Quinton OswaldChief Executive Officer

OIS@AAOOctober 13 2016

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A NEW PARADIGM FOR THE

Detectionof Ocular Diseases

FIRST APPLICATIONAge-Related Macular Degeneration (AMD)

The #1 Cause of Vision Loss in People 60+*

… in diseases where early detectioncan dramatically affect outome

* In developed countries

P H Y S I C I A N - D R I V E NDiagnosis and Treatment

PAT I E N T- A C T I VAT E DDetection

T E C H N O LO G Y- E N A B L E D

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AMD Innovation Focused on Physician-Driven Diagnosis and Treatment

1MarketsandMarkets Report 2 GlobalData estimate of 2023 AMD Global Treatment Market

ACCURATEDIAGNOSIS

EFFECTIVETREATMEN

T

Optical Coherence

Tomography(OCT)

Anti-VEGFsand

Future Novel Therapies

DrivingSignificant

Markets HOWEVER:

$1B1

~$10B2

Detection IsNot Timely

TreatmentDemonstrates Efficacy but

Functional Vision May Never Be

Restored

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Broad Macro Trends Support Focus onPatient Empowerment

2

Technology-EnabledRemote

Detection and Diagnosis

1

Earlier DiseaseDetection Drives

Better Outcomes

3

ReimbursementBecomes

Outcomes-Driven

$ $

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VisualAcuity

SevereVisionLoss

Dry AMD Wet AMD

Downward Cascade in Vision Loss

May Go Unnoticed by

Patients

The Challenge: Timely Detection of Wet AMD

SlowProgression

RapidProgression

Therapeutics (e.g. Anti VEGFs)

Treat Wet Form Only

Within Weeks:Narrow Window to Detect Transition from Wet Dry

Finding Patients at the Turning Point of Disease …

… So Early Treatment Can Preserve Functional Vision

… 36 Million Globally with AMD

THE DETECTION ‘LOTTERY’

THE CHALLENGE:

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Today: Vast Majority of Wet AMD Patients Are Diagnosed Too Late

Driving Thresholdi.e., ‘Functional

Vision’

Normal

LegalBlindness

20/200

20/40

20/20

TODAY’S REALITY

Lost with Late Dx

Gained with Tx

-18 Letters+8 Letters

~70%*

Below20/40 20/40+

No Longer Have Functional Vision at Diagnosis

BASELINE

May Not Regain Functional Vision with

Treatment

… and

* Analysis of Multiple AMD Studies

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Current Disease Detection Options Are Too Infrequent or Insensitive

Low

High

CLINICALROBUSTNESS

HighLow CONVENIENCE / FREQUENCY

Household Items

Amsler Grid

Smartphone Apps

At HomePatient-Activated

Detection

The Holy Grail

In-Office OCT

Physician-Driven Diagnosis

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CLINICALROBUSTNESS• 94% Maintained

Functional Vision (20/40+) in NIH Study

• Objective measure• Sensitive

Our Pioneering Innovation: Patient-Activated, Clinically Robust Early Disease Detection

CONVENIENCE• 3 minute test per eye• Unique design tailored to

older patient population– Device and Technology

ecosystem

• “Plug and play”• Results sent

directlyto physician

PROVEN

Preferential Hyperacuity Perimetry (PHP)

Detects Onset of Neovascular Leakage within DAYS vs. Week / Months Before

Patients Would Notice Change

3,000+Patients

2 MillionTests

4-5x/Week(for avg. 3.3

yrs)

FDA

Cleared

CE

Marked

MedicareCoverage

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Alert – in event of statistically significant change

5Reminder calls

3

CLOUD HOSTING

Notal Vision Data Monitoring

Center

A Complete, Personalized Monitoring System

Early Detection in Action

OUR ENGINE ROOM IN THE CLOUD• High touch• Technology-enabled• Scalable• Compliant and secure• Fully integrated

billing/reimbursement

1 Patient takes test daily

PHYSICIAN

Physician office calls patient for office visit and treatment

6

Data automatically sent via embedded cellular modem

2 Ongoing monitoring• Monthly reports

pushed• Online access

4

PATIENT

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COMPLEMENTARY

Finally Completing the Missing Linkfor AMD Treatment and Diagnosis

PHYSICIAN-DRIVENFormal Diagnosis

and Treatment with Effective Current and

Future Therapies

2006

PATIENT-ACTIVATED

Convenient, Objective, Accurate Early

Detection

2016

THE NEW REALITY

Taking AMD Treatment to the Next Level

...Shift from

Regaining Vision ... ...to Not Losing It in

the First Place

Enabling Timely Treatment

THANK YOUQUINTON OSWALD, CEOQOswald@notalvision.com(650) 255-4557

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