Department of Ophthalmology and Visual Sciences, Kellogg Eye Center, University of Michigan, Ann Arbor, Michigan, USA.
Curr Opin Ophthalmol. 2019 May;30(3):199-205. doi: 10.1097/ICU.0000000000000558.
Photoreceptor cell death is the ultimate cause of vision loss in many retinal disorders. Currently, there are no commercially available treatments to prevent photoreceptor cell loss and preserve vision, and there is a critical unmet need for neuroprotective modalities to improve photoreceptor survival in a multitude of retinal disorders. This review summarizes the literature published on this topic in the last 18 months.
A plethora of novel therapeutic modalities for photoreceptor neuroprotection have recently been examined in clinical trials for age-related macular degeneration, inherited retinal dystrophies, and macular telangiectasia type 2. These modalities include agents that target the complement pathway, stem cells, gene therapies, and neurotrophic factors. Additionally, improved understanding in the metabolic signals that regulate photoreceptor survival and function may ultimately identify targets for developing novel neuroprotective agents in a multitude of retinal disorders.
Retinal neuroprotection is the next frontier in ophthalmic disease, and the discovery of novel neuroprotective strategies will fill a critical unmet need. Although the clinical utility of existing neuroprotective therapies is still quite limited, we are cautiously optimistic in light of the recent successes described in this review as well as other promising developments.
光感受器细胞死亡是许多视网膜疾病导致视力丧失的最终原因。目前，尚无商业上可用于预防光感受器细胞损失和保护视力的治疗方法，因此迫切需要神经保护方式来改善多种视网膜疾病中的光感受器存活率。本综述总结了过去 18 个月来关于该主题的文献。
针对年龄相关性黄斑变性、遗传性视网膜营养不良和 2 型黄斑毛细血管扩张症，最近在临床试验中检查了许多用于光感受器神经保护的新治疗方法。这些方法包括针对补体途径、干细胞、基因治疗和神经营养因子的药物。此外，对调节光感受器存活和功能的代谢信号的深入了解可能最终会确定在多种视网膜疾病中开发新型神经保护剂的靶标。
视网膜神经保护是眼科疾病的下一个前沿领域，发现新的神经保护策略将满足迫切的未满足需求。尽管现有神经保护疗法的临床实用性仍然相当有限，但鉴于本综述中描述的最近成功以及其他有前途的进展，我们持谨慎乐观的态度。
