The Optimal Optical CoronagraphWorkshop at the Lorentz Center in September 2017 in Leiden, the Netherlands gathered a diverse group of 30 researchers working on exoplanet instrumentation to stimulate the emergence and sharing of new ideas. This contribution is the final part of a series of three papers summarizing the outcomes of the workshop, and presents an overview of novel optical technologies and systems that are implemented or considered for high-contrast imaging instruments on both ground-based and space telescopes. The overall objective of high contrast instruments is to provide direct observations and characterizations of exoplanets at contrast levels as extreme as 10$^-10$. We list shortcomings of current technologies, and identify opportunities and development paths for new technologies that enable quantum leaps in performance. Specifically, we discuss the design and manufacturing of key components like advanced deformable mirrors and coronagraphic optics, and their amalgamation in ``adaptive coronagraph’’ systems. Moreover, we discuss highly integrated system designs that combine contrast-enhancing techniques and characterization techniques (like high-resolution spectroscopy) while minimizing the overall complexity. Finally, we explore extreme implementations using all-photonics solutions for ground-based telescopes and dedicated huge apertures for space telescopes.