Previous episodes
In this breaking news episode, John Kitchens, MD, and Scott Krzywonos react to the announcement that Biogen will acquire Apellis Pharmaceuticals for $5.6 billion, an approximately 8x revenue multiple driven largely by Syfovre (pegcetacoplan), which accounts for the majority of Apellis’ srevenue.
In this breaking news episode, John Kitchens, MD, and Scott Krzywonos react to the announcement that Biogen will acquire Apellis Pharmaceuticals for $5.6 billion, an approximately 8x revenue multiple driven largely by Syfovre (pegcetacoplan), which accounts for the majority of Apellis’ srevenue. The discussion focuses on what this acquisition could mean for the future of geographic atrophy (GA) treatment, including concerns around strategic priorities, industry support programs, and whether Biogen will maintain Apellis’ current momentum in retina. Bottom Line This acquisition has the potential to reshape the geographic atrophy landscape — but its success will depend on whether Biogen maintains Apellis’ clinical focus, physician relationships, and commitment to innovation in retina. Hosts: John Kitchens, MD Scott Krzywonos 🎧 Listen now at RetinUp.com or wherever you get your podcasts.
Marion Munk on Photobiomodulation in AMD | Plus, Oliver Hvidt on Norlase and the Future of Laser Technology This episode of RetinUp combines clinical innovation and device engineering, starting with a discussion on photobiomodulation (PBM) in age-related macular degeneration (AMD), followed by a deep dive into the future of ophthalmic laser technology. First, Marion Munk, MD, shares her extensive real-world experience using the Valeda Light Delivery System (Alcon) for PBM, including patient selection, treatment protocols, and functional outcomes. With over 300 patients treated, she provides one of the most comprehensive perspectives currently available on how PBM is being implemented in clinical practice. The episode then shifts to Oliver Hvidt, co-founder and CEO of Norlase, who explains how his training in economics led him to develop a next-generation, portable laser systems. The conversation explores how engineering, economics, and workflow design intersect to improve efficiency in retina practices. The episode opens with a brief discussion on optometric scope expansion in Kansas, where John explains that fears surrounding scope changes may be overblown. Hosts: John Kitchens, MD Scott Krzywonos Guests: Marion Munk, MD – Medical Retina & Uveitis Specialist, Gutblick Group (Switzerland) Oliver Hvidt – Co-Founder & CEO, Norlase Topics Covered Scope Expansion in Optometry Kansas legislation expanding optometric procedural scope Real-world experience from Kentucky following similar changes Why expanded scope has had limited impact on retina practice The evolving role of optometry as general ophthalmology declines Photobiomodulation in AMD (Marion Munk, MD) Differences between general “red light therapy” and medical PBM The Valeda Light Delivery System and evidence from LIGHTSITE trials Real-world outcomes from 300+ treated patients Ideal patient profiles (drusen-predominant AMD, non–center-involving GA) Reported benefits: improved dark adaptation, contrast, and daily function ~50–60% of patients reporting subjective improvement Challenges in correlating functional gains with OCT or structural changes Implementation strategies: standardized imaging, AI-assisted analysis, and patient tracking When to continue vs. discontinue treatment in non-responders Norlase and the Future of Laser Technology (Oliver Hvidt) Founding story: from engineering collaboration to ophthalmic application Redesigning laser architecture using semiconductor technology Miniaturization and portability (headset-based indirect laser systems) MEMS-based pattern scanning vs. traditional galvanometer systems Designing equipment around workflow efficiency, not just performance Addressing increasing patient volume with limited clinical resources Funding challenges in a post-COVID, AI-dominated investment landscape Future roadmap: software-driven upgrades and multi-specialty applications Key Takeaways Photobiomodulation is gaining traction, but patient selection and expectation-setting are critical. Functional improvements in AMD may not always correlate with structural imaging. Device innovation in retina is increasingly focused on efficiency, portability, and workflow integration. The future of ophthalmic technology will depend as much on practice economics as clinical performance. Sponsor Acknowledgment This episode includes a segment made possible with support from Alcon, featuring technologies like UNITY VCS designed to enhance surgical performance and efficiency. Credits: Production & Marketing: Laura Brown Business Operations: Liz Hogan 🎧 Listen at RetinUp.com | Apple Podcasts | Spotify | YouTube
Show Summary In this special RetinUp Mailbag episode, John Kitchens and Scott Krzywonos answer listener questions from retina specialists around the country about three issues: cash-pay diversification, the future of emerging therapies in light of payer realities, and how practices can realistically adopt expensive new technology as reimbursements decline. The conversation explores whether concierge retina models could emerge in certain markets, how insurers may respond to high-cost innovations like gene therapy and tyrosine kinase inhibitors, and what practical frameworks practices use when deciding whether to invest in new surgical or imaging equipment. Throughout the episode, a central theme emerges: innovation in retina continues to accelerate, but reimbursement pressure is forcing practices to rethink business models, technology adoption, and long-term sustainability. Topics Covered Cash-Pay Diversification in Retina Listener question from Jed Assam, MD (VRA Vision, Sioux Falls, South Dakota) Whether concierge retina could work, and whether VIP-style care models might translate to retina practices Potential cash-pay services such as photobiomodulation (PBM) therapy Operational considerations for scheduling concierge visits separately from standard clinic flow Geographic limitations for cash-pay models in smaller markets Future Therapies and Insurance Coverage Listener question from Deepak Sambhara, MD (Eye Clinic of Wisconsin, Wausau, Wisconsin) How payers may respond to upcoming therapies such as tyrosine kinase inhibitors and gene therapy The likelihood of step therapy policies changing Pricing challenges for long-duration treatments Economic implications of one-time gene therapy approaches Technology Adoption in an Era of Declining Reimbursement Listener question from Priya Vakharia, MD (Retina Vitreous Associates of Florida, Tampa, Florida) How practices decide when to adopt new surgical technology Cost pressures from declining surgical reimbursement Evaluating investments in surgical and imaging equipment The potential role of AI-driven analysis in improving efficiency and clinical decision-making Key Takeaways Concierge-style retina care may be viable in affluent metropolitan markets but remains niche. Insurance economics will strongly influence how quickly new therapies reach patients. Practices increasingly rely on ROI analysis and efficiency gains when deciding whether to adopt new technologies. Artificial intelligence may help practices manage growing data complexity, though its financial model remains uncertain. Have a Question for the Next Mailbag? RetinUp listeners can submit questions by sending a voice memo to info@retinup.com, leaving a comment on YouTube, or connecting with John and Scott on LinkedIn. Sign up for our newsletter at RetinUp.com.
Guests: Thomas Stone, MD – Program Committee Chair, ASRS Business of Retina Meeting Maria Berrocal, MD – CEO, Drs. Berrocal & Associates; Associate Professor, University of Puerto Rico David Mandell, JD, MBA – Co-Founder & Partner, OJM Group Show Summary RetinUp brings together three distinct but interconnected conversations focused on the business, surgical innovation, and financial realities of retina practice. First, Tom Stone joins the show to preview the upcoming ASRS Business of Retina Meeting in Houston (March 20–22). He outlines this year’s agenda, which covers staffing strategies, AI in practice operations, drug inventory management, coding updates, and a new full-day clinical trials workshop designed to help practices launch research programs from the ground up. Next, in the Vitreoretinal View segment, Maria Berrocal discusses her experience using the Alcon UNITY VCS system, focusing on flow-based vitrectomy, 30,000 cpm performance, and the evolution of 27-gauge surgery. She also shares early observations comparing case times and complication rates versus legacy systems. For the long-form interview, David Mandell of the OJM Group offers a structured framework for physician wealth management across career stages—covering early-career planning, mid-career tax strategy and asset protection, and retirement-phase portfolio positioning. Topics Covered ASRS Business of Retina Meeting The 2026 meeting agenda: staffing, AI implementation, and drug inventory strategy Coding updates and compliance (including Modifier -25) Launch of the Clinical Trials Workshop (capped at 80 participants, so register soon!) Dedicated business curriculum for fellows Vitreoretinal View – Surgical Innovation Transition from vacuum-based to flow-based vitrectomy on Alcon UNITY VCS 27-gauge adoption and surface vitrectomy precision Reduced instrument frustrations Physician Wealth Strategy Why retina specialists are unique when it comes to wealth strategy Early-career debt balancing, disability protection, and lifestyle creep Mid-career tax optimization and liability protection Retirement red-zone portfolio repositioning Assessing private equity offers Key Takeaways The Business of Retina Meeting is will be in Houston March 20-22. Registration link below. Flow-based vitrectomy may meaningfully refine 27-gauge surgery. Financial discipline—not peak income—is what ultimately determines long-term security. Resources Mentioned ASRS Business of Retina Meeting – Register Here OJM Group – ojmgroup.com Use the code RetinUp26 to get a free copy of the book Wealth Planning for the Modern Physician: Residency to Retirement at the OJM Bookstore.
This episode of RetinUp is a special deep dive into the Vit-Buckle Society (VBS), tracing its origins and previewing what’s ahead for the 2026 meeting.
This episode of RetinUp is a special deep dive into the Vit-Buckle Society (VBS), tracing its origins and previewing what’s ahead for the 2026 meeting. In the first segment, Ross Lakhanpal, MD, shares the founding story of VBS — from informal dinner discussions among fellows to one of the most distinctive and influential meetings in retina. What began as an effort to preserve surgical retina education has evolved into a meeting known for its creativity, honesty, and strong sense of community. The episode then shifts to Aleksandra Ratchitskaya, MD, who outlines the agenda and structure of the 2026 VBS meeting, including expanded programming for trainees, new educational tracks, and the continued emphasis on open discussion and real-world clinical challenges. Across both conversations, a consistent theme emerges: VBS succeeds because it prioritizes authenticity, collaboration, and the full experience of being a retina specialist — not just the science. Hosts: John Kitchens, MD Scott Krzywonos Guests: Ross Lakhanpal, MD, FACS – Founding Member, Vit-Buckle Society (VBS); Retina Care Center (Maryland) Aleksandra Ratchitskaya, MD, – President, Vit-Buckle Society (VBS) Topics Covered The Founding of VBS (Ross Lakhanpal, MD,) Origins in 2004–2006 among fellows seeking more surgical retina focus Early dinner meetings piggybacking on major conferences (ASRS, AAO) Initial industry support from Bausch + Lomb and later Alcon The role of key mentors including Timothy Murray, MD, and Harry Flynn, MD, Transition from informal gatherings to a standalone national meeting Early challenges with organization, funding, and defining a clear vision Building a Distinctive Retina Meeting Introduction of debates, live surgery, and unconventional formats The importance of creativity, energy, and peer-driven programming Balancing innovation with professionalism as the meeting grew The role of medical conference planners (MCPI) in scaling the event How VBS differentiated itself from traditional, science-heavy meetings Leadership Transition and Growth Decision to hand leadership to the next generation Evolution of programming under new leadership Increased focus on year-round education, social media, and engagement Current leadership structure and succession planning Why maintaining a strong culture and relationships is critical to continuity 2026 VBS Meeting Preview (Aleksandra Ratchitskaya, MD,) Expanded Thursday programming for fellows, trainees, and early-career specialists “VBS Silver” sessions for more experienced physicians Fellows Forum-style competitions, including surgical video presentations Awards, including Lifetime Achievement and Mentorship recognition Dedicated sessions on practice management, advocacy, and wellness Signature VBS Elements Surgical case discussions focused on complications and real-world challenges Debates on controversial clinical and professional topics A strong emphasis on honesty and open dialogue Social programming built around the Alice in Wonderland theme Networking that reflects the collaborative, peer-driven culture of VBS Key Takeaways VBS was founded to address a gap in surgical retina education and has grown into a broader platform for professional development. The meeting’s success is rooted in its culture of openness, creativity, and peer collaboration. Leadership transition to younger physicians has strengthened the organization and expanded its reach. VBS continues to stand out by addressing the full scope of retina practice, including clinical, personal, and professional challenges. Credits Production & Marketing: Laura Brown Business Operations: Liz Hogan 🎧 Listen at RetinUp.com | Apple Podcasts | Spotify | YouTube