Retina Round-Up: Dominik Fischer
Following the launch of The Ophthalmologist’s Retina newsletter in 2024, we present a round-up of Retina editorials. Here, Dominik Fischer outlines how age remains an important risk factor in many retinal diseases
Age remains an important risk factor in many retinal diseases. And while we have the means for high resolution diagnostics – as well as fantastic treatment options for a wide range of vision threatening conditions – aging remains a stubbornly unyielding risk factor, e.g., for AMD and vascular occlusive events.
I often joke with my patients that the best way to decrease their risk of disease progression is to get younger! Arriving at middle-age myself begins to drive this reality back home. I was very pleased when my fitness app showed that my training efforts reduced my biological age by 5.5 years, but would it not be nice to change the inevitable aging process by more than that?
A recent Nature paper (1) showed that genes related to cilium organization and glucose transport play a key role in aging of neurons, and that a CRISPR-Cas9 approach interfering with such genes could boost activation of neural stem cells and lead to “the production of new neurons in old brains.” Let us hope that this will translate to new treatment modalities in retinal conditions where we currently manage secondary complications, all while hoping that the loss of retinal neurons remains limited.
Until such advances come to clinics, we remain hopeful that we can help develop new exciting treatment modalities. One such modality is anti-VEGF gene therapy: a one-shot approach that can potentially reduce the need of future injections by around 80-90 percent (2).
In the meantime, stay young and healthy!
- TJ Ruetz et al., “CRISPR-Cas9 screens reveal regulators of aging in neural stem cells,” Nature (2024). PMID: 39358505
- A Peter et al., “Gene therapy for neovascular age-related macular degeneration by subretinal delivery of RGX-314: a phase 1/2a dose-escalation study Campochiaro,” The Lancet, 403, 1563 (2024). PMID: 38554726.
Dominik Fischer MD DPhil FEBO MRCOphth, Professor of Ophthalmology, University of Oxford; Consultant Ophthalmic Surgeon, Oxford Eye Hospital; Consultant Ophthalmologist & Vitreoretinal Surgeon, The Retina Clinic London; Visiting Professor, Jules Gonin Hospital & University of Lausanne; Professor of Ophthalmology, Eberhard Karls University of Tubingen