Advancements in ocular gene therapy delivery: vectors and subretinal, intravitreal, and suprachoroidal techniques

Expert Opin Biol Ther. 2022 Sep;22(9):1193-1208. doi: 10.1080/14712598.2022.2121646. Epub 2022 Sep 19.

Abstract

Introduction: Ocular gene therapy represents fertile ground for rapid innovation, with ever-expanding therapeutic strategies, molecular targets, and indications.

Areas covered: Potential indications for ocular gene therapy have classically focused on inherited retinal disease (IRD) but more recently include acquired retinal diseases, such as neovascular age-related macular degeneration, geographic atrophy, and diabetic retinopathy. Ocular gene therapy strategies have proliferated recently, and include gene augmentation, gene inactivation, gene editing, RNA modulation, and gene-independent gene augmentation. Viral vector therapeutic constructs include adeno-associated virus and lentivirus and continue to evolve through directed evolution and rationale design. Ocular gene therapy administration techniques have expanded beyond pars plana vitrectomy with subretinal injection to intravitreal injection and suprachoroidal injection.

Expert opinion: The success of treatment for IRD, paired with the promise of clinical research in acquired retinal diseases and in administration techniques, has raised the possibility of in-office gene therapy for common retinal disorders within the next 5 to 10 years.

Keywords: Gene therapy; genome editing; inherited retinal disease; intravitreal; non-viral gene therapy; subretinal; suprachoroidal.

MeSH terms

  • Dependovirus / genetics
  • Gene Transfer Techniques
  • Genetic Therapy* / methods
  • Genetic Vectors
  • Humans
  • Intravitreal Injections
  • Retinal Diseases* / genetics
  • Retinal Diseases* / therapy