Szabó Viktória, Varsányi Balázs, Barboni Mirella, Takács Ágnes, Knézy Krisztina, Molnár Mária Judit, Nagy Zoltán Zsolt, György Bence, Rivolta Carlo
Semmelweis University, Department of Ophthalmology, Mária Str. 39, Budapest, 1085, Hungary.
Semmelweis University, Department of Ophthalmology, Mária Str. 39, Budapest, 1085, Hungary; Ganglion Medical Center, Váradi Str. 10/A, Pécs, 7621, Hungary.
Mol Cell Probes. 2025 Feb;79:102008. doi: 10.1016/j.mcp.2025.102008. Epub 2025 Jan 18.
The rapid advancements in the field of genetics have significantly propelled the development of gene therapies, paving the way for innovative treatments of various hereditary disorders. This review focuses on the genetics of ophthalmologic conditions, highlighting the currently approved ophthalmic gene therapy and exploring emerging therapeutic strategies under development. Inherited retinal dystrophies represent a heterogeneous group of genetic disorders that manifest across a broad spectrum from infancy to late middle age. Key clinical features include nyctalopia (night blindness), constriction of the visual field, impairments in color perception, reduced central visual acuity, and rapid eye movements. Recent technological advancements, such as multimodal imaging, psychophysical assessments, and electrophysiological testing, have greatly enhanced our ability to understand disease progression and establish genotype-phenotype correlations. Additionally, the integration of molecular diagnostics into clinical practice is revolutionizing patient stratification and the design of targeted interventions, underscoring the transformative potential of personalized medicine in ophthalmology. The review also covers the challenges and opportunities in developing gene therapies for other ophthalmic conditions, such as age-related macular degeneration and optic neuropathies. We discuss the viral and non-viral vector systems used in ocular gene therapy, highlighting their advantages and limitations. Additionally, we explore the potential of emerging technologies like CRISPR/Cas9 in treating genetic eye diseases. We briefly address the regulatory landscape, concerns, challenges, and future directions of gene therapy in ophthalmology. We emphasize the need for long-term safety and efficacy data as these innovative treatments move from bench to bedside.
遗传学领域的快速发展极大地推动了基因治疗的发展,为各种遗传性疾病的创新治疗铺平了道路。本综述聚焦于眼科疾病的遗传学,重点介绍了目前已获批的眼科基因治疗方法,并探讨了正在研发的新兴治疗策略。遗传性视网膜营养不良是一组异质性的遗传疾病,其临床表现范围广泛,从婴儿期到中年后期均可出现。主要临床特征包括夜盲、视野缩小、色觉障碍、中心视力下降以及快速眼球运动。近期的技术进步,如多模态成像、心理物理学评估和电生理测试,极大地提高了我们理解疾病进展并建立基因型 - 表型相关性的能力。此外,将分子诊断整合到临床实践中正在彻底改变患者分层和靶向干预措施的设计,突显了个性化医学在眼科的变革潜力。该综述还涵盖了为其他眼科疾病(如年龄相关性黄斑变性和视神经病变)开发基因治疗所面临的挑战和机遇。我们讨论了用于眼部基因治疗的病毒和非病毒载体系统,强调了它们的优点和局限性。此外,我们还探讨了CRISPR/Cas9等新兴技术在治疗遗传性眼病方面的潜力。我们简要阐述了眼科基因治疗的监管环境、关注点、挑战及未来方向。随着这些创新治疗方法从实验室走向临床,我们强调了获取长期安全性和有效性数据的必要性。