Macular Degeneration
1. Gene Therapy for Wet AMD
- RGX-314 and other investigational gene therapies are showing promise for wet age-related macular degeneration (AMD). These therapies use viral vectors to deliver genetic instructions to the eye, enabling it to produce anti-VEGF proteins internally. This approach could dramatically reduce or eliminate the need for frequent intraocular injections, providing a potential "one-and-done" solution[1][2]. Early clinical trials have demonstrated sustained disease control, fewer required injections, and improvements in visual acuity, with ongoing Phase 3 trials aiming for FDA approval[1][2].
2. New Long-Acting and Combination Drugs
- Drugs like Vabysmo allow for longer intervals (up to 3–4 months) between injections for wet AMD, reducing treatment burden for patients[3]. Combination therapies, such as Opthea’s OPT-302, are also in clinical trials and may further improve outcomes by targeting multiple disease pathways[3].
3. Treatments for Dry AMD (Geographic Atrophy)
- Pegcetacoplan (Syfovre™) and Avacincaptad pegol (IZERVAY™) are recently FDA-approved drugs for advanced dry AMD (geographic atrophy)[4][5]. These intraocular injections slow the progression of retinal lesions, helping to preserve vision for longer periods. Clinical trials have shown that more frequent administration yields better results in slowing disease progression[4][5].
- Modifier gene therapies and retinal patch technologies are also being studied for advanced dry AMD, targeting multiple disease mechanisms and aiming to repair or replace damaged retinal tissue[5].
Dry Eye Disease
1. Novel Pharmaceuticals and Biologics
- Lifitegrast and Reproxalap represent new classes of anti-inflammatory eye drops that act more quickly and with fewer side effects than traditional steroids or cyclosporine[6][7]. Reproxalap, in particular, targets reactive aldehyde species involved in ocular inflammation, and is awaiting FDA approval[7].
- NOV03 (perfluorohexyloctane) is a preservative-free eyedrop shown to stabilize tears and reduce evaporation, especially for patients with meibomian gland dysfunction[8].
2. Advanced Devices and Procedures
- Canalicular gel devices (e.g., Lacrifill) offer a new, minimally invasive way to maintain tear film by occluding tear drainage, with fewer complications than traditional punctal plugs[9].
- Thermomechanical devices and intense pulsed light (IPL) therapy target meibomian gland dysfunction, a leading cause of evaporative dry eye, by restoring gland function and improving tear stability[10][7].
- Intranasal neurostimulators are a novel, device-based approach to increase natural tear production for patients with severe dry eye[6].
3. Emerging Immunotherapies and Regenerative Approaches
- Research is advancing into biologics, stem cell therapy, gene therapy, nanotechnology, and exosome-based treatments for dry eye disease. These aim to modulate immune responses, repair tissue, and address the underlying causes of chronic dry eye, moving beyond symptom management to disease modification[11].
4. Other Innovations
- Platelet-rich plasma drops, amniotic membrane therapies, and specialty scleral lenses are being used to promote corneal healing and protect the ocular surface in severe cases[6].