Objective:

To explore the advantages and early results of suprachoroidal gene therapy for retinal diseases, specifically nonproliferative diabetic retinopathy and neovascular age-related macular degeneration.

Key Findings:

• 70.8% of NPDR patients improved by at least 1 step on the Diabetic Retinopathy Severity Scale after a single suprachoroidal injection of ABBV-RGX-314, indicating a significant therapeutic effect.
• Vision-threatening events reduced from 37.5% in the control group to 4.2% in the treated cohort, demonstrating a marked improvement in patient safety.
• AAVIATE trial showed significant reductions in annualized anti-VEGF injection rates, with reductions of 66.7% to 85.7% across different dose cohorts, highlighting the treatment's potential to lessen the burden of ongoing therapy.

Interpretation:

Suprachoroidal gene therapy offers a less invasive and more targeted approach compared to subretinal and intravitreal injections, with promising early results indicating potential for broader access and reduced treatment burden for patients.

Limitations:

• Transfection efficiency remains a critical factor for the long-term success of suprachoroidal delivery, necessitating further investigation into optimizing this aspect.
• Further studies are needed to confirm the durability and efficacy of this delivery method, particularly in diverse patient populations.

Conclusion:

Suprachoroidal gene therapy may represent a significant advancement in the treatment of chronic retinal diseases, potentially allowing for safer and more effective outpatient procedures, which could reshape the landscape of retinal therapy.