New eye drops may prevent a common cause of blindness

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In a new study, researchers have developed eye drops that could prevent vision loss after retinal vein occlusion, a major cause of blindness for millions of adults worldwide.

They found that the experimental therapy—which targets a common cause of neurodegeneration and vascular leakage in the eye—could have broader therapeutic effects than existing drugs.

The research was conducted by a team at Columbia University Irving Medical Center.

Retinal vein occlusion occurs when a major vein that drains blood from the retina is blocked, usually due to a blood clot.

As a result, blood and other fluids leak into the retina, damaging specialized light-sensing neurons called photoreceptors.

Standard treatment for the condition currently relies on drugs that reduce fluid leakage from blood vessels and abnormal blood vessel growth. But there are significant drawbacks.

These therapies require repeated injections directly into the eye, and for the patients who brave this daunting prospect, the treatment ultimately fails to prevent vision loss in the majority of cases.

The new treatment targets an enzyme called caspase-9. Under normal conditions, caspase-9 is believed to be primarily involved in programmed cell death, a tightly regulated mechanism for naturally eliminating damaged or excess cells.

However, in the current study, the team discovered that when blood vessels are injured by retinal vein occlusion, the caspase-9 becomes uncontrollably activated, triggering processes that can damage the retina.

They found that a highly selective caspase-9 inhibitor, delivered in the form of eye drops, improved a variety of clinical measures of retinal function in a mouse model of the condition.

Most importantly, the treatment reduced swelling, improved blood flow, and decreased neuronal damage in the retina.

The team believes these eye drops may offer several advantages over existing therapies.

Patients could administer the drug themselves and wouldn’t have to get a series of injections. Also, the new eye drops target a different pathway of retinal injury and thus may help patients who do not respond to the current therapy.

The researchers are preparing to test the eye drops in people with retinal vein occlusion during a phase I clinical trial.

One author of the study is Carol M. Troy, MD, Ph.D., a professor of pathology & cell biology and of neurology.

The study is published in Nature Communications.

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