Neuroprotection key to long-term glaucoma therapy
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LAS VEGAS —Finding treatment options for glaucoma beyond IOP lowering may be the future course toward preventing blindness in glaucoma, according to a speaker here.
“Remember that visual loss in glaucoma arises from damage to the retinal ganglion cell interfering with transmission of visual information to the brain,” Richard A. Lewis, MD, said during the Binkhorst Lecture at the American Society of Cataract and Refractive Surgery meeting. “Very simply, and if we can impact this pathway, we can treat the disease in very, very different ways.”
Neuroprotection has long been a topic discussed during much of Lewis’ career, he said. Now, medications including NT-501 encapsulated cell therapy (Neurotech), are being investigated for their potential neuroprotective benefits, Lewis said.
“And I encourage anyone in industry to continue to pursue this because this neuroprotection route is going to be the key in long-term therapy,” Lewis said.
Outside of medications, other avenues for treating glaucoma range from over-the-counter supplements to genetic targeting, Lewis said.
High doses of vitamin B3 may be able to improve retinal function in some patients with glaucoma being treated for intraocular pressure, Lewis said.
“Perhaps the most exciting area of all is going to be the genetic targets,” Lewis said. “If we look at what is going on in cornea and retina, it’s already happening. In both of those spaces, there are phase 2 and phase 3 studies that are happening,” Lewis said.
“The opportunity is there. Unfortunately, glaucoma, again, is a little lacking in this area, but I think the opportunity is on the horizon, and I think it will represent a great chance for our patients,” he said.
The road to neuroprotection would require a “multifactorial approach,” Lewis said. Strategies to strengthen retinal ganglion cells, lower IOP and treat affected genes must come together to make neuroprotection a reality.
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Lewis R. ASCRS Binkhorst lecture: We can prevent blindness in glaucoma - Why don’t we? Presented at: American Society of Cataract and Refractive Surgery meeting; July 23-27, 2021; Las Vegas.
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