A quick Q&A with Mariya Moosajee, Professor of Molecular Ophthalmology, Consultant Ophthalmologist and Head of Genetics at Moorfields Eye Hospital NHS Foundation Trust, UCL Institute of Ophthalmology and The Francis Crick Institute, London, UK.
What is the most exciting thing happening in retina right now?
I specialise in inherited eye diseases and despite there only being one approved retinal gene therapy, and several failed clinical trials, I am still inspired by the growing number of genetic therapeutic approaches under development. The technologies of gene editing, antisense oligonucleotides, mRNA/siRNA therapy, non-viral DNA plasmid vectors, the use of lipid nanoparticles, small molecule drugs, and the dual AAV approach for larger genes, all hold great promise. I am heartened to see gene therapy being developed for age-related macular degeneration, with potential applications for other common conditions, such as myopia, in the future.
Can you make a bold prediction for the future of retina treatment?
Not exactly a prediction, but a wish for an affordable and translatable genetic treatment for the majority of patients with inherited retinal diseases. One which is safe and effective, for example, where we can swap the coding sequence of a gene into a cassette and prescribe the appropriate gene therapy that will help preserve sight. It's idealistic, and in reality, will be challenging.
What advice would you give yourself if you were starting off in the retina space?
I think entering any subspeciality can be overwhelming. Each has grown and evolved through the remarkable work of great academic and clinical ophthalmologists. It can be hard to see your place in a large crowd, or visualise your achievements being as successful as the pioneers. But we must acknowledge that it is a very different time, with improved levels of knowledge and access to unbelievable technology. Many conditions do not have effective treatments, and there is still much to learn about their pathophysiology. Every small discovery cumulatively adds to the advancement of the field you are working in. So just keep taking forward steps, undertake research, add to the evidence-base, and contribute your clinical viewpoint so ophthalmology keeps advancing for the benefit of patients.
