AAO 2019 DailyOCT 12, 2019

Neuroprotection Moves Ahead

At Glaucoma Subspecialty Day on Saturday, Jeffrey L. Goldberg, MD, PhD, provided an overview of current research in neuroprotection, neuroregeneration, and neuroenhancement—in other words, research that strives to “get those sick retinal ganglion cells [RGCs] to fire on all cylinders.”

These avenues of investigation “are all very reasonable goals that we’re making great progress on preclinically,” Dr. Goldberg said. “The question is, how do we bring them forward?”

Targeting the window. “We’ve come to understand a lot about the biology of this process” of glaucomatous degeneration, Dr. Goldberg said. “At some point, the axon is actually physically damaged in the eye,” followed later by RGC death. “So there is a window between dysfunction and death, and taking advantage of that window is an opportunity for us.”

Potential strategies. Research underway includes evaluation of ciliary neurotrophic factor (CNTF), which has been shown to enhance the survival and regeneration of RGCs Dr. Goldberg is involved in a trial of the CNTF Renexus (NT-501 implant; Neurotech). “One-year data is closing this month,” he said, adding that the Renexus implant is also being studied for the treatment of macular telangiectasia type 2.

Another drug under evaluation is the recombinant human nerve growth factor cenegermin (Oxervate; Dompé), which is FDA approved for the indication of neurotrophic keratitis. In a short-term trial of neuroenhancement, the drug is being given at higher doses than those used for the drug’s current indication, Dr. Goldberg said.

And in a nondrug tactic, virtual reality goggles are being evaluated for their ability to activate RGCs by providing visual stimulation.

More on Monday. Dr. Goldberg will discuss these topics in greater detail during the Robert N. Shaffer Lecture, to be held Monday, 9:31-9:56 a.m. This takes place during Sym33, Focus on Quality of Life in Glaucoma: Measuring and Optimizing Functional and Patient-Centered Outcomes, which takes place 8:30-10:00 a.m. in the Esplanade Ballroom in Moscone South. —Jean Shaw

Financial disclosures: Dr. Goldberg: Aerie Pharmaceuticals: C; Alcon: C; Allergan: C; Bausch + Lomb: C; Eyenovia: C; Galimedix: C; Pfizer: C; Quark: C.

Disclosure key. C = Consultant/Advisor; E = Employee; L = Speakers bureau; O = Equity owner; P = Patents/Royalty; S = Grant support.