VIDEO: AMD research should focus on regenerative medicine to restore vision

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I think this is a great question, and if you ask me, this is the most important question out of all questions that we covered today.

We have to improve early detection and risk prediction. We should work on developing more sensitive and specific biomarkers for risk prediction, both genetic and image biomarkers. We should explore precision medicine. That’s very important because that would consider genetic predisposition, molecular subtypes, individual variations in age-related macular degeneration patients and their pathogenesis, and that actually can provide us more patient-specific treatments that actually potentially would be much more successful.

In the past couple of years, we actually had tremendous success getting FDA approval for geographic atrophy medications, but we should not stop here. We should investigate novel therapeutic targets and pathways, AMD pathophysiology such as lipid metabolism, inflammation. We should work on cell death pathways, visual cycle modulators, neuroprotection, oxidative stress, mitochondrial dysfunction. We have to develop novel pharmacological approaches and gene-based therapies that would actually help us modify this awful disease in the very early stage. Combination therapy is another very important thing. With combination therapy, we target multiple pathways at the same time simultaneously that might offer more synergistic benefits and possibly reduce the treatment burden. We should also work on the medications and their durability — port systems, as an example. What in particular we have to advance in research is regenerative medicine, including stem cell-based therapies, gene editing techniques and tissue engineering, so that we can actually help these patients restore vision if there is actually profound central vision loss.

We should continue to work on artificial intelligence, and that was a huge boom in artificial intelligence in ophthalmology in the past decade. But I don’t think that we are done. I think there is so much more to be done. We have to develop better algorithms that can actually identify the disease earlier, that can identify risk factors for the disease progression, that can assess treatment responses, and these algorithms should be open-source algorithms and reproducible in clinical practice. We lack that. That’s actually very important when it comes to AI. The other thing is also virtual reality and augmented reality. This would be very important because it potentially can displace the image for the patients who actually have central vision loss and help them with their disability.

And I would definitely finish with the longitudinal studies and real-world evidence research that help with the natural history of AMD and the factors that actually are influencing disease progression. We have so much more to learn about this disease. This is a very complex disease.