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


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FORMAT: Monograph

RELEASE DATE: June 1, 2020
EXPIRATION DATE: June 30, 2021

MAXIMUM CREDITS: 1.0 AMA PRA Category 1 Credit™

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LEARNING METHOD AND MEDIUM
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, read the supplement, answer all questions in the post test, and complete the Activity Evaluation/Credit Request form. To receive credit for this activity, please follow the instructions provided on the post test and Activity Evaluation/Credit Request form. This educational activity should take a maximum of 1.0 hour to complete.

ACTIVITY DESCRIPTION
The health of the corneal surface depends on a feedback mechanism that involves sensory 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 keratitis, which is characterized by disrupted tearing and progressive corneal damage that does not readily heal. Until very recently, a lack of effective treatments to reinnervate and heal eyes 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 benefit before the disease progresses to the point of corneal perforation and subsequent loss of visual acuity. The desired results of this activity are to aid clinicians in gaining knowledge and closing practice gaps related to the pathophysiology of neurotrophic keratitis as well as current best practices for screening, diagnosis, and treatment.

TARGET AUDIENCE
This educational activity is intended for ophthalmologists.

LEARNING OBJECTIVES
Upon completion of this activity, participants will be better able to:
  • Describe the pathophysiologic mechanisms driving neurotrophic keratitis
  • Discuss the relationship between corneal innervation and ocular surface healing in neurotrophic keratitis treatment
  • Integrate evaluation of corneal sensitivity into assessment of ocular surface disease
  • Review clinical trial data for approved neurotrophic keratitis therapy
  • Develop evidence-based treatment strategies for patients with neurotrophic keratitis

ACCREDITATION STATEMENT
This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of New York Eye and Ear Infirmary of Mount Sinaiand MedEdicus LLC. The New York Eye and Ear Infirmary of Mount Sinai is accredited by the ACCME to provide continuing medical education for physicians.

AMA CREDIT DESIGNATION STATEMENT
The New York Eye and Ear Infirmary of Mount Sinai designates this enduring material for a maximum of 1.0 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

GRANTOR STATEMENT
This continuing medical education activity is supported through an unrestricted educational grant from Dompé US, Inc.

DISCLOSURE POLICY STATEMENT
It is the policy of New York Eye and Ear Infirmary of Mount Sinai that the faculty and anyone in a position to control activity content disclose any real or apparent conflicts of interest relating to the topics of the educational activity in which they are participating. They are also required to disclose discussions of unlabeled/unapproved uses of drugs or devices during their presentations. New York Eye and Ear Infirmary of Mount Sinai is committed to providing its learners with quality CME activities and related materials that promote improvements in healthcare and not the proprietary interests of a commercial interest and, thus, has established policies and procedures in place that identify and resolve all conflicts of interest prior to the execution or release of its educational activities. Full disclosure of faculty/planners and their commercial relationships, if any, follows.

DISCLOSURES
Kenneth A. Beckman, MD, had a financial agreement or affiliation during the past year with the following commercial interests in the form of Royalty: eyeXpress; Consultant/Advisory Board: Alcon; Allergan; Avedro, Inc; Bausch & Lomb Incorporated; Bruder Healthcare; Dompé farmaceutici SpA; EyePoint Pharmaceuticals; Eyevance; Johnson & Johnson Vision Care, Inc; Kala Pharmaceuticals; Mallinckrodt; Ocular Therapeutix, Inc; Omeros Corporation; Refocus Group, Inc; Shire; Sun Pharmaceutical Industries, Inc; Takeda Pharmaceuticals USA, Inc; and TearLab Corporation; Contracted Research: Avedro, Inc; Icare USA; Kala Pharmaceuticals; and Refocus Group, Inc; Honoraria from promotional, advertising or non-CME services received directly from commercial interest or their Agents (eg, Speakers Bureaus): Alcon; Allergan; Avedro, Inc; Bausch & Lomb Incorporated; Dompé farmaceutici SpA; Johnson & Johnson Vision Care, Inc; Refocus Group, Inc; Shire; Takeda Pharmaceuticals USA, Inc; TearLab Corporation; and Zeiss; Ownership Interest (Stock options, or other
holdings, excluding diversified mutual funds): Avedro, Inc; eyeXpress; Rapid Pathogen Screening, Inc; and RxSIGHT.

Mark S. Milner, MD, had a financial agreement or affiliation during the past year with the following commercial interests in the form of Consultant/Advisory Board: Allergan; Avedro, Inc; Bausch & Lomb Incorporated; Bio-Tissue; Dompé farmaceutici SpA; Eyevance; Kala Pharmaceuticals; Mallinckrodt; Ocular Science; Omeros Corporation; Novaliq GmbH Germany; Shire; and Sun Pharmaceutical Industries, Inc; Honoraria from promotional, advertising or non-CME services received directly from commercial interest or their Agents (eg, Speakers Bureaus): Allergan; Avedro, Inc; Bausch & Lomb Incorporated; Bio-Tissue; Dompé farmaceutici SpA; Eyevance; Shire; and Sun Pharmaceutical Industries, Inc; Ownership Interest (Stock options, or other holdings, excluding diversified mutual funds): Eyevance; Ocular Science; and Percept.

John Sheppard, MD, MMSc, had a financial agreement or affiliation during the past year with the following commercial interests in the form of Consultant/Advisory Board: Alcon; Aldeyra Therapeutics; Allergan; Allysta Pharmaceuticals, Inc; Avedro, Inc; Bausch & Lomb Incorporated; Bio-Tissue; Bruder Healthcare; Clementia Pharmaceuticals Inc; Dompé farmaceutici SpA; EyeGate; EyePoint Pharmaceuticals; Glaukos Corporation; Hovione; Johnson & Johnson Vision Care, Inc; Kala Pharmaceuticals; LacriSciences LLC; LayerBio, Inc; Mallinckrodt; Novartis Pharmaceuticals Corporation; Noveome Biotherapeutics, Inc; Ocular Therapeutix, Inc; Omeros Corporation; Oyster Point Pharma, Inc; Quidel Corporation; ScienceBased Health, Shire; Sun Pharmaceutical Industries, Inc; Takeda Pharmaceuticals USA, Inc; TearLab Corporation; and TopiVert Ltd; Contracted Research: Alcon; Bausch & Lomb Incorporated; Chengdu Kanghong Pharmaceutical Group Co Ltd; Clearside Biomedical, Inc; EyeGate; Hovione; Kala Pharmaceuticals; and Mallinckrodt; Honoraria from promotional, advertising or non-CME services received directly from commercial interest or their Agents (eg, Speakers Bureaus): Alcon; Bausch & Lomb Incorporated; Bio-Tissue; Dompé farmaceutici SpA; and Mallinckrodt; Ownership Interest (Stock options, or other holdings, excluding diversified mutual funds): Doctors Optimal Formula; Eyedetec Medical; EyeRx Research, Inc; Eyevance; Lacrisciences LLC; LayerBio, Inc; Noveome Biotherapeutics, Inc; Oyster Point Pharma, Inc; ProVision Network; Rapid Pathogen Screening, Inc; Scientifically Developed Solutions, LLC; Strathspey Crowne; and TearLab Corporation.

Elizabeth Yeu, MD, had a financial agreement or affiliation during the past year with the following commercial interests in the form of Consultant/Advisory Board: Alcon; Allergan; ArcScan, Inc; Aurea Medical; Avedro, Inc; Bausch & Lomb Incorporated; Beaver-Visitec International; Bio-Tissue; Bruder Healthcare; Cassini Technologies; CorneaGen; EyePoint Pharmaceuticals; Glaukos Corporation; Johnson & Johnson Vision Care, Inc; Kala Pharmaceuticals; LENSAR, LLC; Merck & Co., Inc; Mynosys Cellular Devices Inc; Novartis Pharmaceuticals Corporation; Ocular Science; Ocular Therapeutix, Inc; OCuSOFT Inc; Omeros Corporation; Oyster Point Pharma, Inc; ScienceBased Health; Shire; Sun Pharmaceutical Industries, Inc; TearLab Corporation; and Zeiss; Contracted Research: Alcon; Allergan; Bausch & Lomb Incorporated; Bio-Tissue; iOptics; Kala Pharmaceuticals; and Topcon Medical Systems, Inc; Ownership Interest (Stock options, or other holdings, excluding diversified mutual funds): ArcScan, Inc; CorneaGen; Ocular Science; Oyster Point Pharma, Inc; and Strathspey Crown.

NEW YORK EYE AND EAR INFIRMARY OF MOUNT SINAI PEER REVIEW DISCLOSURE
Angie E. Wen, MD, has no relevant commercial relationships to disclose.

EDITORIAL SUPPORT DISCLOSURES
Cheryl Guttman-Krader; Melissa Carter-Ozhan, MS; Cynthia Tornallyay, RD, MBA, CHCP; Kimberly Corbin, CHCP; Barbara Aubel; and Michelle Ong have no relevant commercial relationships to disclose.

DISCLOSURE ATTESTATION
The contributing physicians listed above have attested to the following:
  1. that the relationships/affiliations noted will not bias or otherwise influence their involvement in this activity;
  2. that practice recommendations given relevant to the companies with whom they have relationships/affiliations will be supported by the best available evidence or, absent evidence, will be consistent with generally accepted medical practice; and
  3. that all reasonable clinical alternatives will be discussed when making practice recommendations.

OFF-LABEL DISCUSSION
This CME activity includes discussion of unlabeled and/or investigative uses of drugs. Please refer to the official prescribing information for each drug discussed in this activity for FDA-approved dosing, indications, and warnings.

New York Eye and Ear Infirmary of Mount Sinai Privacy & Confidentiality Policies
https://www.nyee.edu/education/cme

CME Provider Contact Information
For questions about this activity, call 212-870-8125.

TO OBTAIN AMA PRA CATEGORY 1 CREDIT™
To obtain AMA PRA Category 1 Credit ™ for this activity, read the material in its entirety and consult referenced sources as necessary. Please take the post test and evaluation online. Upon passing, you will receive your certificate immediately. You must score 70% or higher to receive credit for this activity, and may take the test up to 2 times. Upon registering and successfully completing the post test, your certificate will be made available online and you can print it or file it.

DISCLAIMER
The views and opinions expressed in this educational activity are those of the faculty and do not necessarily represent the views of New York Eye and Ear Infirmary of Mount Sinai , MedEdicus LLC, Dompé US, Inc, EyeNet, or the American Academy of Ophthalmology.

This CME activity is copyrighted to MedEdicus LLC ©2020. All rights reserved. 207

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