Age-related macular degeneration: suitability of optogenetic therapy for geographic atrophy
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Shamsnajafabadi, Hoda
Ng, Benjamin WJ
Xue, Kanmin
De Silva, Samantha R
Downes, Susan M
MacLaren, Robert E
Cehajic-Kapetanovic, Jasmina
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Abstract
Age-related macular degeneration (AMD) is a growing public health concern given the aging population and it is the leading cause of blindness in developed countries, affecting individuals over the age of 55 years. AMD affects the retinal pigment epithelium (RPE) and Bruch’s membrane in the macula, leading to secondary photoreceptor degeneration and eventual loss of central vision. Late AMD is divided into two forms: neovascular AMD and geographic atrophy (GA). GA accounts for around 60% of late AMD and has been the most challenging subtype to treat. Recent advances include approval of new intravitreally administered therapeutics, pegcetacoplan (Syfovre) and avacincaptad pegol (Iveric Bio), which target complement factors C3 and C5, respectively, which slow down the rate of enlargement of the area of atrophy. However, there is currently no treatment to reverse the central vision loss associated with GA. Optogenetics may provide a strategy for rescuing visual function in GA by imparting light-sensitivity to the surviving inner retina (i.e., retinal ganglion cells or bipolar cells). It takes advantage of residual inner retinal architecture to transmit visual stimuli along the visual pathway, while a wide range of photosensitive proteins are available for consideration. Herein, we review the anatomical changes in GA, discuss the suitability of optogenetic therapeutic sensors in different target cells in pre-clinical models, and consider the advantages and disadvantages of different routes of administration of therapeutic vectors.
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Frontiers in Neuroscience
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18
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© 2024 Borchert, Shamsnajafabadi, Ng, Xue, De Silva, Downes, MacLaren and Cehajic-Kapetanovic. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
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Borchert, GA; Shamsnajafabadi, H; Ng, BWJ; Xue, K; De Silva, SR; Downes, SM; MacLaren, RE; Cehajic-Kapetanovic, J, Age-related macular degeneration: suitability of optogenetic therapy for geographic atrophy, Frontiers in Neuroscience, 2024, 18, pp. 1415575