Artificial intelligence, new modes of action and more: Updates from ARVO 2023

The 2023 ARVO Annual Meeting gave us a great opportunity to discuss the work we are doing to shape the future of ophthalmology. The sense of collective progress was palpable - I may be somewhat biased, but I truly believe we’re on the precipice of a seismic shift that will positively impact the lives of millions of people living with vision loss. Here are a few of my key takeaways from the meeting:?

Exploring the role of inflammation in eye health

Anti-vascular endothelial growth factor (VEGF) injections have long been a mainstay in the treatment of retinal conditions and for good reason – targeting the process of neovascularisation and blood vessel leakage has proven to be a highly effective way of slowing the progression of retinal conditions and, in some cases, even improving vision. However, there are other processes and disease mechanisms at play in retinal conditions, and it’s been great to hear about how the focus in ophthalmology research is increasingly expanding beyond VEGF to find treatments that could stop these other processes in their tracks. This is good news for the future of eye care because, in theory, the more pathways we can target, the greater the range of medicines we can develop, and therefore the greater the likelihood of finding a treatment solution – or combination of treatments - that meets the needs of individual patients.?

Inflammation is one example of a process that is currently generating a lot of excitement in the field of ophthalmology, including at ARVO 2023. Over the last decade, inflammation has been a key research focus in many therapy areas, including in heart disease and cancer, and is now under increasing scrutiny for its role in the development and progression of retinal conditions too. Inflammatory processes play an important role in the development and progression of a number of retinal conditions and in particular in uveitic macular edema, a form of eye inflammation. This inflammation can then lead to degeneration of photoreceptors (the light-sensing cells in the retina responsible for vision), ultimately leading to vision loss. Researchers, including the pRED team at Roche, are working to develop medicines that target disease processes like inflammation, so that we can add another tool to the toolbox for combatting leading causes of vision loss.?

The below image, taken from one of the presentations at ARVO, shows the presence of inflammation (in turquoise and purple) building up inside the retina.?

Smarter solutions to monitor disease?

People often ask me if there will ever be a cure for vision loss caused by retinal conditions. Reversing vision loss is no mean feat, and while I am hopeful and look forward to seeing what advancements can be made in the coming decade, I see a bigger impact in the near-term in continuing to improve our capabilities in early diagnosis, so we can stop vision loss in its tracks before it has a significant impact on people’s lives. This is a key research focus for us at Roche and hearing at ARVO about advancements being made in imaging technology and artificial intelligence (AI) throughout the industry has reassured me that this is indeed the way the field is headed.?

New capabilities for AI systems are transforming industries everywhere we turn – one much discussed example being the launch of the natural language chatbot, Chat GPT. The same is now true in ophthalmology. Impressively, using AI, we can detect the signs of retinal conditions earlier, we can monitor the progression of disease more accurately and we can even predict the future progression of a person’s condition. With AI and deep learning becoming more commonplace in healthcare, we are even seeing remote monitoring tools enabling people to obtain retinal images themselves in their own home, so that we can detect a worsening in a person’s condition before their next in-person appointment. These additional and detailed data support faster and more informed decision making around the most appropriate course of action for each individual patient, enabling a much more personalised care approach.???