 So we had the ID Tech X show right here and you just had a keynote, so who are you? So I'm Richard Kirk, Chief Executive Polyphotonics and I've just been talking about a treatment for diabetic retinopathy which developed a few years ago. So I've just been sharing our findings, telling everybody about it. The thousand people in here and I'll post the whole keynote in the video. So right here it looks like a mask and it looks like really exciting because there's a lot of people affected by diabetic retinopathy or what's it called? Well diabetic retinopathy is a disease that's a consequence of diabetes and it almost two-thirds of people with type 2 diabetes will go on and develop some form of diabetic retinopathy and ultimately it makes you go blind. How many people is that? Well it depends on the figures but we're looking at in excess of 400 million people worldwide with diabetes so a fair portion of those have this disease. So perhaps 300 million or more than 200 million people? With the disease well over 100 million people with the disease but with many more with background conditions and lots more undiagnosed as well. So 100 million people are going blind because of diabetes? Yes. Right now? Yes. And you have a solution? Yes. I mean there's another thing they're doing, they're doing this painful thing with getting injections right? Well there's two types of standard injection and one is it's literally an injection into the eye and that's an intraocular injection, it's a drug which is a suppressant of neovascular growth at the back of the eye, it's a VEGF suppressant. But it's as painful as it sounds, I mean it's an injection into the eye repeatedly. Well eye is sleeping right, you don't see the needle come in. You do? No they clamp the eye, they hold it open and the injection into the eye, you see everything. It's really bad, it's awful. But you have a solution where and is it even better, your solution than what the injection would do? Well we believe so, we've got some clinical trials that show it is and the beauty of our treatment is it's a mask, it's not dissimilar to a kind of mask that you would wear on an aeroplane but you wear it at night as you go to sleep and the mask emits a light into the eye and as you're asleep it prevents dark adaptation of the rod, the rod being one of the two photoreceptors and as we suppress the rod activity we reduce the oxygen demand at the back of the eye and that's the principle behind it so it's very very simple, you can almost put it on the back of an envelope and it costs a fraction of the current treatment which is why payers like the National Health Service or insurance groups are really excited. It could save hundreds of millions in the UK alone. So it's just a mask, what kind of light is it emitting in your eye? So it looks... Does it look like you're looking at daylight while you're sleeping? No, it's a fairly low level light and it looks like a green light but the eye adapts to it very very quickly. The brain has something called a troxel effect which kicks in and after a few minutes the brain just decides it's not interesting and chooses to ignore it but anyway it's a light that the cone doesn't see. Now our cone photoreceptor is what we use in daytime and for all our central vision so talking to you now I'm using my cone I'm looking directly at you. If we were activating the cone at night then it would be almost impossible to sleep so the beauty of the mask is it only affects the rod and we just don't see it so it's really very very simple. It doesn't change your sleeping patterns or do you mean green now or people that wear it? No it doesn't because as part of the clinical trials and the regulatory approvals we have to demonstrate that it doesn't change sleeping patterns, it doesn't change the electrophysiology at the back of the eye and all of these things so we have to test it on healthy people as well and the evidence shows it doesn't affect sleeping at all. In fact to some degree we would say it improves it and that's partly because people who use this mask have a number of complications from the disease of diabetes and the eye disease is just one of a number of complications so they have interrupted sleeping anyway but we find that they start to change their habits if you start to do something regularly as simple as putting a mask on every night and then looking at how we use that mask then it forms a habit and what we see as long-term users actually report improved sleeping patterns. So potentially you can have like sleep sensors in there or you could like show a graph of how good your sleep was. Yeah it's a really good point so eventually we can have sleep sensors in there we can record the type of sleep you're having the quality of the sleep and it could be linked to all these other things. So yeah you're completely right this is just the first part of what could be a very comprehensive tool to analyze lifestyle and sleeping. And in your presentation you said it's all about oxygen so your solution? It's almost an oxygen mask so oxygen is the driver it's the hypoxia that happens in the retina at night and it happens to healthy people it's just that that hypoxia as the rod starts to demand more oxygen it's the hypoxia that drives neovascularization and when you're diabetic the neovascularization is compromised and that's the you end up in this vicious circle of oxygen starvation neovascularization compromise neovascularization and then you start to develop aneurysms and bleeding. So the light can trigger the oxygenation? So what the light does is suppress the oxygen demand in the patients at night. It suppresses it because it prevents the dark adaptation of the rod. So it's remarkably simple. It's triggering immune systems right? No, no, no it's simply suppressing the dark adaptation of the rod. Very simple. Is it an LED type of light? This particular version of the mask is an OLED, an organic light emitting diode which is where we come from. Is that the best kind of light? Is it more natural light than LED? Is that changing anything? No, that doesn't really matter. The light that we're putting into the eyes within the visible spectrum anyway, although we've had to do lots of tests about its wider implications of illuminating the eye at night and we've done lots of safety tests around that. But the source of the light doesn't matter so much as the wavelength and what type of light it is. So a wavelength, you have a specific... It's a very narrow wavelength, a very specific wavelength. The one you just emits that one exactly and that's the one that you don't need any other wavelength. So other wavelengths would start to activate other parts or other photoreceptors and they would, if anything, activate the photoreceptors and that's what we don't want to do. We want to suppress them. This is really important in revolutionising. In your presentation you were talking about one lady that, for example, got improved vision out of that? That's right, Isabel. It doesn't happen with everybody but sometimes patients can see a fairly quick improvement in as little as three to four months and in some patients who have worn glasses for a long time, we're changing the shape at the back of the eye to some degree and we're reducing the edema and Isabel was a long-term patient. She'd worn the mask for about 12 months but she'd also worn glasses all her life and we changed the shape at the back of the eye so much that she needed a new prescription. So Isabel was quite unusual. That doesn't happen to a lot of people but what we're looking for is a reduction in the size of the cyst but also a parallel improvement in visual acuity. The two go together. And so of course it's amazing to save sight. People can keep seeing that that's a huge value but right now if you get injections, if people get injections it costs 6,000 pounds per year. At least per eye or per eye. Yes. 6,000 pounds per eye per year. Yes. And that cost is definitely cheaper. Oh, it's a fraction of the cost. The NHS, you know, estimate that on adoption of this they could save at least 300 million a year in the UK alone. So if you look at that across the world, you know, the savings are colossal. So that's why you are working with NHS, right? NHS is a key partner. They're one of our largest research partners. One of our largest funders as well. They've been funding a number of clinical trials. But we're also working in a number of other countries, in particular in Brazil. We're working in the US. We're working in the Middle East and in France. So we're starting to spread our wings and move abroad. When you have this slide where you have all these different countries and you say the United Kingdom is in the bottom right and Denmark is near over there, is it, does it have to do with the regulations? It does. I mean, the indices on this graph are very interesting. It's to do with the ease of doing business, the levels of corruption, etc. of which, you know, Denmark and the United Kingdom score very highly on. Well, in terms of very low levels of corruption. Very low. But the countermeasure to that is the fact that there are a lot of bureaucracy and a lot of regulation. It's actually very difficult to get very simple things done. And that's one of the problems. And that's why the UK scores so low on that. How long have you been having the solution going on? So we developed, we started our trials, our own trials in 2011. We knew fairly quickly that the mass worked, but we had to develop the efficacy. We had to develop the proof. We were able in so much as we had regulatory approval about three years ago. And so we've been battling levels of bureaucracy and, and, and, you know, the inability for institutions to adopt for the last three years. But so you're talking about seven years of trying to get it? Well, the first few years were developing the science and getting it through its trials. But the last two or three years have been just trying to get it adopted. And, you know, and you have to look at incentives. What, you know, why, why a motivation? Why are certain institutions prevented from acting quickly on innovation? You know, and there's, there's a number of very complex reasons for that. But people are going blind. So you have to hurry up. The frustrating thing is, well, you know, while, while governments and institutions hesitate, people are going blind. That's really frustrating. And but how many users do you have right now? You have thousands or what do you have? Yes, within clinical trials, we have hundreds within clinical trials, and a few thousand within private patients. We have over a million hours of recorded patient use. But also importantly, within those million hours, we don't have a single adverse, serious adverse event reported. No adverse? No. So it's 100% good? Yes. For sure. Yeah. I mean, all these hundreds of users and thousands of users, they are basically all seeing improvements. Well, no, I mean, a majority is seeing improvement. We can't say everybody's seeing improvements. You know, some people are non-responders. Some people have other things going on in their life, which mean that, you know, the mass, it means the mass isn't as effective as it could be. What we can't do is control diabetes. So, you know, if a patient has a number of serious issues related to that diabetes, that will, you know, affect the mass, the efficacy of the mask. But in the majority of patients who wear the mask are very compliant. We see very good improvements, very good. Did you say 67%? The trials have shown it's on average about 67%. Of the people are getting improvements? Yes, which can contrast very well with the current other treatments. The other big treatment being the laser treatments, intra-photo-coagulation, which destroys the ROD photoreceptors. And after a number of laser interventions, you start to lose your peripheral eyesight and eventually you'll use your driver's license, you know, you can't see at night. The other intervention is the injection into the eye, which has some problems associated with it, but the biggest immediate one is the cost of that intervention. Healthcare systems just, you know, can't afford it. But the injection is getting how many percent of people improving? It's on average, well, it depends on which districts, but you're looking at about a 30% have a very good improvement, 30% see a normalization, a stasis of the disease. But you have definitely better than that. It depends. You see, diabetic eye disease is a fairly long disease. You have a very early stage and you have acute late stage. And it depends at what point are you measuring. So what we've seen in our clinical trials that we have very good efficacy with late stage, but also because it's relatively cheap, we can use it earlier in the disease path. And it can be used as a treatment, but also as a prevention. And that's what's quite exciting about the mask, because it's so cheap, we can use it early. But the late stages like the very urgent ones, right? They're going, well, I mean, if you're you see improvements, yeah, yeah, absolutely. If it's late stage, then you've got some vision impairment. It's bad, you know, to even get to that point where you you you need interocular injections is is is bad. But you were talking about a thousand pound per cost. What's the cost of your solution? Is it? Well, they are cheaper differently, right? The mask is a fraction of the cost of the other treatments. Now, some of that cost is the clinical cost. So polyphotonics never sells directly to a patient. We only ever work through prescribed sorry polyphotonics only ever sells start again. Polyphotonics never sells to directly to a patient. We only ever work through health care professionals. For example, the NHS or a private insurance company or, you know, directly with an eye, eye hospital or an eye clinic. Some of those costs are borne by well costs additional overheads from the clinic because, you know, there's some time you have to spend with patients. So you have a very highly qualified or mythologist clinician talking to a patient having regular checkups. What we advise is a three monthly checkup. And this is to make sure that the mask is efficacious, it's working and also to see whether any alternative treatments required. So three months seems to be the regular interval pretty much around the world. Most eye hospitals around the world have regular three months interventions. So the mask is designed to integrate with that existing system. So it will last for three months in a battery or? Yeah, exactly. So it has an on date and an off date. You decide what that date is. So 90 days of all night. Yep. Battery life. Yeah. And then it turns itself off. So there's no no nothing. And there's a an internal clock. So the mask turns on a date that you decide with your physician. And then the mask will turn itself off in three months. And you have to go back and get a replacement. Potentially you could do other versions that people could recharge at home. Well, potentially technology is improving all the time. You know, the lighter meters are getting more efficient. The batteries are getting more efficient. And as those progress and improve, we will follow suit and improve the device. So eventually you could have a device that lasts longer. But what we recommend is working in conjunction with the eye hospital or eye clinic and the physician. So three months regular intervals are recommended. That's for patients with late stage disease. If it's being used as a preventative early stage disease, then you may only go to your physician once a year. And you know, and that would be a different scenario. And OLED lighting seems to be constantly improving. Like at the adi-tech show we're over here. Lots of talk about flexible or printed OLED. Yes. Potentially making the mask lighter. Absolutely. So as the technology is improving initially we could only really make OLEDs on glass. But now we can make flexible OLEDs. So working already? Well, we don't do the OLEDs. We work with an OEM. But they're improving as well. So as all these improvements come through over the next few years, the mass will get thinner, it become more flexible, it'll be more conformable, and more intelligent. You know, there's a bunch of stuff we can put in there. More sensors. More sensors, more communication, looking at sleeping patterns, accelerator devices. Bluetooth. Bluetooth, exactly. All of these things. I like the hub and stuff. So it just goes to the cloud. Exactly. Exactly. That's, I mean, that's all pretty much doable now. It's just a question of time and money and effort and making these things happen. Awesome. But I think it's amazing. Thanks a lot for saving people's vision. Thank you. I think it's great. And improving their vision even. Yes. Yeah, exactly. It's really amazing. Exactly. As I said, it's one of the most common causes of blindness around the world. And stopping that and preventing it and improving vision is very exciting.