Professor Michaelides shares his expectations for the future of retinal disease diagnostics and treatments
In this blog post, the Professor discusses the role of anti-VEGF and looks forward to the future developments in retinal disease diagnosis and treatment.
Jane Olver: I think just another area of importance to patients with medical retinal disease is drug treatment. I know that you do injections for age-related macular degeneration, and also for vein occlusions. Is there anything else you treat by eye injections or drugs?
Professor Michel Michaelides: So there is increasingly going to be more drugs that we inject into the jelly of the eye, into the vitreous ‘intravitreally’. So at the moment, as you say, principally the anti-VEGF group of drugs that combat either leaky blood vessels or abnormal blood vessels. So, we use these drugs for abnormal blood vessels in retinal vein occlusions, in wet AMD and also in proliferative diabetic retinopathy. But we use them also for all the ‘boggy retinas’, macular oedema – in all of these conditions and multiple others including inherited retinal disease. So I have run a clinical trial recently that shows that about a third of patients with retinitis pigmentosa and macular oedema do respond to anti-VEGF agents. So I expect there to be more drugs coming for dry AMD, so we are hopeful that some of these anti-complement drugs may be effective in the future, so keep watching this space.
Jane Olver: You’ve brought up the future and I know I have run out of questions, I said only two and this really is my last. It is impossible to have a crystal ball and say where we will be in the future. But just looking in the short term, two to five years, how do you think your retinal disease diagnostics and treatmentsforf your patients will be different?
Professor Michel Michaelides: I think OCT is going to continue to develop. I think we need higher resolution OCT. It is going to be faster, and we’ll see more detail.
Jane Olver: That sounds very exciting. Is that called Swept-Source?
Professor Michel Michaelides: Swept-Source. I think there will be more generations of OCT. The OCTA – which is allowing us to see the vasculature in the eye – is going to get better, the quantification is going to get better. I think we are going to get adaptive optics imaging systems – that we can use in the clinic rather than just in the research facility – where we can actually see the photoreceptor mosaic in patients. So the imaging side is going to continue to grow. I think the intravitreal delivery of drugs is going to grow. I think there will be some sustained release preparations of anti-VEGF agents.
Jane Olver: Like little pellets.
Professor Michel Michaelides: Yes, little pellets that will give a continuous steady state of the drug in the eye.
Jane Olver: Wonderful!
Professor Michel Michaelides: That will be of great benefit, and I genuinely believe some of the gene therapy approaches are going to ……
Jane Olver: Is that an injection in the vein?
Professor Michel Michaelides: No, this is directly into the eye, so underneath the retina and so the first gene replacement strategy has just received FDA approval which is a real landmark, but I think we can build upon that. I think we can do better.
Jane Olver: Fantastic. I look forward to the bright future for medical retinal disease. Thank you very much.