Clinical Report: A Suprachoroidal Route to Retinal Therapy
Overview
Suprachoroidal gene delivery shows promise as a less invasive alternative to traditional retinal therapies, with early data indicating durable effects and fewer complications. The ongoing clinical development of ABBV-RGX-314 highlights its potential in treating nonproliferative diabetic retinopathy and neovascular age-related macular degeneration.
Background
The treatment of retinal diseases often relies on invasive procedures such as subretinal or intravitreal injections, which can pose risks and complications. Suprachoroidal gene delivery offers a targeted approach that may enhance drug delivery while minimizing systemic exposure. This method's feasibility as an office-based procedure could improve patient access and compliance.
Data Highlights
| Trial | Outcome | Control Group Outcome |
|---|---|---|
| ALTITUDE | 70.8% of patients improved by at least 1 DRSS step | 37.5% worsened by 2 DRSS steps |
| AAVIATE | 66.7% to 85.7% reduction in anti-VEGF injection rates | N/A |
Key Findings
- Suprachoroidal gene therapy may offer a durable effect with fewer complications than traditional methods.
- ABBV-RGX-314 demonstrated a significant improvement in DRSS scores in the ALTITUDE trial.
- Vision-threatening events were reduced from 37.5% in the control group to 4.2% in treated patients.
- AAVIATE trial results showed a marked reduction in annualized anti-VEGF injection rates across all dose cohorts.
- Suprachoroidal delivery is less invasive than subretinal delivery and more targeted than intravitreal injections.
Clinical Implications
The suprachoroidal route for gene therapy could transform the management of retinal diseases by providing a safer, more efficient treatment option. Clinicians should consider the potential of this method in their practice, especially for patients requiring frequent anti-VEGF treatments.
Conclusion
Suprachoroidal gene delivery represents a promising advancement in retinal therapy, with ongoing trials indicating its efficacy and safety. Continued research and clinical validation will be essential to establish its role in routine practice.
References
- Retinal Physician, Flow Mechanics of Suprachoroidal Injection, 2022 -- A compartmentalized delivery route facilitates more targeted retinal drug delivery
- Retinal Physician, Suprachoroidal Drug Delivery Technology, 2022 -- The first FDA approval ushers in a new clinical reality
- Diabetic Retinopathy Preferred Practice Pattern® - PubMed, 2025 -- Standards of care for diabetic retinopathy
- Retinal Physician — Suprachoroidal Drug Delivery Technology
- retinal physician — Expanding the Role of Suprachoroidal Injections
- Study Details | NCT04514653 | RGX-314 Gene Therapy Administered in the Suprachoroidal Space for Participants With Neovascular Age-Related Macular Degeneration (nAMD)
- Surgical Approaches to Retinal Gene Therapy: 2025 Update
- Diabetic Retinopathy Preferred Practice Pattern® - PubMed
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