Newer therapeutic agents for retinal diseases

ABSTRACT

Introduction

Last few decades in medical retina have encountered significant development in the field of pharmacotherapy. With better understanding of molecular mechanisms and disease pathophysiology, alternate pathways are being targeted in various clinical trials.

Areas covered

In this review, a comprehensive list of newer therapeutic agents in various retinal conditions like diabetic macular edema (DME), age-related macular degeneration (ARMD), inherited retinal diseases (IRDs) and non-arteritic ischemic optic neuropathy (NAION) have been elucidated. The review highlights alternate pathways involved in pathogenesis of DME and ARMD, and gives a brief summary of several phase I and phase II trials targeting these pathways. The review also briefly highlights the advancements in the field of gene therapy, stem cell transplantation, neuro-protection and retinal implants in IRDs. Lastly, available treatment options for NAION have been discussed.

Expert opinion

Evidence based medicine has allowed researches and vision scientists to explore newer drugs and target alternate disease pathways. Promising results with initial clinical trials will pave the pathway for larger studies and allow clinicians to overcome treatment burden presently associated with available treatment options.

KEYWORDS:

• Age-related macular degeneration
• clinical trials
• diabetic macular edema
• gene therapy
• inherited retinal diseases
• NAION
• therapeutic advancements

Article highlights

• This article briefly summarizes newer therapeutic drugs in pipeline for various retinal conditions like DME, ARMD, IRDs, and NAION.

• A better understanding of disease pathophysiology has allowed clinicians to explore newer drugs in management of DME, ARMD, IRDs, and NAION.

• Alternate therapies for ARMD and DME involves anti-inflammatory agents, angiopoietin inhibitors, cytokine inhibitors, growth factor inhibitors, Rho kinase inhibitors, complement inhibitors, visual cell modulators etc.

• Port delivery system allows sustained release of ranibizumab in the vitreous cavity and holds a potential to decrease the treatment burden in ARMD and DME.

• Extended spectrum of anti-VEGF agents like Faricimab, Abicipar pegol and OPT-302 have shown promising results in phase II clinical trials.

• Gene therapy and stem cell therapy have opened up a new domain of research in ophthalmic medicine and hopes to offer treatment for various IRDs.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper is not funded.