EyeWorld Weekly Update, January 26, 2018

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January 26, 2018
Volume 24 , Number 3

Novartis enters into licensing agreement for gene therapy treatment

Novartis (Basel, Switzerland) announced a multimillion dollar exclusive licensing agreement with Spark Therapeutics (Philadelphia) for its novel gene therapy treatment (Luxturna, voretigene neparvovec-ryzl) for inherited retinal disease. In the agreement, Novartis will hold rights for Luxturna outside the United States, while Spark will retain rights within the United States. Spark Therapeutics received U.S. Food and Drug Administration (FDA) approval for the first gene therapy to restore functional vision to patients with a rare, inherited retinal disease in December 2017. Under the licensing agreement with Novartis, the company will pay $105 million up front, and Novartis could receive up to $65 million in additional milestone payments, Spark Therapeutics' press release explained. Spark Therapeutics maintains responsibility for obtaining the European Regulatory Agency approval, while Novartis obtains the rights to develop, register, and commercialize the treatment outside the U.S.

FDA approves Topcon's DRI OCT Triton

The DRI OCT Triton Series (Topcon, Oakland, New Jersey) received 510(k) clearance from the FDA, becoming the first commercially available multi-model swept source OCT system in the United States, according to the company's press release. The technology, which features a retinal camera, eye tracking, and other features, functions with a 1 µm, 1050 nm light source at a scanning speed of 100,000 A-scans/second. According to the company, the system can "visualize from vitreous through to sclera" with images that are not obscured by opacities or hemorrhage. Widefield OCT capabilities allow for macula and optic disc mapping in one scan, the press release stated.

Two-part lens system receives CE mark

A two-part IOL system has received the CE mark. PreciSight (InfiniteVision Optics, Strasbourg, France) is comprised of a base and front optic, the latter of which can be exchanged if a patient is unhappy or if his or her vision changes.

Instrument capable of imaging the entire eye developed

Researchers from Poland and Spain have developed a new imaging system with the ability to image the entire eye. Published in the journal Optica, the team described the swept source OCT device that has an electrically tunable lens that allows it to image structures of the anterior segment and the retina. Most clinical OCT images are limited to depths of 2 to 3 mm and, the press release noted, switching between imaging in the anterior and posterior segments is tricky due to how structures in the eye bend light. The electrically tunable lens in the device, which can change optical properties dynamically, a wavelength tunable laser, and high-speed electronics allow for high resolution, speed, and imaging/biometry at depths to capture the whole eye.

RESEARCH BRIEFS

  • Researchers from the University of Wisconsin-Madison have developed a new method to improve delivery of gene therapy for glaucoma. In a study published in Investigative Ophthalmology & Visual Science, researchers explained how the eye's defense system was preventing delivery of genes to the trabecular meshwork, blocking the vector (feline immunodeficiency virus). Thinking proteasomes in the host cells could be attacking the virus vector, investigators temporarily blocked proteasome activity and saw effective transfer of the intended gene into targeted cells. Curtis Brandt, PhD, corresponding author of the study, said in a news release that while this improvement in gene therapy delivery was shown to work in eye organ culture, further research is being done to improve efficiency and identify which gene to deliver before moving toward clinical trials.
  • A pilot study published in the British Journal of Ophthalmology showed the feasibility and accuracy of automated detection of non-proliferative diabetic retinopathy using OCT angiography (OCTA). The research by Sandhu et al. included 106 patients with type 2 diabetes (23 did not have diabetic retinopathy; 83 had mild diabetic retinopathy). OCTA scans were taken of their maculas and five vascular maps were generated per eye. These were analyzed using a computer-aided diagnostic system. According to the research, when data from the superficial retinal map and the deep retinal map were combined, the computer-aided diagnostic system showed 94.3% sensitivity and 87% specificity in properly identifying retinal disease.
  • Research published in the JAMA Ophthalmology used OCT to evaluate changes in the posterior segment of 15 astronauts. Pre- and post-flight OCT scans were taken in each astronaut. According to the study led by Nimesh Patel, PhD, Houston, edema-like changes were seen in the optic nerve head and its surrounding tissue after long-duration spaceflight in microgravity. "While some post-flight changes are similar to those with elevated intracranial pressure, the downward deflection of the Bruch membrane opening height and substantial increase in choroidal folds is not, suggesting an alternate hypothesis for spaceflight-associated neuro-ocular syndrome," Patel et al. wrote.
  • An article in press in Ophthalmology led by Pei-Chang Wu, MD, investigated the effect of time spent outdoors on myopia prevention. Sixteen schools in Taiwan participated in the study, which included 267 children in the experimental group and 426 in the control group. Children in the experimental group were encouraged to spend up to 11 hours outside weekly. Change in spherical equivalent and axial length after 1 year, in addition to outdoor light exposure, were the main outcome measures. Those in the experimental group showed less myopic shift and axial length elongation; the study authors wrote that there was a 54% lower risk of rapid myopia progression in the experimental group. The researchers also found that strong sunlight was not necessary for a protective effect.

This issue of EyeWorld Weekly Update was edited by Amy Goldenberg and Vanessa Caceres.

EyeWorld Weekly Update (ISSN 1089-0319), a digital publication of the American Society of Cataract and Refractive Surgery and the American Society of Ophthalmic Administrators, is published every Friday, distributed by email, and posted live on Friday.

Medical Editors: Eric Donnenfeld, MD, chief medical editor; Rosa Braga-Mele, MD, cataract editor; Clara Chan, MD, cornea editor; Nathan Radcliffe, MD, glaucoma editor; and Vance Thompson, MD, refractive editor.

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