News from ARVO 2023

The 2023 five-day Association for Research in Vision and Ophthalmology (ARVO) conference was held in New Orleans, bringing many ophthalmic researchers from across the world face-to-face for the first time since the Covid pandemic. The following is a selection of just a few of the studies and breakthroughs publicly released at the meeting.

Vision restoration for RP patients

Kiora Pharmaceuticals presented preliminary results from its first human trial on KIO-301 showing it has the potential to restore light perception in blind and ultra-low vision retinitis pigmentosa (RP) patients.

KIO-301, a light-sensing small molecule, had previously been shown to block certain ion channels in the eye allowing cell reactivation in degenerating retinas when exposed to light in animal models. In this phase 1b study, human participants with late-stage RP received a single dose of KIO-301 in their eyes and were then monitored for 29 days. Post-treatment observations included the improvement in patients’ ability to perceive light and dark at days seven, 14 and 29 and identify objects. “These preliminary results suggest the initial low dose of KIO-301 is capable of improving light perception in patients,” said principal investigator Dr Robert Casson from the Royal Adelaide Hospital. “We saw a marked improvement in functional measures, which correlate to neural imaging results that demonstrate increased visual cortex activity in the brain from baseline to two weeks after treatment.”

“Based on how KIO-301 works as a light-sensing ‘photoswitch’, we also see it potentially addressing other inherited and age-related retinal degenerative diseases, namely geographic atrophy and late-stage wet AMD," added Dr Brian Strem, Kiora CEO.

A ‘digital ophthalmologist’

An artificial intelligence (AI) robot designed to evaluate glaucoma data and operate as a ‘digital ophthalmologist’ was unveiled by a University of Tennessee Health Science Center team led by Dr Siamak Yousefi.

Dr Siamak Yousefi with Alborz

Named ‘Alborz’, the robot was taught to recognise glaucoma from visual fields (VFs) and retinal images. “Alborz can both assess glaucoma and interact with ophthalmologists as well as patients (and) can also be used for educational and research purposes for dissemination of AI applications in ophthalmology,” said Dr Yousefi.

High vitamin C, E bad for DED?

Researchers at Oslo Universitetssykehus, Norway, found no evidence supporting dietary vitamin intake alleviates dry-eye disease (DED), discovering instead that higher intakes of vitamins C and E may actually be associated with a higher risk of developing DED.

The study’s 51,551 participants (mean age, 51.2 years; 60% women) were given a DED questionnaire, from which researchers assessed daily intakes of vitamins A, B2, B6, B12, C, and E from food and drinks (excluding supplements). The team noted DED wasn’t just associated with a high intake of vitamins C and E; participants who merely satisfied the recommended intake of vitamins C and E also had increased odds (14% and 10%, respectively) of developing the disease. “The causes for the direction of this association should be explored further as it went against our hypothesis and previous findings,” they said.

Non-incisional glaucoma surgery

US company ViaLase presented trial updates on its non-invasive femtosecond laser image-guided high-precision trabeculotomy (FLigHT) device, ViaLuxe.

Evaluating the system on cadavers, researchers said the outer wall of Schlemm’s canal remained intact and the temperature rise during the FLigHT procedure was a maximum of 3.1°C, providing strong evidence of a dearth of collateral damage, while 24-month safety data from its first-in-human study on 11 patients (17 eyes) with open-angle glaucoma was encouraging, said the company.

ViaLuxe

Twenty-four months post-FLigHT treatment, which created a single channel through the trabecular meshwork and into Schlemm's canal, the authors reported no device-related serious adverse events and observed well-defined channels with no evidence of closure, indicating medium-term durability. "Unlike surgical procedures that require opening the eye, FLigHT is non-incisional and leverages the proven track record of the safety and precision of femtosecond laser technology, which are no doubt factors that contributed to these favourable safety results," said lead author Professor Zoltan Nagy, chair of the Department of Ophthalmology at Semmelweis University in Budapest. Results also showed a mean IOP reduction of 34.6% from baseline. A further multicentre clinical trial is currently underway.

Oral anti-VEGF

Ashvattha Therapeutics presented on D-4517.2, its anti-angiogenic nanomedicine. Subcutaneously or orally administered, it targets activated microglia and the hypertrophic retinal pigment cells responsible for the increased vascularisation associated with neovascular age-related macular degeneration (wet AMD) and diabetic macular oedema (DMO). In a mouse model, preclinical data showed a single 40mg subcutaneous or oral dose of D-4517.2 significantly reduced choroidal neovascular lesion area compared to vehicle control, with effects comparable to those of aflibercept, reported the company.