Innovating for the future to address the global burden of vision loss

A report by Economist Impact, published last week, provides an in-depth analysis of the current state of vision loss worldwide, the pressures on health systems and the urgent need for innovations that transform eye care. While working as an Ophthalmologist, and now in my role at Roche, I have always been passionate about eye health. Having read the report, I wanted to share my thoughts on the findings and the role of innovation for the future of eye care.?

Vision loss – a global epidemic

The report found that, although 90% of vision loss is preventable or treatable, over 1 billion people worldwide are affected — a number that is expected to rise to 1.8 billion by 2050. Retinal diseases, such as age-related macular degeneration (AMD) and diabetic retinopathy (DR), are the most common causes of irreversible vision loss and will impact more and more people as the global population ages. For example, the projected prevalence of DR is set to rise from 103 million in 2020 to 161 million by 2045. Similarly, AMD numbers are predicted to increase by more than 50% to 288 million by 2040. Without interventions, solutions and innovations, we are facing a global crisis in eyecare.

At Roche, we know that innovation is crucial to help tackle the growing demand for eye care, as demonstrated by the huge advances in eye health we’ve already witnessed. Up until 15 years ago, there were few treatment options available for retinal diseases related to age and diabetes (including AMD and DR). Now we have vascular endothelial growth factor (VEGF) inhibitors, which have made an incredible impact in slowing the progression of retinal diseases, with more people retaining their vision for longer across the world. However, despite their success, some challenges exist with VEGF inhibitors as they require frequent injections into the eye, the burden of which can mean for many people the progression of their condition is not optimally managed. In addition to this, there are still far too many people experiencing vision loss due to other conditions such as glaucoma and geographic atrophy (GA). We know better therapies are needed.?

Saving sight today

We want to continue to see advances through innovation at Roche and that is why AMD, including both neovascular AMD (nAMD) and GA, as well as diabetic macular edema (DME), an advanced form of diabetic retinopathy (DR), are key development areas for us today. We are focusing on retinal diseases where there is a real need for innovation to provide effective, longer-lasting treatment options and to develop new treatments where there are currently no options.

Hope in innovation and partnership

Personally, I believe treating people earlier in the progression of their condition is critical. For example, we need to identify treatments for people with diabetic eye disease before they progress to vision-threatening forms of disease such as DME. We should also be able to help people with earlier stages of AMD (known as intermediate AMD) before their disease further advances either through vascular proliferation and leakage to nAMD, or through retinal cell death due to GA. Here again, I hope innovation can help us. We have seen fantastic breakthroughs in diagnostic capabilities, such as artificial intelligence tools to help identify people at the early stages of vision loss. By combining innovative diagnostic tools and techniques alongside ground-breaking medicines, I’m confident we can make a huge change to the lives of everyone affected by vision loss.?

Roche’s own pipeline is extensive, with more phase III retina studies than any other major company. Our aim is to deliver innovations that push past current boundaries in addressing both front and back-of-eye conditions. However, no one scientist or company alone has the answers to find innovative new solutions, and therefore partnership and continued collaboration is essential if we are to achieve the ambitious goal of better visual health for everyone. Roche will continue to join forces with physicians, advocates, regulatory bodies, governments, healthcare systems and other pharmaceutical and biotech companies to identify and deliver tailored, sustainable solutions to address needs and offer new hope to people living with vision-threatening conditions.?

Innovation is challenging. As my colleague Paulo recently mentioned , the majority of medicines tested in clinical trials do not make it to market. However, with such significant needs in eye care, for me, innovation is one of the main ways we can try to address these challenges alongside the global ophthalmology community.

The full Economist Impact report ‘Vision for change: Meeting the growing demand for eye care’ is available to read here , as well as an infographic here that provides a bitesize summary of the findings. I look forward to further discussion on the issues raised at the upcoming symposia at the 15th Asia-Pacific Vitreo-retina Society (APVRS) Congress on 18 November.?