Dr. Mali’s top 5 predictions in ophthalmology for 2019

Joshua Mali, MD, shares how breakthroughs in the technologic and therapeutic spaces will give way to a prosperous, data-rich 2019

Editor’s Note: Welcome to “Eye Catching: Let's Chat,” a blog series featuring contribu-tions from members of the ophthalmic community. These blogs are an opportunity for ophthalmic bloggers to engage with readers with about a topic that is top of mind, whether it is practice management, experiences with patients, the industry, medicine in general, or healthcare reform. The series continues with this blog by Joshua Mali, MD,  a vitreoretinal surgeon at The Eye Associates, a private multispecialty ophthalmology practice in Sarasota, FL. The views expressed in these blogs are those of their respective contributors and do not represent the views of Ophthalmology Times or UBM Medica.

Another year, another wave of technologic and therapeutic advancements. Check out Dr. Mali’s top five predictions for 2019, below:

1) 2019 will be the most data rich year in the history of ophthalmology

With the combination of new and ongoing clinical trials, big data from the IRIS registry, and post-marketing analysis from the most diverse spectrum of pharmaceuticals and medical devices in the market, 2019 will provide the most data ever to analyze across the entire dynamic field of ophthalmology. We will likely gain significant insight into scientific data and discoveries, clinical efficacy of newer ophthalmic pharmaceuticals, and overall current trends among ophthalmologists.

2) Home-based OCT will revolutionize the way we monitor wet AMD patients

With the successful launch of the home-use monitoring device (ForeseeHome, Notal Vision) for patients with dry age-related macular degeneration (AMD), the device the cre-ates a new platform for monitoring wet AMD patients with its pioneering patient-operated home optical coherence tomography (OCT) system. It is designed to identify intraretinal and/or subretinal fluid in the central 10° of eyes diagnosed with wet AMD.

It will allow patients to complete the test at home while the machine-learning algorithm (Notal OCT Analyzer) performs an automated analysis which generates a report and transmits the information to a physician. This innovation represents the symbiotic rela-tionship between artificial intelligence (AI) and telemedicine that could revolutionize the way we monitor and determine treatment intervals for patients receiving intravitreal anti-VEGF injections.

While likely bringing it to market in 2020, we should have an update in 2019 with final product schematics and diagnostic capabilities. While the home-monitoring device is the flagship AI technological device in ophthalmology today for monitoring dry AMD, the home OCT system will inevitably be the new standard of care in wet AMD management.

3) Brolucizumab will receive FDA approval in 2019 and will be a blockbuster medication for wet AMD

Impressive clinical data from landmark clinical trials HAWK and HARRIER will make for an easy and rapid approval process. With its potential for 12-week dosing intervals and superior retinal anatomical benefits, brolucizumab 6 mg (Novartis) will definitely be a game-changer in the wet AMD market.

4) Mergers & acquisitions in the ophthalmic industry will take a temporary breather

After a frenzy of mergers & acquisitions in the ophthalmic industry in 2018, I believe there will be somewhat of a slowdown in consolidation efforts as companies focus more on internal infrastructure and optimization of product delivery. However, I expect expansion should revamp once again late 2020 and into 2021. 

5) There will be a much-needed pullback in government regulations in healthcare
     
While 2018 saw some significant healthcare regulations such as allowing Medicare Advantage plans to use step therapy for Part B drugs, I believe that President Trump and congress will likely ease regulations this year in an effort to ultimately benefit patients and physicians.

Unity is the key to overcoming any challenge or obstacle. It has been said that we "are the fruits of one tree, and the leaves of one branch".¹ When we Americans are united as one people, we can solve any issue; thus, I am extremely optimistic that we will eventually achieve complete healthcare reform in the near future.

I look forward to keeping you updated throughout 2019 and beyond!

Disclosures:

Joshua Mali, MD
E: jmali@theeyeassociates.com
P: 941-923-2020 
Dr. Mali is a board-certified ophthalmologist and award-winning vitreoretinal surgeon at The Eye Associates, a private multispecialty ophthalmology practice in Sarasota, Flori-da. Dr. Mali’s relevant financial disclosures include the following: Regeneron (consult-ant, speaker, stock shareholder, research funding), Genentech/Roche (consultant, speaker), Notal Vision Inc. (consultant, speaker), Alimera Sciences (consultant, speaker, stock shareholder), Allergan (consultant, research funding), Sun Pharmaceutical Indus-tries Inc. (consultant, speaker), Medical Director of Macular Degeneration Association (consultant, speaker), and Founder & CEO of Mali Enterprises. Check out his website here.

References:

1. Author: Bahá’u’lláh. Bahá'í Reference Library. Gleanings From the Writings of Bahá’u’lláh. Pages 287-289. http://reference.bahai.org