CORONADO, Calif. — Whether called neuroprotection, neuroenhancement or regeneration, any of these would be a major step forward in restoring vision in optic neuropathies, a speaker told colleagues.
“Glaucoma and other optic neuropathies, at the end of the day, are going to share more similarities as we figure out how to treat them at the level of the optic nerve head,” Jeffrey L. Goldberg, MD, PhD, said at the annual meeting of the American Glaucoma Society. “The fundamental problem underlying all of these optic neuropathies, including glaucoma, is that, just like throughout the central nervous system, there’s no regeneration after injury.”
However, progress is being made in animal models with regard to regeneration along the optic nerve and in ganglion cell replacement with stem cell therapy. Certain treatments may enhance the function of ganglion cells that are “sick but not yet dead,” Goldberg said.
Neurotrophic factors may be both neuroenhancing and neuroprotective, promoting long-term survival and enhancing function of ganglion cells and other neurons, he said.
Goldberg reported 18-month results of an early phase trial of Neurotech’s NT-501 implant, which was implanted in one eye of 11 patients with primary open-angle glaucoma, using the fellow eye for comparison. In the single-center, investigator-initiated, non-masked trial, the encapsulated cell technology devices intended to deliver ciliary neurotrophic factor long term into the vitreous were inserted through the pars plana and secured.
The primary outcome was safety; achievement of the secondary outcomes of improved functional measures and structural measures was suggested by the changes in visual function and contrast sensitivity as well as increases in ganglion cell complex and retinal nerve fiber layer.
“We don’t actually know if it’s an improvement because we’ve never had a treatment that thickens the nerve fiber layer before,” he said. “These are early days for these kinds of studies.” – by Patricia Nale, ELS
Disclosure: Goldberg reports no relevant financial disclosures.