The Challenges of Drug Delivery for Retinal Diseases - Episode 1

Common Types of Retinal Disorders Explored

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A panel of global experts who treat patients with retinal diseases suggest causes of age-related macular degeneration, diabetic macular edema, and inherited retinal disease.


Albert J. Augustin, MD: Hello, and welcome to this Modern Retina-Ophthalmology Times Europe Viewpoints titled The Challenges of Drug Delivery for Retinal Diseases. My name is Albert Augustin. I am a professor and chairman at the Department of Ophthalmology in Karlsruhe, Germany. Joining me today in this discussion are my colleagues: Dr. François Korobelni, professor and chef de service of ophthalmology in Bordeaux [France]; Dr. Mariya Moosajee, professor of molecular ophthalmology, and consultant ophthalmologist at the UCL Institute of Ophthalmology, Moorfields [Eye Hospital], and Great Ormond Street Hospital for Children in London, UK; Dr. Tunde Peto, professor of clinical ophthalmology and consultant ophthalmologist at Queen's University Belfast and Belfast Health and Social Care Trust in Belfast, Northern Ireland, UK. In 2 days, we will provide an overview of retinal diseases with a review of the available treatment options currently available and look into the future pipeline agents. Let’s get started.

My first question to my colleagues is the following: What are some of the common retinal disorders? I would like you to focus on AMD [age-related macular degeneration], diabetic macular edema, and diabetic retinopathy. François, do you want to start?

Jean-Franҫois Korobelnik, MD: Yes. Hi, everybody. It is my pleasure to be part of this discussion. At the moment, AMD is definitely a real problem that is making us very busy; wet AMD especially. We have treatment options. We must discuss the diagnoses, the treatment, and we have to follow the treatment, which becomes a lot of work. I would also say that DME [diabetic macular edema] and diabetic retinopathy are also very prevalent.

Albert J. Augustin, MD: Dr. Moosajee, would you like to comment a few words on inherited disease?

Mariya Moosajee, MBBS, BSc, PhD, FRCOphth: Absolutely. Inherited retinal diseases are the most common cause of certifiable blindness amongst all working age adults. Conditions like retinitis pigmentosa are pretty common; they affect 1 in 3000 individuals, which is certainly a burden amongst our younger adults.

Albert J. Augustin, MD: Let us move forward and look at the causes of retinal diseases. Dr. Peto, what are the causes of retinal diseases? Can you focus a little bit on age and comorbidities?

Tunde Peto, MD, PhD: The most common cause of AMD is aging. However, smoking and other environmental factors can contribute to the disease. We do have a fair bit of genetic information on why AMD develops but we do not have a treatment that would be based on our genetic understanding. In terms of diabetes and diabetic eye disease, unfortunately diabetic eye disease follows diabetes. With increasing prevalence of diabetes, the diabetic eye disease in patients who are affected by it are increasing as well. Despite all our efforts of controlling the disease, we still have a growing number of patients going blind from diabetic eye disease. Therefore, we are looking for treatment both for diabetes and also for the eye disease that it might cause.

Albert J. Augustin, MD: Thank you very much. Dr. Moosajee, can you give a few words on genetics?

Mariya Moosajee, MBBS, BSc, PhD, FRCOphth: Absolutely. If we take all the inherited retinal disorders together, we know that so far there are over 280 genes known to cause these conditions; these are monogenic disorders. It’s also important to note that there is a vast amount of genetic heterogeneity. The chemical presentation, the phenotype, can look very familiar. However, there can be multiple genes that could be causing this. For example, with retinitis pigmentosa we know that there are over 80 positive genes. Therefore, it is really important that we establish a molecular diagnosis.

Transcript edited for clarity.