Gene therapies and controversial topics

NEW ORLEANS – Judy E. Kim, MD (Milwaukee, Wisconsin), professor of ophthalmology at the Medical College of Wisconsin and a member of Modern Retina’s Street Team at this year’s American Academy of Ophthalmology meeting, said devices and surgical systems are sharing the spotlight with medical treatments, thanks in large part to the introduction of optical coherence tomography-angiography (OCT-A), along with widefield OCT, and their potential in confirming diagnoses and aiding treatment decisions.

Other devices Dr. Kim is excited to hear more about include subthreshold laser.

“It’s always a controversial topic, and it is used more in Europe now than in the U.S.,” Dr. Kim said. Paulo E. Stanga, MD, and Andrew A. Moshfeghi, MD, will debate the pros and cons of using the subthreshold laser for diabetic macular edema (Dr. Kim will moderate that debate).

With the recent introduction of heads-up 3D surgical equipment (NGENUITY, Alcon) and other companies working on 3D as well, “this is an exciting time to be a retina surgeon.” It’s one of the reasons why she’s also looking forward to the surgical videos.

Dr. Kim said several presentations will concentrate on gene therapy and forward-thinking research, including the most up-to-date data on a phase 3 study on inherited retinal dystrophies (IRD) presented by Albert Maguire, MD, on Friday, Nov. 10. In mid-October, the Food and Drug Administration’s Cellular, Tissue and Gene Therapies Advisory Committee unanimously recommended approval of voretigene neparvovec (Spark Therapeutics) as a one-time gene therapy for the treatment of patients with vision loss due to confirmed biallelic RPE65-mediated IRD.

Drug therapies will be equally exciting, Dr. Kim said. Two updates she is looking forward to hearing - the first-time release of clinical trial data from the Diabetic Retinopathy Clinical Research Network Protocol U, which compares the effects of ranibizumab and dexamethasone to ranibizumab alone for persistent central-involved diabetic macular edema. 

“There has been much debate regarding when to start steroid therapy in the management of DME and whether there is an additive or synergistic effect of using both anti-VEGF and a steroid. This phase 2 trial will help us answer some of these questions,” Dr. Kim said.

The lampalizumab phase 3 trial (Chroma) top line results will also be presented.  

“It’s noble when a company - in this case, Genentech - shares negative data as well as the positive data,” she said. “The findings may help us to better formulate future studies on geographic atrophy, which currently has a huge unmet need.”

And, of course, the “late breaking” presentations promise to generate buzz-although these are under wraps until the conference opens.