New hope for
retinal disease.

What is CIRRUS PathFinder?

CIRRUS PathFinder is an artificial intelligence tool integrated directly into the ZEISS CIRRUS OCT imaging platform. It analyses macular OCT scans in real time, automatically highlighting scans that may require closer clinical review. Rather than replacing clinical judgement, it functions as an intelligent second layer of assessment — flagging subtle findings that might otherwise be easy to miss in a busy clinic.

What does it detect?

The AI is trained to identify eight key macular findings: subretinal fluid, intraretinal fluid, retinal pigment epithelium (RPE) atrophy, RPE elevation, disruption of the inner retinal layers, vitreoretinal interface abnormalities, and photoreceptor (inner segment/outer segment) disruption. These findings are relevant to conditions including wet and dry AMD, diabetic macular oedema, epiretinal membrane, and other macular diseases.

How does it work?

PathFinder follows a four-step automated workflow: Acquire — a dense 512×128 Smart Cube scan centred on the fovea is captured; Qualify — image quality is assessed using deep learning; Detect — the AI screens for the eight conditions; Flag — scans with poor quality are highlighted in yellow, and B-scans with detected pathology are highlighted in red for the clinician's review. The tool can be switched on or off, and is also useful as an educational aid.

Why does this matter for patients?

Many serious retinal conditions — including early wet AMD, diabetic macular oedema, and epiretinal membrane — are most treatable when detected early. AI-assisted analysis helps ensure that subtle changes in OCT scans are not overlooked, supporting earlier diagnosis and intervention. It also improves monitoring consistency for patients already on treatment, helping detect signs of disease recurrence or progression between visits.

Availability at this practice

CIRRUS PathFinder is integrated into the ZEISS CIRRUS OCT system used at Asia Pacific Eye Centre. AI-assisted scan assessment is part of the standard retinal imaging workflow for patients undergoing OCT at this clinic.

What is Luxturna?

Luxturna (voretigene neparvovec) is a one-time gene therapy delivered by a single subretinal injection to each eye. It uses a modified adeno-associated virus (AAV2) as a vector to deliver a functional copy of the RPE65 gene directly into the retinal pigment epithelium (RPE) cells. Once delivered, the RPE cells begin producing the RPE65 enzyme, restoring the visual cycle and improving light sensitivity. It is the world's first FDA-approved gene therapy for a genetic disease caused by a mutation in a specific gene.

What is RPE65 retinal dystrophy?

Mutations in both copies of the RPE65 gene disrupt the visual cycle — the biochemical process by which the eye converts light into electrical signals. Without functional RPE65 enzyme, vitamin A cannot be recycled into the light-sensitive form needed by photoreceptors. This causes severe loss of light sensitivity from early childhood, often leading to near-total blindness. Conditions include Leber Congenital Amaurosis type 2 (LCA2) and RPE65-associated retinitis pigmentosa.

Who may be eligible?

Patients with confirmed biallelic RPE65 mutations (both copies of the gene affected), with sufficient remaining viable retinal cells as determined by clinical assessment. Genetic testing is required to confirm eligibility. Luxturna is not recommended for infants under 12 months as the retina is still developing. Earlier treatment — before extensive photoreceptor loss — is expected to yield greater benefit.

Clinical evidence

The Phase 3 pivotal trial (NCT02516369) enrolled 31 patients aged 3 years and older with biallelic RPE65 mutations. The primary endpoint was improvement on the bilateral multi-luminance mobility test (MLMT), which measures the ability to navigate a maze at different light levels. Luxturna-treated patients showed a mean improvement of 1.8 light levels versus 0.2 in controls (p = 0.0013). Durability data at 4 years confirms sustained benefit.

Regulatory status

Approved by the US FDA in December 2017 — the first FDA-approved directly administered in vivo gene therapy for a genetic disease. Subsequently approved by the European Medicines Agency (EMA) in November 2018 and by the Australian TGA. Speak with Dr. Wong to discuss availability and whether genetic testing for RPE65 mutations is appropriate for you or your child.

What is this procedure?

This is a two-part innovation: the Yamane sutureless scleral fixation technique is used to implant a Light Adjustable Lens (LAL) in an eye that lacks the normal capsular support required for standard IOL placement. The LAL is then fine-tuned post-operatively using a UV laser — correcting any residual refractive error without further surgery. The combination addresses both the surgical challenge of absent capsular support and the optical challenge of achieving precise post-operative refraction.

Who is this for?

Patients who need a secondary IOL implant or IOL exchange but do not have capsular support — including those with dislocated or subluxated natural lenses (e.g. Marfan syndrome, pseudoexfoliation, trauma), eyes that have undergone prior complicated cataract surgery resulting in aphakia, and patients needing removal and replacement of a dislocated artificial lens. It is particularly suited to patients who place a high priority on refractive outcome and wish to reduce dependence on spectacles.

The Yamane technique

In conventional scleral-fixated IOL surgery, the lens is anchored to the scleral wall using permanent sutures — which can erode, break, or cause long-term complications. The Yamane technique eliminates sutures entirely: the haptics (support arms) of a three-piece IOL are threaded through narrow tunnels created in the sclera using thin 30-gauge needles, then small flanges are formed at the tips to anchor the lens securely. This provides stable, long-term fixation through a self-sealing wound with no suture-related risk.

The Light Adjustable Lens

The RxSight Light Adjustable Lens (LAL) is made from a photosensitive silicone material whose refractive power can be changed after implantation using a controlled UV light delivery system. Approximately 3 weeks after surgery, once the lens has settled, a series of brief outpatient light treatment sessions are used to adjust the lens power — correcting sphere (−2.00 D to +2.00 D) and astigmatism (up to −2.00 D). The final refraction is then locked in with a final light treatment. This allows true customisation of vision outcome based on how the eye has healed.

Clinical evidence

A 2024 systematic review and meta-analysis of 737 eyes confirmed the Yamane technique achieves excellent stability and visual outcomes comparable to sutured scleral fixation, with a favourable complication profile. Published case reports of Yamane-fixated LAL — including in patients with Marfan syndrome — have documented outstanding refractive outcomes (20/20 uncorrected distance vision) that would not be achievable with a conventional fixed-power IOL in these complex cases. A bench study has confirmed the structural suitability of the LAL haptic-optic junction for Yamane fixation.

Availability at this practice

Scleral fixation of the Light Adjustable Lens using the Yamane technique is available at Asia Pacific Eye Centre. Speak with Dr. Wong at a consultation to discuss whether this approach is suitable for your condition.

What is geographic atrophy?

Geographic atrophy (GA) is the advanced form of dry age-related macular degeneration (AMD). It occurs when cells in the macula — the central part of the retina responsible for detailed, central vision — progressively die. GA leads to an expanding blind spot in the central vision and currently has very limited treatment options. It affects millions of people globally, and is one of the leading causes of irreversible central vision loss in older adults.

How does Izervay work?

Izervay (avacincaptad pegol) is a complement C5 inhibitor. It works by blocking a specific protein (complement C5) in the complement immune pathway, which is overactivated in dry AMD and drives the progressive death of retinal cells in GA. By inhibiting C5, Izervay interrupts this destructive cycle and slows the spread of cell loss. It is given as a monthly intravitreal (into the eye) injection.

Clinical evidence

GATHER1 and GATHER2 were Phase 3, randomised, double-masked, sham-controlled trials enrolling a combined 734 patients. Both trials demonstrated statistically significant reductions in GA lesion growth. Long-term data from the open-label extension study (up to 3.5 years) showed that the treatment benefit increases over time — with greater lesion growth reduction at 3.5 years than at earlier timepoints — and that earlier treatment preserves more retinal tissue.

Safety profile

No new safety signals were identified in up to 3.5 years of follow-up. Notably, no cases of retinal vasculitis or occlusive vasculitis were observed. Real-world data from over 10,000 patients in the United States confirmed a favourable safety profile consistent with the trial data.

Regulatory status

Izervay is approved by the US FDA and the Australian Therapeutic Goods Administration (TGA). It has received conditional approval in Japan. Regulatory review for Singapore is anticipated. Availability in Singapore is subject to HSA approval.

Who may benefit?

Adults with GA secondary to age-related macular degeneration. Earlier treatment — before GA has spread extensively — appears to preserve more retinal tissue. Patients with dry AMD who have noticed changes in central vision should see a retinal specialist promptly for assessment and imaging.

What is the Port Delivery System?

Susvimo uses the Port Delivery System (PDS) — a tiny, permanent, refillable implant about the size of a grain of rice that is surgically placed in the eye wall (sclera) in an outpatient procedure. Once implanted, it continuously releases a concentrated formulation of ranibizumab directly into the eye over several months. When the reservoir is depleted, it is refilled in clinic via a simple office procedure — no repeat surgery required.

Why does this matter?

Diabetic retinopathy currently requires frequent intravitreal injections — often monthly or every two months — to prevent vision loss. For many patients, the treatment burden of repeated injections is a significant barrier to consistent care. Susvimo offers a potential paradigm shift: sustained drug delivery from a single implant, with refills needed only every 9 months, while maintaining effective treatment of the underlying disease.

Clinical evidence

The Pavilion trial (Phase III, NCT04503551) enrolled 174 patients with non-proliferative diabetic retinopathy who had responded to prior anti-VEGF treatment. Participants were randomised to Susvimo (refilled every 9 months) or monthly clinical observation. At 52 weeks, Susvimo achieved superior improvement on the Diabetic Retinopathy Severity Scale (DRSS), and no participant in the Susvimo group required supplemental treatment during the first year.

Who may be suitable?

Patients with diabetic retinopathy who have previously responded to at least two anti-VEGF injections. The implant is placed surgically and requires a suitable candidate assessment. Speak with Dr. Wong to understand whether Susvimo may be an option once it becomes available in Singapore.

Regulatory status

FDA approved for diabetic retinopathy in May 2025 — Susvimo's third FDA-approved indication, following wet AMD and diabetic macular oedema. HSA approval in Singapore has not yet been announced. Availability in Singapore is subject to regulatory review.