A NOVEL, COMBINATION
EYE DROP

We’re in pursuit of developing the world’s first presbyopia-correcting eye drop with the potential to provide a significant improvement in functional vision through the workday.

BRIMOCHOL PF is an investigational drug designed to be a once-daily eye drop to correct for the loss of near vision associated with presbyopia.

A NOVEL, COMBINATION
EYE DROP

We’re in pursuit of developing the world’s first presbyopia-correcting eye drop with the potential to last a minimum of 8 hours.

BRIMOCHOL is an investigational drug designed to be a once-daily eye drop to correct for the loss of near vision associated with presbyopia.

BRIMOCHOL IS UNIQUE

  • BRIMOCHOLTM PF is a proprietary pupil-modulating eye drop that combines two well-studied, FDA-approved pharmaceuticals: carbachol (a cholinergic agent) and brimonidine tartrate (an alpha-2 agonist).
  • Together, they produce a “pinhole effect,” which reduces the size of the pupil so that only centrally focused light rays are able to enter the eye, thereby sharpening distant and near images while minimizing side effects. The result is clarity of vision for near tasks like reading or using a smartphone.
  • This patented combination eye drop has been studied in more than 200 patients in six successfully completed clinical studies.
  • The first of two pivotal Phase 3 trials (BRIO-I and BRIO-II) are underway.

BRIMOCHOL MECHANISM OF ACTION

  • Carbachol is the most potent and durable miotic agent for pupil constriction,1 while brimonidine tartrate is a sympatholytic alpha-2 agonist that prevents pupil dilation. Miotics reduce the size of the pupil, creating a “pinhole” effect that results in an improvement in near visual acuity.
  • The addition of brimonidine tartrate, an inhibitor of iris dilator muscle contraction, may also inhibit the contraction of the ciliary muscle by activating alpha-2 receptors, potentially mitigating the side effects commonly associated with miotics.²
  • Brimonidine tartrate also appears to increase the bioavailability of carbachol by altering aqueous dynamics, prolonging the pinhole effect3,4 and contributing to a longer duration of action.5

WHAT IS PRESBYOPIA?

Presbyopia is a natural, inevitable part of the aging process and the most common cause of vision impairment. Loss of near vision typically begins when adults reach their mid-40s, and the condition is almost universal by age 50.⁶ The vast majority of people will experience presbyopia in their lifetime. It is estimated that presbyopia will affect 2.1 billion people globally in 2020, with approximately 128 million residing in the US.7,8

CAUSES OF PRESBYOPIA

The clear lens in the eye focuses light onto the retina. In younger people, the lens is soft and flexible and changes shape easily, which is what allows us to shift focus between near and distant objects. As we age, the lens becomes more rigid and isn’t able to change shape as easily, making it more difficult to focus up close.

BRIMOCHOL IS UNIQUE

BRIMOCHOL MECHANISM OF ACTION

WHAT IS PRESBYOPIA?

Presbyopia is a natural, inevitable part of the aging process and the most common cause of vision impairment. Loss of near vision typically begins when adults reach their mid-40s, and the condition is almost universal by age 50.⁶ The vast majority of people will experience presbyopia in their lifetime. It is estimated that presbyopia will affect 2.1 billion people globally in 2020, with approximately 123 million residing in the US.⁷

CAUSES OF PRESBYOPIA

The clear lens in the eye focuses light onto the retina. In younger people, the lens is soft and flexible, and changes shape easily, which is what allows us to shift focus between near and distant objects. As we age, the lens becomes more rigid and isn’t able to change shape as easily, making it more difficult to focus up close.

Pipeline

Visus Therapeutics is dedicated to helping the billions of adults who suffer from presbyopia through the development of its investigational medicine, BRIMOCHOL™. BRIMOCHOL is being studied as a prescription eye drop designed to correct the loss of near vision associated with presbyopia.

IMPACT ON DAILY ACTIVITIES

Typically, the first symptom of presbyopia is the tendency to hold reading materials, such as a restaurant menu or a medication label, farther away. Over time, it gets harder to see objects at an intermediate distance, like a computer screen or labels on a store shelf. Reading glasses or bifocals are the most common correction for presbyopia. Without using some type of correction, people may experience blurred vision, eye strain, or headaches.

SPOTLIGHT ON PRESBYOPIA

MEET THE SCIENTIST WHO DISCOVERED BRIMOCHOL™

Photo Collage
Herb Kaufman, MD, age 26

Visus Therapeutics’ lead product candidate, BRIMOCHOL PF, was developed by Dr. Herb Kaufman, a renowned researcher and inventor in ophthalmology. He is perhaps best known for discovering and developing the world’s first antiviral drug for the treatment of virus infection, which led to the introduction of the combination of steroid and antiviral therapy for stromal keratitis in 1962. This achievement was followed by more than 15 research discoveries over his lifetime, which significantly advanced patient care in ophthalmology and beyond. After retiring in 2008 from his role as Emeritus Boyd Professor of Ophthalmology and Pharmacology & Experimental Therapeutics at LSU, instead of basking in retirement life, Dr. Kaufman, along with one of his former fellows, quietly led a research initiative that would eventually culminate in the development of BRIMOCHOL PF.

Herb Kaufman, MD: A Lifetime of Landmark Innovations in Ophthalmology and Beyond

Developed world's first antiviral drug effective for treatment of virus infection.

Introduced combination of steroid/antiviral therapy for stromal keratitis.

Determined that epithelial healing problems are due to hemidesmosomal defects.

Introduced trifluridine, the most effective antiviral to date.

First to successfully cryopreserve corneas suitable for cornea transplantation.

Developed use of pimaricin (natamycin) for treatment of fungal keratitis.

Recognized glaucoma after corneal transplantation.

Introduced bandage soft contact lenses and first studied clinical use.

Made modern eye banks possible. Introduced method of removing cornea and placing it in nourishing solution (McCarey-Kaufman Medium), and then in Optisol.

Co-developed clinical specular microscope with William Bourne, MD.

Determined cause of endothelial damage associated with IOL insertion and introduced use of viscoelastics.

Helped develop the clinical confocal microscope.

Introduced and first studied timolol for treatment of glaucoma.

Developed an early refractive surgery, epikeratophakia.

Helped develop excimer laser refractive surgery with Marguerite McDonald, MD.

Introduced use of collagen shields for drug delivery to cornea.

Used Polymerase chain reaction (PCR) to become the first to confirm ubiquity of herpes shedding.

Developed drug delivery ring for prolonged drop-free dosing.

Patented the combination of carbachol and brimonidine tartrate (BRIMOCHOL) for the treatment of presbyopia.

1. Stamper RL, Lieberman MF, Drake MV, eds. Becker-Shaffer's Diagnostics and Therapy of the Glaucomas. 8th ed. Mosby; 2009.
2. Kubo C, Suzuki R. Involvement of prejunctional alpha 2-adrenoceptor in bovine ciliary muscle movement. J Ocul Pharmacol. 1992;8(3):225-231. doi:10.1089/jop.1992.8.225
3. Data on File
4. Data on File
5. Abdelkader A. Influence of Different Concentrations of Carbachol Drops on the Outcome of Presbyopia Treatment—A Randomized study. International Journal of Ophthalmic Research. 2019;5(1):317-319.
6. Mancil GL, Bailey IL, Brookman KE, et al; American Optometric Association Original Consensus Panel on Care of the Patient with Presbyopia. Optometric Clinical Practice Guideline: Care of the Patient With Presbyopia. American Optometric Association; 2011.
7. Zebardast et al. The Prevalence andDemographic Associations of Presenting Near-Vision Impairment Among AdultsLiving in the United States. Am J Ophthalmol. 2017;174:134-144.
8. U.S. Census Bureau. Table 9. Washington: Population Division. 2014.

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Seattle, WA 98109

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