ILLUMINATING THE FUTURE: ADVANCES IN TARGETED GENE THERAPY AND OPTOGENETICS IN THE TREATMENT OF INHERITED RETINAL DISEASES

Keywords: Retinal Diseases, Genetic Therapy, Photoreceptor Cells, Optogenetics, Adeno-Associated Virus

Abstract

Introduction: Inherited retinal diseases (IRDs) are a group of disorders that lead to progressive vision loss, for which no effective treatments have previously been available. Advances in molecular biology have enabled the development of gene therapies and innovative strategies such as optogenetics, offering hope for improvement or restoration of visual function.

Aim: The aim of this work is to present the current state of knowledge regarding gene therapies used in IRDs, with particular emphasis on their mechanisms of action, possibilities for personalization, integration with other methods, and the potential of optogenetics as an alternative in advanced stages of the disease.

Methods: A literature review was performed using PubMed, Google Scholar, Scopus, and Web of Science. Thirty-nine English publications relevant to inherited retinal diseases and gene therapies were selected. Studies covered mechanisms, efficacy, safety, and diagnostic advances. Irrelevant or methodologically weak papers were excluded.

Results: Therapies based on AAV vectors, CRISPR/Cas9 techniques, prime editing, and antisense oligonucleotides demonstrate effectiveness depending on the type of mutation and disease stage. Optogenetics enables the restoration of light sensitivity regardless of the mutation, even in the absence of photoreceptors. Combining gene therapy with other methods, such as stem cells or neuroprotection, enhances therapeutic potential.

Conclusions: Gene and optogenetic therapies are transforming the treatment approach for IRDs. Selecting strategies based on the molecular background and disease stage enables a personalized approach. Technical and regulatory challenges remain, but development trends indicate a real possibility of effective treatment for many forms of IRDs.

References

Sahel JA, Marazova K, Audo I. Clinical characteristics and current therapies for inherited retinal degenerations. Cold Spring Harb Perspect Med. 2014 Oct;5(2):a017111. https://doi.org/10.1101/cshperspect.a017111

Francis PJ. Genetics of retinal disease. eLS. 2010. https://doi.org/10.1002/9780470015902.A0023109

Karali M, Testa F, Di Iorio G, et al. Genetic epidemiology of inherited retinal diseases in a large patient cohort followed at a single center in Italy. Sci Rep. 2022;12(1):20815. https://doi.org/10.1038/s41598-022-24636-1

Georgiou M, Robson A, Fujinami K, et al. Phenotyping and genotyping inherited retinal diseases: Molecular genetics, clinical and imaging features, and therapeutics of macular dystrophies, cone and cone-rod dystrophies, rod-cone dystrophies, Leber congenital amaurosis, and cone dysfunction syndromes. Prog Retin Eye Res. 2024;100:101244. https://doi.org/10.1016/j.preteyeres.2024.101244

Ong SS, Patel TP, Singh MS. Optical coherence tomography angiography imaging in inherited retinal diseases. J Clin Med. 2019 Dec;8(12):2078. https://doi.org/10.3390/jcm8122078

Birtel J, Gliem M, Harmening WM, Holz FG. Ophthalmic phenotyping: Imaging. In: Retinal Gene Therapy. 2022:53–62. https://doi.org/10.1016/B978-0-12-813944-8.00038-X

Jain R, Daigavane S. Advances and challenges in gene therapy for inherited retinal dystrophies: A comprehensive review. Cureus. 2024 Sep;16(9):e69895. https://doi.org/10.7759/cureus.69895

Toualbi L, Toms M, Moosajee M. The landscape of non-viral gene augmentation strategies for inherited retinal diseases. Int J Mol Sci. 2021;22(5):2318. https://doi.org/10.3390/ijms22052318

Gopinath C, Sarkar S, Ghosh A. Gene therapy for retinal diseases. In: Gene Therapy - Principles and Challenges. 2021:435–454. https://doi.org/10.1007/978-981-15-9184-6_30

John M, Quinn J, Hu M, Cehajic-Kapetanovic J, Xue K. Gene-agnostic therapeutic approaches for inherited retinal degenerations. Front Mol Neurosci. 2023;15:1068185. https://doi.org/10.3389/fnmol.2022.1068185

Kang C, Scott LJ. Voretigene neparvovec: A review in RPE65 mutation-associated inherited retinal dystrophy. Mol Diagn Ther. 2020;24(4):487–495. https://doi.org/10.1007/s40291-020-00475-6

Cehajic-Kapetanovic J, Xue K, Martinez-Fernandez de la Camara C, et al. Initial results from a first-in-human gene therapy trial on X-linked retinitis pigmentosa caused by mutations in RPGR. Nat Med. 2020;26(3):354–359. https://doi.org/10.1038/s41591-020-0763-1

Sladen P, Naeem A, Adefila-Ideozu T, et al. AAV-RPGR gene therapy rescues opsin mislocalisation in a human retinal organoid model of RPGR-associated X-linked retinitis pigmentosa. Int J Mol Sci. 2024;25(3):1839. https://doi.org/10.3390/ijms25031839

Toms M, Dubis AM, de Vrieze E, et al. Clinical and preclinical therapeutic outcome metrics for USH2A-related disease. Hum Mol Genet. 2020;29(11):1882–1899. https://doi.org/10.1093/hmg/ddaa004

Liu S. CRISPR/Cas9 mechanism and applications progression. Trans Mater Biotechnol Life Sci. 2024;3:312–317. https://doi.org/10.62051/b7416e56

Reyon D, Ta T, Tabbaa DG, et al. Development of a gene-editing approach to restore vision loss in Leber congenital amaurosis type 10. Nat Med. 2019;25(2):229–233. https://doi.org/10.1038/s41591-018-0327-9

Yee T, Wert KJ. Base and prime editing in the retina—From preclinical research toward human clinical trials. Int J Mol Sci. 2022;23(20):12375. https://doi.org/10.3390/ijms232012375

Garanto A, Collin RWJ. Design and in vitro use of antisense oligonucleotides to correct pre-mRNA splicing defects in inherited retinal dystrophies. Methods Mol Biol. 2018;1715:61–78. https://doi.org/10.1007/978-1-4939-7522-8_5

Russell SR, Drack AV, Cideciyan AV, et al. Intravitreal sepofarsen for Leber congenital amaurosis type 10 (LCA10). SSRN. 2020. https://doi.org/10.2139/ssrn.3745122

Audo I, Birch DG, Meunier I, et al. QR-421a RNA therapy in retinitis pigmentosa due to mutations in USH2A: Stellar trial Phase 1b/2 interim results. Acta Ophthalmol. 2022;100:267. https://doi.org/10.1111/j.1755-3768.2022.205

Casarosa S, Covello G, Haas D. Exon skipping through chimeric antisense U1 snRNAs to correct retinitis pigmentosa GTPase-regulator (RPGR) splice defect. Nucleic Acid Ther. 2022;32(4):333–349. https://doi.org/10.1089/nat.2021.0053

Sieving PA, Caruso RC, Tao W, et al. Ciliary neurotrophic factor (CNTF) for human retinal degeneration: Phase I trial of CNTF delivered by encapsulated cell intraocular implants. Proc Natl Acad Sci U S A. 2006;103(10):3896–3901. https://doi.org/10.1073/pnas.0600236103

Nakagami Y. Nrf2 is an attractive therapeutic target for retinal diseases. Oxid Med Cell Longev. 2016;2016:7469326. https://doi.org/10.1155/2016/7469326

Dotiwala F, Upadhyay AK. Gene therapy for retinal degenerative diseases: Progress, challenges, and future directions. Invest Ophthalmol Vis Sci. 2023;64(7):39. https://doi.org/10.1167/iovs.64.7.39

Hansen S, McClements ME, Corydon TJ, MacLaren RE. Future perspectives of prime editing for the treatment of inherited retinal diseases. Cells. 2023;12(3):440. https://doi.org/10.3390/cells12030440

Fenner BJ, Tan TE, Barathi A, et al. Gene-based therapeutics for inherited retinal diseases. Front Genet. 2022;12:794805. https://doi.org/10.3389/fgene.2021.794805

Chira S, Jackson CS, Oprea I, et al. Progresses towards safe and efficient gene therapy vectors. Oncotarget. 2015;6:30675–30703. https://doi.org/10.18632/oncotarget.5169

John MC, Quinn J, Hu ML, Cehajic-Kapetanovic J, Xue K. Gene-agnostic therapeutic approaches for inherited retinal degenerations. Front Mol Neurosci. 2022;15:1068185. https://doi.org/10.3389/fnmol.2022.1068185

Kichula EA, Proud CM, Farrar MA, et al. Expert recommendations and clinical considerations in the use of onasemnogene abeparvovec gene therapy for spinal muscular atrophy. Muscle Nerve. 2021;64:413–427. https://doi.org/10.1002/mus.27363

Kulbay M, Tuli N, Akdag A, Kahn Ali S, Qian CX. Optogenetics and targeted gene therapy for retinal diseases: Unravelling the fundamentals, applications, and future perspectives. J Clin Med. 2024;13(14):4224. https://doi.org/10.3390/jcm13144224

Terakita A. The opsins. Genome Biol. 2005;6:213. https://doi.org/10.1186/gb-2005-6-3-213

Yan B, Viswanathan S, Brodie SE, et al. A clinically viable approach to restoring visual function using optogenetic gene therapy. Mol Ther Methods Clin Dev. 2023;29:406–417. https://doi.org/10.1016/j.omtm.2023.05.005

Rodgers J, Hughes S, Ebrahimi AS, et al. Enhanced restoration of visual function by bipolar cell-targeted optogenetic therapy compared to retinal ganglion cell targeting. Mol Ther. 2025;33(1):123-135. https://doi.org/10.1016/j.ymthe.2025.01.030

GenSight Biologics. Dose-escalation study to evaluate the safety and tolerability of GS030 in subjects with retinitis pigmentosa. ClinicalTrials.gov. 2017. http://clinicaltrials.gov/ct2/show/NCT03326336. (Access: 09.07.2025)

Dibas A, Batabyal S, Kim S, et al. Efficacy of intravitreal multi-characteristic opsin (MCO-010) optogenetic gene therapy in a mouse model of Leber congenital amaurosis. J Ocul Pharmacol Ther. 2024;40(10):702–708. https://doi.org/10.1089/jop.2024.0084

Borchert GA, Shamsnajafabadi H, Ng BWJ, et al. Age-related macular degeneration: Suitability of optogenetic therapy for geographic atrophy. Front Neurosci. 2024;18:1415575. https://doi.org/10.3389/fnins.2024.1415575

Stefanov A, Flannery JG. A systematic review of optogenetic vision restoration: History, challenges, and new inventions from bench to bedside. Cold Spring Harb Perspect Med. 2022;13(6):a041304. https://doi.org/10.1101/cshperspect.a041304

Vandekerckhove B, Missinne J, Vonck K, et al. Technological challenges in the development of optogenetic closed-loop therapy approaches in epilepsy and related network disorders of the brain. Micromachines. 2020;12(1):38. https://doi.org/10.3390/mi12010038

Shen Y, Campbell RE, Côté D, Paquet ME. Challenges for therapeutic applications of opsin-based optogenetic tools in humans. Front Neural Circuits. 2020;14:41. https://doi.org/10.3389/fncir.2020.00041

Views:

25

Downloads:

9

Published
2025-08-04
Citations
How to Cite
Dominika Nowak, Adam Zarzycki, Patrycja Długosz, Magdalena Próchnicka, Aleksandra Gradek, Marcin Sawczuk, Julia Tarnowska, Filip Szydzik, Bartosz Żegleń, & Jan Noskowicz. (2025). ILLUMINATING THE FUTURE: ADVANCES IN TARGETED GENE THERAPY AND OPTOGENETICS IN THE TREATMENT OF INHERITED RETINAL DISEASES. International Journal of Innovative Technologies in Social Science, 1(3(47). https://doi.org/10.31435/ijitss.3(47).2025.3520

Most read articles by the same author(s)