Retinal disease therapy
Multi-pronged attack on underlying retinal disease processes drives current research
Leigh Spielberg
Published: Wednesday, March 1, 2017
Cell therapy refers to the transplantation of either HLA-typed RPE cells or stem cells, or a more pharmacologic approach to the diseased cells.GENE THERAPY Gene therapy focuses on treatment of early-stage disease. Because these diseases are monogenetic, they are ideal candidates for gene therapy. The goals include replacing or knocking down a defective gene, controlling gene expression, delivering a suppressor or correcting a mutation that misdirects splicing. With 204 causative genes identified and 244 retinal dystrophy loci mapped, there is clearly no shortage of targets. “Ongoing and anticipated gene therapy trials include treatments for Leber’s congenital amaurosis (LCA) Type 2, choroideremia, Leber’s hereditary optic neuropathy (LHON), Stargardt and Usher syndrome Type 1B,” said Dr Richard. RETINAL IMPLANTS Dr Richard then turned his attention to retinal implant (prosthetic) technology. This incorporates two primary external components: a camera chip and a retina encoder; and an implanted component: the retinal stimulator, which receives pulse sequences and transmits them to the retina. “Visual improvement by retinal stimulation is definitely possible. However, high-resolution implants are difficult to achieve,” said Dr Richard. This was evident in the five-year trial of the Argus II implant, in which patients were clearly able to recognise and use shapes for orientation and environmental information, but do not have any fine resolution. This is because the current maximum number of electrodes per square millimetre is 37. Each electrode generates one phosphene. However, to obtain normal reading speed, more than 5,000 phosphenes are needed per square millimetre. Dr Richard remains very optimistic. “Who knows what the future holds?” Gisbert Richard: richard@uke.de
Tags: Artificial vision, stem cell therapy
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