Lloyd Diamond, Pixium Vision - Spotlight Interview | LSI Europe ‘23

Pixium is a bioelectronics and brain machine interface technology company specialized in neuromodulation application whose mission is to create a world of bionic vision for those who have lost their sight, enabling them to regain partial visual perception and greater autonomy.
Lloyd Diamond
Lloyd Diamond
CEO, Pixium Vision



Scott Pantel  0:15  
Good afternoon. I'm here today with Lloyd Diamond, the CEO of Pixium Vision a company that we're spotlighting, here at LSI, Europe 23, in Barcelona. And so Lloyd, welcome to the studio here. Tell us how how it all began. What was the initial vision for Pixium?

Lloyd Diamond  0:30  
Sure. Thanks for having me. Anyway, Scott. Yeah, appreciate it. Love the opportunity to talk about Pixium so back in 2011. Josie Alan Sal, who's a well known ophthalmologist had this vision, no pun intended of, of starting companies that have sort of one purpose, and that is to solve the blindness question, right. It's something that we've been grappling with for hundreds of years, right blindness. And, and so way before that, he started the Vision Institute in Paris, which is an institute that regroups the brightest minds in research, public and private money, with the goal of developing assets or technologies and then spinning them out into companies to try to solve the blindness issue. So in 2011, Pixium, was born. It was co founded by Josie and then another serial entrepreneur in France. And they said, Look, we want to be a technology play in this field, lot of drug development had been invested in to try to solve the blindness issue injections for wet AMD and, and gene therapies and things of that sort, but nothing really on the tech side. About 10 years earlier, there was a lot of research being done in the field of retinal implants, can you stimulate the cells in the retina, or the optic nerve or the visual cortex to try to bypass the parts of the visual system that weren't working that actually lead to blindness? So they they looked at retinal implants, and they said, you know, we're going to start this company. So they acquired a German company called imi, which was one of the early pioneers in this in the, in the development of retinal implants. And so pixum was born. That first generation technology they called Iris was an epi retinal implant, similar to second sight in the US was one of the market leaders in that space as well. And so they really started to invest time and money in trying to develop that technology. That was back in 2011. 

Scott Pantel  2:42  
Right. So it's been quite a journey for you. And we've LSI has been fortunate enough to be tracking you one of the questions I like to ask entrepreneurs like yourself, who are who are taking on these, this challenging tasks, because it's not easy. And there are times when we look ourselves in the mirror, and we wonder why are we doing this? A technology like Pixium really does change people's lives. So rather than focusing on the technology, I'd like to talk about the impact that you're seeing it have on patients, maybe you could I know you're in humans now, maybe you can give us a couple examples of how the technology is already changing people's lives, and then maybe a vision for the future for us. 

Lloyd Diamond  3:18  
Sure. So I don't want to talk about tech. But I have to baby backtrack a bit. So that first technology, investment by the company didn't work out. And so fast forward, we entered into an agreement with Stanford and now we have an excellent technology called Prima. And we are implanting dry AMD patients. So geographic atrophy is the target. And this is a disease that affects the aging, it's probably, if not the leading cause of blindness amongst the aging, one of the leading causes of blindness. And these patients that we are working with a usually average age in the mid 70s. I mean, these are people that have families have grandchildren, has pets, you know, things that they love people that they love, and, and adore, and they can no longer see them. And their whole lives, they've lived independently. And now they can't do simple tasks like reading a shopping list or cooking or playing, you know, Suzuko or cards or whatever it is that they want to do, nonetheless see their grandchildren. And so it is a an emotional impact on these patients that it goes very deep. It's quite profound. Not to mention the cost of care of these patients, which has been well documented. And so we've implanted now just under 50 patients in Europe in the US. We are completing our final pivotal study in Europe. We will have the data associated with this trial at the end of December early next year, and then we'll publish the data and what we've been able to glean so far is that we have restored central vision which is what they lose in this disease. To the extent where patients are able to gain levels of independence, they can read again, we have patients that are able to read novels as crazy as that may sound for, for professionals and clinicians that understand this disease state, this has never been seen before. I mean, when you lose central vision, you don't get it back. Not even with the injections they have today, there's nothing that you can do. And so now we have patients that can, I don't know, read the weather in the newspaper and play cards, we have a grandmother who's able to read a children's book to their grandchild again, I mean, it's so

Scott Pantel  5:36  
We're not talking about just slowing down something that exists, we're talking about restoring and maybe we talked about a little bit about the current standard of care, you sort of touched on it. But let's talk about how they're currently being treated. And then we can continue with this this part of here.

Lloyd Diamond  5:49  
So um, before the injections, right, I guess, a palace and I there, you know, they have now recently had injections complemented inhibition injections that have been approved for slowing down the growth of the disease, prior there really was no treatment. So basically, patient went to the ophthalmologist, they got a scan for routine eye exam. And the ophthalmologist said, Oh, we're starting to see some formation in the macula. Looks like you have the onset of AMD joining me. And all they could say is we'll just going to watch and wait. And we'll see how it progresses, they'll maybe prescribe some vitamin vitamin A that you can take. And there's mixed results on if that really has an impact on the disease, and a certain percentage, five to 10% will progress to blindness. And there's nothing you can do. So basically, the ophthalmologist will refer them to a retinal specialist, the retinal specialists will begin to track them. And they will begin to only watch the progression of the disease as it enters into the central place of the macula called the fovea. And once it enters that space, now you start having impact on your central vision. And so basically, they say go home and try to learn to compensate your blindness.

Scott Pantel  7:03  
Wow, what a what a yet a tough message to hear what you can do to change that. And restoring vision is something that drives you guys, even in the challenging times. 

Lloyd Diamond  7:11  
Oh, it's our it's our mission. It's every day we have 40 employees that Pixium. They are driven by it, they they're touched and really impacted by the patients that we are dealing with and the people that we come in contact with.

Scott Pantel  7:26  
Tell us a little bit about the size of the opportunity from both a clinical standpoint. So how many? How many? What's the patient? What are the patient populations out there that can be touched by this technology? And then how does that translate into, you know, sort of a market opportunity and a business opportunity? And for many of the investors and partners that are coming on board for the journey? How does that translate for them?

Lloyd Diamond  7:46  
So if you think about age related macular degeneration globally, so there's wet and dry that 200 million people in prevalence, 80% of those are dry. So 100 and 60 million people in the world, of which as I said, five to 9%, will eventually go blind. Our primary target markets are Europe and the US because that's where we're doing our clinical work. That's where we'll get our approvals. First. We are intervening at a stage of the disease where patients will have a visual acuity of around 2300 words. So to put it in perspective, where 2020 best corrected, right? That's normal vision. So these patients have 2300 rowers, so they no longer can use their central vision. In Europe in the US, that's around 250,000 People in prevalence, and there are about 22,000 new patients being diagnosed every year. All of which could benefit from this technology. Now, that's with the current generation of our implant and wearables. But we have a pipeline like every other smart company would, and our next generation, technology will be an implant that will have a lot more vision restoration potential. And there you're looking at roughly a million people in the US and Europe. And again, I'm discounting right now the rest of the world because our first regulatory approvals will be in Europe in the US. So if you think about market opportunity, 250,000 Currently, with the current device up to a million with the new device, and then reimbursement target is roughly around 80,000 minimum in dry AMD and that's based on the cost of care of these patients over the remaining life of their blindness, right and so, you could justify perhaps even a much higher reimbursement. So right now we're just starting that work, but think about it even at 80,000 You know, dollars per patient implanted at about 22,000 patients and incidents you're at about a $1.7 billion market, 

Scott Pantel  9:57  
Massive opportunity and you've touched on the neck Next Generation sort of concepts in the pipeline, I know that you're laser focused on your current mission. But can you talk a little bit more about are there other applications even beyond maybe a second generation device that you can share with us? Or is that information that we'll have to? We'll have to track you for?

Lloyd Diamond  10:13  
Yeah. So yeah, I have to be careful. But people will say, but, but look, we're a neuro stimulation device, right? So, and probably the hardest application is stimulating the retina, it's the forefront of the brain, the not to get too technical, but the balance between activating the device and not doing damage outside or surrounding the device, it's a very fine balance. Again, we're right at the forefront of the brain. And so that's a very tight window, right? That you have to be able to control. But if you're successful in being able to stimulate neurons and cells close to the brain, under those tight, strict conditions, you certainly could think of applications outside of that, which might be less complicated. So you might think of implanting a device in the, you know, just under the skin for perhaps pain management, or maybe even for the vagal nerve, so that there are potential other applications, but not that Pixium would move forward. I mean, we are, as you said, laser focused ophthalmology and vision restoration is our mission. Tech, our mission is bringing, you know, bionic vision to those who've lost their sight. So that's what we were gonna focus on.

Scott Pantel  11:36  
Right, terrific. I know you're invited to many meetings clinic, both clinical meetings, investor meetings, you have a limited amount of time laser focused on the goal, as we've talked about, but I have to ask, why is LSI so fortunate to have you at our meeting this year?

Lloyd Diamond  11:50  
Yeah. I think Scott, we were talking about it before I like I applaud the initiative. I've spent, I don't know, 30 years of my career professional career in, in medical device, a small stint and device drug combination, but medical device. And you know, you know, better than I know, guess it's your mission, that there's so many opportunities in the drug space, the biotech space, there's a huge ecosystem of, of interest investment. strategics, and companies that are focusing on that area, and medtech were kind of the pariah. And so what I like about LSI, to answer your question is, you know, we're not so lonely, right? I mean, being the CEO of a medtech company, can be a lonely endeavor, being the CEO of any startup Canada, but a med tech company can be a very lonely endeavor. And so coming to these meetings, and, you know, socializing and collaborating with similar people in the ecosystem, not just CEOs, and not just investors, but consultants, and you know, and individuals that are all trying to achieve the same goal, and that's to bring disruptive technology to market to change the standard of care from a technology perspective, right, I think is, is essential. And for me, it's you know, revitalizing, right, because we're fighting the fight every day. And then we come here, and you get re energized. So that's a selfish motivation that I have. I mean, you know, you get to reconnect and get get re energized. So I think it's a critical mission that you guys are on 

Scott Pantel  13:26  
Well, that's terrific. And we, we feel grateful that you you've used the LSI platform to share your journey. You know, one of the things we talked about here is all the companies that are changing lives, you truly and what you're doing are changing people's lives. And so you have our full support. We congratulate you on all your success. I look forward to seeing you go into the next next part of your journey.

Lloyd Diamond  13:45  
Thank you. Appreciate it. Thanks a lot. Appreciate it.

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