Hi, my name is Rahul Banerjee. I'm an assistant professor of medicine at the Fred Hutchinson Cancer Center in Seattle, Washington. And I'm excited about our poster that actually is a collaboration with Health Tree about ocular health, eye health, and in particular cataracts in patients with myeloma, and what link dexamethasone or steroids play in that. All of you watching this video probably know that patients don't like dexamethasone for myeloma. I promise you I don't like it either. A lot of side effects, including insomnia, anxiety, high blood sugars. A lot of those patients and physicians can notice pretty quickly. It was really some of the other issues that I've seen in clinic that got me thinking about this. A lot of my patients say that they needed glasses prescription change or that they aren't able to drive as easily as before. Their vision gets blurry. And that got us to thinking, well, why do patients' visions, why does it get blurry basically in the midst of myeloma therapy? And Dex, the villain of myeloma therapy, the hero that becomes the villain, is that somehow playing a role into this. And so we actually used Health Tree data. So thank you to all the patients who contributed to the Health Tree Cure Hub. We looked at 200-something number of patients who had basically answered questions about cataracts in particular. And we went back and looked at the dexamethasone usage for patients who had linked their EMR records or electronic health records to their actual patient history. We did find that of all 200, I think almost 250 patients, cataracts are very common and they went up with time. So among patients who developed cataracts after basically treatment for myeloma, which almost always includes steroids, about a third of patients reported cataracts within six months of starting treatment. By 12 months, it was 48%. So almost half of patients who are going to get cataracts do so early in their treatments with myeloma, early in their journey with myeloma. And again, we wonder whether the dexamethasone is playing part of this. So we looked at almost 100 patients who had kindly authorized de-identified linkage of their medical records. So we could actually go back and look and see exactly how many milligrams under the wire of steroids that they had received going into this. And we found a clear link between total longitudinal lifetimes dexamethasone exposure and risk of visually significant cataracts. To put that kind of into plain English here, patients who reported cataracts being very significant and affecting their quality of life or disrupting their just activities of daily living had almost, I think it was two and a half times as many milligrams of lifetime steroids as those who reported more minor cataracts, suggesting that maybe the duration and the dose together make a difference in patients basically these visual side effects. Interestingly, it wasn't time of exposure to steroids. It was a total combination of the basic the area under the curve, the combination of both the duration and the dose. What that means to me is that it's not just that patients are getting older and if you get older, you start to get more cataracts. There's something about dexamethasone often 40 milligrams weekly, 20 milligrams twice weekly that seems to be doing this. And so based on these findings, we're actually now with HealthSci working on a prospective survey of eye health among patients with myeloma, for example, and actually myeloma and amgus and smoldering saying, hey, do you have blurry vision now? Do you have cataracts? Do you have glaucoma? Have steroids been caused glaucoma? How often do you see your eye doctor? Has anyone told you to see an eye doctor? Stay tuned for questions like that because I think there's a lot that we don't know or to use a pun, there's a lot more that meets the eye when it comes to ocular health and myeloma. And again, thanks to the work of organizations like Health Tree, we're hopefully going to be able to answer some questions about what role steroids, dexamethasone play in this and maybe someday actually look at protocols that actually bring down the steroids earlier to help keep people and keep people's eyes as healthy as we can for as long as we can. Thanks again for having me and I'll see you at our poster.