA
After Treatment in logMarAfter Treatment in logMar
0.170.17±±0.040.04
))20/2920/29((
Mean Unaided VAMean Unaided VA
66Months After Treatment EndMonths After Treatment End
in logMarin logMar
0.180.18±±0.040.04
))20/3020/30((

47. Presbyopia Trial - 2005Presbyopia Trial - 2005
Donald Tan, Improving VA and CSF in Subjects with Low Degrees of Myopia and Early
Presbyopia using Neural Vision Correction (NVC) Technology, APAO 2006
Contrast Sensitivity Average Improvement ~ 100%
Spatial FrequencySpatial Frequency
UCNVA=20/35
UCNVA=20/54
Spatial FrequencySpatial Frequency
UCNVA=20/17
UCNVA=20/33
UCNVA=20/18

48. Super Vision Pilot Study –Super Vision Pilot Study –
Singapore Polytechnic - 2005Singapore Polytechnic - 2005
Treatment GroupTreatment Group
Number of subjectsNumber of subjects 1111
Average AgeAverage Age 21.721.7±7.0±7.0
Mean Cycloplegic SphericalMean Cycloplegic Spherical
EquivalenceEquivalence
--2.7D ± 0.492.7D ± 0.49
Mean Habitual VAMean Habitual VA
Before Treatment in logMarBefore Treatment in logMar
0.060.06±±0.020.02
))20/2320/23((
Mean Habitual VAMean Habitual VA
After Treatment in logMarAfter Treatment in logMar
--0.050.05±±0.020.02
))20/1820/18((

49. Super Vision Pilot Study –Super Vision Pilot Study –
Singapore Polytechnic - 2005Singapore Polytechnic - 2005
Chris Ng, Wilfred Tang, Donald Tan, Cortical enhancement of Habitual VA of
subjects using Neural Vision Correction Technology, Asia ARVO 2007
Contrast Sensitivity Average Improvement ~ 50%
Spatial FrequencySpatial Frequency
3 Months Post Treatment
At End of Treatment
Before Treatment Start

50. Pediatric Myopia in Singapore –Pediatric Myopia in Singapore –
Evergreen Primary School Trial - 2006Evergreen Primary School Trial - 2006
Treatment GroupTreatment Group
Number of subjectsNumber of subjects 3030
Average AgeAverage Age 7.807.80±±0.400.40))7-97-9((
Mean Cycloplegic ObjectiveMean Cycloplegic Objective
RefractionRefraction
--2.71D ± 1.31D2.71D ± 1.31D
Mean Under - Corrected VAMean Under - Corrected VA
Before Treatment in logMarBefore Treatment in logMar
0.470.47±±0.040.04
))20/4720/47((
Mean Under - Corrected VAMean Under - Corrected VA
After Treatment in logMarAfter Treatment in logMar
0.220.22±±0.040.04
))20/3320/33((

51. Pediatric Myopia in Singapore –Pediatric Myopia in Singapore –
Evergreen Primary School Trial - 2006Evergreen Primary School Trial - 2006
Contrast Sensitivity Average Improvement ~ 100%
Spatial FrequencySpatial Frequency
UCVA=20/25
UCVA=20/44
Spatial FrequencySpatial Frequency
UCVA=20/25
UCVA=20/42

52. Results – Change in RefractionResults – Change in Refraction
At 12 Months Post Treatment EndAt 12 Months Post Treatment End
Cycloplegic Objective Refraction (SE)Cycloplegic Objective Refraction (SE)
End ofEnd of
TreatmentTreatment
1212MonthsMonths
PostPost
End ofEnd of
TreatmentTreatment
ChangeChange AverageAverage
Change inChange in
Age GroupAge Group
((SCORMSCORM))
--3.2103.210((DD)) --3.8303.830((DD)) --0.6200.620((DD)) --0.9440.944((DD))

53. Results – Change in Axial LengthResults – Change in Axial Length
At 12 Months Post Treatment EndAt 12 Months Post Treatment End
Axial LengthAxial Length
End ofEnd of
TreatmentTreatment
(mm(mm))
1212MonthsMonths
PostPost
End ofEnd of
TreatmentTreatment
(mm(mm))
ChangeChange
(mm(mm))
AverageAverage
Change inChange in
Age GroupAge Group
(SCORM)(SCORM)
(mm(mm))
24.48524.485 24.81024.810 0.3250.325 0.4000.400

54. Treatment Group Control Group
Number of subjects 67 17
Average Age 32.3±9.1 32.3±9.1
Mean UCVA Improvement
After Treatment in logMar
1.83±0.13 0.30±0.25
%of Subjects who Achieved
2 Lines of Improvement in
at least one eye
64.2% 11.8%
P Value p< 0.005
Mean Cycloplegic Spherical
Equivalence Before Treatment
-1.20D ± 0.34 -1.17D± 0.23
Mean Cycloplegic Spherical
Equivalence After Treatment
-1.17D± 0.38 -1.16D± 0.32
Low Myopia RCT – SERI-SAF - 2005-2008Low Myopia RCT – SERI-SAF - 2005-2008

55. US Clinical Trials –2006 - 2008US Clinical Trials –2006 - 2008
Dan Durrie,
MD
Peter Shaw McMinn,
OD
Presbyopia Treatment Group 15 15
Low Myopia Treatment Group 15 15
Presbyopia Control Group 7 8
Low Myopia Control Group 8 7
Total Number of Subjects 45 45
Low Myopia and Presbyopia

56. US Clinical Trials – Dan Durrie, MD,US Clinical Trials – Dan Durrie, MD,
Peter Shaw McMinn, ODPeter Shaw McMinn, OD
US TrialsUS Trials InternationalInternational
DataData
PresbyopiaPresbyopia
Improvement inImprovement in
Unaided Near VAUnaided Near VA
1.81.8LinesLines 2.02.0LinesLines
Low MyopiaLow Myopia
Improvement inImprovement in
Unaided Distance VAUnaided Distance VA
2.22.2LinesLines 2.62.6LinesLines
ControlsControls
Improvement inImprovement in
Unaided Distance VAUnaided Distance VA
0.40.4LinesLines

57. US Clinical Trials – Dan Durrie, MD,US Clinical Trials – Dan Durrie, MD,
Peter Shaw McMinn, ODPeter Shaw McMinn, OD
Presbyopia Low Myopia
Spatial FrequencySpatial Frequency
UCVA=20/28
UCVA=20/54
UCVA=20/30
Spatial FrequencySpatial Frequency
UCVA=20/30
UCVA=20/54
Spatial FrequencySpatial Frequency
UCVA=20/25
UCVA=20/44
Spatial FrequencySpatial Frequency
UCVA=20/25
UCVA=20/42

58. US Post Cataract StudyUS Post Cataract Study
John Hunkeler, MD, Richard Lindstrom, MDJohn Hunkeler, MD, Richard Lindstrom, MD
Average Age - 70 years old
* Patients Baseline VA 20/15 – No room to improve
No. of EyesNo. of Eyes Distance VADistance VA
ImprovementImprovement
Near VANear VA
ImprovementImprovement
Distance CSFDistance CSF
ImprovementImprovement
Near CSFNear CSF
ImprovementImprovement
RezoomRezoom 2424 1.41.4LinesLines 0.70.7LinesLines 157%157% 135%135%
RestorRestor 1010 1.51.5LinesLines 1.11.1LinesLines 135%135% 143%143%
CrystalensCrystalens 66 0.30.3LinesLines** 1.71.7LinesLines 370%370% 227%227%
AlconAlcon
MonofocalMonofocal
1010 1.31.3LinesLines 0.70.7LinesLines 250%250% 238%238%
AMOAMO
MonofocalMonofocal
1010 1.41.4LinesLines 1.31.3LinesLines 354%354% 263%263%
TotalTotal 6060 1.31.3LinesLines 1.01.0LinesLines 231%231% 190%190%

59. US Post Cataract StudyUS Post Cataract Study
John Hunkeler, MD, Richard Lindstrom, MDJohn Hunkeler, MD, Richard Lindstrom, MD
Spatial FrequencySpatial Frequency
UCVA=20/25
UCVA=20/44
Spatial FrequencySpatial Frequency
After
Before

60. Clinical SummaryClinical Summary
Visual AcuityVisual Acuity
ImprovementImprovement
ContrastContrast
SensitivitySensitivity
ImprovementImprovement
Retention ofRetention of
ImprovementImprovement
11Year PostYear Post
TreatmentTreatment
MainMain
FunctionalFunctional
OutcomeOutcome
MyopiaMyopia
Up to -1.50DUp to -1.50D
2.62.6Lines ETDRSLines ETDRS
(Distance(Distance((
Above 100% inAbove 100% in
All FrequenciesAll Frequencies
80%80%of theof the
ImprovementImprovement
DecreaseDecrease
Dependency onDependency on
SpectaclesSpectacles
PresbyopiaPresbyopia
Up to +1.5DUp to +1.5D
2.02.0Lines ETDRSLines ETDRS
))NearNear((
Average OfAverage Of
100%100%inin
All FrequenciesAll Frequencies
90%90%of theof the
Improvement (afterImprovement (after
6 months6 months((
Delay The Need ofDelay The Need of
Reading GlassesReading Glasses
PostPost
RefractiveRefractive
SurgerySurgery
2.02.0Lines ETDRSLines ETDRS
))DistanceDistance((
Above 100% inAbove 100% in
All FrequenciesAll Frequencies
No DataNo Data
Available YetAvailable Yet
IncreasedIncreased
Quality ofQuality of
Functional VisionFunctional Vision
AmblyopiaAmblyopia 2.52.5Lines ETDRSLines ETDRS
))DistanceDistance((
Above 100% inAbove 100% in
All FrequenciesAll Frequencies
85%85%of theof the
ImprovementImprovement
IncreasedIncreased
Quality of VisionQuality of Vision,,
ImprovedImproved
BinocularityBinocularity
NeuroVision Applications, Visual Improvement and Functional OutcomeNeuroVision Applications, Visual Improvement and Functional Outcome

61. CommercialCommercial
Clinical DataClinical Data
NeuroVision
*This presentation is confidential and may be subject to
legal or some other professional privilege. This
presentation must not be disclosed to any person without
authorisation and is subject to copyright. It may not only be
copied or distributed with the consent of NeuroVision.

62. Low Myopia & Post Refractive SurgeryLow Myopia & Post Refractive Surgery
Commercial DataCommercial Data
Low MyopiaLow Myopia Post Refractive SurgeryPost Refractive Surgery
Number of subjectsNumber of subjects 320320 6060
Average AgeAverage Age 3030))7-557-55(( 3131))18-5518-55((
Mean Manifest SphericalMean Manifest Spherical
Equivalence Before TreatmentEquivalence Before Treatment
--1.34D ± 0.031.34D ± 0.03 --1.12D ± 0.111.12D ± 0.11
Mean Manifest SphericalMean Manifest Spherical
Equivalence After TreatmentEquivalence After Treatment
--1.20D ± 0.041.20D ± 0.04 --1.09D ± 0.121.09D ± 0.12
Mean Unaided VAMean Unaided VA
Before Treatment in logMarBefore Treatment in logMar
0.430.43±±0.010.01
))20/5420/54((
0.270.27±±0.030.03
))20/3820/38((
Mean Unaided VAMean Unaided VA
After Treatment in logMarAfter Treatment in logMar
0.170.17±±0.010.01
))20/3020/30((
0.070.07±±0.020.02
))20/2320/23((
Mean Unaided VAMean Unaided VA
11Year After Treatment in logMarYear After Treatment in logMar
0.210.21±±0.010.01
))20/3320/33((
N/AN/A

63. Low Myopia and Post Refractive SurgeryLow Myopia and Post Refractive Surgery
Commercial DataCommercial Data
Donald Tan, What Is Still Lacking in Refractive Surgery Is the Role of Neuroprocessing, AAO 2005
Donald Tan, Enhancement of Visual Acuity and Contrast Sensitivity in Low Myopes Through the Use of
Neural Vision Correction (NVC) Technology Is Maintained Over One Year, APAO 2005
Lim KL, Fam HB. NeuroVision treatment for low myopia following LASIK regression. J Refract Surg. 2006
Apr;22(4):406-8.
Contrast Sensitivity Average Improvement > 100%
Low Myopia Post Refractive Surgery
Spatial FrequencySpatial Frequency
UCVA=20/28
UCVA=20/54
UCVA=20/30
Spatial FrequencySpatial Frequency
UCVA=20/30
UCVA=20/54
UCVA=20/33
Spatial FrequencySpatial Frequency
UCVA=20/25
UCVA=20/44
Spatial FrequencySpatial Frequency
UCVA=20/23
UCVA=20/38

64. SNEC 2 years commercial resultsSNEC 2 years commercial results
( Low Myopia and Post-Lasik)( Low Myopia and Post-Lasik)
Immediate Post treatment VA improvement (N=224 eyesImmediate Post treatment VA improvement (N=224 eyes))
N=24
N=68
N=95
N=37
-0.10
0.00
0.10
0.20
0.30
0.40
0.50
0.60
0.70
< 0.20 0.20 to <0.30 0.30 to< 0.60 0.60 or >
Baseline Unaided VA
--0.10
0.00
0.10
0.20
0.30
0.40
0.50
0.60
0.70
< 0.20 0.20 to <0.40 0.40 to< 0.60 0.60 or >
Baseline Unaided VA (logMAR)
UnaidedVA(logMAR)
N=24
N=68
N=95
N=37

65. SNEC 2 years commercial resultsSNEC 2 years commercial results
( Low Myopia and Post-Lasik)( Low Myopia and Post-Lasik)
Immediate Post TreatmentImmediate Post Treatment
Unaided Contrast Sensitivity Function ImprovementUnaided Contrast Sensitivity Function Improvement
(N=224 eyes(N=224 eyes))
Spatial FrequencySpatial Frequency
BCVA=20/28
BCVA=20/30
BCVA=20/51
Spatial FrequencySpatial Frequency
Post treatment
Baseline

66. SNEC 2 years commercial resultsSNEC 2 years commercial results
( Low Myopia and Post-Lasik)( Low Myopia and Post-Lasik)
VA Follow-up over 24 monthsVA Follow-up over 24 months
0
0.05
0.1
0.15
0.2
0.25
0.3
0.35
0.4
0.45
1 2 3 4 5
224 eyes
52 eyes 28 eyes
Baseline PTE 6th
month 12th
month 24th
month
120 eyes

67. SNEC 2 years commercial resultsSNEC 2 years commercial results
( Low Myopia and Post-Lasik)( Low Myopia and Post-Lasik)
2-year Post Treatment CSF Improvement2-year Post Treatment CSF Improvement
Spatial FrequencySpatial Frequency
BCVA=20/28
BCVA=20/30
BCVA=20/51
Spatial FrequencySpatial Frequency
Immediate PTE
12 Months
Baseline
24 Months

68. Presbyopia Commercial –Presbyopia Commercial –
2006 - 20072006 - 2007
Number of subjectsNumber of subjects 5353
Average AgeAverage Age 45.8045.80±±0.600.60))40-5640-56((
Mean Near AdditionMean Near Addition ++1.44D ± 0.05D1.44D ± 0.05D
Mean Unaided VAMean Unaided VA
Before Treatment in logMarBefore Treatment in logMar
0.440.44±±0.050.05
))20/5420/54((
Mean Unaided VAMean Unaided VA
After Treatment in logMarAfter Treatment in logMar
0.240.24±±0.040.04
))20/3520/35((

69. Presbyopia Commercial –Presbyopia Commercial –
2006 - 20072006 - 2007
Spatial FrequencySpatial Frequency
UCNVA=20/35
UCNVA=20/54
Spatial FrequencySpatial Frequency
UCNVA=20/24
UCNVA=20/44
Contrast Sensitivity Average Improvement > 100%