GENERAL INFORMATION
Established:  2000
Ownership:  Private
Parent:  Innomed Fund

Core business

Screen based diagnostic tool for early detection of Age-Related
Macular Degeneration (AMD).

Employees:  25
Main Markets:  Optometrists, Ophthalmologists.

Overview

NOTAL VISION was founded in May 2000, by a group of senior
ophthalmologists from Israels' leading medical centers.

The company is developing the first comprehensive diagnostic
solutions for the early detection and frequent monitoring of
Age-Related Macular Degeneration (AMD), the leading cause of
blindness in the western world today.

AMD is a bilateral condition that has three stages. Early AMD is
characterized by the presence of small or medium-sized drusen
(yellow spots due to accumulation of material in one layer of the
retina) and has a very low risk (<2% chance) of progressing to
advanced AMD (see below) within 5 years. Intermediate AMD is
characterized by the presence of at least one large-sized druse
(greatest linear dimension at least 125 microns) or at least 20
medium-sized drusen (greatest linear dimension at least 63
microns but less than 125 microns. Intermediate AMD with focal
hyperpigmentation of the retinal pigment epithelium (RPE) within
1500 microns of the foveal center has a high risk of progressing
to advanced AMD within 5 years. This risk is >50% in the
fellow-eye of an individual with unilateral nonvascular
maculopathy and at least 25% in an individual with bilateral
evidence of intermediate AMD.

To address the growing need for early detection of wet AMD and
for the continuous monitoring of patients with dry AMD, NOTAL
VISION has developed the patented Preferential Hyperacuity
Perimetery - PHP platform, designed to detect and monitor the
progression of the disease in a non-invasive manner.

The PHP technology is based on the well-studied visual phenomenon
of hyperacuity. Hyperacuity (also termed "Vernier acuity") is
defined as the ability to perceive a minute difference in the
relative spatial localization of two or more visual stimuli.
Hyperacuity threshold may be as low as 3 to 6 sec of an arc,
which is approximately 10 times better than the resolution
ability; which is around 30-60 seconds of an arc in the fovea.
The hyperacuity stimuli are highly resistant to retinal image
degradation and thus suitable for assessing retinal function in
patients with opaque media as well. No systematic variation of
hyperacuity threshold has been found, with increasing age, in a
study group of patients whose age ranged from 20 to 85 years.

When a dotted line is presented to a healthy retina, a collinear
set of retinal receptive fields is stimulated. This information
is being processed by specialized neuronal circuits in the visual
cortex, leading to a perception of a straight dotted line. When
there is retinal pigment epithelium (RPE) elevation, such as
occurs in AMD, both in the case of some drusen secondary to early
AMD, and often to a more significant degree when
neovascularization develops, a geometrical shift in photoreceptor
location may occur. As a result, an object image, which would
stimulate certain photoreceptor field when presented to a normal
retina, will stimulate different ones when the pigment epithelium
is elevated. Thus, certain dots, which are presented aligned in a
straight line, may be perceived at a different distorted location
from their true location in space.